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Revision TKR 16 Months Post TKR

Thanks for checking in Layla,

I hope your Christmas was great. I have some pretty good days and some pretty tough days. I have gained some ROM but I still have a lot of inflammation, swelling and pain. I have been released from PT and have been doing my stretching and some indoor biking. It’s a double edged sword right now. If I stay down, ice and elevate, the knee stays less inflamed. When I stretch walk or ride the knee hates me so I am having a hard time strengthening the muscles that support my knee. Again the positives are very slowly coming with ROM, stairs, biking and putting on my shoes are all slightly improved. Ironically I was just considering whether or not I need to contact my Dr to ensure there isn’t something bigger wrong. Hopefully it’s just not ready!

I hope you have had a great 2023 and I have really appreciated this forum.

I am in a wow is me moment, day 4 of it. Frustrated, concerned and definitely down. I am sure some of it is that I can’t participate fully during these holidays and honestly feel like the TKR decision has cost me 6 months of my year!! Ugg sorry for the whining but appreciate the ear.

Happy almost New Year!! 2024 will be great I am sure
 
JamesW57 said:
I have gained some ROM but I still have a lot of inflammation, swelling and pain.
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I’m sorry that you’re still struggling so much with these symptoms. We have others members in a similar situation. This recovery takes a year, and longer for some of us, so, you are not quite halfway through, but where you are now is not where you’ll end up.

After a rough first year I had a lot of improvement in my second year, as my whole leg continued to relax and heal. Hang in there!
 
James, I saw a great analogy somewhere else on the forums and don’t know if you’ve seen it about a water hose. When your knee has swelling, it’s like a full water hose and it doesn’t bend easily. When that water hose or your knee has less fluid, it will bend. That’s why you have to focus on addressing the swelling first, and the ROM will follow. This also explains why overdoing it (which increases swelling) sends you backwards in your recovery rather than helping it. Hope you can give yourself a break and also that you can find a way to get control of the swelling soon. I promise it won’t be swollen forever!
 
Jockette and MSuki,

Thank you both so much for the reply and encouragement. I have really backed off and am spending a lot of time elevating and icing and it has helped. After a couple of weeks of it I really was feeling much better with the swelling somewhat down. I went outside for an hour and gently organized my garage and it swelled back up and I was right back where I started. I will take any suggestions and thoughts. It just doesn’t feel right that I am 3 months post MUA today and it seems like I can do very little without making it mad and obviously once it swells the pain really set in.

know I am really frustrated at this moment as I have always been very active and I can’t be on my feet for more than 15 minutes. Again, I really appreciate and needed to read your thoughts. It puts things back in perspective. Uggg
 
@JamesW57 Patience my friend. At only 3 months post MUA all the swelling is just part of the process. Ice, elevate and pain medication if needed. Ease into any activity. Perhaps do half the job and then come back later to finish. This is all temporary! The new year will bring more activity. Hang in there!
 
Aww, I am sorry you're feeling down. It can feel like a slog some days and there are ups and downs for sure. You are making progress with stairs, biking and putting on shoes...that's all good! I am sorry you can't fully participate in the holidays, try to focus on next Summer, a goal that's a bit further out because I'm sure with each passing month you'll grow stronger and feel steadier on your feet. Hang in there...it will get better!
Cheers to perfect healing in the New Year! :happy-new-years-toast-smiley-emoticon:
@JamesW57
 
Thank you all for the positive comments and support. I hope your Christmas was amazing and Happy New Year! !! I look forward to reading your posts and will use them to keep going and try to improve my patience..
 
Hello to all my MUA friend. TKR July 18, 2023 and got to 80. MUA Sept 26, 2023 115 with pressure and 100 gravity. I was only 115 befor TKR. I just went over 3 months out from MUA. I was stuck at 90 for a few weeks after MUA and a few sessions of dry needling really helped relax the quad and I was able to get to 105. Quad is still tight and my biggest issue is when I walk, stand basically use the knee it swells and then the pain becomes much worse. So, I have done a much better job of icing and elevating and with very minimal use it stays smaller and is much less painful. I am up to about 110 to 115 on a good day. I am no longer going to PT as of 3 weeks ago. I am concerned that my muscles have atrophied so much that going down stairs without holding on isn’t a good idea. Bottom line is I have no idea how long it will take for this swelling to go away. Dr say a year or more. My patience is waning but this forum definitely helps to remind me that I am ok. Hang in there, I feel for you but patience and not overdoing it, not even close, really helps. Take care and happy new year. By the way if anyone find a way to stop the swelling I would love to hear it.
 
