Revision TKR Complicated RTKR revision 2015, considering LTKR

[Randi]

Just to clarify, for @pumpkin and others, I don't have an MCL, it was removed during the revision surgery. My torn tissue is assumed to be fascia. Still wondering if @Josephine has any thoughts on how to deal with this.

 

[wberry]

I think a brace will help. Mine has mentioned them before my revision. Now I am fantastic, so no need. But don't count them out.


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[Pumpkin]

Maybe you could try a knee sleeve, sports stores, running stores, drug stores carry them. Hope you have a good report at the OS next week.

 

[Josephine]

Still wondering if @Josephine has any thoughts on how to deal with this.

Sorry, @Randi - I've absent with a really bad cold that's lasted over two weeks. I read back 3 pages and couldn't see what you were referring to. So if you still need an opinion from me, would you be a dear and describe the problem again? Or perhaps tell me the number of the post I should be looking at. Thanks

 

[Randi]

@Josephine. Hope your cold is better. Here are a few of my whiny explanatory notes ,...

Just got back from the surgeon. I must say he is very nice and concerned and thanked me for letting him know I was having problems. Took x rays and examined and everything basically is ok says my pain must be from some soft tissue that was stretched in the surgery and then injured by specific Physio exercise. But admitted its really a mystery. So off my feet as much as possible for 10 more days, and no Physio till then and added gabapentin for nerve pain. Have to talk to him in a week and see where to go from there .. Not happy but sort of reassured.

8 weeks since my revision and here I am back here complaining again. It's been a crazy ride these past 2,weeks. A little better or level but ok. But somehow in these last few days I managed to get into big trouble again. Trying to think back to what I might have done, here is what I came up with. - I did a tiny bit of grocery shopping using a cart,,someone else carried the bags into the house, I went to a funeral and the ground was uneven, and I attempted to put on socks for the first time since my surgery. Nothing very stressful that I can think of. I felt increased discomfort again yesterday in the same spot as before, inside of my knee. This morning I could barely walk so spoke to my PT who hasn't let me do very much anyway and he was concerned with how I was feeling and the fact that I went back to using the walker because of pain. He went upstairs and came back with one of the surgeons ( mine is on vacation). He assessed, looked at me and my x-Rays , and said ,as others have concurred, that it is likely a tissue tear I am dealingbwith and nothing can fix it except time and rest. So, once again ,,no Physio, ( I'm consistently at 0/120 so nobody's too fussed about my stopping ) and virtually no weight bearing for at least a month ! I truly think I will go out of my mind

I'vev asked before and got no response, so I'll try again...has anyone here had a soft tissue tear post TKR a or revision and if so, how did it get sorted out?

Here I am again. Haven't been writing because I was taught if you don't have anything good to say, dont say anything...but I am so tired and frustrated and upset and hoping someone here can help with suggestions. It's been 3 weeks of non-weight bearing again, that makes about 6 out of 10 weeks of no Physio. My knee feels better if I do nothing but sit, ice, elevate but I truly think I'm going to go out of my mind. Of course I have not been completely not doing anything. I have experimented with short walks, a bit of shopping using a grocery cart,,even went to the pool once. I use the walker sometimes, or the cane, sometimes I don't need anything in the house. And it's always the same. I feel ok for a few minutes then the pain takes over. Sometimes it's the same place the tissue tear is,,sometimes it seems my knee cap itself hurts, sometimes it's the IT band, sometimes it's the tight band feeling... I keep playing with meds, more, less, different combinations...can't figure this out. I've made an appointment for tomorrow with a Physio I used to see, just to see if she has any ideas. Appointment with the OS Dec.,10th. Starting to wonder if I will ever walk properly again. Very upset

 

[Pumpkin]

Thanks for complying the posts!


Sent from my iPod touch using BoneSmart®
LTKR Sept 13 2011
Revision April 15 2014

 

[Randi]

And @Josephine. As earlier stated, pain air DRF 2. It's not the ligament since that's been removed. Best guess is torn fascia type tissue

 

[kneeper]

I have no suggestions but just wanted to say hi.

 

[Thesoutherncook]

Randi, Have you tried a knee support or even an ace bandage? I have similar pain in my old knee and that helped.

 

[Randi]

Randi, Have you tried a knee support or even an ace bandage? I have similar pain in my old knee and that helped.

Thanks for the suggestion. Not doing anything more until I speak to the doc next week.

 

[Josephine]

As earlier stated, pain air DRF 2. It's not the ligament since that's been removed. Best guess is torn fascia type tissue

Which ligament are you referring to - that's been removed?

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are .... If I've asked you these before, please forgive me. But I'd still like to know what the answers are now!

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

Can you describe them like these examples ....

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2

 

[Randi]

Which ligament are you referring to - that's been removed?

Medial cruciate ligament

1. what are your pain levels right now?

I have virtually no pain now, except for some mild stiffness, as long as I am very careful about weight bearing- i.e. - still using a cane, stairs the one at a time way, very little walking, etc I do get very tired very easily when I do much of anything, likely because I have been virtually inactive for most of the last 11 weeks. The pain at DRF2 seems to have subsided but I've been "good" and haven't pushed/tested it for the last week or so.

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

I've weaned off all meds as of a few days ago, except Advil occasionally and more for my other knee!

3. how often are you icing your knee and for how long?

About 4 - 5 times / day, 20 minutes each. Not really swollen to look at.

4. are you elevating your leg, how often and for how long?

Pretty much whenever I'm not walking or sitting to eat.

5. What is your ROM - that's flexion (bend) and extension (straightness)

Haven't been measured for a month but it was 120/0.

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc.

Very little. Might put a few dishes in the dishwasher or fold laundry. My poor wonderful husband!!

