TKR Almost a year and still in pain<

[kleo]

I had almost the same symptoms as you and my dr kept saying the knee was fine. I finally got two other opinions which both said the knee was too lax. I finally had surgery to almost double the size of the spacer and the knee is better than it ever was since the surgery five years ago. I’m hoping it stays this way...go get some other opinions. Don’t suffer as long as I did!

 

[annieo]

Can you please write again what your symptoms were? I'm at a year and although function is great I have ongoing stiffness and pain. Granted, it's minor pain but still!

I also have cracking at certain points when my weight is on a certain place. I realize this part is not uncommon and prob not a problem.

I have my year check up on less than a month and at least will get x-rays.
I just want to know all I can before going in.

 

[Josephine]

1. Pain: 3-6

Oh my goodness!

2. Meds: None

Hmmm - okay

3. Swelling: Moderate

okay

4. ROM: 130/0?

Pretty darned good!

5. No ice

Okay

6. I work around the house, then lie with legs up...3 hours total?

Okay

7. Trying to keep up with house work (probably 70% of normal.) Rarely shopping since it sets me back. Not working right now...I couldn't work full time with the pain.

Good, pleased to hear it

At home, with legs on ottoman, back on floor
Pump feet, toes in circles, pump toes, 20 times - these are usually for when a patient is not yet mobile and shouldn't be necessary now
Knee lifts, 20 times - 20 times?? Unnecessary.

With legs in air:
Scissors front and back, 10 times, Scissors side to side, 10 times - also unnecessary

Lying on back with knees bent:
Roll legs side to side, 10 times - okay, kind of. Don't see what the benefit of these are though
Clam shell, on back, 10 times, Clam shell on right side, 10 times, Clam shell on left side, 10 times - clam shells are the most pernicious exercise going. Causes pain in nearly all the upper thigh muscles. And 30 at a time is very much overdoing it
Modified sit ups on ottoman, 10 times - and these are unnecessary too

I also take a 45 minute walk once a week - Once a week is pointless. A 10 minute walk every day would be much better.

I think your pain is caused by all these exercises. You should stop them all, apart from the walk which I recommended as 10 mins once a day. But do stop all the others. They are doing you harm. Who told you to do them anyway? And why? When?

 

[San Souci]

Thank you for the input! I visited a lymphadema physical therapist who helped me reduce the swelling in my legs. If I don't do them, my legs swell up so I think I will keep at it as long as it's helping. The suggestion for shorter walks is helpful, however. I've known for awhile I should do so, but I've put it off because of the pain. It's time to do it anyway!

 

[arizonaone]

sansouci- yes you should definitely get a second opinion. In my opinion it's rare that the OS who does the original surgery would ever admit that there is something wrong with the size of the implant. That would mean he'd have to admit he did something wrong.

If you know anyone who had revision surgery in your area and was happy with the outcome ask who their OS was. Of course there are other criteria as well when picking a doctor but I think previous outcomes are a pretty good predictor of future ones. That's how I found my new doctor. I tried to do that with my first but no recommended OS took my insurance. Now I have a new plan that this doctor takes.

 

[San Souci]

I took your advice and found a doctor to get a second opinion by talking to a friend who got one. Good news! He identified the problem and I'm on my way to a revision. I trust this guy since he explained everything completely. **Fingers crossed**

 

[arizonaone]

Good to hear, san souci! Glad you got that second opinion!

 

[kneeper]

keep us posted.

 

[Jockette]

What did he say the problem is?

 

[San Souci]

What did he say the problem is?

Jockette, he showed me on the x-ray that my lower leg is looser on one side which makes it bend in 4° when I put weight on it, making me knock kneed. (I wasn't before the knee was replaced.) He had me walk and said it's clear that it is unstable. He's going to open it up, and once he's in there he'll know if it can be corrected with a thicker insert, or if the entire knee replacement needs to be replaced.

 

[Jockette]

I also suspect a loose implant but my second opinion surgeon said it’s not loose. He decided this by just looking at my X-ray. I really thought other tests were done to check for that.

I have some other weird symptoms which he thinks is nerve damage. I agree with that. He started me on gabapentin.

But I am not convinced yet that all my issues are due to upset nerves. Time will tell.

 

[San Souci]

Update: Successful revision surgery in July and now recovering. When the new surgeon opened it up he found that the tibia section just popped off. So, the glue had failed. Other than scraping off the old glue, he didn't need to do a lot of work. I was more stable the first time I stood up. There is more pain this time, but that was expected. Dr. Goldfarb in northern Cincinnati did a great job!

 

[Jockette]

Awesome report of a successful revision!

Best wishes for an uncomplicated recovery.