TKR 19 mos, knee overuse and strain.Worried again.

[Jockette]

(ps that fall must have been terrifying.)

To be honest, I was hoping it did enough damage to warrant a revision (which has never been offered to me) but it didn’t. My knee has issues, but I’m managing.

 

[Legseleven]

I seem to be surrounded by superhero healers in my little corner of the universe. And they are very braggish

Oh dear @Readabook
That’s so challenging when recovery is more than enough to cope with. However it says far more about them than you. Think of girls in High School , it’s about them, not you. I do understand the frustration too, as I have got to the point when I might react totally out of character to the next (well meaning) person who tells me to do my exercises.

We can’t change others but we can change how we think and feel about them and what they say. Shrug them off, your healing journey is your own and on here we all understand and support you in this.

You’re doing very well, and setbacks happen to us all. We can all irritate any part of our body while gardening or any other physical activities and that’s normal for all of us, the very hard part for you is when it happens during the recovery period. We just don’t bounce and heal quite as well (and quickly) as we once did.

Pain = stop for now, as others have said rest, ice and elevate. Just walk a little and do your activities of daily living until things improve.
In time you’ll look back and see how things have improved. I know I’ve read instances on here of healing continuing well into the second and third years. What the surgeon said, it’s just one OS’s opinion. There will be other surgeons who say different, please don’t take that as a fait accompli. It’s like a competition judge - it’s what they think, not necessarily the consensus.
Thinking of you.

 

[Readabook]

@Legseleven- well that maid me tear up! Phew. Deep breathes. And I just got off antidepressants! (which made me feel terrible always so glad I am off) This group pretty miraculous. I so appreciate you all. I did very traditional PT and succeeded- tho I was sick as a dog in the beginning from surgery and meds. But I was never super strong.I am a 30 pound smaller person than when I was in HS 50 years ago! So i had the ROM going for me, but went right from that world to taking my parents to hospitals and doctors- my knee screaming. Hyper flexed at granddaughter's day care at 9 ms asI collapsed into a 4 inch chair! Sports med doc said all sprains take 12 weeks. Its just that i am over a year and a half.... Again, Thank-you, Thank-you.

 

[Layla]

Superhero healers often have short memories. If these types see that you're struggling, or not happy with your progress, anything less than support from them should be ignored. Let them know that you don't view recovery as a competition and that each has his / hers own timeline. We're all unique.

he said if I am not better at 19 mos, I won't be

Nonsense!
While nineteen months is not early recovery, it's certainly not the end of the road for figuring things out or improving function. It's not hopeless.

If you feel the last OS wasn't a good match for you, while it takes research and time, don't hesitate to seek a third or even fourth opinion. You're bound to find someone who offers more clarity, whose explanation and possible solutions makes more sense to you. With each fresh set of eyes, you're more likely to find someone to identify any issues the others may have missed. Don't give up, you have life to live and should live it abundantly.
For now, rest / ice / elevate / take pain relievers as tolerated and know that we're here for you always!

 

[Readabook]

I am curious- my fear seems to be that I massively sprained my soft tissue in my 19 month old replacement. Heard the velcro noise and all. The new to me surgeon assured me that implant was fine. Thank-goodness!!!! He focused on the fact that I mentioned i was a little flexible in joints But he didn't talk at all about soft tissue. Only that no really improves at this point. But don't a lot of folks have missteps and sprains etc? I am upset that he didn't even acknowledge how to get help (I asked about acupuncture, but he said not approved by orthopedics). I don't want to take up space here and I apologize if I sound overwhelmed. Are people talking about soft tissue?

 

[Layla]

Hi Readabook,
You are not just taking up space and there no need for an apology. I am sorry you're feeling overwhelmed.
I'm not sure what you mean by asking "are people talking about soft tissue?" We talk about soft tissue often on this forum. If you use the SEARCH feature at the top right of the page, typing in key words such as "soft tissue" all of the threads where it's been mentioned will pop up.

Only that no really improves at this point.

I wouldn't listen to this. What's the medical evidence that recovery is over at 19 months post TKR? Improvement can still come for months to even another year, or more. There's not a cut-off point although progress does tend to slow over time.

