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Bilateral PKR A Few Quirks

5 months 1 week -

The pain behind my knee went up to a 5 this weekend, even when sitting, in fact, it is worse when sitting. I broke down and contacted the doctor about it. He thinks it is tendonitis and wants me to avoid hamstring curls. Leg press and walking are okay. I should use diclofenac gel (topical NSAID) on the area 3 - 4 times a day. If it doesn't improve, he may use an injection.

I feel a bit of relief knowing there is something I can do for the pain. This has been with me since day 1 after surgery and the only thing that isn't getting better and can get worse.
 
The key to recovery is to find what works for YOU, which won't be the same as the next person.

You seem to be exercising hard; sometimes exercising too much can cause pain and swelling. If this is happening, cut back on exercise.

SugarPeas said:
I've been in the gym twice a week since release focusing on a bike ride warmup for 15 minutes (it takes about 5 minutes to ride without tightness), leg press, leg curl and leg extension.
Click to expand...
You've hit the way to use the bike to improve ROM. The way I look at it is:
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different
 
Tendonitis can take a while to heal--as your doc said, take it a little easy and slowly increase your activity. That's what's worked for me in the past. Roy's given you great suggestions above.
 
Almost 6 months -

Right leg feels good, strong with some tightness, numbness on the outside by the scar and a bit of pain if I try to bend it a little extra. Overall, very happy with right leg.

Left leg is still having trouble with the hamstring/tendon. Pain when sitting, gives out on me, an area that feels warm at night, and the leg jumps when fully extended. I saw the doctor today. After taking X-rays, which looked good, he noticed that I walk on the left leg with a slight bend. He prescribed a muscle relaxer (smallest dose), said to continue to strengthen the quads and to think about strengthening the leg when walking. He feels the leg will improve with.......wait for it.......TIME!

So, I'm back to being impatient and feeling frustrated. If my left leg felt as strong as my right, I'd be happy, but instead, I have for wait for TIME.
 
Do you still have your posterior cruciate ligamentS? Mine were removed, I still don’t quite know why.
 
7 months -

My main focus is the tendon behind my left knee.

After 10 days on muscle relaxers, I was able to get my leg straight when standing and walking. My hamstring also stopped having spasms and the pain left. Sometimes, the spasms were so bad, I could see my leg move when sitting. It also spasmed at night and would wake me up.

That lasted until the muscle relaxers wore off and the spasms came back, but not the pain. I used a heating pad on low heat on the muscle for a couple days and (fingers crossed) the spasms have not returned.

Frustration kicked in last weekend, progress is so slow. I walked .5 miles and my leg was shaking and giving out on me. I was also done for the day, exhausted. It seemed like I was stuck in time, with my level of pain as the only difference.

Then Monday happened. I went to the gym and felt better leaving. It is like the flood gates opened again. I am able to walk farther with short rests. Granted it is only Wednesday, but it feels better, stronger, faster (We can rebuild him - a reference to the 6 million dollar man). I've been walking around the office like a mad woman and I feel good. I still have to sit and rest, but don't need to rest for long. I still have to think about straightening my leg when standing and can't bear my full weight on it, but it can take some weight.

Other than the hamstring, I'm progressing. I have a car, so I've been pushing myself up and lowering myself into it. I still go in rear first, but don't need to use my arms to lower myself. I still use one arm to stand up, but if I am feeling fresh, I can lean very far forward and stand up on my own.

The numbness is still on the outside of both knees and kneeling is difficult. I have range of motion to do everything I want to do. I'm going to try riding a real bike this weekend.

I still go to the gym twice a week to work on leg strength. I've also switched from the bike to the treadmill to practice walking at a slow speed. The other days of the week, I left my energy level guide me.
 
8 months -

I rode a real bike (3 miles). The ground was flat and paved, so it didn't take much work. I also walked about 3 miles on the same day. I napped as soon as I got home and slept the rest of the evening too.

I got into a canoe and sat down without help; however, I was unable to get out of it and needed a hand up.

My energy level is increasing, but a full day of work in the office, wears me out.

Weights, leg extensions - 24 with my left leg on the lightest weight and 30 on the right leg with the weights on number 2.

Stairs are still difficult. Both knees sound like popcorn when I step up. Going down takes concentration and if I am tired, I need to use the handrail for support.

Numbness on the outside of the knee is improving. I can feel a little bit at the top but further down is still numb.

Sitting and standing require concentration and use of the arm rest depending on how tired I am.

