Revised PKR to TKR Agilitymom's revision recovery<<

agilitymom

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i am 18 months post from a patello-femoral KR. It has always been painful and swollen. Dr has no idea why. It is also nearly impossible to go up and down stairs. Just got new surgery date of Oct 22nd for TKR revision. Dr is pushing rental of ice and compression machine called Game Ready. Kind of expensive as insurance does not cover it. Was wondering if anyone else has used this and found it worth while?
 
Hello @agilitymom - and :welome:

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:

I'm sorry your patello-femoral replacement hasn't been a success and I wish you a happier recovery from the revision.

I know that some people have used the Game Ready successfully, but it's not the only way to cool and ice your knee.
There are other suggestions in this article:
Recovery Aids: A comprehensive list for hospital and home

This article offers some advice about recliner chairs, too:
Recliner Chairs: Things you need to know if buying one for your recovery
 
Our hospital uses Game Ready, I did enjoy the feel of the ice and compression round the clock the first 2 days. The cuff is nice as it is large and wraps around from the back. However as you said cost made home use prohibitive for me
 
Welcome to Bonesmart!

I am 17 months post op from a Patellofemoral that I am very unhappy with.

I haven’t had major pain, but I have had major discomfort the entire 17 months. I can kind of go up steps if there aren’t too many, and if I’m holding a railing or using a cane, but it’s very painful to try to go down foot over foot. It’s painful to put weight on my leg when it’s bent.

My X-ray looks great, so “there’s no problem”. Even my highly rated second opinion surgeon didn’t want anything to do with me.

What was your final diagnosis that they decided to do a revision?
 
Quite a few members have mentioned using the Game Ready. If you do a search for Game Ready using the search function at the top of the page you will get a list of posts that mention it. Some of the posts only have the words “game” or “ready” but you will see Many that mention this machine.

I didn’t use an ice machine. I went with gel packs. My mom thinks I was extravagant: she used bags of frozen peas. :heehee:
 
My physical therapist ranted and raved about it and said it was the best thing ever. She said it was the only one they use in their therapy. She looked it up one day while I was doing my "exercises" and was shocked about how much it costs. That cost was prohibitive for me but there are several ice machines on the market which help too and don't cost so much.
 
My original patella femoral replacement was Feb 9, 2016. I have not had any relief from the pain and swelling since surgery. After 18 months of nearly constant PT and icing, my surgeon has agreed that my quality of life is not good and something needs to be done. As of today I have a revision to a TKR scheduled for 22 October.
 
After 18 months of nearly constant PT
Wow, that’s a lot of PT! What did they have you doing?

I stopped doing exercises at home at 4 weeks post op when I found Bonesmart and it’s gentle approach to recovery.

PT was getting difficult and taking 2-3 days to recover from. I figured that was counterproductive so I started looking online and found Bonesmart.

I will leave you our Recovery Guidelines for when you have your revision. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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
5. Here is a week-by-week guide for

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.
 
PT was very gentle, just like Bone Smart recommends, so I was lucky. We never pushed it even for measurements. I am retired Military so have great medical and the surgeon kept sending me to PT in hopes I could get relief and that the knee would heal. At 15 months the surgeon requested bone scan and X-ray. Both were no help to figure it out. Only thing he can think of is my previously very healthy 60 year old knee went south fast after the PKR. I guess we will see in a October.
 
I don't know a thing about Game Ready. I can't rave on enough about my Breg V Pulse machine enough. Its been wonderful. It does both ice & compression. The wonderful thing about it is it comes with 4 containers. You add water to them and freeze them. Then put two in the Breg and get ready to be cooled and relaxed. I've found the 2 frozen cubes last up to 10 - 12 hr. Switch them up and your ready to go. No messing with ice cubes, etc. I have no idea about the cost though. Its got to be cheaper than the Game Ready I'd hope.
 
I use a Cryo Cuff, love the compression. We freeze ice in Cool Whip containers.
 