Looking back to your first post, I'm assuming the deep bend you described in the garden wasn't even two weeks ago. If it's soft tissue, you should be taking it easy, icing, elevating if your knee feels achy and use OTC pain relievers as tolerated. If you aren't noticing a bit less pain each day, or pain that's not improving at all after a week or so, consider calling the OS's office to address the topics you feel weren't touched upon. OR, you can seek out a third opinion (a third OS) if you're unsatisfied with the last one you saw, or deeply concerned about your progress.

For now, I hope you're able to devote more time to healing yourself, over helping others. Taking it slow and easy and giving yourself some grace.

 

[Layla]

Hi again,
I did a quick search on soft tissue for you, results -> HERE
Let us know if you have questions. Hope your night is a relaxing one.

 

[Readabook]

@Layla- you are so kind and much appreciated! Thanks for the guidance, the search, the support. Its so weird to have your surgeon retire and move away. Mine was independent- last man standing as medical conglomerates took over. Had a lovely calm PA and attached PT space with lovely therapists. All very homey. I am clearly having separation anxiety/ or a feeling of who to turn to- even tho the surgeon was super grumpy. He referred his patients to a well thought of young doc- who I saw. He could only tell me his facts when asked to look at another docs patient. I SO appreciate your thoughts. I need to listen and breathe and not let him scare me. My deep bend was two weeks ago. I know- patience.

 

[Jockette]

Even with my unsuccessful PKR, I was still improving, in some ways, in my third year post op!

After my fall, it was all soft tissue “damage” and it took about 2 months to heal back to my normal. And all I did was activities of daily living, no exercises or PT. You’ll get there, but it does take patience.

If you feel there’s more to it and was ignored at your appointment, you can always consider another appointment with a different doctor. Ortho surgeons are good with surgery, but not always good with soft tissue injuries.

 

[Layla]

Thanks for the sweet sentiment. You're welcome, Readabook!
We're here to help. It is difficult to lose physicians you like and have confidence in. Please do try hard to not let Dr. Negative scare you. Our bodies have an amazing ability to heal soft tissue injuries over time, especially when we give them a bit of rest and don't keep aggravating them. Our body is in a constant state of repair. Take it easy and let it all calm down...and it will.
@Readabook

 

[Legseleven]

@Readabook we are all with you and you’re not doing this on your own.
Soft tissue injuries - strains and sprains - can take several months to recover, and can be very painful. Most of us have ‘tweaked’ an ankle at some time in our lives and we know how slow and painful that can be. It’s perhaps harder to cope with because you’ve already had a major op on that leg, which makes us all hyper aware, however this sounds like a straightforward injury to the leg, and perhaps you can think of it as such, rather than connected to the TKR.
I’m sorry that the change in professionals has added to your ordeal.
Patience, ice and elevation are your best friends, and if you still feel unsettled by it all then do you have a good GP you could talk to, or an excellent physiotherapist?
Take it easy, and I do know very well how hard that is to do.

 

[Readabook]

@Legseleven Oh my. I feel like I have found a home on this forum. You all are so kind and informative and supportive. I have what is called a sports medicine doc that I will check in with-actually to try and get gel injections for other knee, but then review this sprain. He will tell me it takes 12 weeks.....
Yes, I have never loved ice, but I am doing it. I can't really take nsaids, so taking tylenol. I have the knee replacement as I had avascular necrosis of my femoral condyle which several very unempathic surgeons missed- leaving me on a cane before I finally found this surgeon. I honestly was terrified and my recovery process was lonely and filled with guilt. (caregiver) Yikes. But I am structurally good. Former surgeon's PA had suggested I don't do active PT anymore (19 mos) as I have a great bend and he doesn't want me to be hurt by an overly enthusiastic therapist- But I think I need to revisit that with what I know now!! Inflammation help for sure.
It is super hard to think of this as not connected to TKR - as that is such a big life and body intrusion. But you are right- I need to find confidence and trust and separate the "parts." Many, many thanks and best of luck to you oxo

 

[EalingGran]

Like you I was rather hypermobile. I used to be able to put my hands flat on the floor when touching my toes and I liked to sit with my knees fully bent back under my bottom.
This definitely led to some overstretched ligaments and residual tendinitis. The last Xrays I had at 2 years after my PKR showed enthesopathy. I get some pain after a lot of stair climbing, by the end of the day.
The tendency to hypermobility gives us great bend but it means we have to be careful not to overdo things.
Rest and ice until your acute injury settles. Then consider something like pilates to build up muscle strength safely. Strong muscles will help to protect the weak/ damaged tendons and ligaments.