Hello to you all. RTKR 18 July 2023, MUA on 26 September 2023. It is now the 14th of January 2024. Swelling only partially down each morning for maybe 20 minutes. I make breakfast and by the time I am done it is full blown swollen and in pain. My only relief is methocarbamol, tramadol along with 2 Tylenol. I have completely stopped all workouts and only stretch lightly and walk often. I have slightly gained ROM and a few other really small gains. I have 2 or 3 positive days throughout a week and try to stay out of frustration and mis-belief. Know one to tell me if I will get better! Today is a very low day as I am currently missing my daughters volleyball tournament mainly because I make the trip miserable for everyone else. Just can’t get around. Thank you all for being on this forum with me and hopefully tomorrow will be the big day right!!! Take care.
 
I am sorry you're struggling with swelling. James. It is difficult missing out on events that involve our kids. Hopefully it doesn't happen too often.

Continue to ice and elevate as often as you're able, it's not too late. Some still have swelling up to between 6-12 months, slowly easing over time, and you're not quite four months removed from the MUA, which likely set you back. You haven't run out of time to get better, so don't lose hope.

As far as elevation goes, it is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

BoneSmart FA, CricketHip, is involved in Therapeutic Massage and has shared this exercise to assist in manual lymph drainage. This gentle, yet effective therapy will help prime your lymphatic system to move fluid and inflammation away from your leg, which in turn will help your range of motion and pain - you may want to give it a try and tag her if you have any questions, she's very helpful and knowledgable on this topic.

While lying supine, take deep breaths...deep, as in breathing in to a count of 5, 4, or 3 seconds, whatever is most comfortable for you. Hold that breath for another count of 5, 4, 3 then blow out completely, still using the count that's comfortable for you. A series of at least 6 reps may help get the excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up. Repeat this whenever you feel up to it during the day or night. Lying flat (supine) is best as the lymph nodes seated in your groin are less restricted, allowing for better lymph flow.

In addition, after the breathing exercise, place your hands lightly on your upper thigh, at the crease in your groin and lightly stroke upwards towards your naval. Be patient because it can take the body time to respond.

I moved two posts from elsewhere on the forum because they seemed relevant to your recovery and you do have a journal of sorts here to reflect back on at a later date, and those posts are part of your healing journey, so I'd like to encourage you to post any updates, questions or concerns about your recovery here.

Thanks for joining us and sharing your recovery with all. I hope you have a great week!
@JamesW57
 
I will absolutely give this exercise a try. It makes perfect since given that when I wake up in the morning after sleeping, mostly on my back that the swelling is much improved. It would be so great if something like this would offer relief. I appreciate the positive and motivating words you shared. Wow this is the most difficult and frustrating ordeal I have aver been through. You all are amazing.
 
Hello to everyone. I haven’t posted in quite a while. I am at 11 months post RTKR. Still have a lot of pain and swelling. I get about 30 minutes of normal almost every morning then it straight down hill. I have an appointment with my Dr. next Thursday. I am sad to say I hope he says there is something wrong that can be fixed. This can’t be the way it will be from now on. I finally increased my ROM, guessing 115 or so and can straighten it. I am riding my bike a little with the seat raised and if feels pretty good until I am done. But wow other than the first 30 minutes of the day I can’t do much. Don’t get me wrong I push through it everyday to the toon of 5 to 10k steps but it’s a challenge. loosing that positive outlook I once had that this will eventually feel much better!!!! James
 
@JamesW57
I moved your post, above, out of an old thread, and into your recovery thread, to keep your history in one place.

JamesW57 said:
But wow other than the first 30 minutes of the day I can’t do much. Don’t get me wrong I push through it everyday to the toon of 5 to 10k steps but it’s a challenge.
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I’m sorry you’re still having so much pain and swelling, I know it’s frustrating. (been there, done that, I had a very tough first year) In light of this, maybe you should consider not pushing to the 10k amount of steps. If there’s anything wrong, pushing could only make it worse.

If your current doctor isn’t much help, maybe consider a second opinion, with a surgeon who has no connection to your current one.

In my case, I had a lot of improvement in my second year, as my whole leg continued to relax and heal. Hopefully you will see that, too.
 
