Revision TKR Kandy's Journey

[Kandy]

InkedMarie, how was the wedding? Beautiful, I am sure.

 

[InkedMarie]

InkedMarie, how was the wedding? Beautiful, I am sure.

It was amazing! Everything went off without a hitch. The justices of the peace had vows for the three kids to say “I will” too. My son & his wife didn’t know that was happening. It was beautiful!

Marie

 

[Kandy]

Well, yesterday was the day. I got behind in my schedule for work and had to work until 8 pm on Thursday, but I met my goal with all my projects and billing before being gone on medical leave. My surgeon said I had significant laxity, that it was over 1 cm out. He said there was no way a thicker insert would have worked for me. So, I am glad I did not go with first 2nd opinion doc who was going to have me try out the thicker insert for 6 months, but go back to OR 6 months down the road if that did not work. My new surgeon (second 2nd opinion doc) said I did not do anything or not do anything to cause this. He said it was just never balanced properly the first time. He explained how I could have loose ligaments but still need an MUA. He did not think he needed to take out ligaments and put in hinged joint (which is what third 2nd opinion doc said at last visit). I can move my knee from sitting to bed without using strap. Last time, I had to use strap for a week to help pick up my leg. Also, I can bend my knee further this time, just its comfortable position. This time, they have done many things differently (and IMHO better) to promote better healing and reduce infection as compared to the dy surgery center where I had my first TKR. I will keep posting progress. If I have a good night tonight, I get to go home tomorrow (or I can choose to stay another night). Rock on!

 

[Jamie]

Congratulations on what sounds like a great beginning to your recovery! I think your decision on surgeon and problem resolution is a good one and I hope it does the trick for you. I'll be looking forward to your updates!

 

[sistersinhim]

What good news! It sounds like you're going to be a new woman with a new, perfect knee! The best is yet to come!

 

[Kandy]

Hello, Is it possible to change my title and description? I would like to change the title to Kandy's Journey and the description from MUA to Revision.

It is hard not to compare the 1st time to this time. There are some subtle differences that I hope are good indicators for a different outcome this time. I only take my prescription pain meds during the day when I have PT, and try to just take advil the rest of the time. I still take the hydrocodone at night, though.

I am working remotely 2-3 hours a day, and I simply cannot think straight when on the narcotics. So, having a clear head is important to me. I have a lot more bruising this time. I also seem to have a sensitivity to touching the skin, where it feels like a thousand knives are stabbing me. This happens on the sides and back of my knee, especially when the TED hose start to bunch up because they are getting stretched out in places. It may be also that the bandage is shrinking and pulling. Today has been easier because I did not put the TED hose on. I am ready to ditch the walker and have been practicing with the cane while PT is here, but the say I am not quite ready for a full transition. Friday is my 2-week check up. I am looking forward to getting out and getting the bandage off.

 

[Jockette]

Is it possible to change my title and description? I would like to change the title to Kandy's Journey and the description from MUA to Revision.

I changed your title for you, and your prefix to Revision TKR. We don’t have a prefix for MUA to REVISION.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

​

​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Kandy]

@Jockette, thank you for the reminders!

I got my bandage and steri-strips off yesterday and have now transitioned to the cane. I read over my operative report, my xray report, and the synovial biopsy. Good news is that I do not have RA! But the biopsy said, "Reactive fibrosis and chronic inflammation. Some of the inflammation is associated with foreign material which is most likely related to to the knee prosthesis." I overthink things. My polyethylene insert was recalled for improper packaging that COULD lead to oxidation and cause the the insert to wear out 7x earlier. So, I wonder if the inflammation was due to microscopic debris from the insert wearing out early.

The lab was supposed to examine the insert microscopically, but all they did was identify the brand, the size, and the model number. I also wonder just how "off" things were during the first surgery. During this second surgery, the surgeon rotated the femur component as much as he could and then placed a posterolateral augment to get my knee to balance (since he did not get to make the original femur cuts). Basically, the surgeon placed a wedge on the lateral side to tighten up the joint space. I am wondering if the first surgeon did things wrong or did this just happened over time.

I hate to say it at 2 weeks out (because it is early and I don't want to jinx things), but things are different, a good different, from the get-go. This pushes me to think that things were not as they should have been the first time through this. And then, I get angry that my original surgeon only wanted to remove a piece of bone cement (which 3 other surgeons said that it would not fix the problem and would cause more trauma to the knee), telling me that there was nothing wrong with my knee stability and that I might have to accept that I might just be an unlucky person who did not get better after a TKR.

I am trying to push aside my anger because it doesn't help my recovery. I would rather put that energy into recovery. Recovery is hard. But, it is like a light switch went off in my head and I am realizing that this time around is so different from before. I am not in as much pain, don't have as much swelling, and am meeting milestones earlier (with less effort). I am just venting, I guess. It's like I am obsessed with trying to find out why things did not go as expected the first time through. Can anyone relate?

 

[sistersinhim]

It's like I am obsessed with trying to find out why things did not go as expected the first time through. Can anyone relate?

I am sure most would feel the same way you do. But, now you can look forward to a much better and more normal recovery. Having already feel the improvement between this TRK and the last one is fantastic!

 

[Jockette]

This pushes me to think that things were not as they should have been the first time through this. And then, I get angry

It's like I am obsessed with trying to find out why things did not go as expected the first time through. Can anyone relate?

Yes, I can relate! I just had a third second opinion, and like the two before, no idea why I have my issues. I have several theories, but I can’t prove any of them.

I told this recent one that my knee often feels out of joint. Can you think how that would feel? After I said it, he said, can you describe that? Um, I thought I just did.

I need a long break before trying for a fourth opinion.

