TKR 2½ Years Post Right TKR<

[maryo52]

@MaisieMUA puts you back to square one in recovery. Your knee bends 130, which is fantastic. However, the inflammation and swelling of the MUA will inhibit that bend for weeks. The trick is to NOT push your bend when your leg is swollen because what that does is set up inflammation where scar tissue gets a foot hold again. It's so so important to trust your knee and remember there is 130 in your knee.

vnmarino_13, isn't that a great feeling? Keep up the anti-swelling measures to minimize any backward progress. You are doing far better than I after intervention. It was a month before I could turn a revolution on the bike.

 

[vnmarino_13]

I wasn't told what my ROM numbers were during the MUA. I was at 45 degrees before the MUA and now I'm about 100 degrees, which I'm happy with right now. My pain is mostly in my quad where it's tight and inflamed. I've been icing it, doing gentle stretches, and elevating my knee. My PT has been doing a great job not pushing me to the point of pain. She has a great way of stretching my knee and surrounding muscles to the point of discomfort, but never beyond that. She also massages the areas that are tight, which provides really good relief.

This is a slow process and I'm starting to learn to have patience. This forum and the members provide awesome tips and recommendations, which have really helped me over the last month.




Sent from my iPad using BoneSmart®

 

[maryo52]

One hundred?! Wow. I am so happy for you. You're proceeding perfectly as far as I can tell.

 

[vnmarino_13]

14 Month Update - I can't beleive its been 14 months already. My knee has progressed well, but I'm still experiencing stiffness and swelling on a daily basis. I had asked my Dr. about it and he indicated that the knee will always swell because its fighting the metal in the knee. That was the 1st time I had heard that. Its more of an annoyance and probably contributes to the stiffness I experience in my knee. I can walk pretty far now and can bike, but if I lightly job, or attempt to jump even ever so slightly it hurts. I still am experiencing numbness on the outter side of my knee, which I understand may or may not go away. Other than that I've been happy with the results so far. I will be holding off doing my other knee until I absolutley need it, and by that time I hope there is the ability to regenerate cartlidge and make the surgery less invasive.

 

[kneeper]

I hadn't ever heard that about the metal. I'm glad you can do most things you want to do.

 

[vnmarino_13]

Hello All,

I'm going on my 3rd year with my knee replacement and I have to say that if I had to do it again I would have not had the surgery. A little history first. I had my replacement done at the age of 48. I had previously did a lot of damage to my knee playing sports, including waiting over a year to have my ACL reconstructed. All the while still playing volleyball, baseball, and basketball. I had 3 surgeries after that for cartilage tears. By the time I decided to have the TKR I was bone on bone and in pain. 4 weeks post TKR I had an MUA which was fine and as a result I went from 45 degrees to 120 degrees right after the MUA.

I now wish I was back to those days, as I have been experiencing pain, swelling and stiffness in my knee and it seems like its getting worse. I have a lot of pain on the inner part of my knee on the femur bone. This is right above the femur metal cap part of the replacement. I also have a lot of pain with my patella tendon and the kneecap, especially going up and down stairs. It feels like the tendon is going to rip or pop out. The swelling is constant and even with ice will not go down.

My orthopedic finally ordered a MRI of my back to see where the nerves are going into my knee, and may order a CT scan if the MRI comes back inconclusive. I don't know what that's going to show, but at least he is finally going to do something.

At this point I'm at a loss and frustrated that I can't be active without being in pain. Any advise would be much appreciated.

 

[Pumpkin]

vnmarino,
Welcome back, sad to read of your pain and challenges with your TKR.
Advise you seek a second opinion with an OS not associated with your present OS in any way, find one that specializes in revisions, they have the experience and background to determine what is going on with troubled knees.
I will tag @Josephine our forum nurse to advise. If you have recent X rays it would be helpful if you would post them.
Hope you find some answers soon,

 

[Josephine]

@vnmarino_13 you will notice I have merged your threads into one recovery thread. Your story is a prime example of why we (I) prefer this as it makes it so much easier to read through your whole story without having to keep going to other threads!

I also read though the entire thread and made some obsevrations:
- First, you had the ACL repair in 1992 - these surgeries can lay down an awful lot of adhesions ('scar tissue') which can be very difficult to deal with.
- Then, to complicate this, it seems like you had a very PT intense recovery.
- I also see you had an MUA only 8 weeks after your TKR which I feel was far too early and can have consequences.

