PKR 11 months post op problem...

[Josephine]

Absolutely!

I'm going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[Dlekapj]

Hi all! It's been a while since I've posted as I've had nothing much of interest to post about. Last Friday I was released form PT 5 weeks post op. My range of motion is up to 135 and I'm doing remarkably well. I still don't do a whole lot of walking around or standing as the knee tends to get really achy. I guess right now my biggest issue is night time. I still am very uncomfortable at night and wake up in quite a bit of pain still. My next doc appt is Friday, but I'm guessing this is still normal. I've cut down on the narcotics as much as I comfortably can and still be able to put in a good home PT session, but I've found that I still need them or the pain will creep back in on me. I'm taking ibuprofen 600 about 3-4 times a day and Norco 2x (sometimes 3..) now. This is what seems to work best for me.
At my appt Friday I plan on asking the doc about my left knee...

 

[kneeper]

Sounds fine.

 

[Dlekapj]

Thank you @kneeper never having been through this, I don't know what's normal and what's not and I've not actually seen the doctor since the operation!!

 

[Jamie]

I can tell you that it's still completely within the normal range to need some type of pain control for months after your surgery. This is especially true at night because you don't move your knee around much. You also might try icing your knee (even as you sleep). That worked wonders for me.

 

[happymum]

Hi @Dlekapj,
Wow sounds like you are doing very well. Being very uncomfortable in bed is the norm or was for me.
I am 12 weeks out and still taking my pain meds at night but it is settling. I am taking less medication than I was during the day.
Best of luck with your recovery.
Deb

 

[Josephine]

As it happens, I took painkillers as prescribed for 4 full months.

So you're not going to answer my questions then? Did you even notice them?

 

[Dlekapj]

Well... I'm back again. 11 months post op and I went Friday for my check up on my PKR. I was totally expecting the surgeon to tell me that I was doing absolutely awesome and keep up whatever I've been doing. But. It didn't happen.

But, first I guess I should tell you a little of what I've been doing. Contrary to the doc's orders before and after the surgery, I was determined that I could run again. My thoughts were, "why do this, if I can't have my life back again?" So, I thought I'd do everything RIGHT. I have some of the must cushioned running shoes (Hokas), I run Galloway (walk/run intervals).. I just thought I've been doing it smart. And really, running with almost NO pain! It's been awesome! Last Tuesday, I went for a run, with no plan. I just ran. And I ran my very first (ran/walk mind you , it ended up being 14 min miles) informal half marathon. I didn't hurt at all. I didn't swell at all. I felt amazing and was on a cloud nine! Then I had the appt on Friday.

The doc comes in and the first question he asks is what I've been doing in the way of physical activity. So, I had to tell him. I have to say, he was amazing. No judging, no condemation, just understanding. But. I could see him thinking and he took his time to explain and show me my x-rays. If you look at the picture, you can see a dark line, and a clear line under the bottom plate. From what I understood of what he was telling me, the dark line was caused by the bone cells dying and replacing themselves, more than likely because of the pounding put on them by running. This didn't concern him as much as the clear line. Which is a space in which the replacement part could slip and dislocate. (at least that is what I understood)

I had to take him seriously. And I was devastated. And he knew it. He said he understood that this was a huge part of my life and he understood that I was devastated (he really did! I could tell) but I needed to find another activity...bike riding.. I know he's right, and I should have listened in the first place. How I wish I'd have gotten the High Tibial Osteotomy that he had suggested when he knew I wanted to continue to run... but it's too late now, I can't turn back the clock. So, I guess it's a good thing I have a good bike...

Has anyone else had an x-ray that looked like this? Is this what you were told was happening by how the x-ray looks? Is anyone else running with a PKR? Even a little bit... once and a while maybe?

 

[Pumpkin]

Dlekapj,
Sorry to hear about your PKR troubles. @Josephine will take a look at your x ray.
You will want to look into the Zero Runner, @Shortie , and @RunA42K have them and like them a lot.
All the best as you move forward,

 

[Jamie]

You may notice that I have merged your two recovery threads. We like to keep our members' recovery posts all in a single thread. That way it's easy for us to go back and read your history before responding to a question or concern. In addition, the thread becomes a journal of your recovery for those who come along later and want to read about you. So, please post in this thread from now on when you want to give an update or ask a question. If you decide you'd like a different thread title at any point, you can change it by using the Thread Tools button at the top right of your screen or just post what you want here and we'll get it changed for you.

I'm so sorry to hear that you're experiencing problems with your PKR as a result of running. We have had a couple of members who ran some on their new knees, but I don't recall anyone who did quite as much as you. It really sounds like you have a good surgeon. I like that he explained everything to you and understood how big a part of your life running has been. It's hard to let go sometimes. I hope you can find a substitute sport that you enjoy.

