TKR 4 months and struggling

[Jimmycanuck]

I’m 70 and I had my right knee done Oct 26 and I am still having pain issues. It’s still feels tight which is to be expected but still painful where fibia bone meets the knee and snaps when bending as well as painful to lift leg up to my butt when stretching at back of the knee. The surgeon says this is normal and last week suggested an injection nerve block to stop the pain and more pain meds. These issues don’t seem normal when reading other posts here. Should I try and find a different surgeon or just suffer till I try nerve block injections?

 

[EalingGran]

We had surgery at almost the same time.
Mine was on October 25th. Mine was a lateral PKR
I still have some pain in the medial and front part of my knee- which my surgeon says is due to soft tissue issues ( strained MCL pre-op and pain from patellar fat pad). He believes it will gradually settle and I am trying to build up strength in my quads/ glutes/ calves.
It is very hard to know at this stage what is normal/ expected and what is a sign of longer lasting problems.
How bad is the pain? Is it getting better or worse or is it just very variable? How good is your ROM and general function? I can see some areas of improvement which give me encouragement.
I am sure one of the staff will be along soon to give you more advice.

 

[Jimmycanuck]

I’m using my hiking walking sticks for balance and slow walks for 30/40 minutes for last seven days and still have clunking sensation. PT says I have excellent range of motion but most pain is at location where Fibia meets the knee and have snapping sensation and pain is about 7.5 out of 10 when I slide my knee up or whenever standing I bend my knee up
At front of knee it’s tight but not really all that painful
I tried my indoor bike few times for maybe 1 minute at really slow revolution and the pain is about a 9 out of 10 and the pain is at back of knee and spot where fibia is attached to knee
surgeon did X-rays again last week and said everything looks good. I really have buyer’s remorse and presently regret having surgery done. I’m hoping nerve block injection will help but I have doubts as I think it will mask an issue that could get worse

 

[EalingGran]

That level of pain sounds really bad. My residual pain is mostly 1 or 2 out if 10. Occasionally 2/3 if I walk much more than 10000 steps in a day.
I would be trying to get a good explanation from my surgeon if I still had that level of pain or push for more tests.
What was your pain like before the surgery?
Interested to see what staff members will say as I am no expert.

 

[Jaycey]

@Jimmycanuck Welcome to BoneSmart! Have you been icing and elevating that op leg. Ice is a natural pain killer. It will help ease that tight feeling. Ice both front and back of the knee.

The sensations you describe are not unusual. Soft tissues, muscles and tendons were traumatised during surgery. They still need time to firm up around the joint. Don't forget - you are only months into a process that can take one year or longer.

I'll leave our recovery guidelines here for you:

Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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​

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. Here is a very general week-by-week guide. Activity progression for TKRs

6. Access 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 a 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 history before providing advice.

 

[Jimmycanuck]

Thank you , this is really good info . I didn’t know I would still have much healing to do after 4.5 months.

 

[benne68]

@Jimmycanuck Something else to keep in mind is that the muscles and soft tissues have to adapt to the new alignment of your leg.

Prior to surgery, as our knees deteriorate, our bodies make adjustments to ease the pain. These changes are subtle and, because they occur slowly, we don't even notice that we are favoring the leg or limping or splaying our foot out to the side. We live with that bad alignment for so long that, when the knee is fixed and our alignment is corrected, all the surrounding tissue has to "relearn" what to do.

It does get better. It just takes time.

 

[Layla]

Happy Four Month Anniversary, Jimmy!
Yes, it will get even better, easier, more fun.
Wait till Summer and you'll be feeling like this ->
All the best! @Jimmycanuck

 

[Jimmycanuck]

Thank you. I hope it does. I went for a slowwwww 20 minute walk this aft and It still feels same as a month ago. Hopefully the knocking goes away as its very distracting.

 

[Kml]

I had a total knee replacement on January 10th and I am still having quite a bit of pain. My knee feels very tight and has weird burning sensations sometimes. I think the burning is nerve pain. My ROM exercises are quite painful and I still walk part of the time with a cane. My leg was bowed so the surgeon fixed my alignment so I think that is why I’m struggling some with my balance. I really thought I would feel better by now,

 

[sistersinhim]

@Kml, welcome to Bonesmart. How about starting your own recovery thread and telling us all about yourself? This is Jimmycanuck's thread and you don't want to railroad this.

