Knee Infection* Cakes 2114 - Knee Recovery Thread

[Jockette]

As long as acetaminophen agrees with you it is ok to take 2 extra strength, which will equal 1,000 mg per dose. I took this every 6 hours, round the clock, which obviously means a dose during the night. Keeping it in your system regularly helps it work better.

You can take up to 4,000 mg in a 24 hour period. Make sure none of your other medications have acetaminophen in it. If they do, make sure you do the math so that you don’t go over the 4,000 daily limit.

 

[Cakes2114]

As long as acetaminophen agrees with you it is ok to take 2 extra strength, which will equal 1,000 mg per dose. I took this every 6 hours, round the clock, which obviously means a dose during the night. Keeping it in your system regularly helps it work better.

You can take up to 4,000 mg in a 24 hour period. Make sure none of your other medications have acetaminophen in it. If they do, make sure you do the math so that you don’t go over the 4,000 daily limit.

Fantastic information! I will definitely check the meds and make adjustments if any have acetaminophen

thank you!

 

[Cakes2114]

Some good news I can walk with my cane! I was actually surprised since I have been non weight bearing for over two months but I gave it a whirl today after the doctor called and approved it... and I can walk with a cane!
I did find out we will be moving slow with my Physical Therapy. There is some issues with my patellar tendon. They want to go slow for the next two weeks and keep the flexion to 45 degrees. I can full weight beat with a cane and hopefully by 2 weeks I can move more aggressively.
Overall pain is manageable. Today I have had some pain behind my knee. I don’t remember having that before but it is ok with pain meds (Dilaudid and acetaminophen), Ice is my new best friend. It truly does help!

I do have to go back to see the doctor on Monday to get the wound vac off. They will be putting a new packing on my knee (the PA is very concerned on the packing because of the instability of the patellar tendon). Which I am honestly shocked about I never had an issue with my patellar tendon before but I am sure my knee is just difficult since this was surgery 13
I was also sent home with a CPM which I am excited about because it means the next two weeks with no PT my knee will still be moving. Only 45 degrees but it is better then nothing.
so now I will do the CPM to 45 degrees, work in walking with the cane, ankle pumps, leg lifts (but they are hard right now because my quad still sleeping), extension when not using the CPM and ice... lots of ice.

If anyone has an explanation of the behind the knee pain let me know. Or experience with a patellar tendon issue after TKR

 

[Cakes2114]

Hey everyone I had my wound vac removed the other day. They have put on Aquacel dressing on my knee for the next week. It is waterproof and seems to have a ton of benefits.

Has anyone else had this put on?

 

[JennyLynne]

I’ve had aquacel on both knees and it is great! I love being able to shower immediately!!

 

[Cakes2114]

I’ve had aquacel on both knees and it is great! I love being able to shower immediately!!

Absolutely the best part so far!

 

[Cakes2114]

Here is some progress so far

 

[PegGar16]

Hi @Cakes2114. Happy yo see that everything is working out well for you and that they were able to do the final stage so quickly. Make sure you pay attention to what is going on with the patella tendon and don't over do it.

 

[Cakes2114]

Hi @Cakes2114. Happy yo see that everything is working out well for you and that they were able to do the final stage so quickly. Make sure you pay attention to what is going on with the patella tendon and don't over do it.

I never thought there would have been an issue with the patellar tendon. I was actually shocked after stage 2 they mentioned it and had me in a brace going from 0-45 degrees for the first two weeks.
I have not restrictions now and and using the cane or even slowly cruising with no cane.

What are some things to look for with regards to the patellar tendon?

 

[PegGar16]

Did they tell you what the issue was or what they did to it? When mine ruptured I found that I could not lift the bottom part of my leg......sitting on the exam table with my legs bent and hanging over the side I could not lift my foot to straighten the leg.

 

[Cakes2114]

Not fully ruptured but tears throughout. Between kneecap dislocations as a kid through my mid twenties to the multiple issues with knee replacements it has a lot of wear and tear.
They did the brace and flexion locking to avoid a rupture. I don’t think I can extend from a flexed state now. I am sure at physical therapy I will find out more tomorrow but I am ready to get started on the road to recovery ASAP

 

[PegGar16]

Sounds like we have the same history. My started dislocating when I was 16 (high school sports) . Got to a point where I would hit a door jam and it would pop out. After my infection cleared up they did a transplant with the new knee. All is good

 

[Cakes2114]

Sounds like we have the same history. My started dislocating when I was 16 (high school sports) . Got to a point where I would hit a door jam and it would pop out. After my infection cleared up they did a transplant with the new knee. All is good

You definitely give me hope! Thank you

 

[Cakes2114]

Hi everyone!
Just wanted to give a quick update. I was cruising along with my total knee revision until about two weeks ago.
Tons of swelling and pain.
I called the doctor and they had me come in the next day.
Fluid draw and xrays were done.

Good news is the implant is not loose and the initial results show no infection.
Bad news a possible MCL tear. I was in an immobilized for two weeks. Now in a hunger brace for the next month. I need to leave locked when walking but I can unlock with sitting and take off in bed.
Has anyone had an issue with their MCL after a TKR?

