PKR 2happy's Recovery<<'

[Celle]

Just pulling back isn't enough. Tell her firmly not to ever do that again.
Of course you have swelling after your PT sessions, if that is the way they treat your knee. It won't improve if you keep allowing this mis-treatment.

 

[2happy]

I am now 15 weeks postop pkr, had cortisone shot 4 weeks ago in knee for pitting edema, tightness and poor flexion. I was at 90 at that time. I had re-evaluation this evening. My flexion is 95, and started with pitting edema again and knee looks and feels tight. I have Ortho appointment 3/21, I am afraid I am going to have a manipulation. Good news is pain is 0 in morning with high of 4 after walking.


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[Josephine]

So you're not going to answer my questions again? I would very much appreciate it if you would let me know your intentions.

 

[2happy]

@Josephine
1) pain 1-2 with rest, 3-5 with activity
2) pain meds- Tylenol
3) swelling- none until activity then slight. Positive pitting seems with too much walking or physical therapy.
4) flexion 95, only gained 5 % since Jan and after cortisone shot. 5 for extension
5) yes for icing 30-60 minutes after activity/walking/OR
6) yes elevate while icing and when at rest
7) activities-- light housekeeping, walking 0.5 miles 2-3 / day
8) @ home exercises- light housework ie: making beds, dishes, laundry,
Leg lifts 2 sets 10 each
Quad stretch 2 sets 10 each
Heel slides 2 sets 10 each
Steps 2-3 x day
I am getting push to return to work, I am RN who did 12 hour shifts and no breaks

 

[2happy]

I was ill for 2 weeks with acute diverticulitis


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[Josephine]

2) pain meds- Tylenol

As an RN, you should know that I need to know the dose and timing!

 

[2happy]

As an RN, you should know that I need to know the dose and timing!

Extra strength 1000 mg q 4-6 hrs

 

[Josephine]

Thank you so much.

1) pain 1-2 with rest, 3-5 with activity

That's a lot of pain at 15 weeks. But there are occasions when the pain can last a lot longer than usual.

2) pain meds- Tylenol 1000mg 4-6hrly

Gotcha, thank you. And how well does this manage your pain?

3) swelling- none until activity then slight. Positive pitting seems with too much walking or physical therapy.

I would imagine. Seems like you have a problem.

4) flexion 95, only gained 5 % since Jan and after cortisone shot. 5 for extension

Okay ........

5) yes for icing 30-60 minutes after activity/walking/OR
6) yes elevate while icing and when at rest

Jolly good!

7) activities-- light housekeeping, walking 0.5 miles 2-3 / day

Okay

8) at home exercises- light housework ie: making beds, dishes, laundry

My comments in bold
Leg lifts 2 sets 10 each - tip about SLRs - once you can do them you don't need to do them any more!
Quad stretch 2 sets 10 each - hmmm okay
Heel slides 2 sets 10 each - heel slides are very easy to do badly and 20 a day in one session is badly. I suggest you read this Heel slides and how to do them properly. However, at this stage, I would say that heel slides are a) contributing to your swelling and b) hindering your ROM
Steps 2-3 x day - not really sure that this means? How many steps at a time?

I am getting push to return to work, I am RN who did 12 hour shifts and no breaks

Well, quite obviously this is not on yet as 12 hour shifts will certainly make your condition a LOT worse.

I was ill for 2 weeks with acute diverticulitis

When was this? And what medications were used to treat it?

 

[2happy]

@Josephine
1 ) & 2) using lidocaine patches on 12 hrs off 12 hrs...helps
3) I got gut feeling something inside knee is messed up, Ortho appointment 3/21
8) I have cut back exercises until I see Ortho
Diverticulitis diagnosed 2/20 and was on augmentin for 10 days with clear liquids and slow advance in diet. I am almost back to regular diet.
I appreciate and am grateful to you for your advice


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[Josephine]

I got gut feeling something inside knee is messed up, Ortho appointment 3/21

To be honest, I can't see anything in what you've told me to make me suppose that. In my experience, most of these issues are caused by too much/too aggressive exercising.

Apart from your 'gut feeling' what else makes you suspect your knee is badly done?

 

[2happy]

To be honest, I can't see anything in what you've told me to make me suppose that. In my experience, most of these issues are caused by too much/too aggressive exercising.

Apart from your 'gut feeling' what else makes you suspect your knee is badly done?

My knee cap doesn't feel like it moves correctly. I can't walk more than 0.5 mile or stand for greater than 1 hour. Flexion at almost 16 weeks 95, and knee is tight

 

[2happy]

Ortho appointment 3/21--- Ortho said recovery slow go due to previous surgeries. Plan to cont PT, work on flexion and walking. Scope and manipulation -- Ortho said it would be a set back and need to PT. I am working on re-training brain on guarding of knee pain from past 2½ years of issues


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[2happy]

Has anyone heard of 'patella clunk syndrome'?

 

[Celle]

No, but if you're feeling clunking in your knee, it could be this:
Clicking/clunking knee joint after surgery
It is normal and it's caused because you now have hard metal and plastic parts moving over one another, instead of the relatively softer bone and cartilage.
As long as it doesn't hurt, you can ignore it.

MY 5-year-old knee still makes clunking noises, while my 2-year old knee does not. Since they both work well, I ignore the noise.

 

[2happy]

I am now 5 months post op PKR. I was doing better with walking and stairs last 2 weeks. I continue PT 2 x week. I woke this morning with unstable knee--knee cap seems to buckle and get stuck. Also medial side of knee (had medial one), I am experiencing sharp shooting pains with walking. Tylenol does not help. I have elevating and icing, helps until I get up and walk. Hesitant to do anything physical. Should I be worried or is more of 'par for the course in recovery'????

 

[KarriB]

Probably all depends on your activity and what you're doing at PT.

 

[2happy]

Probably all depends on your activity and what you're doing at PT.

Thanks for reply nothing has changed in physical therapy. I am trying to walk more to get ready for return to work. I wish I never had replacement, I have more pain now

 

[KarriB]

I went back and looked at what you're doing at PT and then remembered this article below. Your pain could be from overdoing at PT and you've been at it for so long your knee can't recover. I also remember your under workman's comp. How long will that continue? As Josephine said a few pages back you really don't need to do all that exercising. Just the squats alone you were doing early on are painful and counter productive while trying to heal from surgery.
Would WC keep you from seeking a second opinion?

https://bonesmart.org/forum/threads...e-consequences-of-doing-too-much-of-it.26764/

 

[2happy]

@KarriB. My Ortho ordered PT to be aggressive ! I am so frustrated. I feel as if everyone thinks I am a sissy with pain- PT, Ortho and family. I have tried hard. I just have a gut feeling something is wrong. I have not X-ray since surgery. My swelling was treated with cortisone shot ( who thought I'd still be getting shots after replacement). I have spoken with PT about exercises and to be honest some I do half heartedly. Yes, it's workmen comp and they just want me back to work by mid May. Thanks for allowing me to vent


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[sistersinhim]

I believe that's your problem, aggressive PT. You know that the BoneSmart guidelines stress gentle PT. Your knee hasn't had a chance to heal with this type of therapy. And it stays inflamed all the time. If you stop all PT for at least a month, your knee will heal better,your pain will diminish, your knee will swell less, and its movement improve. Less pain=more healing and movement!