I know nothing about Game Ready. I do have an ice machine by Polar Care. I don’t think I could live without it! I was doing ice packs for a few days and having to change them often. With my Polar Care I put frozen water bottles, ice and water in it and it lasts about 12hours. Without the frozen water bottles in it the ice does not last as long. There seems to be some debate about whether compression is useful or not. I totally recommend an ice machine though.
 
I don't know a thing about Game Ready. I can't rave on enough about my Breg V Pulse machine enough. Its been wonderful. It does both ice & compression. The wonderful thing about it is it comes with 4 containers. You add water to them and freeze them. Then put two in the Breg and get ready to be cooled and relaxed. I've found the 2 frozen cubes last up to 10 - 12 hr. Switch them up and your ready to go. No messing with ice cubes, etc. I have no idea about the cost though. Its got to be cheaper than the Game Ready I'd hope.
 
Finally had my revision to a PKR from 18 months earlier. Surgery was a revision from PKR to TKR on right knee on October 22, 2018. After surgery, which was done under a nerve block and an epidural, the Dr. greeted me by saying “You aren’t crazy.” I think he did not really believe there was anything wrong with the first implant but after 17 months of my complaining he finally agreed that a TKR was inevitable. When he told me the Partial appliance was really loose, it totally made sense to me. Anyway, after 3 days in hospital I am home with my snuggle pups and the hubs is taking great care of me.
I was wondering if any other Dr.s or PT have recommended just a rolled up towel under the calf as elevation. Last year it was 3 pillows stacked like in your pix. When I asked about that protocol I was told that it kept a bend in the knee and as a result that is how the knee would heal, with a bend in it. Goes against everything I have ever read or been told about elevating above waist or heart to lessen swelling. I am having lots of swelling.
Using my Game Ready ice and compression machine but still experiencing lots of swelling.
 
I was wondering if any other Dr.s or PT have recommended just a rolled up towel under the calf as elevation.
That causes too much pain. A slight bend in the knee is much more comfortable.
When I asked about that protocol I was told that it kept a bend in the knee and as a result that is how the knee would heal, with a bend in it.
That's certainly not true. You won't keep that bend forever! What about those in a brace for a month or so? Does their knees heal that way and not be able to bend? Of course not. I don't know why your doctor thinks it does. You will be up moving around, so your knee is not in the same position 24/7!
 
Welcome to to recovery again!

At 15 months the surgeon requested bone scan and X-ray. Both were no help to figure it out
When he told me the Partial appliance was really loose, it totally made sense to me.
Wow, so the loose implant didn’t show up on X-rays or bone scan. Interesting.

What were your symptoms, other than pain and swelling, that made sense when you found out it was loose?

I think mine is loose. It feels fine when I’m sitting on my couch with my feet on the ottoman. It likes the angle of the elevating wedge the hospital sent home with me. I recently tried a lounge doctor, and my knee did not like that angle. Different height chairs make it unhappy. I still can’t sleep on my side, with operated leg on top, it feels like a heavy weight inside is off balance. It’s uncomfortable when I lean forward and feels out if joint when I stand up straight again. It’s painful to do stairs foot over foot. I don’t seem to have a lot of swelling, if any.

My original surgeon offered me absolutely nothing at my one year check up, and my second opinion at 15 months looked at my X-ray and said it was not loose. No other tests have been ordered.

I’m not happy with my outcome, but this has been a very bad experience for me and I am so afraid of doing it all over again. That’s even if I found a surgeon who thought another surgery was necessary. So far 2 have not.

I hope your recovery goes really well this time.
 
Hello @agilitymom - and :welome: to recovery again.
Sistersinhim has left you the recovery reading, in Post #11.

I was wondering if any other Dr.s or PT have recommended just a rolled up towel under the calf as elevation. Last year it was 3 pillows stacked like in your pix. When I asked about that protocol I was told that it kept a bend in the knee and as a result that is how the knee would heal, with a bend in it. Goes against everything I have ever read or been told about elevating above waist or heart to lessen swelling.
You'll see that we still recommend elevating your leg on 3 pillows. It's just not true that elevating with your leg completely straight is essential - and it's much more comfortable to have a slight bend.
Now you're home, you can elevate the way you like.
 

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