PKR One Year Out - Pleased With Outcome

[EalingGran]

I am 9 weeks post a right lateral compartment knee replacement ( fixed lateral Oxford implant) and I don't know how well I am doing. It seems hard to compare my progress with TKR blogs.
Some sites say half knees should heal twice as fast as TKR and you read blogs on some surgeons' websites with patients playing golf/ driving etc at 6 weeks.
I am 66, have a BMI of 24 and was never that sporty. I was a bit hypermobile ( could put hands flat on floor with legs straight and knock kneed from childhood.
I developed a Bakers cyst 2 years ago and supra- patellar bursitis and pes anserine bursa. My knee MRI showed severe lateral arthritis but I also had moderate medial and femoro- patellar arthritis. I had become much more severely knock kneed on the affected side before surgery. The leg was very twisted and an orthotist said my right leg was 2.5 cm shorter ( my surgeon said that that was just due to the knock knee and legs would be equal post surgery) . I also have moderate hip arthritis on right and fairly severe lumbar arthritis with episodes of severe sciatica on the right.
Since surgery my range of movement is excellent 135 degrees flexion and fully straight extension. The surgery has straightened my leg and my husband says I am walking better and faster than pre-op. I am doing all my exercises religiously 3x day and having private pilates once a week. The supra patellar bursa has shrunk and so have the Bakers cyst and pes anserine bursa.
But I still get soreness/ some swelling of knee and upper calf and mild warmth of knee. I can walk 10000 steps/ day if I go steadily and ice my knee frequently. I can walk freely without a crutch but take it out because of ice/ wet leaves and use it on uneven ground and on steps.I have a aircast cryocuff and I am using it a twice in the day and re- applying it regularly at night- otherwise I wouldn't sleep. I am just taking one naproxen in the morning and paracetamol or ibuprofen at night plus zopiclone 3.75.
Sleep is difficult- even slight soreness keeps me awake and not helped by 2 colds/ chest infections post op.
I still have more severe twinges if I put too much weight on the bent leg so still going up and downstairs one at a time.
I wonder if some of this is residual arthritis in the unoperated compartments. At my 6 week check my surgeon thought I was doing ok and about average in terms of pain/ recovery. He said I would still improve up to 12 months or more.
I sometimes think I am doing ok but at other times feel quite depressed. I know a couple of people with medial knee replacements who are back to normal.
I find it hard to gauge what is reasonable given that most blogs are for TKR and most UKRs are medial not lateral. My knee wasn't that painful pre- op ( my surgeon said that lateral compartment arthritis is less painful than medial and presents very late). The reason I went for surgery was I was shocked by the worsening deformity and the twisting seemed to be contributing to the hip pain and sciatica ( which are better post op).

 

[FourCats]

Welcome! It sounds like you’re doing very well. Your surgeon is correct that you will continue to improve in the months ahead. It’s at least a year long process of healing.

No two surgeries are alike. Please don’t compare the stories of others with yours. I had both knees replaced within a year of each other and both were very different and continue that way.

This is a great forum for information and encouragement. Glad you found us!

 

[sistersinhim]

Some sites say half knees should heal twice as fast as TKR and you read blogs on some surgeons' websites with patients playing golf/ driving etc at 6 weeks.

This might be true for a few people but the vast majority have found that recovery is almost the same time frame as from a total.

I am doing all my exercises religiously 3x day and having private pilates once a week.

It sounds like you are doing too much for a knee that has recently been partially replaced. It takes a long time for the healing to complete, usually a year.


Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, 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.

KNEE RECOVERY 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.

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 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 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.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep

 

[sistersinhim]

Please tell us the exact date of your right lateral partial replacement and I'll add that information to your signature. Knowing this makes it much easier for us to be able to advise you. You can also read the thread of other PKRs by clicking on the

prefix. This will give you an idea of what is and isn't normal.

 

[EalingGran]

Thanks I suppose I worry that just having had a partial knee replacement I will still have some pain from the other compartments. My surgeon thought because I was so knock kneed that correcting that would relieve the pressure on the other compartments and the hip/ back. Just have to hope he is right It would be good to hear from others who have had partial replacements.

How long did your knees stay swollen/ warm/ sore for post your joint surgery?

