Revision TKR Partial Revision Failure

[Jockette]

Very nice. Your sister is very good!

 

[Cementless]

Where can I find the article about "scar tissue/adhesions" and the cause? I need to send it to my brother-in-law who is 6 1/2 months TKR and has been told he has scar tissue, bend only 100, and pushes himself to the max at the gym, walks 3 miles a day. He is also a pro golfer. Can't tell him any thing!

 

[sistersinhim]

Is this what you are talking about?
Yes, the number-obsessed PTs will rattle on about it as if the big. bad "scar tissue" is just sitting there, waiting to pounce if you don't do enough exercise.

Actually, it's quite the reverse. The infamous scar tissue (which is more correctly called adhesions) is very rare, and one of the easiest ways to develop it is to work your knee too hard. Over-worked knees get inflamed and hot, and hot tissues become drier than normal and more likely to stick together and form adhesions.

This article explains the difference between scar tissue and adhesions:
MUA (Manipulation under Anaesthetic) and Adhesions

You need normal scar tissue. That's what holds your incision together, and it's part of the normal healing process. Without it, you'd always have an open wound.

 

[Cementless]

@sistersinhim, I think that is the article. My brother-in law was told by his OS yesterday that he most likely has "scar tissue" and that the hip on the side of the TKR is bone on bone. He has already had the other hip replaced. The OS measured his bend causing pain to get it to 100. The OS told him "moderation" is the key to his exercising. I don't think he will listen...very macho, the more exercising the better is his theory.

 

[sistersinhim]

Some people just won't listen. They believe their way is the only right way. Let him do his own thing. You can point him to this site, but it probably wouldn't do any good.

 

[Jockette]

Hi, @Cementless How are you coming along?

 

[Cementless]

@Jockette, I think I am doing OK. I am trying to reduce my Tramadol just a little and find I get irritable. My knee is somewhat more swollen than my other knee. I get tired being on my feet after 5-6 hrs. and need to rest and elevate (some icing). When I sit at my desk top, my knee hurts some because of the angle. I have a bend of 110. Still need to work on my extension some. Tomorrow we go to the airport to pick our son up for the holidays, so I plan to use my cane which stays in the closet. No need around the house and short outings. Night is the worst time because my knees like to try and get in a fetal position which causes pain. I am not doing any exercises except ADL. Feeling a little guilty on that. I do a lot of walking in the house and taking the dog out.

I have to share a funny story that only BoneSmart people can appreciate. Yesterday while I was using the rest room, I was reading a magazine (resting it on my lap over my PJ's). The magazine starts to slip off and my instinct was to stop it from sliding off. Well, I slapped my revision knee HARD and surprised myself....what have I done! I did stop the magazine from sliding and I am a little sore today on my revision knee! That was sure a stupid thing to do!!!

Merry Christmas and Happy Holidays to my BoneSmart family!!! :tree lights::santa hug::reindeerlights:

 

[Jockette]

That all sounds right for not quite 3 months out. Too funny about slapping your knee! Amazing the things we do automatically.

Enjoy your son’s visit, Merry Christmas to all of you!
:nativity::treestar:

 

[sistersinhim]

I do a lot of walking in the house and taking the dog out.

These are exercises so you have nothing to feel guilty about!

 

[Cementless]

I have just started to read the threads on the hip replacement website. I probably should start my on thread concerning my husband who is 72 yrs. old. Our PCP has diagnosed him with R. Trochanteric bursitis and he does have psoriatic arthritis. He is not good about taking NSAIDS. A regular hip X-ray did not show bone on bone. I guess I should make him an appointment with my OS that did my L TK revision but he is not ready. It hurts for him to get up out of a chair. This has been going on for a couple of years but worse lately. I have also noticed during the last couple of years he shuffles his feet but does not have Parkinson. He has some balance issues and this may be how he walks to compensate for the pain. Scared to think about how to go about handling this situation.

The PCP gave him some PT exercises to do but he is not compliant. When he has done them, it seems to make his hip worse.

I started a thread on the Pre Op Hip replacement site. Any suggestions would be appreciated.

Cementless

 

[Cementless]

The thread title is: My Husband's R. Hip Pain, what to do?

 

[Pumpkin]

Cemetless,
It is a good idea to have your husband checked out by your OS. Just because the x ray doesn't show much damage, once they get in there, it can be in much worse shape.
He is probably shuffling because it hurts to fully weight bear.
Have him fill out the score chart, both of you and the OS will see just how limited his life has become.
Score chart: how bad is my arthritic hip/knee

Thanks for the like to your hip thread for your husband.

 

[Cementless]

@pumpkin, how do you measure hip flexion, abduction, ext rotation, adduction?

 

[Pumpkin]

Answered in the Your hip pre op thread.

 

[Jockette]

How’s your knee doing?

 

[Cementless]

@Jockette, I think my knee is doing well. The muscles around my calf (L. side), under my knee, and the left side of the thigh get sore. I usually take a muscle relaxer (Robaxin 750mg) once or twice a day along with 2 ES Tylenol and Tramadol 25 mg. My bend is now 120 degrees. I think my extension is good. I limp for a moment when I get up from sitting at the computer too long or getting out of the car. I don't need the cane anymore and did not use it when we picked our son up from the airport. My son thought I looked so good, he forgot I had knee surgery! lol
My 2019 goal is to ride the stationary bike 10-20 mins a day to loosening my knee up. Maybe a little strength training exercises? Maybe I will try my Pilates again? Thanks for asking.

Hope the New Year brings you a new knee!!!

 

[Cementless]

I measured my revision knee (L) and it is 15 3/4". My R knee is 15 ". I wonder if the swelling and the extra cone and sleeve added during the revision will always make it bigger? It still feels swollen. My calf measurements are the same. My left thigh (knee revision side) is 18". My Right thigh is 17". I think I limp. I'm sure it will get better in time. Any thoughts?

 

[Pumpkin]

Cementless,
You are only 3 months from your revision, swelling is normal. It takes a year+ to recover 100%, your knee is in charge and it will take what ever time it needs to heal.
If you are limping you need to use a cane to avoid developing habits you will have to break later. You can also ask for a PT referral for gait training.

 

[Cementless]

Just finished reading some replies on this website and have been feeling impatient that my revision knee (3 months yesterday) still is sore when I get up from a 90 degree sitting position. Pretty much OK other than that. Feel the need to get off my Tramadol 25 mg (I take with 2 ES Tylenol) every 12- 14 hrs. Again it does ease the discomfort. Robaxin 750 mg in between once a day. So tired of taking pills!!! Feel irritable and my husband gets the brunt of it!

 

[sistersinhim]

still is sore when I get up from a 90 degree sitting position. Pretty much OK other than that.

At three months you're complaining about that after having a revision?! You are doing great! Just think back to where you were just a month ago. What an improvement!