Revision TKR August 1st 2023 Second TKR Revision Left Knee

End of week 8 update -

The illness (fever and chills) has come back, and the knee/shin pain is not getting better at all. In addition, I seem to be getting all kinds of strange aches all over my body. I suspect Lyme disease (I had a tick bite maybe a month or more ago) but before I can get tested for that, I had to have a PCR Covid test today, though in the course of this illness I've tested negative 5X with the home Covid tests.

If all goes well I can get the Lyme test tomorrow or the next day and get proper treatment for this. There are at least five known cases of Lyme disease bacteria infecting a TKR joint, and I sure don't want that.

If I do have Lyme, I wonder if it is the cause or at least an aggravating factor for this painful knee and shin problem, and perhaps the back problem as well.

My knee has been more painful and swollen lately, and RoM has decreased to 85°.
 
I’m sorry you are now dealing with this additional issue.

Maybe you should also be checked for a knee infection? Does your surgeon know that your knee is more painful and swollen and ROM has decreased?
 
HI @Jockette , thanks for your comment.

The knee swelling and loss of RoM is very recent and seems to fit more into the day to day variation I see. There are no other symptoms that indicate a knee infection, so I am not so worried about that. I have to first get this recurring illness under control and then see what the knee is like. If this is Lyme it may be aggravating the existing swelling in my knee - swollen knees are not uncommon when Lyme is involved. Hopefully, fixing this recurring illness will make everything else feel better, for psychological reasons if no other.
 
Even though Lyme Disease is very rare, it's best you get tested for it. How long ago did you get the tick bite? Hopefully, those aches and pains are just part of this recovery.

Be sure to let your OS know what's going on.
 
I hope you get help for it soon. I’m sure it feels like you’ve been in recovery forever.
 
End of week 9 update -

The problem with my shin is not improving very quickly. My surgeon's office says that compression of the peroneal nerve is not uncommon after knee surgeries and it typically takes a few months to resolve, so I may have another month or so to go with this.

The blood test results came back, and I don't have Lyme disease, but I did test positive for mono. I've never had it as far as I know and it seems to be pretty rare in (relatively speaking) older people like me (I'm 62.) Wikipedia says that 95% of people catch the virus before they reach adulthood. The good news is that a month has already gone by and so another 2-4 weeks they say and I should be good.

I came down with this a few weeks after taking a course of oral steroids, which are said to suppress the immune system. I wonder if I had the virus in the distant past and taking the steroids allowed the inactivated virus (after you recover from the virus it stays in your system forever in an inactive form) to wake up and make me sick?

Flexion is back to 90° and I am still doing my easy exercises.

I was going to look into acupuncture to try to address the swelling in my knee (which is not improving) but since I may be contagious I think I should wait a bit. Likewise I have to make sure I don't give it to someone else in the house.

This week's quote from Roseanne Roseannadanna is "If it's not one thing, it's another!"
 
@WFD so sorry you are still fighting this issue with your knee. Not ideal that you have other issues to complicate things. :hairpulling:

I have been out of the US for many years to not sure how it works these days. But in the UK I found a good osteopath who did acupuncture after every adjustment. My issue was not swelling. But any good practitioner will be able to address your own issues.

Feel better soon!
 
End of week 10 update -

Things were going pretty much OK - my back issue is gone and the mono as well, though I am still isolating until the end of the month.

Then on Saturday I did some minor chores - put out the garden hoses and hooked them up, and got out a ladder to retie a tarp protecting our firewood pile. By the following day my knee was stiff and my shin was on fire. It was like I lost at least a month. Today I am better but not all caught up. My flexion is down to 85° from 90°. When the swelling improves I am sure it will go up to 90, but getting to 100 will required the swelling to go down even further and it seems to be really stubborn about that. My surgical knee has been at least 3.5cm larger in circumference than my good knee for more than 18 months and I wonder if it is permanent...

Man, this is frustrating. Being unable to do much of anything for more than 18 months is getting really old.
 
I’m sorry that your leg is still so sensitive to activity. The LOA procedure is pretty traumatic. Add on a recent illness like mono… I’m sure it’s very hard not to be able to do the things you need/want to do. My husband went through something similar.
 
WRD,

I haven't caught up and read all your posts... I'm sorry you are dealing with many complications.

But have you tried dry needling? My PT performs this for me, on occasion. It is similar to acupuncture but addresses the muscles. I have had good luck with it in my calf. It seems to release some tension and helps my range.

