PKR Citylady52 Recovery thread Left medial PKR December 22, 2020

[Jaycey]

@Citylady52 You haven't said - are you using the aircast they recommended for you. It's not unusual to get swelling off and on. You aren't even a month out of surgery.

Are you icing and elevating as well?

 

[Citylady52]

Thank you Jaycee. Yes, I tried air cast but because I ordered it myself on Amazon rather than having it fitted by the orthotist at the orthopedic foot surgeon office., I'm not certain that I have the correct product or put it on right. I think that I did. I found it to be very uncomfortable and it did not do anything to prevent ankle motion front to back. Only side to side. When I took it off there were strange looking bumps and swelling areas all over the shin. being that I'm only four weeks out and still at risk of a blood clot forming I am wary of this device. And yes, it's hard to separate out which paints and swelling are from the knee surgery and which are from an ankle or tendon injury. I am really in a quandary and I'm not even certain what is wrong. For That reason I reached out to the foot and ankle people I see at Penn and fortunately was able to get an appointment for tomorrow. So hopefully I can get a clearer picture of what's going on. They communicate the knee surgeon group. I asked for a virtual appointment but they said they need to examine and "stress" the ankle to try and figure out what's happening. I will Update when I know more. This is really discouraging. I've been living with nothing but pain and foot and leg problems for a long time including having endured a stress fracture before the surgery which caused it to be delayed.

 

[Jaycey]

Well at least you have an appointment. That's a great start. I am sure it will be a very safe environment.

Please don't be discouraged. Very early days for you and at least you are moving forward.

I look forward to your update!

 

[Celle]

Also, PT pointed out that a person with s partial as opposed to total knee has much more ROM etc just by virtue of what was done to the knee. Therefore, they are sometimes able to do some exercises sooner.

I'm sorry, but your PT is wrong about this. There is no difference at all in the amount of ROM possible between a PKR and a TKR.

Even though only one knee compartment is replaced in a PKR, the surgery is almost as traumatic as for a TKR. Your knee is still opened up, soft tissues pulled aside, your kneecap turned over, and the ends of two large bones sawn and shaped.

With a few exceptions, recovery from a PKR is just as long and difficult as recovery from a TKR.

I have had a PKR, a Revision to TKR, and a TKR on my other knee. Of my three recoveries, my recovery from the PKR was the most difficult.

 

[Citylady52]

Well at least you have an appointment. That's a great start. I am sure it will be a very safe environment.

Please don't be discouraged. Very early days for you and at least you are moving forward.

I look forward to your update!

Thank you Jaycee. Your kind encouraging words mean Soooooo much. Here is update. Just got back from orthopedic surgeon. They said that I have tendonitis in both peroneal longus and achilles. They agree that this most likely occurred as result of the rather vigorous manipulations done during surgery. they also pointed out and observed that I am a very tiny boned women woman with very tiny ankles and no padding around them. The preferred treatment for this is a walking boot but that will not work when rehabbing a knee. They fitted me with a special brace to wear instead that goes inside the sneaker. It's a Med Spec ASO Ankle Stabilizer. I had to pay 200.00 for this. But part of that is for professional orthotist to select the right brace for my issue and to fit it properly. I also wanted to have something put on to leave the office with them not have to wait for Amazon. It's not the easiest thing to put on and off.

The other instructions I want to try and stay off of the foot as much as possible for the next two weeks and only do sitting and lying down exercises. My doctor said that since it's four weeks away since the injury occurred that warm therapy rather than ice is suggested. Not so much need for icing and elevation at this point. Unless it's for my knee which I will have to deal with separately. So I am having a pity party but I am somewhat relieved to at least have a diagnosis.

Take away: if anybody is planning knee surgery and has very tiny bony ankles, it might be a good idea to discuss with the surgeon to see if there's some way that they can be cushioned and protected during the procedure.

 

[Citylady52]

to clarify above. ..,., that was orthopedic FOOT AND ANKLE SURGEON ( not the knee surgeon).

 

[Citylady52]

Also, PT pointed out that a person with s partial as opposed to total knee has much more ROM etc just by virtue of what was done to the knee. Therefore, they are sometimes able to do some exercises sooner.

I'm sorry, but your PT is wrong about this. There is no difference at all in the amount of ROM possible between a PKR and a TKR.

Even though only one knee compartment is replaced in a PKR, the surgery is almost as traumatic as for a TKR. Your knee is still opened up, soft tissues pulled aside, your kneecap turned over, and the ends of two large bones sawn and shaped.

With a few exceptions, recovery from a PKR is just a long and difficult as recovery from a TKR.

I have had a PKR, a Revision to TKR, and a TKR on my other knee. Of my three recoveries, my recovery from the PKR was the most difficult.

Would have to agree. I had a LOT of pain with this TKR. Knee still hurts but subsiding some. Cannot imagine TKR being any worse.