My surgery was on 25th October 2022

 

[EalingGran]

Thanks for replying. I find it encouraging that you say that most people find partials take as long as TKR to recover.
I will ease off a little on the exercises and see if that helps with the soreness.

 

[EalingGran]

Thanks for replying. I find it encouraging that you say that most people find partials take as long as TKR to recover.
I will ease off a little on the exercises and see if that helps with the soreness.

I have a few specific queries which I would be interested in other people's views.
1. When is it ok to try kneeling on my new knee? My surgeon says I should be able to kneeling on my PKR. I have knelt briefly when getting up from the floor. I padded the knee and it wasn't really painful- just a bit odd due to the patch of numbness.
2. What are other people's experience about the post op numb patch. I think it is slightly smaller 9 weeks on. Has anyone ever lost it completely and got full sensation back?
3. Is it OK to use anti- inflammatory gel on the knee area post PKR or TKR?
4. Does anyone find it helpful to still use a knee support if they are going to be doing a bit more- like walking further on a particular day?

 

[Jockette]

When is it ok to try kneeling on my new knee?

I would wait many more months before trying to kneel. You want to be well healed first. As with every aspect of this recovery, You will find many different opinions. Some surgeons say you can kneel, some say don’t. We have members who can, and others who don’t, just because it feels so uncomfortable. Be careful when trying and do what’s best for your body.

What are other people's experience about the post op numb patch.

The numb patch can take a very long time but it will lessen over time so that you barely notice except when shaving your legs. Mine is hardly there now.

Is it OK to use anti- inflammatory gel on the knee area post PKR or TKR?

If you want to use something to assist with healing and scar management, 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.

Does anyone find it helpful to still use a knee support if they are going to be doing a bit more- like walking further on a particular day?

We do have members who find this helpful. Personally, I did not. As always, we are all different, and we each find different things to help our own recoveries.
There really are no rules, use common sense and do what feels right for you.

 

[sistersinhim]

I have a few specific queries which I would be interested in other people's views.
1. When is it ok to try kneeling on my new knee? My surgeon says I should be able to kneeling on my PKR. I have knelt briefly when getting up from the floor. I padded the knee and it wasn't really painful- just a bit odd due to the patch of numbness.
2. What are other people's experience about the post op numb patch. I think it is slightly smaller 9 weeks on. Has anyone ever lost it completely and got full sensation back?
3. Is it OK to use anti- inflammatory gel on the knee area post PKR or TKR?
4. Does anyone find it helpful to still use a knee support if they are going to be doing a bit more- like walking further on a particular day?

1. That is a personal choice. I have a total and I choose not to. Rather than kneel, I sit on the floor then roll over and walk my way up with my arms.
2. I've had 5 knee surgeries on this right knee and it still has a numb area on the (lateral), outside. I do occasionally get 'zingers' that are telling me that my nerves are still rerouting or healing. For most people, these numb areas eventually go away.
3. As long as you have no open areas at all on your knee, including the stitch/staple areas, your knee should be OK having the gel on it. It would be a good idea to check with your doctor first before using anything on your knee.
4. Some people do. I didn't, the pressure on a wrap is quite painful for me. You can try it and see how you do. I don't think it'd be a good idea to rely on it all the time, but once in while should be fine if your knee accepts it.

 

[JusticeRider]

Hello EalingGran, greetings from a fellow PKR recipient! I have a patellofemoral replacement, so a different procedure from yours, but also a partial. I am four months out and I’m definitely finding that a year long recovery is going to be more realistic.

1. I haven’t tried kneeling yet. I want to make sure my knee is well healed before I try it. I haven’t been able to kneel in 20 yrs due to cartilage damage in both knees, so I’m not in a hurry

2: I still have a small area of numbness on one side of my knee. I don’t like shaving there, but otherwise I’m not too bothered by it. After one of my hip surgeries, I had a numb area the size of my whole hand on my thigh. It eventually went away but it took a year and a half. I expect this may be the same.

3. I tried Voltaren anti inflammatory gel on my knee. It worked pretty well but was about the same effect for me as taking an ibuprofen and less convenient, so I stopped using it and just took the ibuprofen instead. (They are both NSAIDS so even the gel counts toward your daily limit!)

