TKR Everything Comes to She Who Waits

[Pumpkin]

You know it sometimes feels like there is a really good replacement knee in there just needing somebody to untie it.

You are going to want to tell the OS this, if he is listening this will help.

 

[new knee in June]

@patient 99
Great job on the gardening 3 hours is a long time, stay out of the O.D.I.C
Jim says thank you for the Birthday wishes
Out for & good food & great Company tonight.....AHH.... The "Promised Land"
Have a wonderful Day
Love,
Diana

 

[KTF]

Hi. I never quite know where to start a conversation here. I trust the moderators to move it if necessary. I want to comment on @patient 99 and her post of may 18 regarding her fears, etc. I am 12 weeks now and I relate to all that she is saying and I would love to hear how she is now, 4 weeks+ later. Has there been improvement, are you feeling more confident?
My left knee is a champ with 122 ROM and lots of assorted discomfort, but nothing that scares me. My right knee is "stuck" at about 96-101, depending on the day. That number would be disappointing by comparison but not frightening if it weren't for the pain associated with the "stuck"! I have scar tissue that seems to have a nerve caught or some such thing that makes it impossible to flex the knee and keeps it in a protected position. The pain is excruciating and impossible to push through voluntarily ( as my surgeon suggest I do or get used to no more rom)!!! He thinks the nerve pain will go away in time, but I'll get no more rom if I don't force the issue. Manipulation is being discussed. I can't stand my OS and won't see him anymore; he is a good cutter but lousy communicator, no empathy, cold, Instills fear.
I walk really well, and feel certain I could increase my rom in time if I understood that this nerve pain and scar tissue will go away. Or is my surgeon correct? @Josephine
@patient 99 , how are you?

 

[KTF]

@patient 99 I responded to an old thread not knowing how to move around this forum to find current conversation. I stumbled onto this. Hopefully, my note will catch up with you.

 

[71Beetle]

hi @patient 99 - stopping by to say hello! Sounds like you are doing well with 3 hours of gardening. I am envious, I have to admit. I will get more done this weekend hopefully.

@new knee in June - Happy Birthday to your hubby. Hope you had a nice time out.

 

[patient 99]

I am 12 weeks now and I relate to all that she is saying

Hi KTF I am sad to say that there is no improvement with my knee. It still feels like there is a good replacement knee in there just wanting to be untied. I get some nerve pain if I bend more than my knee wants me to (ROM 100/0). I am seeking a second opinion on 8 July.

Two things I would say. First you are in the very early stages of recovery. I am 17 months post op. So there is still plenty time for ROM improvement. However, excruciating pain sounds like quite another matter. You have tagged Josephine who will be able to advise you much better than me. But I know for certain that she will advise against any action which causes you pain.

How do you know that your problems are being caused by scar tissue? Carol

 

[KTF]

@patient 99 I'm sorry, so sorry. Do you know what causes your delays and discomfort ? In my case, the consensus of opinions of PTs and the OS is that it is scar tissue. My X-rays are good. How are your X-rays?

 

[patient 99]

My X-rays are good.

Yes my Xrays are good too. When I go on 8 July for my second opinion I am hoping the OS will agree to an MRI scan so that my soft tissue can be seen. I think my problem is excessive scar tissue or adhesions (BS library explains what adhesions are). But I am a bit cautious when it comes to self diagnosing - I've no medical background and know only what I have picked up from BS. So who knows? I'm hoping the surgeon does.

How do you feel about having an MUA? My understanding is that they tend not to be offered if your flexion is 90 or over. Carol

 

[KTF]

I really want more information on MUA's. My OS seems reluctantly willing to do it, but not after 3.5 months, so I have a month to decide. He is not a talker, so I did not get out of him what his reticence is. He believes I should just push through it. He's nutz! I don't think he understands/believes me when I say it is not a pain that one can voluntarily cause by pushing.

 

[Josephine]

And an arthroscopic arthrolysis is similar to an open arthrolysis except the former is key hole?
(he said) `I do not think that her symptoms are bad enough for an open arthrolysis. An arthroscopic arthrolysis is possible, but in my experience it is rarely really successful and increases the risk of infection'.

Arthroscopic specifies use of an arthroscope which is used though small stand wounds about the size of a Yale key - henc 'keyhole' surgery. Open procedures are done using a scalpel to make a 2-4" incision. Neither give the surgeon a very good view of the interior of the joint which is limited to about 10" of the whole. It's a bit like looking into a honeycombe. Whether you do it pushing a drinking straw into the holes or by cutting it in half and just looking, there is a LOT more out of sight than can ever be seen.

Is it normally done when ROM is approx. 100/0

I would say not. Any knee that can get to 100/0 is unlikely to have adhesions.

My right knee is "stuck" at about 96-101, depending on the day. That number would be disappointing by comparison but not frightening if it weren't for the pain associated with the "stuck"! I have scar tissue that seems to have a nerve caught or some such thing that makes it impossible to flex the knee and keeps it in a protected position.

I very much doubt your problems are caused by adhesions (the proper name for 'scar' tissue). Look at this article MUA (Manipulation under Anaesthetic) and Adhesions.

