TKR Almost Two Years Post Op and Still Struggling and Searching for Answers

[Readabook]

Hello everyone! I had a right total knee replacement November 20th, 2024. I had avascular necrosis in femoral condyle. I think from a fall. So no choice but to have replacement. Despite everything looking great after surgery and PT and perfect bend etc I easily get tendonitis around patella. I slipped down a step a month ago and annoyed knee and xray showed small bit of fluid behind patella. But implant was reported fine. I saw my retired surgeon's PA and he said xray was good and he could tell the fluid had gone by then, He basically told me to saty strong and take it easy.... I have tried to "rest" but a few days ago did a deep bend into garden and my knee felt like a velcro strip had been pulled...OW. I am taking tylenol and alternating ice and heat. I have a house with many stairs and go up and down all day. I have been taking care of family members thru out my tkr recovery with births and deaths and it has all been stressful and i just keep inflaming things! I always hear that the implant is strong, but I am worried about things again. I do my exercise at home and also have foot and ankle issue since surgery. That is finally improving!! I can't take nsaids which is a bummer. I have osteoporosis and am a little bit loose limbed... Curious if others have similar experiences. I was hoping to be all perfect by 18 mos, but I guess I am a long hauler. Nice to meet folks! Ps: no swelling, excellent rom. Sides of knee and patella are very angry.

 

[Legseleven]

I'm so sorry to read that you are dealing with this. It sounds painful and any incidents post op can cause great concern. The implants are strong and it’s all the muscles, tendons and ligaments which take the time to heal, often a long time. You’re doing all the right things resting and icing. Perhaps another chat with the PA will help put your mind at rest. You sound like a wonderful caregiver and I hope you can concentrate on yourself for a bit. Is there anyone who could help you?
Thinking of you, I too have lots of stairs.

 

[Readabook]

THank-you! I am worried. Everyone is shocked that I have discomfort this late in the process.

 

[Layla]

Hello,
Welcome to BoneSmart and thank you for joining us as an Insider.
I am sorry you're dealing with pain issues nineteen months post op. You sound like a very active devoted caregiver. You have my sympathy for the losses you've suffered as you're physically healing, yourself.

Obviously you need to avoid those deep bends for awhile. Also, I am wondering if you can avoid heavy stair climbing until you're feeling stronger? If you're able, try to get more use out of less trips up and down. Grabbing things you know you'll need throughout the day, saving yourself extra trips...if possible. You may also consider setting aside daily exercises while you're hurting in favor of easy gentle walks. The inflamed soft tissues around the patella need a break from the constant irritation / repetitive stress so everything can calm down. If the pain isn't easing after several days of less activity and the remedies you mentioned you were trying, you may want to contact your OS's office for an evaluation or advice.
I hope with some rest you feel better soon. Please keep us posted.
@Readabook

 

[Readabook]

Thank-you Layla! I knew nothing about TKR going in and only heard success stories. I am hoping there are other in this group who have had a similar late recovery experience. I don't mean that misery loves company, but " i am going that as well" kind of thing... Hard to see how it will ever get better.

 

[Layla]

You're welcome!

Understandable that you are looking for similar recoveries and reassurance. One thing you'll find repeated here, over and over again is that no two recoveries are alike, even with the same person.
You sound like a very loving, selfless caregiver to those who are special to you in life, but you can only give so much before you begin suffering for it. Keep in mind what the flight attendant advises us all to do in a crisis. Put your oxygen mask on first before helping others. Taking care of your own essential needs first can make you better able to care for others afterward.
Make yourself and your recovery a priority for awhile. Orders from Headquarters, lol
Happy Saturday!

 

[Readabook]

Ha! Yes. What one finds in this situation is "You're not better yet??? My friend was playing xyz at 6 wks etc....!"
I am guessing that it is super bad tendon issues, but the tearing sound scared me and I have no idea what a failed implant feels like. My surgeon has closed his office and retired. I hope to see a new person this summer.

 

[Layla]

"You're not better yet??? My friend was playing xyz at 6 wks etc....!"

Most do not understand unless they've been through joint replacement and recovery themselves.
We have a thread about these "Tall Tales", of people leaping tall buildings within a single bound at three months post op. Slight exaggeration, but you know what I mean. Thread here, for your amusement -> HERE

You might consider finding a reputable OS to schedule a visit with and establish yourself as a patient for confirmation that all is well with the implant, which I'm guessing it is, but it will offer you the peace of mind you're looking for. Something to think about...

 

[sistersinhim]

I'm thinking that tearing sound you heard was probably adhesions breaking up. This is nothing to worry about, but I agree with Layla, if after a few weeks you haven't improved, seek out another OS, one that has no affiliation with your past doctor. You want someone to look at it with new eyes.

 

[Readabook]

Thank-you - it is a horrible feeling! And I sort of forgot about adhesions as I have always had great bend. Thanks for normalizing that a bit.