 

[Pumpkin]

Sorry to hear you have a partial MCL tear, hopefully it will heal with the brace you are wearing.
We have had other members with tears after TKR, don't think anyone currently is dealing with a torn MCL.
I have had a tear in my MCL since 1974 when I broke my tibia, never knew about it until I had an MRI in 2000. Assume it healed sufficiently while I was casted foot to thigh for the fracture.

Currently I have a hinged revision knee that substitutes for most of the ligaments.

 

[Cakes2114]

You always make me feel more sane!
I never in a million years thought I would come back with a MCL issue after everything.
After three months of no issues I thought I was in the clear.
I did not have an MRI at this time. I am sure if it is still loose at my next visit they will order one.
I am not sure what else they can or would even do besides immobilizing. Like if they take the brace off at the next visit and then I swell up again what happens next?

 

[Pumpkin]

Hard to say what they will do if you knee is still unstable.
IMO, until your next visit don't get too hung up on the what ifs, hopefully it will be fine.

 

[Cakes2114]

Hi everyone!
I am back with a few new questions. I have been on and off Meloxicam since October 2020.

Every time I go off I struggle to walk. In December I was at the doctor for a 6 month check. My knee is fairly complicated so I am still see him every 6 months. At my December. Heck I talked to the doctor about stiffness and pain. He put me back on Meloxicam for three months.

Now I am back off Meloxicam since March 24th and I am struggling. I moved my June appointment with to the next available appointment in April. I need to get some blood work done before they will refill the Meloxicam.

My question is do people stay on this for a while?
Long term side affects?

Any other medicine that people can suggest?

My knee was complicated and my two stage knee revision from a staph infection was my 13 surgery. I partially tore my MCL about 4 months after the last surgery. I am at 90 degrees flexion. The doctor feels this is the best it can be because he is worried about infection if he goes in the clean out with a scope (which is probably why I got the staph infection from another doctor in the first place).

I am trying to figure this pain out… I cannot function without the Meloxicam but I doubt they will keep me on it forever?

I am wondering if you can get arthritis after a knee replacement? I am wondering how they diagnosis some with arthritis? I also have pain in my right elbow but maybe I am trying to connect things that are not connected.

Any words of wisdom??

 

[Jamie]

@Cakes2114 .... sorry to hear that you're still struggling with pain in your knee. Given the number of surgeries you've had on that knee, it probably will take a bit longer than normal for things to stabilize and be more comfortable for you.

As you may know, Meloxicam is an NSAID that is prescribed for arthritis, but it would work on a knee that's had a replacement also. Once your knee is replaced, there is no more arthritis. But there still are plenty of soft tissue areas that can bring the type of pain you're describing.

All NSAIDs have the risk of certain side effects, especially if taken long term or in higher doses. The number one side effect includes a range of gastric issues to include the possibility of bleeding. So, it usually isn't a good idea to be on them long term. So your surgeon is wise to take you off Meloxicam as soon as possible.

Have you tried Extra Strength Tylenol taken on a set schedule? Many times it can do a great job relieving pain after surgery. You take 2 500mg tablets (1000mg) at a time every 6 hours. It's important not to go over the maximum limit of acetaminophen (the active ingredient in Tylenol) in any 24 hour period. Acetaminophen is included in many over-the-counter medications so if you take something for colds, sinus, congestion, or allergies, be sure and count that in your daily total. You can find out how much acetaminophen is in any of these products from the label.

Another possible suggestion that you could discuss with your surgeon (or your GP if your surgeon isn't willing to talk about additional pain relief medication) would be Tramadol. You can take Tramadol with the Tylenol at alternate times during the day for better pain management when Tylenol alone doesn't work. Once you get pain under control, you can use the Tramadol on an as-needed basis.

You mention that you're struggling to walk. What exactly is going on? Can you give me some more details? I'm wondering if the OneStep program might be able to help you. It's a gait-based app that provides specific exercises to ensure that you maintain a proper gait. Poor gait can cause a lot of problems. If you'd like to learn more about OneStep and how it might work for you, we're having a Webinar this coming Saturday to show people how the app works. It will feature one of the OneStep therapists as well as Dr. Sinha to answer any questions you might have. I think the sidebar ad to sign up will appear on the forum tomorrow so you can register to attend.

 

[sistersinhim]

It is obvious you have some inflammation and the Meloxicam helps to flush that out. I also am plagued with inflammation in many joints and have had to take NSAIDS for over 25 years. I try to come off and have your results. OUCH! What I have found that helps me is to take a smaller dose and take a day or two off each week. I made a huge mistake a couple of years ago by cutting my pill in half, taking those every day. Doing so caused numerous ulcers in my digestive system. I learned to never cut a pill in half unless it is scored. It may release too much medicine at one time. That's what happened to me.

You might want to try taking your Meloxicam every other day and see if you can manage with that. It has really helped me to do it that way.