I'll get no more rom if I don't force the issue. Manipulation is being discussed

This is very, very wrong. A knee should never be forced. However, you are now 12 weeks out so an MUA might be worth a try if you're not progressing.

I can't stand my OS and won't see him anymore

Ah well. Time to find another chap then?

 

[patient 99]

@patient 99
I am very impressed with your comedic genius I feel you are
Finally at my wacky level of nuttiness
Now, not only do I still have it, You also have it....

Once you have it how do you get rid of it?

 

[new knee in June]

@patient 99
You can't get rid off it It's a permanent life-long condition
How is your Knee ? Any better ? I hope so
Diana

 

[patient 99]

It's a permanent life-long condition

I came to BS with a new knee. Now my `new knee in June' (get it???) has turned into a life-long condition! Look I can't stop it. Its like turrets.

 

[patient 99]

How is your Knee

I thought you would never ask <grin>. You sitting comfortably? Yesterday it was bad. I got very upset. I said to Mike I'm in a no win situation. Come 8 July the OS will say one of two things. Either best to leave it as it is (what a prospect) or suggest surgery (what a prospect).

But today, albeit that I've had the elastic sleeve on, its been trouble free. Even at 17 mths out it is still a bit of a roller coaster. I've been trying very hard not rely on the elastic support, but I think I am going to give that up. I will ask on 8 July if wearing the support all the time is likely to make things worse. Hopefully the answer will be No. Most of the time I wear trousers so the ugly support isn't on show. It will be difficult when I go on my mini break on 1 August, because then I will want to wear dresses and stylish shoes - which surprise surprise are not that comfortable. I had a pair of shoes made for me quite recently, but they are black and wont match the summer frocks! @Pumpkln mentioned that she used kinesio tex gold tape rather than an elastic support. I'm going to check it out and ask my PT to show me how to use it. So there is hope.

You know I have this constant drive to get to the bottom of things. Well I really would like to understand how that elastic support gives so much relief. It was never suggested to me by the OS. I just stumbled upon it. Can't imagine how I would have coped without it.

@daughterstalker Do you use any kind of knee/calf support?

BTW Diana did you see that Bobby Womack died. Now there was an artist, heaps better than what's his name 3000 - what say you Raqia @Bionic woman2? He was only 70. A baby. xx Carol

 

[patient 99]

@daugher stalker Do you use any kind of knee'calf support?

 

[Pumpkin]

Carol,
After you try the Kinesio tape, you still may find the knee sleeve is better for you. Everyone is different. I wish I could tolerate the knee sleeve longer than an hour.
Your appointment is coming up fast, I will be interested in what they have to say.

 

[new knee in June]

@patient 99
Hello Carol
I'm sorry your knee has been bothering you May I ask, what & where is your pain ?
I know you said " tight band" around your knee, is there anywhere else you have pain ?
Please don't think only surgery or live with it...there are also plenty of things in between
That may help you ( I know you will ask ) So, here goes.....more P.T., more rest, massage,
Arthroscopic surgery, pain cream ( Aspercreme ) Are you on any over-the-counter pain meds. ?
I don't know Bobby Womack ( I hope his manly parts are intact ) I will tag @daughter stalker
For you, I don't think yours went thru.
Have a wonderful Evening,
Diana

 

[patient 99]

what & where is your pain ?

Thanks for asking Diana. It better prepares me for 8 July (but you knew that). The horizontal tight band cuts into me just above the knee (it crosses the top 2 inches of my scar). There is also a tight vertical band on the medial side of my knee. There is some swelling just below the knee. Most times that's not a problem, but sometimes it can be painful. From time to time I get nerve pain on the medial side of the knee - particularly if I bend beyond 90. All in all walking is an effort. I'll make a note of this for the OS.

I don't know Bobby Womack

Now I get to say `google it Diana' `google it Raqia' @Bionic woman2. I've waited a long time for this moment. It feels even better than I imagined. CAROL

 

[new knee in June]

@patient 99
Hello Carol,
Sorry about the delay, I had work today. I got to see my boss & his wife before he goes
To his new school. We get a new Administration person tomorrow We have a high turn-
Over ( every 2 yrs. or so ) I have to break him in to my charming ways I "googled"
Mr. Womack, poor fellow
I am glad I could help you put into words your problems with your knee. I think the most telling
Is you have difficulty walking. Tell your new O.S exactly what you told me. You said your O.S.
Manually checked your knee, wouldn't he be able to diagnosis scar tissue ?
The waiting game begins until July 8.
I really hope you get the answers you need to move forward
Thinking of you,
Love,
Diana

 

[71Beetle]

Hi @patient 99, hope you had a good weekend despite the pain in your knees. It is hard to know what works best, taping or elastic support but hopefully you will find something soon. I have close to a dozen elastic support sleeves as I could never find one that felt comfortable or that did not slide down my leg. I likely should have had one made for me but the point of that is moot now.

Where are you going on your mini break August 1st? I know what you mean about finding the right shoes for summer dresses. I bought 3 pair of shoes today. One of the pair is a lovely pink that will add a splash of colour to some of my outfits!

Hope you have a great week!