PKR 9 weeks post half knee replacement

[EalingGran]

I am now 11 and a half weeks post lateral PKR surgery and just notebooking my current situation before I see my surgeon on 18th. So sorry for long post but just trying to clarify my thoughts.
It is a bit of a curate's egg with some good and some definitely not so good.
Not currently helped though, by still feeling very rough with a chest infection/ no appetite/poor sleep/ no energy. Feeling fed up as it is our Ruby wedding anniversary tomorrow and we were meant to be in Sri Lanka for a holiday to celebrate - but had to cancel because of my joint problems and surgery. Not even sure if I am going to be able to enjoy lunch out tomorrow. So definitely feeling sorry for myself and glass more than half empty.
On the good side.
My scar is beautiful. Glued so it is really neat and perfectly healed. Less than 4 inches long.
My leg which was previously over 20 degrees valgus is now pretty much straight and my gait is much better than pre-op.
The general post op pain and stiffness is definitely improving and my knee no longer swells or gets warm very much if I walk 10000 steps in a day. Until this recent chest infection my sleep was getting better and I am more comfortable in bed at night than in the early weeks.
I have managed to stop all my painkillers except for occasional paracetamol. The idea for this was to see if my previously severe hip pain came back now my leg is straight. I have moderate hip arthritis and lumbar arthritis with some stenosis. So far after two weeks the hip is ok- so probably won't go on waiting list for hip surgery. I am having an ultra sound of the hip on 17th which might also be informative.
I no longer have much if any pain at rest, although I didn't really have much resting pain pre- op.
The pain I had pre- op in the back of my knee ( I think from my Bakers cyst) has gone.
My supra patellar bursa has gone and my Bakers cyst has shrunk post op.
I have great ROM 135 flexion/ 0 extension on operation side compared to 145 flexion/ 0 extension on my untreated leg.
The not so good side.
I still have moderately severe twinges of pain in the medial side of my knee if I put too much weight on my bent leg- particularly if knee is not directly above the ankle but pushed even slightly forwards. This means I can not really walk up or downstairs normally. This is very similar to some of the pain I had previously and I worry that it is due to the untreated medial compartment of my knee. This did definitely have some arthritis- although my surgeon who is a big proponent of PKR thought it was basically OK.
Similarly I still have some crepitus and occasional pain in the femoro patellar joint- which similarly had some definite arthritis on MRI but my surgeon did not think would trouble me once my leg was straight.
I still get some medial knee pain if I walk more than one mile. Further I have tried so far is about one and a half mile walk.
In conclusion I think my surgery is fine but I worry that perhaps I would have been better with a TKR for full pain relief.
I think I am going to have to make the best of things as I guess it is still early days and I certainly don't want any more surgery.

 

[JusticeRider]

Oh EalingGran, I am sorry about your anniversary trip How many years is the ruby anniversary? That must be so disappointing, and nothing you could have helped! Hopefully you can go next year instead? And have twice as much fun because you’re celebrating TWO anniversaries in one! We were supposed to go to Greece for our 20th anniversary in July 2020 and you can probably guess how that turned out! I hope you can enjoy a special lunch with your other half tomorrow and try to focus on the love you have for one another that has carried you this far

I’m sorry too that you’ve been sick and that certainly doesn’t help the mood. Recovering from this surgery is hard enough. But it really does sound like you’re recovering very well! I’m impressed with your 10,000 steps a day! And your ROM is amazing. It’s really great that your pain levels are so low too! But I can also understand worrying about those other two compartments in your knee. That’s the scary thing about the partial, isn’t it? Hoping the rest of your knee can stay healthy and last as long as possible.

Let’s hope that as your knee gets stronger and stronger, there is less stress on your knee as a whole and it will function better and with less pain. And those other two compartments will last you for many years!

So sorry for long post but just trying to clarify my thoughts

Hahahaha…I am the queen of long posts! Take this one for example! Sorry about that
Wishing you the very best, always, and especially tomorrow for your special day. Happy anniversary!!