4. I have struggled with swelling, especially from weeks 4-12. It has improved a lot lately but it got really bad previously and I sometimes still get some later in the evening or if I overdo. I found a stretchy, lightly compressive knee sleeve to be extremely helpful. I wear mine most of the day. I plan on gradually phasing it out but for now it is really helping to control the swelling.

On another note, I’m glad to hear that for you, finding out that this is a year long recovery was a relief. I felt the same. On the one hand, it was very disappointing since I had been given to expect a much shorter, easier recovery. But on the other hand, I was relieved to find out that my struggles were normal and there was not something wrong with me or some personal failing holding me back. Once you recalibrate your expectations and settle in for the long haul, it makes for a less stressful recovery. Wishing you the very best of luck, EalingGran!

 

[Jockette]

On another note, I’m glad to hear that for you, finding out that this is a year long recovery was a relief. I felt the same. On the one hand, it was very disappointing since I had been given to expect a much shorter, easier recovery. But on the other hand, I was relieved to find out that my struggles were normal and there was not something wrong with me or some personal failing holding me back. Once you recalibrate your expectations and settle in for the long haul, it makes for a less stressful recovery. Wishing you the very best of luck, EalingGran!

I felt the same! I was being treated as if I wasn’t working hard enough, or doing enough exercises, and that’s why I was having such a difficult recovery. I was actually pretty angry for quite a while that I was not given appropriate expectations in all aspects of this recovery.

Thankfully I found Bonesmart!

 

[EalingGran]

When is it ok to try kneeling on my new knee?

I would wait many more months before trying to kneel. You want to be well healed first. As with every aspect of this recovery, You will find many different opinions. Some surgeons say you can kneel, some say don’t. We have members who can, and others who don’t, just because it feels so uncomfortable. Be careful when trying and do what’s best for your body.

What are other people's experience about the post op numb patch.

The numb patch can take a very long time but it will lessen over time so that you barely notice except when shaving your legs. Mine is hardly there now.

Is it OK to use anti- inflammatory gel on the knee area post PKR or TKR?

If you want to use something to assist with healing and scar management, 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.

Does anyone find it helpful to still use a knee support if they are going to be doing a bit more- like walking further on a particular day?

We do have members who find this helpful. Personally, I did not. As always, we are all different, and we each find different things to help our own recoveries.
There really are no rules, use common sense and do what feels right for you.

Thanks!

 

[EalingGran]

I have a few specific queries which I would be interested in other people's views.
1. When is it ok to try kneeling on my new knee? My surgeon says I should be able to kneeling on my PKR. I have knelt briefly when getting up from the floor. I padded the knee and it wasn't really painful- just a bit odd due to the patch of numbness.
2. What are other people's experience about the post op numb patch. I think it is slightly smaller 9 weeks on. Has anyone ever lost it completely and got full sensation back?
3. Is it OK to use anti- inflammatory gel on the knee area post PKR or TKR?
4. Does anyone find it helpful to still use a knee support if they are going to be doing a bit more- like walking further on a particular day?

1. That is a personal choice. I have a total and I choose not to. Rather than kneel, I sit on the floor then roll over and walk my way up with my arms.
2. I've had 5 knee surgeries on this right knee and it still has a numb area on the (lateral), outside. I do occasionally get 'zingers' that are telling me that my nerves are still rerouting or healing. For most people, these numb areas eventually go away.
3. As long as you have no open areas at all on your knee, including the stitch/staple areas, your knee should be OK having the gel on it. It would be a good idea to check with your doctor first before using anything on your knee.
4. Some people do. I didn't, the pressure on a wrap is quite painful for me. You can try it and see how you do. I don't think it'd be a good idea to rely on it all the time, but once in while should be fine if your knee accepts it.

Thanks! Good to get some views on these queries

 

[Jockette]

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Happy Posting!

 

[EalingGran]

Hello EalingGran, greetings from a fellow PKR recipient! I have a patellofemoral replacement, so a different procedure from yours, but also a partial. I am four months out and I’m definitely finding that a year long recovery is going to be more realistic.

