TKR Almost 5 years post RTK, still having issues

I also did almost no exercising - none at all for the left TKR - and I have 2 perfect knees.

If you feel you really must do exercises, here are a few suggestions:
Home physio (PT) and activity progress: suggestions

However, you're far enough out from surgery for the activities of normal life to be sufficient exercise. Walking is good and you do squats every time you sit down on and get up from a chair or the toilet. You'll be doing steps and stairs too, which involves bending, strength and balancing. See what I mean?
 
Tonight I went for the longest walk since I had surgery 12 weeks ago. We went to the beach to watch the sunset. Despite the long walk from the parking area to the beach, my knee didn't bother me (I did have my knee sleeve on), but my right hip got very sore. It felt like my right leg is shorter than my left. I haven't noticed that before, but the walks have been much shorter. I also forgot to take my cane, and I have always used that on walks outside the house. Could tight calf or hamstring muscles cause this or could the leg actually be shorter since surgery and I didn't notice it because I used the cane.
 
Perhaps but it's likely to be only a very small amount since you haven't noticed it before. FWIW even people with normal hips have a few mm discrepancy. But did you walk on the beach? Walking on sand can be very hard on a new knee and you're only 13 weeks out. Next time, take your cane!
 
I didn't walk on the beach--just watched my granddaughter play in the sand from the pavement--but I will remember my cane for next time.
 
@sdgrandma, you posted on SDKate's thread that you recently lost your father. I am so sorry to hear that. Sudden deaths like his are such a shock. My condolences to you and your whole family.

I'm glad that you were feeling well enough to fly home and to provide your mother with support, and then to return after the North Carolina wedding to help her settle her affairs. A lot of flying there, and you seem to have managed the plane trips okay. That's great! I've read on other threads that the swelling can persist for months after surgery for some of us. I'm sorry that neither rest nor elevation help; have you tried icing it and taking an occasional over-the-counter Aleve?
 
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@SarahJane -- thanks for the kind words. It has been a crazy seven weeks! I have only spent one week at home since my dad died. I forgot my ice packs at home, so I haven't been icing. I have read that he swelling can persist for as long as a year so I am trying to be patient. I do take Aleve daily, though.
 
Wow, one week at home out of seven. That can be so difficult. I spent a couple of months spending about six out of seven days at my cousin's in a town about an hour - hour and a half away from home when she had some family crises. Like you, I was happy to help, but you feel like you're in a holding pattern so removed from your day-to-day life, routines, and friends. Or at least I did.

Is it possible for you to buy some ice packs? I can't imagine life without them; whenever my knee is swollen --
like tonight-- I ice.

You're probably still super busy. I hope you'll be able to check in with us when you haves chance.
 
My right TKR surgery was done in June 2015. I followed all the recovery advice - ice, elevation, gentle PT only - and while my activity really isn't limited, I still have some swelling on the outer aspect of the joint and a feeling around my knee of an ACE wrap that is applied too tightly.

I have great flexion and extension, but it always feels tight. There is a popping sound when I bend it and although I don't have true pain I can never forget about my knee. It is more bothersome than before I had the surgery.

I get hip pain when I walk long distances and I never had that before. I can't kneel at all, and if the top of the knee gets bumped it is like an electric shock. I was hoping I would be able to play on the floor with my grandkids, but it is too hard to get back up. Any words of wisdom?
 
sdgrandma,
Welcome back to BoneSmart, sorry you are back with troubles with your TKR.
What does your surgeon say?

Suggest you get a second opinion, with a surgeon who specializes in revisions, they have the education and experience to figure out what is going on with challenging knees. You will want to find a surgeon who has no relationship with your present surgeon, not even golf buddies.
 
Thanks, @pumpkin--I haven't been back to the surgeon since my 1 year check. I really want to avoid another surgery if at all possible. After the TKA, I swore I'd never go through the procedure again. My husband is a great person but a terrible nurse! He has no patience for the healing process. Plus, I did my due diligence choosing this doctor--I have lots of nurse contacts in the ORs and on the orthopedic units at the hospitals. He got high praise from everyone.
 
