PKR Bilateral patellofemoral KRs<

[hawkfan]

@Jockette , what is your before story? Did you have any problems with it before your surgery? I am sure my muscles are tight also, and struggling with the new knee.

 

[Jockette]

I would have thought TKR would have corrected that.

I have never had a patella problem and now it seems I might. I taped my knee last night following a video of “taping for patella mal tracking” and it made a difference right away.

I know that in part is good news that the tape is helping, but I didn’t go through surgery and a long difficult recovery to end up taping a knee that never needed it before surgery.

 

[hawkfan]

@Jockette , I see the doc today so I will see see what he says about it. I will update later!

 

[Jockette]

I see mine on the 13th for my one year check up. I have a list of concerns. It will be interesting to see if taping my knee alleviates more than one of my concerns.

 

[sistersinhim]

Good luck on your doctor visit today! Be sure and let us know what happens.

 

[Josephine]

Can I ask why glute squeezes would be bad to do?

It's not the exercise itself, it's the quantity of them. Plus the fact that as yet you are only 6 weeks out.

Also, what are your thoughts about increasing time on the bike if I cut out the other exercises?

Not yet.

And what about walking

Did you actually read the article (the group left you in post #4) Activity progression for TKRs? I suggest you do because walking and how much is covered in there in fine detail!

 

[sistersinhim]

I followed the activity guide as best as I could, and had a good recovery.

 

[hawkfan]

@Josephine , yes I did read it. Along with a lot of other information. It must have been “brain fog”.

@sistersinhim , I will !

 

[hawkfan]

Well, I felt like my appt. went pretty well. Doc said I was walking well, my mobility and ROM were great. The first thing he did was say he wanted to watch me stand up first, then go walk. I said I still have to use my hands to push up because it still hurts in front of knee. He said that was normal for his partial patella femoral replacement patients more than the TKR ones and was not surprised. And explained that most of us have not used our quads in 10-15+years and so we have very weak quads. So we need to strengthen them and as they get stronger the pain will get better and Better as it will track better.

My left knee is trying to track to the outside some as my inner muscles are so weak. The xray looked good, so glad there wasn’t anything wrong. He said it will take a lot of work and could take up to 6 months to really get where I need to be. Just take it slow and add gradually to my strength training. I am taking less pain meds now and will switch to Tramadol for awhile to transition off the hydrocodone. I start back to work on Monday but will phase it in with part days. My swelling is also improving but is still moderate.

 

[Jockette]

explained that most of us have not used our quads in 10-15+years

I seriously doubt that. At least in my case. And in your case also, at your age.

He said it will take a lot of work

Daily activities will do just fine, especially if you plan to go back to work next week with 2 moderately swollen knees. It’s too early in your recovery to start strength training.

 

[sistersinhim]

and explained that most of us have not used our quads in 10-15+years and so we have very weak quads.

I find this a very insulting statement from your OS. Does he thing we all have been sitting on our rears for 10-15 years! You don't have to work hard to strengthen those quads. They naturally get stronger each time you use them. Just walking strengthens them! Do you daily living activities and that will be enough. Especially with you going back to work! Don't be bullied!

 

[hawkfan]

Wow, I didn’t expect those responses! Thank you for your support. I am not insulted at all and totally agree in my case. He is talking about patients similar to me which is only about 10% . My quads have been weak my whole life and I am a big walker/hiker. That never strengthened them before so I would be surprised that it would now. Doing a squat or a lunge has been difficult for me since I was in my twenties. Assuming because of my kneecaps being turned out. I am planning on not over doing it. I am taking into consideration both points of view (OS and Bone Smart),and knowing my situation. Thank you for being concerned.

 

[kneeper]

I think your doc is correct about taking it slowly and that the strength will come.