 

[EalingGran]

Thanks so much for your kind wishes- it is 40 years. So hard to believe where all the years went and our kids are now 38 and 36.... I shouldn't feel sorry for myself as we are extremely fortunate and my husband has been a treasure recently. Even made me a cup of tea at 2 am when I was coughing so much

 

[JusticeRider]

40 years! So inspiring! And he does sound like a gem…making tea in the middle of the night That’s wonderful.

 

[EalingGran]

@JusticeRider Thanks- yes he really has been a gem especially over last few months.
I have still been pretty rough in last few days but definitely slightly better from cough- thank goodness.
Feeling more positive and going to do an update just to be able to properly remember where I am up to.

Now 12 weeks post PKR.
Stopped all painkillers 2 weeks ago- mainly to see if my severe hip pain came back once my knock knee had been corrected. So far, so good- no hip pain but knee pain and lower back pain have got worse. Turned down booked hip injection

My main worry is the medial knee pain- worse on stairs and very similar to one of the knee pains I had pre-surgery. My fear was that my surgeon had been over-optimistic in doing a PKR as the MRI report did show both medial and patellofemoral arthritis as well as very severe lateral damage.

Had a really good and thorough appointment with my surgeon this afternoon. He examined me carefully and showed me the actual preoperative MRIs in detail on a good big screen. He is sure after seeing both the pictures and the inside of my knee in surgery that there is too much cartilage medially to be causing the pain. He says it is soft tissue pain probably from the medial collateral ligament which was stretched and 'unhappy ' on the pre-op MRI and is now doing things differently with a re-aligned leg.

He admitted he is a big enthusiast for PKR as he thinks it is a better operation for a lot of patients and that he occasionally can be a bit over-optimistic- but that my medial compartment was 'pretty pristine".
The bit of pain at front of the knee - he is sure is due to some post-op stress/pain in the patellar fat pad and will settle. Apparently, he drilled a hole in the patella as part of lateral PKR which apparently you don't need to do for medial PKR and that takes a while to settle.

The hip MRI is not that bad and in his view, I may go years without a problem now my leg is straight and realigned.

He has given me a follow-up in 6 months just in case things don't settle or my hip flares up and the name of a really good back consultant in case sciatica recurs and I need an injection. Feeling much more hopeful.

 

[JusticeRider]

@EalingGran , great report! I’m so glad your hip pain has subsided and you don’t have to worry about that right now. I hope your cough will clear up very soon and then you can just concentrate on healing your knee.

It sounds like you had a really good appointment with your surgeon! Hopefully that set your mind at ease. He sounds very knowledgeable about PKR’s, and it’s so nice that he takes the time to explain things thoroughly. There are so many different little aches and pains and twinges that pop up during this recovery. It can be scary, and it’s always good to hear ‘it’s OK, this is normal, don’t worry’.

I didn’t know they drilled through your patella for a lateral PKR! Now I’m curious. I know I read about patellofemoral and medial PKR’s but now I’m not sure if I actually saw anything about how the lateral one works. As you know, most of the info out there has to do with medial. How did yours work (if you don’t mind sharing when you have time)?

Anyway, thanks again for the update! Just know that we are all here rooting for you and cheering you along the way! You’re doing great EalingGran

 

[EalingGran]

If you put Oxford Fixed Lateral- surgical technique into Google you can get the 25 page surgical technique manual from Zimmer Biomet. It is really remarkable what level of information is out there.
I have tried reading it but can't quite figure the patella part.

 

[JusticeRider]

Oh wow, thanks EalingGran! I’ll check it out. I find all of this fascinating! I could never be in the medical profession because I can’t stand blood, suffering, needles, etc, but the information part is so very interesting to me! Since my (actual) work is very physical in nature, I am still not working so have lots of time on my hands for reading.

