PKR What went wrong?

[Purpledog]

Thank goodness for bonesmart! I’d be totally lost otherwise.
I had a patellafemoral replacement in October 2023. It’s been a very painful experience. Right after surgery I had a spinal leak and spent 18 hours in the ER. I have had quite a bit of pain in my knee since the surgery, now 4 months ago. Much more pain than before surgery.
That said, I am now able to exercise and walk- but it still hurts quite a bit to go up and down stairs, to sit for any length of time, etc. I now wonder if my surgeon was experienced. What could have gone wrong and how can I fix it? X-rays look fine, ROM is excellent. Do I need to wait a year with the thought that it is just slowly healing and will one day be good? Do I have to live with this pain forever? I’ve stopped complaining to family and friends- 4 months of whining is a long time.

 

[sistersinhim]

At 4 months out from this replacement, you are only 1/3 of the way healed and pain is completely normal. Along with pain, you're probably still having some swelling. That's normal, too. This is a very long recovery, an average of a year. What you are experiencing is the up and down recovery of a joint replacement.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, 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.

KNEE RECOVERY 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.

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 these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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 a 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 history before providing advice.

 

[sistersinhim]

@Purpledog, please tell us the exact date of your PKR and which knee it was. I will add that information to your signature for you so we all can see when your surgery was on each of your posts.

 

[Jockette]

I, also, have a Patellofemoral PKR and my recovery was nothing like the ones I read about beforehand. I expected to be fully recovered in 2-3 months. No one told me that partials can take a long as a full year, on average, for recovery.

Thank goodness for bonesmart!

I agree, finding Bonesmart was a game changer for me! So much information here that I wasn‘t given beforehand.

 

[Purpledog]

Thanks - the encouragement here is so helpful!
My surgery was October 23 on my right knee.

 

[mendogal]

Hi!

At four months it's really normal to have some difficulty with stairs and don't get me started on pain and stiffness with sitting! - yes, mine were total knees, not partial, but plenty of our members with partials experience that same issue, and I'm sure some of them will chime in.

I have found it really helpful to post all my small milestones here on BoneSmart, because it puts the focus on increasing function. But this is also a place to ask questions, express concerns, share tales of success or of frustration... whatever your mood, we're here for you!

 

[Purpledog]

Great idea. I do have positive moments. Thanks for your input!

 

[Purpledog]

Just an update in case anyone finds this thread. At 4.5 months postop my physical therapist suggested healing touch therapy. I'm not one to be very open minded about these things, but I was anxious to get better so I tried it. It might be a coincidence but the day after that therapy I started to feel whole again. My knee is sometimes sore, and often stiff, but I am back to doing modified yoga and can walk several miles at a time! And best of all, I can go up and down the subway stairs in NY, carrying bags, and no pain! Kneecap replacement was way more painful than I ever imagined it would be (and I've had some harsh surgeries in my life), but now I can look forward to enjoying life again. I am now at almost 6 months. The hardest part was that the pain was not severe but relentless. And my friend just got a total knee replacement with almost no pain at all. It's crazy, and it's really hard to be patient when other people are doing so much better.
Wishing everyone the best recovery!

 

[Layla]

Hi Purpledog,
Wonderful news that you're feeling great and doing so well! Thanks so much for taking the tine to update on your current status and share what's worked for you, it is much appreciated.
May it only get better!
@Purpledog

 

[benne68]

best of all, I can go up and down the subway stairs in NY, carrying bags, and no pain!

That is a huge achievement -- those stairs are steep! Glad to read you are doing so well.

 

[lrj]

At 4.5 months postop my physical therapist suggested healing touch therapy. I'm not one to be very open minded about these things, but I was anxious to get better so I tried it.

Pre-surgery, I was in so much pain and had tried everything else, so I skeptically tried acupuncture. It helped me so much!
I also had patella femoral PKR. My doctor said it would take about a year to get to best it's going to get afterwards, but that did not prepare me for the recovery, especially the first 2 weeks. I'm now 4 and 7 months post op. I can now go hiking and do yard work. But things still stiffen up after sitting for an extended period, low chairs are a struggle, and standing still is a bit difficult. I'm looking forward to the day when my knees are not the focal point of my life. In the meantime, I just prefer to focus on the improvements as they come.