Lounge Doctor

TKR 8 months post op and knee getting worse

krobar

new member
Joined
Mar 20, 2021
Messages
6
Age
61
Gender
Male
Country
United States United States
Had my knee replaced 9 months ago and recovered well initially and regained an excellent ROM according to my PT and doctor, they said i was in the top 1 percent.

At about 4-5 months my knee started bothering me and i feel i've been going backwards since. At my 8 month check up the doc drained 20 cc's of fluid which was the third time since surgery that he had to drain it. Even after the draining it is very stiff, warm to the touch and feels like it's encased in wet concrete. A couple weeks ago they ordered blood work to see if there was a deep infection as i had cellulitis in my big toe which occurred around the time i stopped making progress. The blood work showed no signs of infection.

Regardless, something is not right. I have pain going up and down stairs, the area around the top of the tibial plateau aches even while seated or reclined, i also am experiencing a pain on the kneecap which feels very similar to the feeling you get from e stim, like a sharp twinge similar to an electrical shock. I am seeing the doctor this Monday and am not sure what he's going to suggest next.

I wonder if there still is a chance there could be an infection. Been reading up on bone scans, arthrograms, CT scans, MRI's. I read where it could be loose parts or soft tissue problem. I'm probably doing too much research. I appreciate any info others can share.
 
Last edited:

Pumpkln

MODERATOR
Moderator
Joined
Oct 27, 2011
Messages
25,374
Location
United States, West
Gender
Female
Country
United States United States
@krobar,
Welcome to BoneSmart, glad you joined us!! :welome:
Sorry to hear after a great start things have gotten worse.
Have they done any cultures on the fluid drained from your knee? That would show if you had an infection and which pathogen.

On Monday your surgeon should be suggesting further imaging, likely a bone scan which will show increased metabolic activity if your prosthesis is loose. Ask about the cultures of the fluid in your knee, if he has done one, they should have the results.

Recommend you seek a second opinion for your TKR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled knees. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!
 

TimeBuster

member
Joined
Apr 30, 2019
Messages
136
Age
65
Location
New Jersey
Gender
Male
Country
United States United States
If your doctor didn't culture fluid after three times post-op, my question would be why not?
Things that make you go Hmm.

Good luck with your next appointment.
 
Last edited by a moderator:

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
23,867
Location
Virginia
Gender
Female
Country
United States United States
I agree with Pumpkln that you should be getting a second opinion. One from a doctor that has no connection at all with your current doctor, not even a social connection. You want someone looking at your knee with fresh eyes.
 

eaglemom

graduate
Joined
May 26, 2013
Messages
531
Age
63
Gender
Female
Country
United States United States
I agree about a different opinion. However, I'm afraid you'll run into issues trying to see someone else. The rule of thumb is usually no other surgeon will see another surgeons' work until its at least 1 year old.

Don't be surprised if the new surgeon wants all of the surgery notes. Start getting those things in order now for when your one year is up.
 
OP
OP
K

krobar

new member
Joined
Mar 20, 2021
Messages
6
Age
61
Gender
Male
Country
United States United States
Met with my doc yesterday, drained another 20 cc’s and sent to some out of state lab to test for infection. He’s pretty sure there’s no infection, went through my most recent X-rays as compared to post op X-rays. No evidence of loose parts he says. Ruled out scar tissue as my ROM is so good. He told me everyone’s body heals differently and that this is normal, for me. It sure doesn’t feel normal.
 
OP
OP
K

krobar

new member
Joined
Mar 20, 2021
Messages
6
Age
61
Gender
Male
Country
United States United States
July 2020, left knee
 

Jockette

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Aug 29, 2017
Messages
20,769
Age
65
Location
Delaware
Gender
Female
Country
United States United States
July 2020, left knee
I’m sorry to be so technical, but can we have the day of the date also?

How is your knee feeling now, any improvement?
 

kahoona310

new member
Joined
Mar 5, 2021
Messages
6
Age
64
Gender
Female
Country
United States United States
Feb. 5, 2021. At this point, I haven't had one day without pain.
 

FCBayern

FORUM ADVISOR
Forum Advisor
Joined
Oct 11, 2011
Messages
1,650
Age
61
Location
Roatan
Gender
Male
Country
Honduras Honduras
My first 6 weeks were pretty tough @kahoona310, but it does get better and I couldn't be happier with my results now.
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
44,106
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
Your ROM is good, @kahoona310 . It might be a good idea to ease off the exercising and spend extra time elevating and icing your knee, to see if doing that reduces some of your pain and swelling. Just use your knee during your activities of daily living (ADLs) for a while - that's exercise too.
 

Jockette

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Aug 29, 2017
Messages
20,769
Age
65
Location
Delaware
Gender
Female
Country
United States United States
What is your activity level? What exercise, if any, are you doing? If you have a job, does it stress your knee? Do you go up and down stairs often?
 

kahoona310

new member
Joined
Mar 5, 2021
Messages
6
Age
64
Gender
Female
Country
United States United States
I was 7 weeks 3 days out and progressing not without pain but it was bearable and getting a good 4 hours of sleep a night. PT was progressing slow and steady. My surgeon was pleased. The next day my PT decided to "break up scar tissue" at the end of my session (mind you my surgeon mentioned nothing of this the day before at our visit) and PT said "this may hurt a bit". He pushed down so hard and slowly I told him to stop and he continued "3..2...1..".I asked him what the hell was that and he said this is helping to heal the knee faster, that he was going to do it one more time, gentler (no pain, no gain, right?). I grabbed his hand and stopped him. I limped out to the car and my husband was so mad. That night I was almost in as much pain as day one of surgery. Next day I called the NP, crying (she was concerned because she never heard me in that much pain before). She said "Scar tissue?". I was told to rest and ice, for at least 2 days, Tylenol, Ibuprofen, high knee elevation, Oxy for break through pain, NO PT for 2 weeks. but continue home exercises as tolerated. If after 2 weeks no improvement call and be seen by surgeon. Getting slowly better but I am furious I was set back weeks.
 
OP
OP
K

krobar

new member
Joined
Mar 20, 2021
Messages
6
Age
61
Gender
Male
Country
United States United States
What is your activity level? What exercise, if any, are you doing? If you have a job, does it stress your knee? Do you go up and down stairs often?
i go to the gym 5-6 days a week, alternating between stationary bike, eliptical some stairmaster. My doctor knows me from the gym and knows how intense i work out and he says dont hold back. Only thing he said to avoid was leg extensions. I am up and down stairs at work a number of times as im self employed and need to load customers with my forklift
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
44,106
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
I think you're trying too hard and doing too much. Recovering from a joint replacement isn't like training for an athletic event.
Doing too much exercise is counter-productive - it keeps your knee irritated and swollen inside.
TKR recovery and an analogy to athletic training
.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.
Knee recovery - Lose the Work Ethic!!

I suggest you ease off the gym sessions and spend much more time resting, icing and elevating your knee, to help it calm down and reduce its internal and external swelling.
 

New

Active Antibacterial
STEPS Challenge

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
54,855
Messages
1,429,466
BoneSmarties
34,001
Latest member
Jolaw
Recent bookmarks
0

Top Bottom