 

[Layla]

Hi EG
It sounds like you had a good visit with your surgeon on Wednesday. He seems very thorough and conservative not rushing into anything. Good news that he feels you have some mileage left on your hip. I hope it's years! Thanks for sharing the good news of your appointment.
A wonderful week to you!
@EalingGran

 

[EalingGran]

@Layla Thanks for popping by.
@JusticeRider Thanks for your good wishes.
I am feeling generally better as my cough is finally improving a bit as well.
I am going upstairs more normally at least some of the time. We have an old Victorian house on three floors with steep staircases- so I go up and downstairs a lot. I can now do 2-3 flights of stairs normally/ day but I still tire easily and it gets sore if I try to do the stairs normally all the time. Still it is definitely progress.
I can walk a mile and a half with very minimal ( 1-2/10) pain on no painkillers but I went to a big exhibition today and I found stopping and starting and standing a lot looking at the pictures made my knee more sore than walking.

 

[JusticeRider]

If you put Oxford Fixed Lateral- surgical technique into Google you can get the 25 page surgical technique manual from Zimmer Biomet.

Wow EalingGran, that was very detailed and almost graphic with all the descriptions of tools and instruments and cutting and drilling! My patellofemoral components were also Zimmer, so maybe there’s a manual for that one online too. Not sure I want to read it though! I read my surgical report that was pretty descriptive but not as much carpentry talk as this. On the other hand, I now know that there’s a tool called a ‘curly whirly’???

 

[Layla]

Happy Three Month Anniversary!
I hope your cough is easing and you've recovered from visiting the exhibition on Sunday.
Thanks for all of the support you offer others around the form. It is appreciated.
Have a great Thursday and wonderful weekend!
@EalingGran

 

[EalingGran]

@Layla Thanks.
I am doing ok overall despite the medial twinges if I do too many stairs the normal way going up. I can still only do a few steps going down the normal way though.
I actually travelled on the tube to Central London by myself for the first time since my operation. It was good not to be so dependent on having my husband with me. It was to have lunch with a couple of old school friends in an Italian restaurant. I carried my crutch but the only time I used it was getting off the train as there was a step/ gap. I feel this is real progress- now home and resting with some ice and feel good.

 

[sistersinhim]

This is a big success story!

 

[Layla]

Great update and progress you're making! You're doing so well and what an accomplishment to successfully travel alone to Central London to dine with friends at an Italian restaurant. Sounds like fun! May it only get better with each passing month.
@EalingGran

 

[kneeper]

It sounds like you're making good progress. It is true that standing can tire out the knee more than you'd think. And certain types of walking or different steps can have their own challenges. But you're getting there!

 

[JusticeRider]

EalingGran, I’m so glad you got to go out, have some fun, and feel some independence again! That’s a milestone! Hope you’re doing well today.

 

[EalingGran]

@JusticeRider Thanks.
A bit more stiff and sore yesterday again.
Probably because I overdid it a bit. I had a credit for a reformer pilates session that I cancelled just before my surgery. It was due to expire- so I thought I would try the reformer machines. I enjoyed the class but definitely a bit more sore last night. It really is two steps forward and one step back for me.
How are you doing? Hope your progress is more steady these days.

 

[EalingGran]

Thinking about my recovery and current pain twinges particularly on stairs.
I wish I had discovered BoneSmart earlier and done some of the knee score tests from the links here earlier. I wish I had my pre-op Oxford knee score for comparison.
I also wish I had used my fit bit to time my walking speed pre- operation. My husband reckons I am walking faster now than I was before surgery.
I suspect I am better now than before my operation but it is still a bit marginal and it would be good to have objective evidence.

 

[beachy]

You're still in the early part of recovery. At 3 months you're going to have different kinds of pains here and there. Nothing like the weeks post op, but the knee is still healing.
My first tkr recovery was pretty good. By 5 months I was basically pain free and able to walk a few miles. You'll get there!