 

[Pumpkin]

Glad to hear you have some support for your foot.
I had grade 2 tears in my peroneal tendons at about 5 weeks, went through some of what you are facing. They could not use the boot, so I had a brace to support my ankle/foot.
The initial healing was 3-4 months, full healing took a year.

 

[Citylady52]

Glad to hear you have some support for your foot.
I had grade 2 tears in my peroneal tendons at about 5 weeks, went through some of what you are facing. They could not use the boot, so I had a brace to support my ankle/foot.
The initial healing was 3-4 months, full healing took a year.

Wow. That sounds quite bad. How ever did you manage? What do you think caused the tears? How did they detetmine they were tears as opposed to just inflammation or tendinitis? I am finding the brace to be very uncomfortable. Rubs the ankle bone.

 

[Pumpkin]

I had a near fall, did a major muscle contraction on my new TKR side, spraining the ligaments. A PT did not believe me and did a maneuver that tore the tendons.
Diagnosis was with an MRI.

Lots of rest, ice, elevation, and medication, I stayed off my foot, when walking crutches and partial wt bearing. I also found the brace very uncomfortable and went to a soft brace to remind me to be careful.

 

[sistersinhim]

Can you put a cloth or something that could pad your ankle from the brace.

 

[Citylady52]

So, that brace has stiff metal or plastic up the side. Killer painful on outside ankle bone. Also, couple of questions.
1) some serious sharp knee pain in the joint. Intermittent. Esp when any torque happening. Moving leg in bed can be very painful. How long does this pain last?Stopped Tramadol which was only taking at night. Also stopped Gaba. Maybe should resume? Tylenol pretty useless and not great for the liver.
2) Having extremely hard time staying positive. I’m not a positive person to start with and worry a lot. This setback with the tendons really getting to me.

 

[Citylady52]

Can you put a cloth or something that could pad your ankle from the brace.

I’m going to look around for something. Thank you! A piece of foam might be good.

 

[Pumpkin]

Tramadol which was only taking at night. Also stopped Gaba. Maybe should resume?

Resuming your pain medications, given your injury, is a good idea.
Call the ortho place and let them know how the brace is hurting you, they should be able to make adjustments, add padding, etc.

 

[Citylady52]

Call the ortho place and let them know how the brace is hurting you, they should be able to make adjustments, add padding, etc.
[/QUOTE]

Found a piece of foam that seems to help. The "brace" consists of fabric with lace-ups and figure eight straps and firm sides. supposed to keep motion limited. a boot would be first choice but not when one is recovering from knee replacement.

 

[kneeper]

1) some serious sharp knee pain in the joint. Intermittent. Esp when any torque happening. Moving leg in bed can be very painful. How long does this pain last?

Your knee will be sensitive to an torque for a while. I found that I just had to move carefully. It should gradually go away.

 

[Citylady52]

So I’m over three months out now. Was beginning to turn corner end of a Jan and came down with awful GI infection fever etc still struggling and sick but that’s another story. Couldn't do therapy. Finally started up again and attempting to do stairs. Was walking well no cane. Trying to strengthen. Feel pain in ankle and up outside of operated leg including outer knee. Ankle aches. What to do? So discouraged. Seems that muscles may be weak which maybe puts strain on ligaments and tendons. I’m supposed to start outpatient physical therapy three times a week. Delayed because waiting to be vaccinated. So just doing exercises inside that therapist gave me. Should I ice, just walk on it, ignore it? No idea.

 

[sistersinhim]

Icing is always a good idea. If you keep a cloth between the ice and your skin you can not over ice.

 

[Celle]

Finally started up again and attempting to do stairs. Was walking well no cane. Trying to strengthen. Feel pain in ankle and up outside of operated leg including outer knee. Ankle aches. What to do? So discouraged. Seems that muscles may be weak which maybe puts strain on ligaments and tendons. I’m supposed to start outpatient physical therapy three times a week. Delayed because waiting to be vaccinated. So just doing exercises inside that therapist gave me. Should I ice, just walk on it, ignore it?

Given your history so far, I think you need to be very cautious about PT. Beware of trying to do too much, too soon, because that will set back your recovery.

Since complete recovery from a knee replacement usually takes a full year, there's no need to rush, either with Range of Motion (ROM), or with strengthening. You have small bones and you've already had a tendon injury. Aim for slow and steady progress, rather than trying to get quick results.

Walking is the best exercise of all for a new knee, so even walking around your house, doing daily activities, is exercise therapy. Your leg muscles are going to strengthen naturally, just as you use them.

I think that starting straight back with PT 3 times a week may be too much. Why not start with just once a week and gradually increase the number of sessions, if you have no setbacks?

Keep up with the icing, specially after PT. IF your ankle aches, it needs a bit more help. Using your cane will help there.

 

[kneeper]

I vote for gradual as well.