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Revised PKR to TKR 12 months later but can’t find my thread

@Jamie I’m confused with the apps. I have both on my phone. The new one I find difficult to use and can’t work out how to edit a post or add an image so I swap to the old one to do this. As the text editor often types what you don’t want I often need to edit what I’ve typed. While the new one is aesthetically pleasing am I missing something ie where to download pics and where to do editing. I’m just worried you will delete the old one and then I won’t have those options available to me. Thanks.


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Wow, that is a huge implant! Your poor bone they put it in!
 
Is it huge @Jockette? I’m not sure. I haven’t pulled out all the old X-rays to compare. I use the apps on my phone as I find them easier except for the above issues lol


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It looks huge in length to me in that it goes way down, compared to other non stem replacement pictures I’ve seen.

Mine is only a Patellofemoral which is just one piece on the lower end of the thigh bone.
 
No, it's not huge. I'd just say it's large-ish! It's just a choice the surgeon made. Perhaps he's had problems with loosening with the more traditional types.

As for the 'nerve thing', I did say it was probably due to inadequate pain meds. So the 665mg of paracetamol are not enough. It needs to be 1,000 4 times a day.
 
Ohhhhh sorry I see what you mean. That was your answer to that question. Lol. I took it as two different questions but I guess you’re right. That effect is because of inadequate pain meds.

@Josephine thanks for your reply. That makes sense. He did say part of the previous implant hadn’t ‘joined’. He also said the cement was perfect and there should be no issues with this one

Sorry I didn’t put two and two together. I didn’t think of nerve spasms as pain but of course they are and inadequate meds explains this. Thank you so much for your help. I’ll make sure I take some tramadol and Panadol in the middle of the night. Hopefully that will make a difference. Otherwise I’ll try endone.


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@Josephine I had a follow up appointment with the surgeon today. He received the results of the frozen section that was sent away to culture. The immediate test came back negative however the one sent away came back positive for two bugs. He said they usually ignore this result when all other tests have come back negative.

He then had a look at my knee and it has come up looking red and angry on the left side. He asked me how long it had been like that and I answered all the time but probably worse the last couple of days. He inspected it and said it was possibly infection so he aspirated but could get no fluid just blood which he suspects is a haematoma.

He is sending that off to be tested. He has started me on antibiotics as I still have the sweating, nausea and heart rate between 90-125.

I went to gp for blood results. Liver function was abnormal (I never drink alcohol) hb 90 and platelets low. She has put me on alternative hrt just in case that’s causing issues. I will have bloods done again in four weeks to ensure everything settles down as it could all be related to the surgery.

My question is: all the tests I had testing for infection came back negative. The final test - the frozen section grew bugs after 14 days. Is it possible that there is an infection even though all the other tests came back negative? I do realise that there is a possibility it could be a contaminant but is it equally possible it could be infection? Otherwise why bother doing the frozen section after all tests come back negative if you’re going to discard the result if it’s positive for infection anyway?


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Good point! It's often very difficult to get reliable results for PPI infection (peri-prosthetic infection). But if it showing external symptoms such as being red, angry and warm/hot I'd say that was showing a more than likely chance of PPI.
 
It’s 3 weeks since my revision. I don’t know where I’m at in this recovery. I think much of it is due to the unrelated yet related issues I have to deal with including sweating, nausea, the most incredibly painful sciatica I have ever experienced in my life that contributes to my nausea and affects my ability to move my knee as the pain goes into the back of my knee and feels like it’s pulling. I also had a reddened area that looked like infection and was aspirated. Obviously there was no infection as I haven’t heard from the surgeon. My liver function test was out of whack but no one seems concerned nor are they concerned about a resting heart rate of 90-125. I have no idea what to make of any of this.

I’m doing ADLs and heel slides when I can and a few extension exercises but that’s all. My knee is incredibly swollen so I’m not expecting much in the way of extension or flexion at this point. I am about to commence physio for sciatica (not my knee) and will purchase a tens machine for the sciatica as I tried it and it helped.

The surgeon gave me a whole new medication regime doubling the dose of the long lasting meds and changing the break through meds to endone. This regime worked a lot better than the last however I continue to have a great deal of pain especially at night.

That’s my latest news for now. Not much of an update but it is what it is. Hopefully someone has answers and I can eventually have a satisfactory recovery.


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I think once you get that sciatic pain gone, you'll find your knee will be better than you think it will be. It has had time to do some healing since you've been down.