I also suffer from extreme stiffness, some days worst than others, where I can't bend my knee at all. Some of the people I know say they have had the stiffness last for a year.

After my 6th week after my LOA and MUA, I finally was able to move the pedal of a bike all the way around on high tip toes. I was happy I was able to do that. I have been wearing a compression sleeve (One I received from the doctor when I got my hematoma. I've cut it down to only cover my knee.) I think that has helped me quite a bit. I have also noticed, for me anyway, I work around the house or yard for 30-40 minutes and then taking breaks in between the work has helped me to last longer. I have to force myself to sit and take the break.

The frustration is real! I hope you get more "good" days moving forward.
 
@hemaknee , I plan to try acupuncture but I am waiting a little while longer to make sure I am not contagious. Don’t want to give mono to anyone.
 
End of week 11 update -

The nerve issue in my shin was getting better, so I decided to add an additional stretching exercise to my routine - nothing strenuous, just a wall slide for 15 minutes, and now today my shin is very painful. I did something like this last weekend too. At age 62 you would think I was better at learning but nooo....

The mono and back issue are completely gone, and my flexion is still at 90°. I still can't seem to get the swelling to go down.

I measure the temperature difference between my two knees in the morning and evening. The morning measurements used to show my surgical knee at 1-3° warmer than my good knee. Within the last week or so this has dropped to zero on average, so there is hope that the inflammation is starting the process of winding down. The evening measurement is still in the 4-5° range, and sometimes more. I suspect the swelling will not go down until my surgical knee is not warmer than the good knee at the end of the day, but at least now I know my knee fully calms down after a night's sleep.
 
What do you call a wall slide? Like a squat with your back sliding against a wall?
 
A wall slide has you lying on the floor with the sole of your foot on the wall and your knee bent. You slide the foot down the wall, bending your knee as it slides down. The advantage is that it allows you to hold a gentle stretch for a long time with your muscles relaxed.

I’m sure you can find images on the web.

For some reason it irritates my shin problem but in the past I found it to be an easy way to get a relaxing stretch (depending how hard I pushed it of course.)
 
I pictured a wall slide the way crickethip described.

How hard is it for you to get up off the floor? That in itself is probably a PT workout! I’ve only been on the floor once since my surgery (I went to sit on my husband’s four wheeled walker and it rolled away from me and I landed on the floor instead. ( I know, not very smart! :doh:) It was quite the challenge to get up. My other knee isn’t great and the floor was not carpeted, so even kneeling on my better knee was not something I was eager to try.
 
I don’t have any trouble getting up from the floor - I’m a lifelong weightlifter and although I’ve lost a lot during this recovery, I still retain enough strength so that things like this are easy.

It really drives home how important resistance training is for overall health and robustness.
 
Thank you for the explanation of your version of wall slides @WFD . So it's basically heel slides with some gravity added in. Interesting that this movement sets off your shin area.. makes me visualize that your swelling is compressing that area from being forced to better flexion.
I scrolled up a few posts and see that you were diagnosed with Mono? Nice to have that thrown into the mix, right? Hopefully the Dr is correct and you are headed towards the end of that!

You're going for acupuncture for the swelling and inflammation, have you considered lymphatic drainage?
Forgive me if I've already asked you this.
 
...oh, and keep in mind that many here on Bonesmart advocate not measuring things like RoM, to keep from obsessing over it. As an engineer, I'm all about obsessing over the details, but that's just the way I am.
Ahhh, an engineer.. yes.. that explains so much of your attention to detail. I have some engineers in my family.
The details are important for how your brain works, for sure.
 
Hi @WFD … just realms you posts. Sounds like you are past the mono - which is very good. Just wanted to give you a heads up about the adult Version. It is called Epstein Barr Virus . I had a very bad case of mono (hospitalized , liver shut down etc) when I was 15 I had “chronic fatigue” well into my mid 20’s (43 now) - when I wore myself down I would get sick. About every 4 years I now have a flare up of Epstein Barr. I start feeling VERY fatigued and depressed for no apparent reason (life is good!) I have one lymph node that swells in my armpit. Lots of coffee doesn’t help. I finally started getting tested when I feel this way, or the lymph node gets sensitive. They test you 2 or ideally 3 times of the course of a couple months . It shows if the virus is increasing or decreasing (tail end of infection) I have found the knowledge extremely helpful in taking care of my immune system and health. The virus just has to run it’s course but I would Definitely speak to your General Practitioner Doctor about this - knowledge is power!
 

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