TKR Can lost ROM be regained

[Majic]

@CATSMUM I feel grotty generally. I have what are thought to be muscle pains around each knee, and sometimes down my shins. I'm unsteady on my feet, very tired and a bit dizzy. My Shingles spots have just about stopped itching thank goodness, but it has certainly affected me badly, and I am finding concentration difficult.
Before the TKRs I had lots of energy and could walk albeit painfully. Now if I walk far my muscles seize up and I have to stop. I did manage to walk 2 miles on holiday with stops to sit down and stretch, but after the 1st TKR I joined a walking group for people in recovery from various operations and was walking 2/3 miles a week from 4 months post op.
I think the 3 months UTI and the year of antibiotics has sapped all my energy and my weight loss has made my muscles weak and tight. My ROM is not bad, but I just feel useless, my 91 year old Mother has more energy. My husband is doing the washing and ironing and helps with the cooking so I feel very little use around the house. Also as I can't drive I can't go far without him taking me which makes me feel a nuisance as well.
This is such a depressing post I doubt anyone will have got this far, but in bed at night I wonder why I went through all this, and why I just didn't live with the pain.
I know I have a while to go to the 1/2 year mark, but for the last 4/6 weeks I seem to have gone backwards, and I can now see no light at the end of the tunnel.

 

[newlybionic]

I'm so sorry you are feeling like that. It is very difficult when you are not feeling so well to lose hope. Between the UTI, shingles and TKR you have been through so much. Even though the shingles rash has disappeared it still can cause you some problems. I would suggest that you seek out a counselor to talk to so you have a place to work through all your feelings. A log of the things that you do everyday might also be a help. Then you can see the things that you have been doing and be able to see the improvements no matter how small. It pray that you start to feel better soon.

 

[Pumpkin]

Magic,
Sorry to hear of all the troubles you are having, being on antibiotics for so long and all the side effects. Shingles in miserable, glad they are finally clearing. Hoping when all these infections clear you will start feeling better.
I agree with newlybionic, a counselor may help you get through all of this.
Sending you positive thoughts.

 

[LFitz]

I'm so sorry for all that you are dealing with during your recovery. Please remember this is a safe place to come and share your concerns, your struggles and your successes. I hope you to try not to compare your recovery with your neighbors recovery or others that you know because your walk has been unique to you and what you have gone through. And if avoiding your neighbor makes you feel a little stronger right now than do what helps you. Hoping things start to fell like they are turning around soon.


Sent from my iPhone using BoneSmart Forum

 

[sistersinhim]

I am so sorry you're going through so much. I'll be praying for you!

 

[Wanttobebiking]

Hang in there Magic! Glad to hear the shingles are improving and so happy to hear you have a very helpful husband so you don't have to deal with it alone.

 

[Majic]

I have had three hospital appointments this week, one for a bone scan which was running about 45 minutes late, one for my final eye check after my shingles this was running 1hour 45 minutes late and actually took about 10 minutes when it was finally my turn. Yesterday was the one to be fitted with orthotics and alleluia I didn't have to waiting! They feel very odd at the moment and I have to wear them for 2/3 hours a day to start with. Has anyone any tips about how to get used to them?
I said in a post in March that I was sick of being in so much pain and I still am. Some days every step I take makes me want to cry it is so painful. Are there people who are just worse after TKRs than before? Perhaps one of the moderators knows.

 

[Majic]

GOOD NEWS AND BAD NEWS but mainly bad. I have now had 3 swimming lessons and 1 session with a new physiotherapist and have a hydrotherapy session next Tuesday. My muscles are definitely strengthening and my shingles exhaustion seems to be going away despite the blistering heat at the moment.
This morning I saw my OS for X-Ray's of both knees and my annual checkup for right knee. The X-Ray's were fine, he was very pleased. Everything was in place and moving correctly, as I expected it to be. I explained to him about the continuing discomfort and sometimes pain under my knees and sometimes around the sides, mainly outsides. After examining me he said it was the patellar tendon (not sure of the spellings) and that it is something that some people have at their annual checkup. He said that there is a lot of scaring around it after a TKR and that it should improve with time. He suggested building up the other muscles more to support the patella and using a topical anti inflammatory gel on the area. He said that patients who had this problem rarely complained of it at their 5 yearly check up. Does anyone know anything about this, I know @Raffs was having something similar, but I don't know how she is as she hasn't posted for ages. Please help if you can, I feel totally despondent and after going through so much I don't know how I can face a lifetime of pain.

 

[FlaGranny]

I already have patellar tendinitis before surgery. It can be quite painful at times. I hope it doesn't continue. I'm hoping that cleaning up all the patellar bone spurs at surgery may eventually clear it up. It is my major worry about after surgery.

 

[Majic]

@FlaGranny Many thanks your reply. I really hope your 2 ops go really well and you get rid of your problems. My OS did say it only happened occasionally and I have been very unlucky. This seems to have been the story of my last two years unfortunately. All the best or your future.