 

[Readabook]

@EalingGran - I had to look that word up. I remember all of us putting our hands flat on the floor... I could only sit crosslegged! Are you you finding that you can do pilates with a replacement? I am so unsure.

 

[EalingGran]

I have a really great pilates teacher. She has loads of free classes on YouTube. Google Katja pilates and they come up. There are some things I can't do anymore- like sit back fully in childs pose with my full weight. But generally I can do most things. It is just about listening to your body and taking account of any pain.
She has a 20 minute glute strengthening video which is knee friendly with no squats. It builds up strength but doesn't aggravate things.
I am more wary of yoga. I used to be very "good" at yoga because of my bendiness. I am also quite competitive. I tried a yoga class after my PKR and ended up overdoing things. I have learnt to avoid group classes where I can be led into following others into doing too much. I also avoid water based exercises/ classes because I can't judge my knee in water.

 

[eaglemom]

It is so easy for our 'friends' to mean well by saying things to us. But then again, they aren't the ones whom have had the surgery and are recovering!! I think they say those things to encourage you, but frankly it just doesn't ever sit right with me. And I see you are the same way. I've learned to tune them out, or say something about when they've had this surgery then I'll listen!!

As for total healing at 19 months that might be a tad over simplified in an answer. Your knee will be healing for quite sometime. It will tell you when, for example you walk on uneven sand at the beach, that evening its not happy with you. The lesson learned is to not walk on uneven surfaces. It takes time and none of us wants to wait. Now that you have a soft tissue injury it will slow the knee down some. You said your not a fan of ice, I get that. But if you can, try icing some to get the internal swelling down.

You've got this, its just taking more time than you'd like. Take a deep breath and realize you'll get there, just maybe not in your timeline, but the knees.

 

[Readabook]

@eaglemom thanks so much. My mind wanders- from being so upset that a stupid bend in garden could cause that sound and this discomfort- when I have been going up and down stairs daily. Like why now as I try to find some normal. Sigh. Oh well-"the implant is stable"- which is most important thing. I don't know if I should be a nudge ans ask for something that will show soft tissue tears.. and what is the point of that. I basically have to heal. And at two weeks my patience is challenged!! Off to ice!! SO MANY THANKs for being so kind and supportive. I hope I can pass that on. ox

 

[Layla]

I basically have to heal. And at two weeks my patience is challenged!!

You're right, you do need to heal and it's understandable this feels like a challenge, but please draw on all the patience you have. Healing from a soft tissue injury can take weeks to months, depending upon the severity. It's unfortunate the OS you visited with for a second opinion didn't give you more of an idea of what to expect. It is important that you continue to take it easy for a time because if you return to activities too soon, you could re-injure those healing soft tissues. Patience Pills below. Take as needed

 

[Readabook]

@Layla : He gave me none!! I was very much a number that he was supposed to check retired doc's patient's implants. I made mistake of saying I was a bit flexible which prob helped my ROM and he ran with that and told me that I would prob always get in trouble because of that ( I am 68 and have never had issues- I am not that bendy!) That orthopedic society did not approve of acupuncture or prob anything else I could think of. That I would need other knee replaced and that I would not respond to gel. (I have in the past. ) Blah!! Oh well. He is known to be a good surgeon and uses same implant as my retired doc- hence referral. But I have other things to explore. oxo

 

[eaglemom]

I'm sorry he didn't 'listen' to you. That is always so frustrating. I will share with you that one surgeon never spent more than 3-5 minutes with me. He'd walk in the room and tell me how my knee was, that we were doing x,y,z & he'd walk out. I'd finally had it, because you always waited over an hour to see him. When he walked into the exam room, I stood up and moved my chair in front of the door!! Somewhat childish, but it got his attention. I said I deserved his entire attention and more than 5 minutes of his time. He just looked at me and finally said "yes you do." Now that is totally out of character for me, but something had to change. Now, I'm not saying that's something you should do, but rather you need to somehow let him know you have concerns and don't want to be blown off.

For now I think you need to concentrate on healing the soft tissue then deal with other issues. It's all going to be baby steps. You've got this.