 

[katchmo]

I had my tkr due to patellofemoral syndrome. I am 10 weeks out and at this point I still have a lot of pain under my kneecap, more than I did before surgery. I was very upset when I found out they left my kneecap in but he said they sliced off the cartilage and resurfaced it. I have to wonder if I would have less pain if they removed the kneecap since that was where all my problems were (my other compartments were "pristine!") but my OS assures me this would not be the case. He says it is nerve pain that should eventually settle down. I'm on gabapentin for it and it helps. My quads are weak too, just like you, squats and lunges have been problematic since I was 23, but I'm waiting till three months out to start specific strengthening exercises on advice from someone here. I could walk till the cows came home preop, but stairs and chairs, oy. Good luck with your recovery!

 

[hawkfan]

@katchmo, I was so happy to hear from you! thank you for sharing and encouragement! I re-read your post also. have been too tired to respond. I have gone back to work now full time so I have been dead tired after. Getting stronger though!

My quads are weak! I could walk till the cows came home preop, but stairs and chairs, oy!

That was my situation exactly!!! we are definitely knee twins and just 4 days apart surgery date! I did both at once, and it definitely adds to the recovery. My os left my kneecap in too, and said my knees were pristine elsewhere also!
Which is great news. But now, I am still maltracking in my left knee but my right feels pretty good. My right leg is stronger so that is probably why? I worry about my left, if it will ever be right. This is so hard but I mostly try to stay positive. I don’t have a lot of pain except when lifting my leg with knee bent or after more activity. When I walk, it feels mechanical, not natural at all, and feels like a band is wound tight around the knee still. Not as bad as early on though. Hard to explain!

 

[hawkfan]

Where I am at: 11 weeks post op. Can walk up stairs leg over leg, but not easily. Going down is harder bc of my left knee. Feels like bone sticking in the front of the knee. Not free movement. Ride stationary recumbent bike 10-15 min. Once or twice a day. Walk about 7 blocks at most as muscles start to tell me enough and start to swell. Doing some strengthening but not every day. Have to push up with hands to get up still! So frustrating. Ice and elevate 3 times a day. I can tell people think I should be doing better. I had no clue this would take so long or be this hard. I really appreciate reading everyone’s posts on here as it helps me to be patient.

 

[hawkfan]

My PT measured my rom as 128 on right and 125 on left. -1 flexion on both. So good there at least. Should my walking be smooth feeling and more normal by now? I have never needed a cane and my gait is normal, just have stiffness and wierd feeling, and of course I walk slower. Feel old..

 

[Mutti3]

Yes, it is a journey of weird feeling knees and stiffness ! This are baby knees we adopted by surgical intervention! It does get much better with time.

 

[Jockette]

Should my walking be smooth feeling and more normal by now?

11 weeks is still very early in recovery. And, there are no “shoulds”. I wasn’t walking smoothly at 11 weeks. It will happen as you heal more.

 

[hawkfan]

Well it has now been 9 months since my bilateral PKR and I havent posted in quite a long while. Unfortunately, I still have pain, stiffness and "that hunk of wood" feeling (as @Jockette says). It is very disappointing and upsetting. My main issues are if I have my knee bent for a while and then try straightening it, it is very painful to do that! Mostly on my left knee but the right bothers me also. It hurts to get up and down, go up and especially down stairs. My flexion and extension are very good and not a problem at all. I know many others have trouble with that and i am grateful that I don't have that to worry about!
I saw my OS in July and he said to wait out the year and hopefully it will resolve as he has seen that many times. He said that I am the Poster Child for this type of problem (kneecap maltracking).
Well, it will be a year in less than 3 months and I decided to call and make another appt. with the OS. I see him in 2 weeks and we are supposed to decide if we are going to go ahead and do a "scope" to see if scar tissue is the problem and if it appears to be, he will clean that up. He would rather wait the full year but I told him a year would be a few weeks AFTER my deductible starts all over again so if he thinks the surgery is going to happen, lets do it before the end of the year. I also think maybe I should get a second opinion on this and I would like to try Mayo Clinic. Does anyone have any suggestions for a Dr. at Mayo who is good at diagnosing and fixing this problem? I go there for kidney/liver issues already and am familiar with them.
I am not looking forward to more surgery and if I thought continuing to exercise and waiting would fix it I would be fine with that. I just feel that it shouldn't be feeling this way at 9 months any longer. I have tried to be patient knowing it is a marathon not a race!