 

[sistersinhim]

You are very welcome. Let us know how you do. Adhesions might not cause just a bad bend and can be anywhere around a joint. They are really pretty rare. Before my TKR, I had, had 5 knee surgeries on that right knee. I asked the OS if he saw any adhesions, and he said not a one. I was obsessed with not overdoing my recoveries, so I kept my knee cool. Here is a little explanation about adhesions:

The scar tissue many talk about, (which is more correctly called adhesions), is very rare, and one of the easiest ways to develop it is to work your knee too hard. Over-worked knees get inflamed and hot, and hot tissues become drier than normal and more likely to stick together and form adhesions.

This article explains the difference between scar tissue and adhesions:
MUA (Manipulation under Anaesthetic) and Adhesions

You need normal scar tissue. That's what holds your incision together, and it's part of the normal healing process. Without it, you'd always have an open wound.

 

[Readabook]

That is so interesting and a bit confusing- you see folks get procedures to remove scar tissue, you hear you must exercise a lot to prevent scar tissue.... I always figured since I had a good bend that I must not have much scar tissue... Thanks very much for this!

 

[Readabook]

I met with a new surgeon. He was very professional and pleasant. Huge orthopedic center. Xrays were taken and implant is great. Bend is great etc. However he seemed to be a bit surprised that I got so inflamed after bending into the garden ( and all the powering around I do. ) At 19 months. He did say the velcro sound was likely scar tissue. And thats ok. He gave me the talk about how not patient is happy with a tkr even if it looks great. I was sort of embarrassed. I had to do this surgery as I had chondral deficits. I couldn't walk. I did mention that chiropractors and podiatrists and PTs have commented on how loose limbed I am. I never thought about, but I am lanky long limbed underweight lady. Not so good for joints. And he cautioned me that overdoing certain things, even minor could cause me tendonitis. My other docs are now keeping that in mind. Its not always cool than you can be bendy when you are 68. I can't take nsaids as they cause my shins and arms to get easily bleed if i bang something (which from my description you know I do! ) Also after years of loving aleve I think it gives me tummy trouble. I actually took a pepcid ac tonight and then took an aleve...We shall see. Last point was that he noted that my other knee which has been awful over the years, but actually stayed calm for the right to recover- now has "significant" arthritis and i think he would like to discuss replacement. I will save that story for another post. Freaked out enough and its early in the week!! Ps. are allowed post xrays? Just curious. Best to all.

 

[Layla]

Hello and Happy Wednesday!
It's always reassuring to deal with a pleasant, professional physician. It's great that you liked him.
You don't need to be embarrassed after he mentioned that no one is perfectly happy with their TKR result. For one, I don't believe that's true, but with that said, our prosthetic joint will never match the healthy natural joint we lost due to deterioration. So there's bound to be comparisons made between life before and after joint replacement.

You'll know when the time is right to discuss Left TKR replacement, so I hope until then you are comfortable enough to put it in the back of your mind until you're feeling ready.
Regarding X-rays, yes, you can post them on your thread. Following you'll find a few tips on posting
them -> HERE

Have a great rest of the day!
@Readabook

 

[Readabook]

Thank-you Layla. I am a bit overwhelmed and thinking about the visit I had with this new to me surgeon. I actually miss my very grumpy former knee doc who had his own little practice, but shut the doors and moved to Florida! My tendonitis in 19 mos old knee is really bad after my lunge into the garden. And now the other knee (with the "significant arthritis"" is on fire as well. I wan to keep exercising, but I read some other posts here that I should really do nothing and rest ( super hard). Just all on fire right now.

 

[sistersinhim]

Rest, elevation and ice are the best thing for both of your poor knees now. You need to get the inflammation down, and exercising right now won't help that.

 

[Layla]

I'm sorry you're hurting and miss your old surgeon. Hopefully you'll grow to appreciate the new one.

Are you considered hyper-mobile? Your joints move more than average?

You likely irritated soft tissues when you heard the noise while gardening. Straining tendons, muscles or scar tissue around the joint. If you inflamed tendons and don't rest, the inflammation and recovery can take longer.
Try to avoid any activity that aggravates the situation. Take easy walks and do gentle stretches in-between rest, icing / elevating to reduce the inflammation. Keep in mind that 'Pain Is Your Body Asking For Change' and a good cue to stop what your doing because repeated irritation can lead to tendinitis. Please rest and let us know how you're doing after a few days. We're here for you, Readabook.
I hope you have a pleasant weekend.
@Readabook

 

[Readabook]

@sistersinhim @Layla ok... stunned that i am like this at this point in recovery. I also got a steroid shot in an ankle/tried aleve/ and dropped a book on my foot last night. Blood thinners galore and now bruises. That knee doc really dismissed me and now I feel like I am beyond the point of a normal recovery- he said if I am not better at 19 mos , I won't be. I guess my joints do move a bit more than average- never really thought about it.

 

[Jockette]

My PKR is not a success story, and after 3 second opinions, I understand being dismissed by the surgeons. I don’t have any advice, I just wanted to let you know I know how you feel.

I did fall 6 years after my PKR, and landed mostly on the PKR knee, no major damage, “just” soft tissues upset. My leg swelled a lot and bruised, which hurt and greatly diminished my ROM. It did take about 2 months for that to heal back to my normal.

 

[Readabook]

@Jockette - many thanks for this. I seem to be surrounded by superhero healers in my little corner of the universe. And they are very braggish! I so appreciate hearing other's stories. ox (ps that fall must have been terrifying.)