@JamesW57
I'm sorry to hear you are still having a lot of pain and swelling. I'm only a week ahead of you post op. Even at 11 mo post-op I celebrate every small victory that I experience. Glad your ROM is up to approx. 115. I know it's discouraging at times, but focus on the positive, your ROM increased after your MUA and you can walk 5 -10k steps a day, it may be a struggle, but you are able to do it! Does icing help with the swelling? For me, doing leg strength exercises helps with stiffness and pain. Hope your physician can figure out what the issue is. Keep us posted. Hang in there!
 
Hi James,
We do often remind members that recovery can take a full year and may continue to notice progress into their second and even third years post op.
Since you enjoy thirty minutes of comfort in the morning before the pain begins ramping up, wondering if you're doing anything physical early in the day, aside from the activities of daily living, like a walk or workout? If so, consider taking a little break and see if it makes a difference. Please don't lose hope that it will get better. Try switching it up a bit and see if you're able to figure out what may be causing the pain you're dealing with.
Lots of comfort to you!
@JamesW57
 
Layla said:
Since you enjoy thirty minutes of comfort in the morning before the pain begins ramping up, wondering if you're doing anything physical early in the day, aside from the activities of daily living, like a walk or workout? If so, consider taking a little break and see if it makes a difference.
Click to expand...
Agree with @Layla and @Jockette that pushing through pain may be not helpful. Try easing off and interspersing shorter bouts of gentle exercises with icing and rest for a few days?
 
Thank you for the replies. After struggling a lot for a couple of months after my MUA I joined this forum and followed the thoughts and ideas. Primarily I completely stopped any activity short of necessity, iced constantly and wow although it’s tough to stay down it paid off and I was able to reduce some of the swelling. I then only did active daily living and was able to gain some ROM but it would still swell and become painful. So I slowed down even with that and it didn’t change much as far as swelling and pain. When I get up in the morning I only do ADL. I make breakfast and coffee and ease into the day. Yet it will still swell.
I can’t thank you all enough and perhaps it is just more time. I will post my Dr appointment outcomes after this Thursday.
 
Swelling at your stage is still normal. Some people are swelling into the second year or even more. Our soft tissues can become extremely angry and react with that swelling. Icing, resting and elevating should help some. I think it's just a time-thing for you.
 
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Thank you all for the reactions and your thoughts sisterinhim. I think you are probably right. I have always been super active so this year has been tough to say the least!
 
Hello all. I had my 1 year post surgery Dr.visit. I explained, and he could see, I still have a lot of swelling and pain. I’ll post his comments but long story short, he said my previous surgery and this one has caused some falsification along my patella tendon which is and will continue to cause issues. He thinks the knee will eventually burn its self out (not sure what that means) but it could be still a year or more away. He said the final outcome will most likely not be as good as thought. He said additional surgery would be a bad thing!

His notes:
James is a 58 y.o. male who presents today one year status post right total knee arthroplasty with removal of hardware in the proximal tibia on 7/18/2023 with Dr. Gillen. He then had a closed manipulation under anesthesia of the right knee with Dr. Vosburgh on 9/26/2023. He feels the manipulation helped in the long run. He returns with concerns with swelling and the knee making clicking noises. The swelling is consistent throughout the day. He is taking methocarbamol and tramadol at lunch time. He takes the tramadol PRN at night time. The patient ices the knee multiple times a day.

Lower extremity: The incision is benign. There is an effusion present the knee as well as diffuse swelling. Range of motion 0-110 degrees. The knee is stable to varus and valgus stress. There is no evidence of patellar instability.

Review of Relevant Data:
Pertinent Labs and Radiology have been reviewed.
X-Ray Knee Right 2 Views Right
Satisfactory position alignment of cemented posterior stabilized total
knee implants. No obvious loosening or surgical complication is noted.
Patella Baha is noted with some calcification along the course of the
patellar ligament. No acute bony abnormality is noted.

Recommendation/Plan:
X-ray findings including the patella baja were discussed with the patient. Patient will continue to be active with biking and playing golf. He may pursue activities if tolerated, but he was cautioned not to overexert the knee. He will continue with his oral routine of muscle relaxant and tramadol. I do not see an indication for return to formal physical therapy. I do believe that the knee will burn itself out and be less inflamed and in the future. The patient will call for follow-up in 1 year for recheck.

Should I see a different knee specialist for a second opinion? If so, any great knee specialist suggestions?

This was a hard one to swallow! I am not even 60% in my opinion and the pain gets worse if I use it!!

Thanks for any thoughts and sorry for the lengthy message.
 
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