I would still seek out an OS the is a revision specialist. I'm not saying that you would necessarily need more surgery but that is the person that is used to seeing problems and will know what if anything can be done. You are not happy the way things are now so you why not try it? I had a revision and it was the best thing I could have done for my knee and my sanity. Recovery was easier and quicker for me.
 
I agree that you should get an opinion of a surgeon who is used to seeing such problems. That would be a revision specialist. Depending on where you are in South Dakota, it might be a bit of a challenge. The best doctors in this area are usually in larger cities and/or attached to a university hospital. Such a consultation may be the only way you can truly get an idea why you still have that tight feeling. As Marian said, seeing such a surgeon doesn't mean you need more surgery. It also doesn't mean that your original surgeon was bad in any way. It's just that the primary doctors tend not to see as many of the problems that can result and might miss a diagnosis because of this. Ligament balance with knees is so critical and it's one of the areas that can be a problem after surgery. Of course, it's up to you. You know what you are comfortable living with.
 
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I appreciate your thoughts @Jamie, @pumpkin and @newlybionic. I did some research and there are two doctors who do revisions--mine and one who practices at the other hospital in town. It is worth looking into the possibilities for the tightness. Thanks for sharing!
 
I haven't been back to the surgeon since my 1 year check. I really want to avoid another surgery if at all possible.
Going to see a surgeon doesn't inevitably result in surgery you know! At least half the patients a surgeon see only require advice and reassurance.

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
@Josephine

1) Pain level is 2-3--it is more of a very tight feeling around the knee although the top of the knee scar is tender to touch (no warmth or redness or other signs of infection, and not a new thing either)

2) I take naproxen sodium (Aleve) 200 mg every morning and acetaminophen 1000 mg in the evening. Neither really helps tightness, but it works for the other arthritic joints

3) swelling is slight to moderate, depending on the day. The popping, clicking noise and a feeling of one part of the joint catching on something is worse when the swelling is less. It feels almost like the bone on bone sensation I had before surgery.

4) Flexion is at least 125 and extension is 0

5) I haven't been icing in the last 6-8 months. It didn't seem to make any difference after the first year post-op

6) I elevate the leg at least twice a day for an hour and use a pillow at night to keep the leg higher

7) I do daily housework--vacuuming, laundry, cooking. I try to walk 1-2 miles a day, some of which is shopping or just around the house. I average five times up and down a flight of stairs each day.

8) I was going to the gym daily where I walked a treadmill for 1 mile and rode a recumbent bike for 20 minutes in addition to some upper body weight use (started going in May 2016, almost a year after the surgery). I haven't been there in 3 months though--we spent time in a warmer climate and just walked the sidewalk along the beach daily.

No PT sessions since early September 2015

Thanks!
 
1) Pain level is 2-3--it is more of a very tight feeling around the knee although the top of the knee scar is tender to touch (no warmth or redness or other signs of infection, and not a new thing either)
There are many manifestations of pain including soreness, burning, stabbing, throbbing, aching, swelling and stiffness. Be sure you take all these into account and medicate accordingly.
2) I take naproxen 200 mg every morning and acetaminophen 1000 mg in the evening. Neither really helps tightness, but it works for the other arthritic joints
Of course they won't help with those paltry doses! You should be taking the naproxen at least twice a day and the acetaminophen 1,0000mg 4 times a day.
3) swelling is slight to moderate
Read what I said above about types of pain.
4) Flexion is at least 125 and extension is 0
That's not bad!
6) I elevate the leg at least twice a day for an hour and use a pillow at night to keep the leg higher
. Elevate for at least 40-60mins and more than 4 times a day.
7) I do daily housework--vacuuming, laundry, cooking. I try to walk 1-2 miles a day, some of which is shopping or just around the house. I average five times up and down a flight of stairs each day.
Well that's okay.

I think your pain is just a hangover of things that haven't settled down yet. For this to go on for almost 2 years is not uncommon but I can understand your disappointment. However, the way to get this under control is to treat it with pain killers as I've suggested. From your description, I doubt you have anything sinister going on in there but it wouldn't hurt to have your surgeon give it the once over!
 
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