 

[sistersinhim]

Hopefully the knocking goes away as its very distracting.

You will learn to ignore this knocking or it will completely go away. I still have knocking with certain movements. Of course, with no kneecap, I can really hear it, but I know it's just the plastic running over the implant and nothing wrong with it.

As long as your knocking isn't causing you a lot of pain, I think it's OK. If you continue to stress about it you should call your doctor and get his/her comment about it.

 

[Jimmycanuck]

Update. Today is March 5 . TKR Oct 26 2022. Tomorrow I see a second surgeon for (I lost count) The pain today is same if not worse than 3 months ago. Knee knocks like crazy and pain back of knee up the thigh and down to ankle as well as front of knee and down shin to ankle and lots of swelling . My original surgeon is sending me to this surgeon for second opinion on wether or not to reopen my knee and attempt to fix things. To say this experience has been depressing is an understatement. . After I see this surgeon I see my original surgeon 3 weeks later for final decision.
I truly wish I had never gotten this surgery done. I had much less pain , greater mobility and less depression
Call it Buyers Remorse. I’m hoping there is a light at end of this huge dark tunnel

 

[EalingGran]

Sorry to hear of your troubles and I hope you can get an answer from this new surgeon as to why your knee is so painful and clunky.

 

[Jimmycanuck]

Update: it’s now been 4 months and 3 weeks 2 days since TKR. It’s amazing what results one can get when using a good physio therapist and a second opinion surgeon that fully explains and demonstrates new prosthetic and answered all my questions, even the dumb ones. After a few really deep leg massages and 4 extra weeks physio, this morning I walked at my normal gait for 1 klms on walking track at my PT office. WOW did it feel strange yet awesome. A few hrs later ( this aft) I walked around my neighborhood on sidewalks for about 1.5 klms. My knee is still somewhat stiff especially first thing in morning but the physio sure helps to make it easier to do all proper stretches and exercises for the TKR.
Today has been the best day I have walked in over 2.5 years.

 

[sistersinhim]

What a wonderful improvement you have had! It's great to hear.

 

[Jammy]

Great to hear this news. I know how frustrating this can be and have also regretted doing this. Hopefully I'm on the mend now after three months, but I still have pain and walk like The Monster. You just have to look at the benefits of doing this way down the road. Recuperation takes a lot longer than I was advised. I keep hearing "a year." Yikes. Sounds like you're on your way to feeling better. Please make sure your PT doesn't do anything that hurts you. It seems you have a good one, so hopefully not.

 

[Jimmycanuck]

New update: 5 full months
More PAIN front of knee below kneecap and Painful to put weight on knee and back to needing walker.
This is not a fun journey

 

[Jockette]

painful to lift leg up to my butt when stretching at back of the knee.

I would stop doing this stretch, your knee is not ready for it, thus the pain.

this morning I walked at my normal gait for 1 klms on walking track at my PT office. WOW did it feel strange yet awesome. A few hrs later ( this aft) I walked around my neighborhood on sidewalks for about 1.5 klms. My knee is still somewhat stiff especially first thing in morning but the physio sure helps to make it easier to do all proper stretches and exercises for the TKR.
Today has been the best day I have walked in over 2.5 years.

I think maybe, in your happiness at waking so well, that you overdid it, and walked more than your knee was ready for. 5 months is not yet halfway healed, in this year long recovery, and we need to pace ourselves according to what our knee is ready for.

Don’t look at a slow pace as doing nothing, or not working hard enough, look at it as giving your knee the best opportunity in which to heal. Recovery is temporary, you’ll get to the end, just not as fast as you’d like.

 

[VA Mom]

@Jimmycanuck , I’m so sorry you’re having pain again. Perhaps another visit to that second surgeon may be in order. But, before that, keep trying to do as much rest as activity. And, maybe see if that good physical therapist has any recommendations?