TKR Second Opinion

[CiscoKid7]

So I had my TKR, 7-16-2020. I have bruising behind my calf, some bulging behind my knee, and bruising up most of my back side of leg. At 4 months surgeon side it's Ok, physical therapists say not normal. Got 2nd opinion, at 6 months, and he couldn't tell me anything. Now it's over 8 months, and it's still there. I have pain and tightness mainly in morning, and at night. I am seeing physical therapist again today, for the maybe third go round of treatment. I had no pro-op issues, except being on diabetic pill for 12 years, and borderline blood pressure. What can be done about bruising and pain? help, the CiscoKid.

 

[Celle]

Hello @CiscoKid7 - and

Thank you for telling us your surgery date. I've put it into your signature, for easy reference and I've added your name to the July Sparklers 2020 surgery team thread.

A certain amount of bruising post-op is inevitable. See this article: Bruising after surgery

But to still have bruising to the extent that you do is unusual and I think it needs further investigation.

The bulging behind your knee could be a Baker's cyst. Baker's cysts and other knee bursae
That should resolve itself, but you can ease some of the discomfort by icing the back of your knee. Make sure that you have several layers of material between the icing medium and your skin, so that you don't get "freezer burn".

As for the bruising, it could be because one or two blood vessels are continuing to leak. That should have stopped by now, so I suggest you go back to one of the surgeons you've seen, remind them that you are now 8 months post-op and you would like an explanation and some treatment. You may have to be firm about this, so take someone with you if you can, for moral support and to back up what you're saying.

If possible, can you post a photo of the bruising for us, so we can see its extent?
Uploading a picture or x-rays in a post

 

[Celle]

I know it's quite a while since your surgery, but the recovery guidelines contain some articles that ae still useful for you, such as the one about icing.

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.

People 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 are the final judge as to the recovery approach you choose.
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. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[CiscoKid7]

 

[CiscoKid7]

It goes up almost the whole back side of my leg.

 

[Celle]

I'm relieved to see that it doesn't look like new bruising. That was my concern.

It might be persistent brown staining from the iron content in your original bruising. I had brown staining for some time and my doctor told me that's what it was.

Because of the effect of gravity, any bruising in and around your knee is going to migrate to the back of your leg,

See your surgeon again (or show him/her your leg via teleconference) and tell him that both you and your PT are concerned. Ask him if there could be a reason why bruising is persisting for so long, and when he estimates the bruising will fade away.

 

[Jamie]

You mention that you have pain. How serious is it (scale of 1-10)? What makes it worse and does anything make it better? Where is the pain on the back of your knee according to this chart?

 

[CiscoKid7]

Left front: LF3-CDE, LF4- CDE, and LB4- D, and LB-3-D

 

[CiscoKid7]

Pain can be up to an 8, and is in morning, and worst at night. Ice, and elevation seems to help

 

[CiscoKid7]

Worst is LF3-D!

 

[eaglemom]

I'm sure you've tried this, but I'll ask anyway. Have you tired icing the back / side of your leg? It seems we always get trained to simply ice the front of our knees when the back side needs it also.

I'm certainly NOT comp airing our knee situations, as we know we are all very different. But I'm at 17 months and still have bruising down my leg. Because of the extent of the type of surgery that I had my surgeon put my recovery at 18 to 24 month, and longer. Ugh.

Switch up the ice, make sure your elevating high enough and a schedule for pain medication. See if that helps at all.

 

[CiscoKid7]

Thank you eaglemom. At least unfortunately I'm not alone. I will pray for you, thanks, CiscoKid7. Did you receive a 25 year knee?
What is your pain medication schedule look like, as I need all the help I can get?

 

[CiscoKid7]

Going on 13.5 months, and still bruising behind my leg, on calf, joint (and swelling) and lower thigh. Surgeon says give it a year, him not realizing it's past a year! Duh. No op complications though. Was something cut?

 

[CiscoKid7]

Need a knee surgeon for a second opinion out of my area, that is honest, and good, thanks, Joe. Zip code 61265.

 

[Jockette]

Hi, Joe, I‘ll tag @Jamie for you, she might be able to recommend a surgeon for you. It’s disheartening when our surgeons don’t look at our details enough before advising us.

While many of us continue to improve in our second year (I did!) it’s good to get a second opinion at the one year mark, if you’re not sure you‘re recovering well.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you. You can always bookmark this thread so you can find it easily.

Best wishes on your continuing recovery!

 

[Jamie]

You'll probably need to drive a bit to see a good revision surgeon. If you're willing to go to Chicago, here are some recommendations:


Midwest Orthpedics at Rush
Chicago, IL
877-632-6637
http://www.rushortho.com/scott_sporer.cfm
Dr. Scott Sporer
Hip and knee revisions
Speaker at 2018 ICJR workshop on problem hips and knees

Dr. Brett Levine
Complex hip and knee revisions

Dr. Craig Della Valle
Hip and knee revisions

Dr. Richard Berger
Adult reconstruction hip and knee

Dr. Wayne G. Paprosky
Midwest Orthopedics of Rush University Medical Center
Northwestern University Joint Replacement Institute
Winfield, IL
Speaker at 2018 ICJR workshop on problem hips and knees.
Works with patients who have significant bone loss.


Illinois Bone & Joint Institute
847-375-3000
Dr. Jeffrey Goldstein
Hip and knee revisions

Crystal Lake Orthopedics
815-398-9491
Dr. Frank Bohnenkamp
Hip and knee revisions
Dr. John Bottros
Hip and knee revisions

Midwest Bone & Joint Institute
855-625-2663
Dr. Vincent Cannestra
Hip and knee revisions

 

[eaglemom]

While your waiting to get a second opinion - use this time to get all of your post-op paperwork & surgery reports. Usually when you see a different surgeon than the one whom preformed your procedure they want to "review" everything prior to seeing you. If you have it now that can help speed up the process.

 

[CiscoKid7]

I will be seeing a Surgeon from Rushortho, on Monday, and I can't wait! But I think it might be a ruptured Baker's cyst, ( I failed to tell you about growth behind my knee) that is starting to grow again, per medical doctor, I know. Hopefully we'll see Monday. Thanks, Bone Smart.

 

[Jockette]

I hope you have a good appointment and get some answers.

 

[CiscoKid7]

Well after all these 15 months, of 2 surgeons not wanting to do their job, and avoid me from a my pain and suffering, by just ordering me an ultrasound, I have been finally diagnosed with a Baker's cyst, which probably came from the surgery, with all my bruising which still persists. Well will see how this next doctor treats it. Thank you bone smart, for letting be rant. I hope nobody else has to go through such an ordeal.