 

[CATSMUM]

Very sorry to hear about your running problem, hope everything works out and you can find a more low impact exercise.

 

[Celle]

I'm going to ask @Josephine to look at your X-Ray, to see what she thinks.

 

[Dlekapj]

Thank you everyone! I'm just having to find a new me... running is such a big part of my life, and I'm actually thinking ...an addiction. And, it's so much harder when I feel great! Yes, there is some achie feeling, but my knee feels really good now, especially compared to how it was before the surgery! So, it makes it that much harder to have to cut out something that I really love. But, I don't look forward to having to go through a revision, so... I'll be good..or as good as possible. And I'd appreciate anything @Josephine may be able to impart to me by looking at the x-ray.

 

[StillShortie]

Hello,

So sorry to hear you are having problems. I so know where you are coming from with he running addiction - it was the one thing I was most disappointed with after my TKR (and revision but that is another story!)

I looked and looked for exercise that wasn't running but was like running with no impact but I soon found there was none in my opinion!

After help from the lovely Bonesmarties I did invest (and it wasn't cheap!) in a ZeroRunner and it is as close to running as is possible I know it is not outside running but the action, the feel, the sweat inducing endorphins it is running with no impact.

I wish you all the best for the next stage of your knee journey.

Shortie xx

 

[Josephine]

@Dlekapj you'll note I have edited your photo - made it smaller and increased the contrast to make it sharper.

From what I understood of what he was telling me, the dark line was caused by the bone cells dying and replacing themselves, more than likely because of the pounding put on them by running. This didn't concern him as much as the clear line. Which is a space in which the replacement part could slip and dislocate.

Yes, that's a fairly accurate description of what's going on there. Sad thing is that where the damage has been done, it's not going to regenerate and repair itself. Sorry, but that's the truth of it. Such a shame for you - I don't doubt you are devastated.

How I wish I'd have gotten the high tibial osteotomy that he had suggested when he knew I wanted to continue to run

Actually, no you don't. They are a lot more painful in recovery than a knee replacement and a lot of the time, they don't last too long. I've known quite a few had HTO's and then had to have a TKR within a year.

running is such a big part of my life, and I'm actually thinking ...an addiction.

Well, you'll just have to figure out an alternative way of doing it - such as using an elliptical or, as the man said, cycling. There are always alternatives.

 

[Dlekapj]

Thank you for responding @Josephine . I guess wishing won't change things :( My daughter has an elliptical that I can use until I reinstate my gym membership, and she also has a pool. I do have alternatives, but maybe one day, I'll inherit a small fortune from a distant relative and be able to get one of those zero runners! My hubby told me to do a Go Fund Me, LOL! ( he was teasing). The doctor had actually given me a hope that the bone could repair itself, do you think that is not so? We can have ourselves in worse condition than we are by googling things, but by googling failed PKR images, it looks like mine is in pretty bad shape right now.

 

[Lovestoread]

So sorry to read this. I guess we always want to believe we are one of the lucky ones and think "it won't happen to me." It's a hard pill to swallow for you, that's for sure. I sincerely hope you can find a new passion....one that will eventually make you as happy as running has done. Good luck....and keep us posted.


Sent from my iPad using BoneSmart®

 

[Josephine]

The doctor had actually given me a hope that the bone could repair itself, do you think that is not so?

I'm sorry to have to say this, but no it will not. Let me explain ...

The red arrows pointing to the dark line is dead bone
The blue arrows pointing to the white is empty space
The green arrows pointing to the dark area under the implant is bone cement

When a fracture heals, it does so from both sides so the new bone meet and grow into each other
Here there is no new growth and nothing for it to interact with if there was.

In short, it needs to be done again.

 

[Hopper]

Oh @Dlekapj - hope things get sorted for you. Not being able to run is awful and quite a depressing thought for some of us. High intensity interval work is my alternative. Be good!

 

[Dlekapj]

pshewwwww.... I'm taking all this in. I took a nap this afternoon (I never do that) but dreampt that my I went running and was turning to take a route that I knew no one would look for me on (trying to hide what I was doing from my family) and my daughter caught me just as I was turning. I guess I've been caught and now having to pay the price. Thank you for your honesty with me @Josephine . And thank you for your understand @Hopper ... Unless someone is a "runner" (if you are, you know it ;) ) they really don't know how hard this is. It sounds silly to some... "find something else to do", "you don't have to run, walk fast!" etc etc. Yep, I don't have to (in fact.. I can't now), Yes, I can find something else (I will...) I need a 12 step program to do it though...