 

[agsmom]

@Kandy, I can relate!!! I had my original TKR in early December, 2021 and my revision TKR in late June, 2022. The original surgeon placed the prosthesis incorrectly and I could never bear full weight on the surgical leg. It progressively became more valgus and could be moved side to side by the ankle while the top of my leg was held steady. The original surgeon told me it could still improve and I should keep working harder; I was already doing 2 1/2 hours of home exercise/stretching per day. The revision surgeon told me the surgery had been done incorrectly and would never get better. Thank goodness I found him and he knew what he was doing!

I’m currently 8 1/2 months post revision and things are going so much better than before. I’m continuing to gain ROM and the pain and swelling are often absent. I do still have some muscle weakness but I’m hoping that will continue to improve. I can also walk up/down a few steps the normal way, something I thought might never happen. I even have times when I forget that I had two knee surgeries almost back to back.

I’m so glad you’re doing better this time around. I hope things continue to improve and that your recovery goes smoothly.

PS I also get very angry at times when I think about the first surgery. I think that’s pretty normal.

 

[Ghostpipe]

Hi Kandy. Thank you for your ongoing and detailed posts. I am about to embark upon the second and third opinion journey, after two painful years, and your story sounds a lot like mine.
Please keep your posts going, you are certainly helping me, and very likely many others in coming to terms and acting upon an unsuccessful surgery.
Good luck with your recovery.

 

[Layla]

I am trying to push aside my anger because it doesn't help my recovery. I would rather put that energy into recovery. Recovery is hard. But, it is like a light switch went off in my head and I am realizing that this time around is so different from before. I am not in as much pain, don't have as much swelling, and am meeting milestones earlier (with less effort)

It is so wise of you to push aside your anger, Kandy, because as you mentioned it doesn't help the healing process. Your state of mind can dictate how quickly you make a full recovery. Thankfully you're already noticing the positive differences. I am delighted for you. May it only get better!
Happy One Month Anniversary!

 

[Kandy]

I am sure most would feel the same way you do. But, now you can look forward to a much better and more normal recovery. Having already feel the improvement between this TRK and the last one is fantastic!

Thank you for your encouragement!!

 

[Kandy]

I told this recent one that my knee often feels out of joint. Can you think how that would feel? After I said it, he said, can you describe that? Um, I thought I just did.

Jockette, I know exactly what you are saying. It almost feels like you are on stilts and have to keep your knee straight to be able to walk. I am sure this was most disappointing. I encourage you to keep seeking answers when you are ready.

 

[Kandy]

PS I also get very angry at times when I think about the first surgery. I think that’s pretty normal.

@agsmom, Not sure I can ask this here or not, but did you consider legal action to at least pay for the added expense of the second surgery? I am so happy that things are going better for you!

 

[Kandy]

I am about to embark upon the second and third opinion journey, after two painful years, and your story sounds a lot like mine.

@Ghostpipe, I pray that you get the answers you seek. I felt really stuck after the second and third opinion because they seemed so different. So, I tried to establish the similarities between the two. I briefly considered the fourth opinion, but did not know where to turn and thought it just muddle things even more. But then, my rheumatologist asked me if I considered a 4th opinion ( as if she could read my mind). She was able to give me a name and they had a relatively quick opening. I am so glad to have had that opinion because it gave me peace of mind.

 

[Kandy]

Your state of mind can dictate how quickly you make a full recovery.

@Layla, you are very wise!!

 

[Kandy]

Update: I am 4 weeks 5 days post surgery. Part of me wanted to reel in the excitement and not make too much ado about it. I have been going to outpatient PT for 5 sessions now. It is more the Bonesmart way and never forceful or painful. I can confidently tell you that my ROM is equal to where I was at 5 months post-op from the original surgery. I have taken photos from January (14-months post-op first surgery) and now. Swelling is less now than it was in January. Even my therapist commented on it, as he has been my therapist after I "fired" the facility that was too aggressive in February 2022. My pain is still a 3 to 4, so he does not want to do anything to agravate that. My original surgeon told me that my knee wasn't swollen, that it was just scar tissue that made it bigger. He also said it was normal to be hot compared to the tissue around it. Now, my knee is warm, but never as hot as it was in January.

I have developed a clunk noise. I remember that I developed this the first time, too. It wasn't painful at first and it isn't painful now. The first time, both the therapist and the surgeon said that was normal as the implant was "settling" in. But later, it became painful and one of the many symptoms of the knee instability. So, it is unsettling now to me, as I remind myself it is perfectly normal.

And the anger thing... it is still a struggle, especially now. I worked so hard after the first surgery. I couldn't shake the nagging thought that I was somehow responsible for the lack of progress. And now, I want to cry happy tears because I did not know it could be like this. It is not a breeze by any stretch of the imagination, but it is indescribably different and better this go around. Which leads me to the next thing...

I have been working remotely from home since Week 2. The last two weeks, it has been about 6 to 7 hours a day. I do get up and ride the bike 3 times a day, do stretches and my exercises as I am instructed. But often, time gets away from me and I realized I have sat for a 2 or 3 hour period. And then, I am so stiff I can hardly walk. Also, I am feeling overwhelmed at work and obviously not as efficient as I want to be or am accustomed to. I own my own professional business and have a responsibility to my clients. Sometimes, things just cannot wait. So, getting that balance right between work and self care has also been a struggle (and the reason why you have not seen me on here in 2 weeks).

 

[Layla]

Thanks for the update! You seem to be doing pretty well. It is understandable that many need to return to work before the recommended twelve weeks post op. Concentrating on work for 6-7 hours a day may feel a bit overwhelming at this point, but hopefully you get back into the groove more with each passing week.
Wishing you a peaceful easy rest of the work week.
@Kandy