 

[Majic]

@ladyfleur I have been following a thread by @jenkneefur in 2012 about patellar tendinitis, to which you replied because you were a fellow sufferer. I am hoping you are both around still as I am now having the same problem and interested in the outcome both of you had. If it was good how did you achieve it and how long did it take you to recover?

 

[Majic]

@Pumpkln , can you change my thread title please to 'Patellar Tendon Problems page 20'. Or something similar to indicate my present problems or no one will answer and give me any advice.

 

[newlybionic]

I hope you hear from someone who,has had your current problem and can let you know their outcome.

 

[Majic]

@newlybionic Thanks Marion, that's what I hope will happen, and why I have asked for my thread title to be changed.

 

[CATSMUM]

Raffs is still suffering from her patella tendinitis. She's had 3 PRP injections (paid for privately) to help improve the blood flow to that tendon, however, she's not that sure if they've been that successful. She's still having Physio and has been told that the tendonitis can take a long time to settle down. She's also been told to strap her knee up and use her knee support when it's bad. Apparently yesterday was the first day that she thought there might be a little improvement but she didn't want to tempt fate by saying anything further!!

 

[Majic]

@CATSMUM Thanks very much Claire for the news of Raffs. I miss her very much here, you obviously keep in touch privately. Please give her my good wishes. I also see my OS privately, but he said there was nothing he knew of that would help, and it was a case of time. How are you now?

 

[CATSMUM]

I contacted Raffs and she said that she'll try and update her thread this weekend. You could ask him about PRP treatment but I know that Raffs had trouble getting her insurance company to cover the costs for it.
I'm getting there, slowly. As you know l had my mua 3 weeks ago and adhesions were broken - knee is bending quite well now but l will need a lot of Physio/exercises to get everything back into working order again, thankfully, my trainer is one who believes in slowly, slowly catchy monkey!!

 

[Raffs]

Hello @Majic . I am so sorry to hear about all your problems and issues. I will give you as much info as I can about patella tendonitis and hope that some of what I say will help you.

So.....I was finally diagnosed back in February after a MRI scan. OS said at the time that everything else looks good and normal, just that the patella tendon was inflamed and not healing properly. He sent me for an ultrasound scan with a specialist radiologist who then carried out a PRP (platelet-rich plasma) injection. This involved a small amount of blood being taken from my arm, the blood was then spun in a centrifuge to separate out the plasma which was then injected directly into the tendon. The plasma contains the growth and healing elements of blood (so I understand) so injecting it directly into the tendon helps with the healing process. To cut a very long story short I have now had three PRP injections at 6 weekly intervals. At the last appointment (mid June), the radiologist could tell that the tendon was less inflamed than at the first appointment in March. I was starting to feel an improvement myself but was still not fully recovered by a fairly long way. The third injection was incredibly painful - the needle had to go through scar tissue made by the previous injections and, oh my, the pain! This third injection (6 weeks ago tomorrow) has taken longer to recover from but I am now - finally - starting to feel the benefits. My knee is still tight and sore but it has improved. The radiologist told me that each injection will take up to 3 months to fully work so I won't know until mid September how successful the treatment has been. I am due to see my OS then so I can update him. As @CATSMUM said, my injections were paid for (after a bit of a fight) by our health insurance company - they were approx. £850 each! I believe the treatment is available on the NHS but not sure how widely available it is.

I have been seeing a physiotherapist pretty much every week since February and he has really helped. He uses a very small ultrasound machine on the tendon for 7 minutes - apparently ultrasound can be used to heal as well as to scan. However, he said that he wouldn't be as happy to use ultrasound if I had a TKR instead of my PKR because ultrasound can cause the metal in the implant to heat up! As I only have a small amount of metal in my PKR it is fine to use ultrasound. He also massages the tendon fairly vigorously with his thumb - it hurts and feels good at the same time! Doing this enables him to feel my tendon so he knows how much it has improved. He also tapes my knee to give the tendon some support and to keep the patella slightly raised in order to allow the tendon to heal. The taping also acts as light compression which gives me some pain relief. On bad days I also sometimes wear a lightweight, pull-on elasticated knee support - my physio, OS and the radiologist have all seen the support and are happy for me to wear it. I am also doing some stretching exercises with my physio but nothing strenuous and nothing to stress the tendon.

I haven't had any tape on my knee or worn my support since Wednesday - 5 days! This is a MAJOR development as it is the first time all year that I have been going about my daily life with a 'naked' knee! Yes, it is still tight and sore but no worse than when I have it taped. This feels like a small breakthrough.

Physio says tendon problems can take up to two years to heal - eek! And when I've asked the physio and OS why has this happened to me they say it is very rare, I am unlucky (!) and it was probably caused by the tendon being overloaded and stressed after the surgery - lesson learned for the future for whenever I need to have my other knee done!

