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TKR 10 months now and still hurting

krobar

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Had my knee replaced 9 months ago and recovered well initially and regained an excellent ROM according to my PT and doctor, they said i was in the top 1 percent.

At about 4-5 months my knee started bothering me and i feel i've been going backwards since. At my 8 month check up the doc drained 20 cc's of fluid which was the third time since surgery that he had to drain it. Even after the draining it is very stiff, warm to the touch and feels like it's encased in wet concrete. A couple weeks ago they ordered blood work to see if there was a deep infection as i had cellulitis in my big toe which occurred around the time i stopped making progress. The blood work showed no signs of infection.

Regardless, something is not right. I have pain going up and down stairs, the area around the top of the tibial plateau aches even while seated or reclined, i also am experiencing a pain on the kneecap which feels very similar to the feeling you get from e stim, like a sharp twinge similar to an electrical shock. I am seeing the doctor this Monday and am not sure what he's going to suggest next.

I wonder if there still is a chance there could be an infection. Been reading up on bone scans, arthrograms, CT scans, MRI's. I read where it could be loose parts or soft tissue problem. I'm probably doing too much research. I appreciate any info others can share.
 
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Pumpkln

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@krobar,
Welcome to BoneSmart, glad you joined us!! :welome:
Sorry to hear after a great start things have gotten worse.
Have they done any cultures on the fluid drained from your knee? That would show if you had an infection and which pathogen.

On Monday your surgeon should be suggesting further imaging, likely a bone scan which will show increased metabolic activity if your prosthesis is loose. Ask about the cultures of the fluid in your knee, if he has done one, they should have the results.

Recommend you seek a second opinion for your TKR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled knees. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!
 

TimeBuster

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If your doctor didn't culture fluid after three times post-op, my question would be why not?
Things that make you go Hmm.

Good luck with your next appointment.
 
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sistersinhim

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I agree with Pumpkln that you should be getting a second opinion. One from a doctor that has no connection at all with your current doctor, not even a social connection. You want someone looking at your knee with fresh eyes.
 

eaglemom

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I agree about a different opinion. However, I'm afraid you'll run into issues trying to see someone else. The rule of thumb is usually no other surgeon will see another surgeons' work until its at least 1 year old.

Don't be surprised if the new surgeon wants all of the surgery notes. Start getting those things in order now for when your one year is up.
 
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krobar

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Met with my doc yesterday, drained another 20 cc’s and sent to some out of state lab to test for infection. He’s pretty sure there’s no infection, went through my most recent X-rays as compared to post op X-rays. No evidence of loose parts he says. Ruled out scar tissue as my ROM is so good. He told me everyone’s body heals differently and that this is normal, for me. It sure doesn’t feel normal.
 
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krobar

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July 2020, left knee
 

Jockette

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July 2020, left knee
I’m sorry to be so technical, but can we have the day of the date also?

How is your knee feeling now, any improvement?
 

Jockette

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What is your activity level? What exercise, if any, are you doing? If you have a job, does it stress your knee? Do you go up and down stairs often?
 
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krobar

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What is your activity level? What exercise, if any, are you doing? If you have a job, does it stress your knee? Do you go up and down stairs often?
i go to the gym 5-6 days a week, alternating between stationary bike, eliptical some stairmaster. My doctor knows me from the gym and knows how intense i work out and he says dont hold back. Only thing he said to avoid was leg extensions. I am up and down stairs at work a number of times as im self employed and need to load customers with my forklift
 

Celle

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I think you're trying too hard and doing too much. Recovering from a joint replacement isn't like training for an athletic event.
Doing too much exercise is counter-productive - it keeps your knee irritated and swollen inside.
TKR recovery and an analogy to athletic training
.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.
Knee recovery - Lose the Work Ethic!!

I suggest you ease off the gym sessions and spend much more time resting, icing and elevating your knee, to help it calm down and reduce its internal and external swelling.
 
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krobar

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I’m so frustrated. I felt better at 4 months than I do at 10 months. Doctor tells me to be patient but I still get swelling, been drained 3-4 times since surgery. He told me I could play golf at 3 months but I struggle to play 9 holes at 10 months. Infection ruled out. X-rays normal. Can’t get second opinion until a year. So sick of this :censored: . Help!! I’m convinced somethings not right.
 

Celle

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I'm sorry you're still having problems.

Did you ease off the exercising?

While you probably won't find anyone to give you a second opinion before July, that's not so far away now, so you could start looking for surgeons who specialise in problem knees.
You need someone with no connection, either professional or social, with your current surgeon, so you get a completely independent opinion.

You may have to travel out of your area to see the right person.
 

Celle

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By he way, @krobar ,
You'll notice that I have merged your two threads together as it's best if members in recovery only have one thread.
This is because:
  • That way, you have all your information in one place. This makes it easier for others to go back and review your history before providing advice.
  • If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.

Please keep all your questions and updates on this thread. We won't miss your new question as, between us, the staff read all new posts each day.
If you need an urgent response to a question, tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts?

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle
 

Jamie

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@krobar, everyone heals differently and at their own pace. It sounds to me that your knee is responding to an activity level that it's not ready for with irritation and swelling. If you're going to the gym 5 days a week for a hard workout AND you have a fairly active job, I'm not surprised that you've had increased swelling.

I suggest that you cut things back for several months (yes, it can actually take that long for a knee to settle that's become chronically inflamed), start icing and elevating if you develop fluid in your knee, and stop having it drained. Granted, extracting fluid is necessary to check for infection, but if you're getting it drained just to relieve swelling or pressure, that's not a good idea. Each time you do, you risk introducing an infection. I would suggest you either stop the gym workouts on your lower body or do milder exercises so that you're not "working hard" at getting back to normal.
 

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