But I also noticed this comment from last October

he indicated that the knee will always swell because its fighting the metal in the knee.

What a completely idiotic and incomprehensible remark to make!

However, coming back to the present.....

At this point I'm at a loss and frustrated that I can't be active without being in pain. Any advise would be much appreciated.

I can only imagine your disappointment and I can see reasons for this state of affairs.

But to give you structured advice, I really need to ask you some questions if you don't mind, 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)

2. are you using pain medications now, if so what, how much are you taking (in mg please) and how often?

3. are you still icing your knee and if so, how often and for how long?

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

5. What is your ROM now?

6. is your leg very swollen? If so, which knee does it most closely compare with?

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

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example (which means please make a list and not an essay!)

Exercises done at home: (enter number) of sessions each day
enter exercise + enter number of reps and sets
enter exercise + enter number of reps and sets
etc., etc.

At PT
enter exercise + enter number of reps and sets
enter exercise + enter number of reps and sets
etc., etc.

 

[Clipless]

... I'm still experiencing stiffness and swelling on a daily basis. I had asked my Dr. about it and he indicated that the knee will always swell because its fighting the metal in the knee...

Hi, I am quoting one of your old posts because I'm appalled at what your surgeon told you about "fighting the metal" (???). That sounds utterly bogus, especially in light of your increasing difficulties. And, no, you should NOT have swelling after three years. There are a host of potential problems to rule out (metal allergy, infection, loosening), but your OS has his blinders on- not a good thing.

I agree that you need to find a new, unaffiliated OS who specializes in revisions. There are some excellent revisionists in the greater LA area. Visit a few and go from there. My OS is in Burbank and he does revisions, for example. I have other names for you. PM me.

 

[Celle]

Hi, I am quoting one of your old posts because I'm appalled at what your surgeon told you about "fighting the metal" (???). That sounds utterly bogus, especially in light of your increasing difficulties. And, no, you should NOT have swelling after three years. There are a host of potential problems to rule out (metal allergy, infection, loosening), but your OS has his blinders on- not a good thing.

I agree. I've never heard that rubbish about fighting the metal. it sounds like one of those things that doctors sometimes say, to palm you off when they don't have an explanation for your problems.

Please get a second opinion.

 

[vnmarino_13]

@Josephine Thanks for the reply... please see below

1. 2 just sitting around or lying down. Walking on flat surfaces 3, going up and down stairs 7.

2. are you using pain medications now Not really. Every once in a while I'll take some Aleve.

3. icing Yes at these every other day for 15 minutes at most.

4. elevating No

5. ROM I don't have a way to measure but I would estimate it when stretched and loose to be at 120 max.

6. swollen? Moderate

7.activity level? I was more active before my surgery. Now when I walk long distances, stand for a while, play baseball with my kids, do any work around the house my knee swells up and is more painful afterwards.

8. PT None....I've tried leg extensions on my weigh bench using 10 pounds and that swelled my knee up. Bosu ball for balancing and strengthening the quad seems to be the best. I've tried yoga which was good. I don't have the time to spend doing it consistently.

 

[Josephine]

1. 2 just sitting around or lying down. Walking on flat surfaces 3, going up and down stairs 7.

Interesting - are you making yourself do stairs normally?

2. are you using pain medications now Not really. Every once in a while I'll take some Aleve.

Really? With those pain scores?

3. icing Yes at these every other day for 15 minutes at most.
4. elevating No

You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day. And elevate when you ice or rest!

5. ROM I don't have a way to measure but I would estimate it when stretched and loose to be at 120 max.

Well that's not bad - ish!

6. swollen? Moderate

That sounds about right

7.activity level? When I walk long distances, stand for a while, play baseball with my kids, do any work around the house my knee swells up and is more painful afterwards.

I see.

8. PT None. I've tried leg extensions on my weigh bench using 10 pounds and that swelled my knee up. Bosu ball for balancing and strengthening the quad seems to be the best. I've tried yoga which was good. I don't have the time to spend doing it consistently.

Why are you doing leg extensions? Do you have problems with extension?

Try this suggestion Extension: how to estimate it and ways to improve it.
As for your Flexion: how to photograph your leg so it can be measured