I have suffered quite badly from the blues because of this. I was not in a good place at the beginning of the year but went to see my GP who was fantastic (as always) and she has really helped me. I am not embarrassed to say that I've been taking a very low dose anti-depressant for a few months which has been an absolute revelation. I didn't realise how low I was until I started to feel like myself again, if that makes sense. I won't be on them for much longer, my GP has a very sensible plan for me - I am taking them short term to help me get through this (and a few other non knee related problems). I know they are very controversial but they have really helped me. I totally and utterly understand how the constant pain and not feeling fully recovered can make you feel, please do seek some help if you feel you need it.

Please tag me if you have any questions - I absolutely understand how you feel - my surgery was nearly 13 months ago and I am still not there yet. But.... my knee does function very well, moves great, bends great and I can walk quickly again (I love overtaking people!!) - once the tendon is finally healed then I will be a very happy Raffs!

Good luck! xx

 

[Majic]

@Raffs what a delight it is to hear from you again. You have obviously read my thread and know what has happened to me over the last few months. My Patellar Tendinitis was diagnosed last Thursday, but I am doubting the diagnosis since although it had been hurting all week, it hasn't hurt since!

It was replaced on Friday by very tight arcs around the outsides of both knees, over the numb patches a TKR causes. On Saturday this became pains from under the centre of my kneecaps diagonally across my legs towards and slightly down my shins. This feels like muscle pain. I have just been doing some cooking, and have had to stop and sit with ice along my elevated legs where the pains are. And so it continues.

The muscle pains down the outside of my legs have virtually gone after months of massage and new orthotics in my shoes after I had a gait analysis, but the pains are always replaced by ones elsewhere. My latest lot of bad news is that my quick and large weight loss has tipped me into the osteoporotic level after my recent bone scan, and I am in danger of a fracture unless I take special tablets. These involve setting the alarm half an hour earlier than usual, once a week, getting out of bed taking the pill with a whole tumbler of water, and staying upright for 30 minutes before even having a cup of tea!, my Doctor says that there is an alternative treatment involving an injection every six months but that tha NHS are reluctant to use it because of its cost. I shall see how I get on with the pills, at least it is not every day!

I have now virtually recovered from the Shingles I had, although still slightly spotty under my hairline. I am starting hydrotherapy tomorrow morning, and I have started having swimming lessons, trying to build up my leg muscles. My OS said that the stronger the rest of the leg muscles the less pressure on the patellar tendon. I just hope he is right. Standing is becoming a little bit easier I think, but walking uphill carrying shopping is very painful usually.

My puzzle is that the pains are bilateral although my knees were done 9 months apart, and the newest is the least painful, and the oldest knee was not like this until I had the second one done. What can be the answer.

I am so glad that you seem to be improving at last, I do hope that by the September you will be feeling you are getting back to normal. Many many thanks for replying, there aren't many of us left from our original contacts. Nearly everyone has improved so much they have dropped off the site and gone back to life.

 

[Majic]

@Josephine I wonder of you have any advice for me? I feel I shouldn't still be on this website and bothering you, but I still have a lot of problems and don't know where to turn, or whether I am doing the right thing at the moment.

My knees are both over the 1 year mark. 12 & 21 months. I am in pain every day in both legs, sometimes under the knees,sometimes down one side or other of my shins. Both knees were X-rayed last week and declared very good, and I must say they looked very good to me too.

My OS thought the pains were caused by my patellar tendons, and that they would settle down before my 5 year check up, as it was not common but not unknown for it to be painful after 1 year. He said that building up the muscles in the rest of my leg would help, and there was nothing he could do to help.

Up to my 2nd TKR I had not much problem with the first which managed to support me until the 2nd was done, but started to hurt as I recovered from the second. My Physio told me I would have a longer recovery than many as the catheter gave me a very persistent UTI, I had 5 different antibiotics and dropped from 8 and a half stones to below 7 in 2months, and was on antibiotics from 5th August until June 23rd, during which time I also had a cataract operation and recently Shingles around one eye and in my hair. The antivirals made me very unsteady on my feet and I wobbled around for 10 days, which I could tell was doing my muscles no good.

Because of the weight loss my muscles atrophied and I had lots of massage to get them to relax and start to stretch again. I can tell from my arms that I have not yet regained all my muscle strength, as I still find it hard to lift heavy objects. I have also had to have custome made orthotics as I started to use the wrong muscles to walk because of tightness in my large muscles.

I have been frantic about the state I have found myself in after all this time of hoping and praying and believing that I would soon get there and be pain free for the first time in years.

I have started weekly hydrotherapy, but after the first session this week, I ached and had pains in places I didn't know I had muscles. I have also started swimming lessons as I haven't swum for years and have found that my arms are barely strong enough, although after four times I am improving although sometimes my muscles suddenly tighten and I have to stop the lesson.

I am sorry to deluge you with this long diatribe, but I really want to know if you think that I am doing the right things or am going in the wrong direction completely. Most of my fellow July Sparklers have long since dropped off the site and forgotten about their knees so I feel a nuisance still be here. I have contacted @Raffs who has a similar problem, but mine is bilateral even though this time last year one was OK.
Please forgive me for bothering you with such a long post and please don't feel you need to reply over the weekend, you very much deserve your time off.