Knee Infection* Cakes 2114 - Knee Recovery Thread

[Cakes2114]

@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.

Thank you so much for this reply.

Extra Stregnth Tylenol sounds like a great option.
As for my gait since I also struggle with flexion and I am only at 90 degrees I simply do not walk correctly.
I am seeing the doctor on April 22. It is for the pain and stiffness. The doctor does not want to go back in because he feels I am prone to infection but I am struggling. And struggling more with the Meloxicam ending.

 

[Jamie]

You're correct that only having 90 degrees of flex would make a difference with your ability to walk properly. In the coming weeks and months, if you can do a lot of gentle bends and stretches on that knee, it may be possible to gain additional ROM. The OneStep therapists can work with you wherever you are, but you may want to do this on your own at your pace for a while to see how that goes. First order of business is to try and reduce any pain and swelling, though, and to keep inflammation at a minimum.

 

[Cakes2114]

Hi all-

Not sure if this is the correct place to post but I figured I would pick up on my old thread.

I had a two staged knee revision in May 2020 and June 2020. First TKR was 2018.

I never obtain full ROM. Struggled to get last 110 and now have deteriorated to about 80.
Since March 2024 I started to buckle. It is not terrible painful but I cannot control my leg if the buckle starts. I have not fallen but my left leg (never had surgery) has been catching me from falling.

It happens 4-15 times a week.

I ended back at the doctor. He mentioned a patella button. Which is never had through my 13 surgeries and back three knee replacements.

I am trying PT first and will need a MRI if PT does not strengthen my knee. My lateral quad is not activating correctly. It seems to trigger after the other parts of the quad are firing. Hopefully some PT retrains my leg but I believe the patella button will eventually be inevitable.

Has anyone had a patella button after any form of a TKR? Recovery? Hospital length stay? How long out of work?

Thanks in advance if you can shed any light on this surgery?

 

[benne68]

Welcome back, @Cakes2114. I'm sorry to read that you are having stability issues with your knee after all this time and glad you are trying some physical therapy to improve your leg strength.

Since this issue is a continuation of your TKR recovery, posting here in your Recovery thread is the right place.

While I have a patella button in one of my knees, it was placed during the initial surgery so I don't have experience with revision surgery to place it. I can’t think of other members who had the patella resurfaced and a patella button put in as a later surgery after TKR, but perhaps someone will stop who has been through this surgery will stop by and share their experience.

Given your complex history and previous problems with dislocation, I would encourage you to get a second opinion from a specialist who is not affiliated with the surgeon who did the previous surgeries.
If you need help finding someone, let us know and we might be able to offer suggestions.

 

[Jockette]

I never obtain full ROM. Struggled to get last 110 and now have deteriorated to about 80.
Since March 2024 I started to buckle. It is not terrible painful but I cannot control my leg if the buckle starts. I have not fallen but my left leg (never had surgery) has been catching me from falling.

It happens 4-15 times a week.

I ended back at the doctor. He mentioned a patella button. Which is never had through my 13 surgeries and back three knee replacements.

I would encourage you to get a second opinion from a specialist who is not affiliated with the surgeon who did the previous surgeries.

I agree, I would seek a second opinion from a surgeon who is not associated with your current one, before I agreed to have surgery to insert a patella button.

 

[mendogal]

Muscles of the thigh misfiring doesn't sound like a patellar issue.
I am a third vote for a second opinion with a knee specialist, preferably one who doesn't practice at the same medical center as your original surgeon.

 

[Pumpkin]

HI Cakes2114,
I had a patellar button added when I had my knee revised with a hinged TKR for medial lateral stability. Recovery was similar to a TKR.
4th vote for a second opinion about your patella.
Wishing all the best with PT to help resolve some of your problems.

 

[Cakes2114]

Hello all-

Thanks for jumping in. This is actually my second opinion doctor after I had the issues with the initial TKR.
I honestly trust him.
We are not ready for any button I was inquiring on the recovery.

PT for now
MRI next if needed
Then a game plan

I am jumping to the surgical option just trying to gather information at this time

 

[sistersinhim]

I agree that adding a patella button will not help your quads misfiring issue. I'm hoping you will find that the PT helps with that.

 

[benne68]

PT for now
MRI next if needed
Then a game plan

That's a smart way to approach this. I'm glad you have seen a second opinion doctor. Please keep us posted on how you are doing.

 

[Jamie]

This does sound like an issue for a good therapist. Be sure whoever you choose to work with is experienced in this particular problem and has the initials “DPT” after their name. This means they have extra diagnostic and treatment training that gives them the title of Doctor of Physical Therapy. It may take 4-6 months to get things working correctly with your quad, so be prepared for that.