1. I haven’t tried kneeling yet. I want to make sure my knee is well healed before I try it. I haven’t been able to kneel in 20 yrs due to cartilage damage in both knees, so I’m not in a hurry

2: I still have a small area of numbness on one side of my knee. I don’t like shaving there, but otherwise I’m not too bothered by it. After one of my hip surgeries, I had a numb area the size of my whole hand on my thigh. It eventually went away but it took a year and a half. I expect this may be the same.

3. I tried Voltaren anti inflammatory gel on my knee. It worked pretty well but was about the same effect for me as taking an ibuprofen and less convenient, so I stopped using it and just took the ibuprofen instead. (They are both NSAIDS so even the gel counts toward your daily limit!)

4. I have struggled with swelling, especially from weeks 4-12. It has improved a lot lately but it got really bad previously and I sometimes still get some later in the evening or if I overdo. I found a stretchy, lightly compressive knee sleeve to be extremely helpful. I wear mine most of the day. I plan on gradually phasing it out but for now it is really helping to control the swelling.

On another note, I’m glad to hear that for you, finding out that this is a year long recovery was a relief. I felt the same. On the one hand, it was very disappointing since I had been given to expect a much shorter, easier recovery. But on the other hand, I was relieved to find out that my struggles were normal and there was not something wrong with me or some personal failing holding me back. Once you recalibrate your expectations and settle in for the long haul, it makes for a less stressful recovery. Wishing you the very best of luck, EalingGran!

Thanks so much for answering these queries with your experience. I had been feeling demoralised because my daughter- in-laws father seemed to have a very speedy recovery from a medial PKR. He was back on the golf course at about 4-5 weeks and is skiing again 9 months later ( I don't think this is wise but say nothing...). I feel a bit better today and even managed a few stairs normally going up- instead of one step at a time. That really felt like progress.
My only new worry is that the circulation in my foot/ leg doesn't seem so good post op and I have developed some sore purplish areas on a couple of toes where my gripper sock was too tight. I will have to be really careful with the skin. It is very difficult because it is too cold to go barefoot.

 

[sistersinhim]

I had been feeling demoralised because my daughter- in-laws father seemed to have a very speedy recovery from a medial PKR. He was back on the golf course at about 4-5 weeks and is skiing again 9 months later ( I don't think this is wise but say nothing...).

Did you actually see this first hand? Many times we forget how bad things were after a while. Just like giving birth. It's a big OUCH, but that is forgotten as the joy of a new life takes over. It is the same with the knees. They are like a new baby and it really hurts at first. As time goes on and we are doing more of the things we love to do, the past pain is just that...past, along with the memory. Also, every knee is different as is every recovery. Each surgery is individual, so is recovery.

I feel a bit better today and even managed a few stairs normally going up- instead of one step at a time. That really felt like progress

That is progress and a nice, big step in your recovery!

My only new worry is that the circulation in my foot/ leg doesn't seem so good post op and I have developed some sore purplish areas on a couple of toes where my gripper sock was too tight.

The circulation will probably improve as your swelling goes down. Hopefully, those toes will return to their natural color.

 

[EalingGran]

Finally beginning to feel a bit better but still very variable 10 weeks post PKR.
Just interested to ask a couple of questions.
1.When on average did most people manage to walk upstairs normally, one foot after another? How long after before you could go downstairs normally?
2. When could you manage do get in and out of a bath? I have a walk in shower but long for a really nice soak but don't think I could get out of a bath safely yet.

 

[sistersinhim]

I was able to go up the steps normally at about 3 months, and down at about 4 months. Most of us have found going down much more difficult than going up the steps.

It was over a year before I tried getting out of a tub. I was scared to try it! Of course, I was alone most of the time. Others have done much better than me, I'm sure.


You'll notice that I have merged your two threads together as it's best if members in recovery only have one thread. We find it much easier for everyone.
This is because:

• That way, you have all your information in one place. This makes it easier for others to go back and review your history before providing advice.
• If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please keep all your questions and updates on this thread. We won't miss your new question as, between us, the staff read all new posts each day.
If you need an urgent response to a question, tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts?

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

 

[ski_bum]

@EalingGran
Try walking backwards down the stairs for a few times.
BUT hang on and make sure you are at the bottom before you turn around.
Good Luck.

 

[EalingGran]

Thanks. Have a couple of small steps with a rail that I will try this on.