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

As per my instructions from OS and PT, NO Physio for the last month,,actually only had about 5 sessions throughout the last 11 weeks. I do a few heel slides once in a while just to make sure I can still bend. I have been in the swimming pool twice for about 20 minutes each, walking back and forth. The first time I was very sore after, the second time I slowed down and it was fine.

My main issue at this point is that I am being told to virtually do no weight bearing until this tissue heals and I am beyond frustration and concerned that I am losing strength overall . I see my OS next week so maybe this will change. What I really want to know is if you are aware of others who have been told to be so inactive for so long and what their outcomes were.

 

[PegGar16]

Hi Randi. I am going through something similar. 10 Weeks after my TKR I fractured the patella and tore the patella tendon. After it was re-attached I had a total of 8 weeks of it being kept immobile, and then weekly having the brace adjusted 30* for flexibility. My biggest fear was the knee not bending after all that time. I had to start from scratch at PT again when I started a couple of weeks ago. It is a slow process because I have to deal with the tendon but I am moving forward. The quad muscle kept its strength well..it was all the lower leg I have to deal with. I know we are dealing with different tendons but wanted to let you know that I am going through it too

 

[Randi]

@PegGar16 I'm so sorry you have had to deal with this. Thanks for sharing. Hope you recover quickly !

 

[PegGar16]

You too! I am looking for a better New Year

 

[Steve4kids]

Hello,
I really understand . Your not alone. I haven't been able to walk for 6 months. No weight bearing for the last 2 months and beforehand it hurt so bad I could only move a few feet. I have no knee, might get one the end of January. I thought I would loose my leg, happy to be free of it, but I think I will pull through
I keep going into bad depressions then up again, the pain was awful. I kept changing my drugs around finally I got, the right combo and told my pain Dr. . The pain Dr. Gave me better drugs then the ortho Dr. He was not afraid to give me stronger meds and that made the difference. I wasn't getting the right kind and not enough. Better now.
You can go to the market , that sounds so good, I wish I could do that. I have no friends to see me and everyone in my life seems to have moved on. Like I was dead. Ok , no choice.
Hang in there, it will get better but it takes a long time, my hope keeps going up and down and I look for answers, but they don't come. Small successes make it better. I can't plan ahead so I don't. It sounds like you really need to get your pain under control, get a pain management Dr. , some of the meds will bring on more depression , be careful. This will teach you patience. I will follow your progress, your victories will help others. Hang in there.



TKR April 12 , 2015
Marłch 10,2015,1st Stage, partial replacement antibiotic wash.
May 15, 2015, Debridement
October 29, 2015, knee replacement removed. Antibiotic Spacers in

 

[Steve4kids]

My left thigh is smaller than my fore arm , and my knee, or where it was, is big as a cantaloupe. People on this sight encourage me and say I can come back. That really helps a lot ..



TKR April 12 , 2015
Marłch 10,2015,1st Stage, partial replacement antibiotic wash.
May 15, 2015, Debridement
October 29, 2015, knee replacement removed. Antibiotic Spacers in

 

[Celle]

My main issue at this point is that I am being told to virtually do no weight bearing until this tissue heals and I am beyond frustration and concerned that I am losing strength overall . I see my OS next week so maybe this will change. What I really want to know is if you are aware of others who have been told to be so inactive for so long and what their outcomes were.

I feel your frustration!

However, yes, others have been in that situation. It's a huge trial of your patience, but it will be worth it. Your knee needs it. Although you may be losing condition now, it will come back again.

I wonder if @KarriB can reassure you? She had to be pretty much immobile for a month.

 

[KarriB]

@Randi I was in an imbolizer for for a solid month and then only when walking for 2 more weeks. I had a staph infection in my month old RTKR that showed itself with a high fever and a seeping infection that looked like a small stream. My OS performed an antibiotic washout surgery where he washed it out twice. Once as soon as it was opened and again after the surgerical team left the OR, scrubbed in again then did another washout scrub. So while my soft tissue didn't tear, it had been scrubbed with a strong antibiotic and was in bad shape (compromised, said my OS). Two weeks in the imbolizer led to 3, 4 and then 2 more only while walking. Twice a week I saw my OS and asked, "will my knee bend again?" His answer was, "the knee will bend when we tell it to bend." And it did! Now it did take a few weeks to get to 90. I was in an imbolizer from Nov. 27-Jan.9. When I started walking without the imbolizer my leg felt very weak and wobbly, so I was glad he had said to phase it out slowly, starting without using it in bed or while sitting/elevating.
My OS was very conservative and ordered non aggressive bending at PT and showed me this by pushing my foot about 1 inch with his foot! I started just bending my leg while walking, bending a little more every few days. I have a walk in shower that has one 4 inch lip to step over, that felt like a mountain, but for a few weeks that was all I did, walk and daily living with a bending knee. I went back to part time teaching at the end of January. By the end of February I was riding a bike for about 10 minutes and by April I was riding for 20 minutes. In June I began swimming laps again using a flutter kick and whip kick. This summer I realized I can actually squat in the water. I am a poster patient for gaining ROM well after the TKR timetable. The RTKR has a better ROM than my left.
It did drive me crazy being inactive for so long, but I was so scared I did exactly what my Drs said. I did not need an MUA, just easy walking, heel slides and wonderful massages from the PTs. After 4 months my PT did begin to build strength in my leg, but I was never in any pain. My RTKR is my go to leg for stairs, biking, getting up etc. Please feel free to ask questions, I feel your pain and frustration, I was an emotional wreck for 6 weeks! Good news was, I had very little swelling for that month!

 

[Celle]

Thanks, @KarriB !