The tendon is improving but I still have to concentrate on straightening my leg when walking. I also practice standing with it straight. There is a spot I hit when the leg gives out on my completely. I'm still figuring that out. I think the tendon will take longer than the knees to heal at this point.
 
So glad that you took the time to post this, thank you. I am just over four months out from bilateral, and am on the verge of having another bout of the blues at the continuing pain and discomfort if I do some things, I seem to have hit a plateau. Everything you mentioned in your post with which you are having difficulty is the same with me, only for me it is still worse.
i have started at the gym and find that half arc leg extensions with just the lowest weight of ten pounds is too much and makes me sore. Leg curls, done very cautiously with the lowest weight of ten pounds is just about ok, but has upset the tendons if I do more than twenty.
I have little problem with walking, never have, but do buckle, and more than twenty minutes up and down slopes makes me sore.
Reading about you gives me hope for the months ahead.
Swelling is still my biggest problem and causes the most pain. Are you still swelling? It’s in the top 30s here, and I feel that the heat isn’t helping with this, my knees seem to fill up so quickly in the morning so my main activity for the day has to be done as soon as I get up.
 
Ghost, The blues are real. The slow pace of progress is frustrating. The pain that comes and goes feels like a setback and the energy drain made me have great empathy for the very old.

The plateaus happen, then you will break through. I don't know how long that will take, I think everyone is different. It's also frustrating when you have a good day, then overdo it and have to hobble around again. Be as patient as you can be and be kind to yourself.

When I couldn't lift the lowest weight with one leg, I assisted with the other leg. Just enough extra lift to finish the full movement. Then rest between the reps until I was ready to go again. It took about 2 months of that until I was able to lift the weight with one leg.

Don't upset the tendons. I'm still not doing hamstring weights because it causes pain.

Yes, I still have swelling and after too much exercise the swelling increases, the muscles are tired and my legs are done. As much as I want to get up and vacuum or do some other chore, I can't. I'll get nauseous if I try to do too much.

Hang in there. It takes time - as much as you want your time to be less, it doesn't work that way.

One thing that helped me was reading back over my posts to see how much progress I am actually making. The small progress can be lost in the day-to-day, but is more visible in the month-to-month.
 
9 months -

The past month I did not see much progress. Despite being vaccinated, I came down with COVID from an unvaccinated friend that I spent a weekend with. I had to quarantine at home so I couldn't get to the gym or do much.

I have noticed that my legs are very stiff after extended rides in a car and I have to walk around for several minutes to get them to loosen up. The knees also feel swollen for a day after a very long car ride, 8+ hours. A few rounds of ibuprofen helped with that.

The hamstring is still problematic, but the left leg is stronger. When using steps, I can almost step up with the left leg unassisted. I can stand up from sitting unassisted, but sitting usually requires a little support from my arms.
 
For years and years I was one of those who when making long car trips stopped as seldom as possible to get there faster (typical male!:heehee:) @SugarPeas. I've finally learned that stopping every hour or two to stretch and walk a little actually makes me feel much better at the end of a trip than getting there an hour or two earlier does.
 
10 months -

The good news:

Right leg is good, strong and can do anything I ask of it. Flexion appears to be back to pre-surgery; although, there is still some pain if I try to bend it beyond where it goes naturally. It doesn't feel normal yet, but I'm happy with it.

I can sleep is whatever position I want without discomfort.

I was able to get out of a canoe this weekend unassisted. The only suitable land was on my left side (my bad side). I found a good foot hold, shifted my weight to the leg, and while trying to stand, pushed up with my arms. That's not an easy thing to do when the canoe is still in the water, but I did it!

For the first time since surgery, my body was exhausted before my legs. That might have to do with the hangover I was nursing, but it was still surprising.

I am able to use the Versa Climber in the garage. That requires a lot of pushing down with the leg. I've tried it a few times before, but always had to get off after 2 minutes. I stop after 20 minutes now because I don't want to over do it. The Vera Climber gives me the same feeling as running used to without the force on the knees.

Still working on:

Left leg. The hamstring continues to heal, but I always feel it. Sitting in a car can still be painful. I can go up and down most steps with it, but grab the rails just in case and move at a snail's pace. I think the hamstring will take longer to heal than the knee, so I do what I can and wait.

Numbness - There is still skin numbness on the outside of both legs that extends down my shin bone about 3 inches, but the feeling directly across from the scar is coming back.

Fitness - after 1 1/2 years of pandemic and 10 months of knee recovery, my fitness and weight need improvement. I'd like to get on the Versa Climber for 45 minutes 4x/week. I hope to be there by 2022, but I'm not going to rush it. There are too many variables and I don't want to be forced into taking 2 weeks off while I recover.