Has someone been coming in and checking your heart rate? If not, is it possible that your detector isn't working properly? I have found that mine reads different things on different readers.
 
@sistersinhim I checked my heart rate monitor against the one in the drs surgery and they were identical. It’s brand new. I can feel my heart rate (and I’m a nurse) and have counted it many times and it’s correct. It was the same in hospital and had everyone in a tizz and again the same in the doctors surgery.

My knee has had time to do some healing and I’ve been able to walk without aids since the day I arrived home from hospital however I use a stick when I go out for safety purposes. I have no issues lifting the leg from the floor onto the bed without using the leg lifter. The exercise for extension I find difficult due to the sciatica and even the heel slides are made difficult by sciatica. Hopefully physio and the tens machine will help.


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I use the one on my phone and sometimes it can't even find a regular beat enough to register. When I use the Gear Fit, it does OK. If yours is just like a professional monitor, then I'm sure it's accurate. I don't know why no one seems concerned about it. Maybe it's high because of a low blood count. You did have two major surgeries close together. I'd call and bug the doctor again and make them tell you if it's OK or not! It's better to be sure. Then, you can relax about it. That would probably make it slow down on its own!
 
@sistersinhim I have no idea either but I have made a gp appointment for tomorrow and I’ll chat with her about it then. Weirdest thing. It’s not good for anyone running a high heart rate even at rest. My haemaglobin was 90. Low but not too drastic. Normally one can rectify this oneself with a proper diet. That too will be retested in about three weeks.


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Oh good, I'm glad you're seeing the gp tomorrow. Be sure and let us know what he says.
 
@Celle I have been reading your comments in other threads regarding revision TKR and whether they are easier to recover from.

I understand that it’s very individual but wow I am struggling with the pain of this latest one. I’m not sure if I’m just expecting too much too soon, whether it’s because of the long stem, the sciatica or the fact that I had two surgeries two months apart with the first one resulting in excruciating pain I was not expecting and now this one very similar.

Maybe I have lost my ability to tolerate pain but I’ve always had a high pain tolerance. I just don’t know what’s going on. My heart rate remains between 90-125 at rest. I’m always sweating yet no infection except that one culture that came back positive that the surgeon is convinced is contaminant. I’m not. Now my gp is sending me to endocrinologist.

I’m lost with it all and losing my usually accepting state of mind. I’d accept that it is what it is if I knew what IT is lol

Anyway just thought I’d ask
 
Shelli, it's only about 3 weeks since you had the revision.

It's probably a combination of all the factors you mentioned.

Patience my dear, you are still in the very early days.
 
I've never said that all revisions are easier to recover from than the original surgery - just that mine was.

You've had two surgeries within 3 months, been running a fever, have a relatively low Hb and a rapid heart rate, and I think you may be overdoing the activity.

Your revision knee is still a very new baby. It's only just started on its year-long healing journey and it only needs minimal exercises at the moment.
It probably still needs you to be using a walking aid.

Persistent pain is usually caused by two things in the early days - over-exercise and under-medication.
Are you sufficiently medicated for pain? How much time are you spending resting, elevating and icing that new knee?
 
@Celle. I am using a walking aid if I go anywhere as I get too tired without it. I forget it at home as I have a very small home, it’s two steps from the lounge to the kitchen and four to the bathroom. I’m not doing any exercise and spend most of the day sitting, icing and elevating unless I have an appointment or need the chemist or grab some shopping. I think I’ve watched everything on Netflix, Stan and Foxtel lol. All I do is walk a bit and make something easy to eat. My mum comes down to do the hard stuff every few days and she won’t allow me to do anything trust me.

I go to PT but that is only for sciatica. The surgeon wrote the PT a note requesting he only work on sciatica, he didn’t want to work the knee yet. The physio has now written a note requesting a plan to start exercising the knee. He was telling me what he intends to do and that includes half lunges to work hips. Not sure I like this idea. He is now saying it might be time to start pushing through the pain and putting up with a bit of pain to gain ROM. I don’t like that idea either.

I tried to stop the endone. I have slow release tramadol and Oxycodone. I had endone for break through pain but the point of the Oxycodone which he prescribed three times a day 20 mg was to hopefully allow me to wean off endone. Well it didn’t work. Two days without and back to excruciating pain and sciatica was worse so I rang for another script today.


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That is not the therapist for you!
Remember, it’s your knee, your decision.
 
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