TKR 3 months out/ snapping sharp pain on left front of knee

[Brbmks]

TKR (L) on September 12. I've been in Physical thrapy since10 days after surgery. My ROM is very good however when I walk I get a sharp pain like something is catching in the front of my knee. It doesn't happen all the time but when it does it hurts like heck and makes me hesitant to walk with a regular heel/toe gait. I wennt back to surgeon last month and he said everything looked good and just to continue with PT. Physical therapist has beeen doing everything but said at some point there is going to be nothing more that PT can do. I had a R TKR done in 2020 so I know what to expect and this is something very different from the last knee.Has anyone else had this situation?Is there someone on here who might have an idea what this is? I am very frustrated

 

[hikertina]

I had my knee replacement on 9/27 and close to my 3 month mark.
I had a similar problem and one of my super smart PT‘s figured out it was related to IT band. He worked on IT band tightness with these tools (a bit painful for sure) but once tightness worked out pain was gone. He also told me to use lacrosse ball to massage trigger points

Of course not sure same thing but just throwing it out there

Tina

 

[Jockette]

I’m sorry you are having such a pain at this point. As you have found, no two knee replacements are the same, even on the same people.

How often do you go to PT and what do you do there?
What exercises do you do at home?
What activities are generally part of a normal day for you?

Here’s a refresher course for you:

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

​

​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[ski_bum]

I had my knee replacement on 9/27 and close to my 3 month mark.
I had a similar problem and one of my super smart PT‘s figured out it was related to IT band. He worked on IT band tightness with these tools (a bit painful for sure) but once tightness worked out pain was gone. He also told me to use lacrosse ball to massage trigger points

Of course not sure same thing but just throwing it out there

Tina

@Brbmks
@hikertina
Bomesmart has a great post about IT Band. Use search top right IT Band.

I have & had 2 IT Band issues and found relief by using a roller.
Leg in the air and roll from above the knee to the hip. Works for me.
Good Luck.
Don

 

[Brbmks]

I was out of PT for a few weeks due to the flu- but I started back again this week 3x a week. I start with a therapy ball and roll my feet back and forth over it as well as do some bridges with it while lying on table. Not painful, I also do sit to stand, calf stretches, up and down a step, sitting leg raises and end with the bike for about 10minutes. Therapist also does a lot of massage on knee and thigh. I used to walk outside quite a bit pre surgery as well as volunteer at a nursing home, but this snapping pain is prohibiting that. I do go up and down the stairs, do laundry, etc. Doctor also wants me to walk a mile a day which I just can't do yet.

 

[Jockette]

That is a huge amount of PT for a healing, 3 month old knee. I suggest you consider cutting back quite a bit, and give your knee some down time so it can heal. The pain you are feeling could very well be from overdoing all this activity.

Often, our medical team has a one size fits all protocol and they don’t consider each knee individually. Maybe you were able to do all this with the first knee, but this knee apparently isn’t healed enough yet to do all this. In many cases, less is more.

Don’t look at cutting back (temporarily) as doing nothing, look at it as giving your knee the best opportunity in which to heal. Give your knee time to heal and you will gradually get back to doing the things you want.

 

[benne68]

I agree with @Jockette that you should take a break from PT for a while, @Brbmks. Unfortunately, many physical therapists do not understand what is needed after knee replacement and use the same protocols they would for someone recovering from an athletic injury. They are not the same!

However, if you don't stop completely, at least cut out the bridges and sit-to-stand exercises. Both put a lot of stress on a recovering knee (even if it doesn't hurt when you are doing it.) Also, be sure that the resistance on the bike is set to zero so you aren't putting pressure on your knee.

At this stage in recovery your bones, ligaments and tendons are still healing from the trauma of surgery; it's too soon to be doing exercises designed for building strength.

Good luck.

 

[Brbmks]

I had my knee replacement on 9/27 and close to my 3 month mark.
I had a similar problem and one of my super smart PT‘s figured out it was related to IT band. He worked on IT band tightness with these tools (a bit painful for sure) but once tightness worked out pain was gone. He also told me to use lacrosse ball to massage trigger points

Of course not sure same thing but just throwing it out there

Tina

Thanks, Tina. I will talk to my physical therapist. He does do a lot of deep massage in that area so that's probably what he is trying to do. I will also find something to help roll out my thigh and see if that helps on my own.

 

[sistersinhim]

I bought an old-fashioned roller pin to roll on my IT band. I still have to do it every week or so. Those things just don't want to go away!

 

[Claire56]

@Brbmks I had a similar problem that turned out to be a "floating body" at about 6 o'clock slightly behind the kneecap. It showed up on the standard X-rays. Any way you could get your doctor to look at this possibility? Maybe an ultrasound?

 

[Layla]

Happy Four Month Anniversary and Happy New Year too!
How are you doing since you last posted? Hopefully well and pleased with your progress. Let us know as time allows.
Until then, all the best to you!
@Brbmks

 

[Brbmks]

Hello and Happy New Year to you (a bit late). I'm almost 6 months out and still have pain in the knee when I roll off the ball of my foot. Additionally I've been getting a lot of pain in the hip area down to the knee. I was told I have bursitis in that hip and have gotten some injections but this is the worst its ever felt. X-ray shows minimal hip arthritis. I was doing better for a while and then the knee and hip pain started up again. I try to walk every day for at least a mile. I see the surgeon this week for a 6 month check,so I'll see what he says.

 

[Layla]

Aww, I am sorry you're dealing with pain in your knee and your hip also. With any luck the hip arthritis progresses very slowly. I hope you have a good visit with the surgeon this week. Let us know how it goes.
Take care!
@Brbmks