Foot flexibility - my toes on both feet are stiff and my left arch seems "stretched," so I make sure to manually stretch the toes and do some plantar fasciitis stretches for my arch. I suspect it has to do with the extra weight and the awkward gait so I wear tennis shoes everywhere. New tennis shoes with lots of support. I hope to wear cute shoes again one day.

I'm still lifting weights and walking twice a week. I'm still exhausted when I get home from a day in the office.
 
11 months -

I went white water rafting a few weeks ago. Nine class 5 rapids later, I am here to tell the tale, but I would not recommend it until you are sure your legs are strong enough to hold on in the raft. Fortunately, I had a great guide and we worked together to keep me in the raft, but I shouldn't have put him in that position. If you want to White Water and are still in recovery, wait. My left leg was not strong enough to hold on and my range of motion, in both legs, hindered it even more. I will go back next summer, but I'm going on a more gentle river until I know I can handle the bigger ones.

Right leg is good. I can still feel some tightness and numbness on the lateral side. It still hurts a bit when I bend it too far. But, it does everything I ask of it, ride bikes, walk, go up and down stairs, etc.

The Left leg implant is okay. The hamstring is not. I believe I will need to see a separate doctor for that. It has started cramping again, first at night, now during the day. Exercise seems to make it worse. If I walk more than 3 miles during the day or more than 1 mile at one time, the hamstring is irritated. I don't know how to make it better.

When the hamstring is irritated, sitting with my feet on the floor hurts, riding in a car hurts, and the leg is weak. I can't go up or down stairs leading with it. It is frustrating and my greatest fear is that it will not get better. I also feel like I'm watching life pass me by.

So, if you are in the beginning of this journey, it will get better. Measure accomplishments in weeks or months, not days. Be patient and when the depression creeps in, find something creative to do with your hands. You will heal, but it will take time.
 
@SugarPeas
Thanks for the update, glad you are doing well, even with the added adventure of your not quite ready knees white water rafting.
Next year, calmer river and more healing you should do great with calmer white water rafting.
 
Thank you for taking the time to update. So many posters disappear after a few months if they don’t have problems, and updates later on on bilateral procedures are few and far between.
Sorry to hear that you are still having the hamstring issue. I can sympathise fully, having my own tendon problem in one shin which will just not go away. Such a frustration when one thing holds you back from embracing life with new knees.
White water rafting is something I have always wanted to, envious! At least you managed to do it, and I realise, and hope, that in four months time I will be up for challenges like that.
Keep on healing, and let us know how you are doing with that hamstring.
 
One Year -

I had my one year follow up with the doctor. X-Rays showed the knees have healed well.

A year ago, I couldn't walk through a grocery store without severe pain and I had to ice them when I got home. Every exercise I tried made them swell and hurt. So, one year later, I can do the small things that I want to without pain. Bigger things make my legs tired.

For example, I toured some mansions in Newport, RI. Four stories of stairs with lots of walking and stairs in the house where I stayed. By Saturday night, my legs were exhausted.

I was putting lights up on an outside tree and had to take a chair to sit down, often. I also went for a walk in a State Park and chose a path with several benches so I could stop and rest. I am good for about 3 miles in one day, but I have to slow down and rest frequently. The doctor thinks it is a function of strength and fitness. Since I stopped lifting weights to allow the hamstring to heal, I tend to agree with him. My legs do not feel as strong. The fitness is hard for me to wrap my head around. I was an athlete and this stopping to rest or working until exhaustion is new to me.

The hamstring will still cramp if I over do it, so I stopped all added exercise. The hamstring feels better. I guess the time to be lazy is over, but I am starting out very slowly. I am also going to take more time to recover. It used to take me a day or two to recover from a hard work out, but now it is more like a week or two.

Would I do it again? I think Yes, the pain level prior to surgery was constantly a 2 or 3. There is no pain now, just exhaustion and some stiffness. I am hopeful that once I start back on a fitness plan, both of those will get better.
 
While my knee replacement did not have a good outcome I still saw a lot of improvement in my second year, and @FCBayern said he also saw improvement in the second year. I’m hoping you will, also.
 
Strength and fitness were definitely an issue for me at 1 year @SugarPeas. I know part of that was my lack of mobility before TKR, add to that recovery time and I had a lot of work to do to get them strong again. I regained much of that strength and actually improved my ROM considerably during my second year of recovery. Today I'm more active and doing things I hadn't been able to for years, all pain free!
 
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