Revision TKR Failure of TKR

[LTKR4Xmas]

Well, I had a 6 week follow up with my OS today. He didn't bother to measure my extension, as it is obviously "straight", even if it doesn't achieve a negative as my other leg probably does. I did ask him to measure my flexion, though. -- We weren't happy. :(

I knew I wasn't at 90 yet, but it turns out I'm only at 70. So I've got to see him again in 4 weeks, for a total of 10 weeks by then, and if I'm not at 115, he'll do a MUA.

I don't know if I mentioned this before or not, but I'm unemployed and lost my insurance, so I couldn't afford to go to PT...just what I did around the house. I'm covered as of tomorrow under "Obamacare" so he wrote me a new script. I see a LOT of hard work ahead of me now. At least I'm beginning to sleep better at night though, so I'm not sleeping all day and will be ABLE to do PT!

Please pray for me.
Thanks.
Marla

 

[newlybionic]

Be careful because doing too much PT can bring on swelling which will decrease range of motion. Try to have PT just work on helping you do some stretches a couple some massages to help your knee loosen up. I found it helpful to sit in my shower and let warm water run over my quads and slowly bend my knee back with my other foot.

 

[Spex10]

Whatever you do, don't worry about a MUA. If you don't need one that's great. If you do, its OK. It'll help. Its not nearly as bad as people think.
Thank goodness for Obamacare (as long as it lasts )

 

[KarriB]

If you have access to an exercise bike that's the way I'd go. Nothing helped me as much as riding a bike. Riding at 0 resistance loosened up my knee and helped ROM.

 

[LTKR4Xmas]

Spex10, thanks so much. You're the first person I've seen/heard say anything positive about MUA. It's looking like that's what's going to have to happen, as i haven't yet found any PT/physical rehab places around which accept the "Marketplace", so I actually stopped in to check into why people say they'really so bad to see what's ahead.

 

[Spex10]

I've posted quite a lot about my MUA. It was last month. Went really well and made a huge difference. Much less pain and stiffness than I was led to expect. It didn't 'reset' my recovery. The physios were laughing when I bounced in two days after it saying that everyone should have one. Do not fear a MUA by an experienced OS.

 

[Josephine]

the very unlikely expectation that the nerve endings will heal properly and restore feeling to the area, then wallah!!! She comes back with the surprise ending that her knee had restored feeling after "only" 5 years!!

The message being, you can't ever predict what nerves can or will do!

I had a 6 week follow up with my OS today. I knew I wasn't at 90 yet, but it turns out I'm only at 70. So I've got to see him again in 4 weeks, for a total of 10 weeks by then, and if I'm not at 115, he'll do a MUA.

Actually, 70 at 6 weeks out isn't at all bad so I really wouldn't worry about it. It's more than likely that your only problem is swelling. It usually is. And I'll bet that your flexion is up to 90 in a few more weeks which will clearly indicate that all you need is time.

It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.

The physios were laughing when I bounced in two days after it saying that everyone should have one. Do not fear a MUA by an experienced OS.

I would strenuously disagree with this. An MUA is not a minor procedure as it involves a general anaesthetic which has risks all on it's own. And since the likelihood is that there are no adhesions in her knee, it would be, to put it mildly, somewhat irresponsible to do that when it's not really indicated.

 

[Spex10]

Sorry Josephine but I equally strenuously disagree with you. I had one. I know what it was like. If you look among other threads you will find others who had similar recent experiences like mine.

 

[Josephine]

The voice of the minority! It always knows better than the professionals!

 

[Pumpkin]

@LTKR4Xmas ,
Welcome back to BoneSmart, I have added you to the 2021 January Jackpots and your revision surgery date to your signature.

Sorry to hear your TKR has failed and you had to have a revision TKR. Sending you best wishes for a successful recovery.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

​

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

​

Activity progression for TKRs​

6. Access these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[LTKR4Xmas]

Well, thank you for all that. I hope this is the right place to post my update on my total knee revision.

So, to recap results from my first surgery, even after a MUA, I never achieved a good ROM. I continued to have pain and pain-disturbed sleep for over a year. It had finally begun to get just a tiny bit better, then it began to get worse again. I had less than a 90 degree flexion.. I had a limp, and could not take stairs properly I was in worse shape than before my surgery and my OS seemed to be happy with that. By that time,, I had no health insurance due to unemployment and qas just having to live with it.

Then 3 years after surgery, my knee had begun to catch and click. in the meantime, I had obtained a copy of my surgical report and learned that I had received a Johnson & Johnson Depuy Attune implant. It didn't take a lot of research to learn they were failing left and right. So I went back to the OS again. He did X-rays, and thought it looked Ike the bonding had detached. So he did a nuclear scan, which was more conclusive that the bonding had in fact fallen away.

A cardiologist friend of mine from church suggested I see a revision specialist, and so I did, and my revision was done on 1/26/2021. This has been near miraculous! At 2 weeks, I no longer needed a walker. My extension was at zero at less than 3 weeks and my flexion was already at 90. At that point, I was also able to stop taking pain meds and muscle relaxers, and simply use ice. (After 4 years of pain!!) I am now 6 weeks out and at 115 flexion, but still gaining. I can finally take stairs properly again! I still have some very minor pain but compared to what I suffered for so long after my original TKR, I am THRILLED!

Ever since my surgery, everyone who has seen me has been amazed....including my PCP. When I went to church at just a few days over 2 weeks post surgery (walking with a straight leg, no walker, cane, or other device), a lady came up to me and said "I thought you were going to have knee surgery". I said "I did!" and thought she was going to fall over!

I could not be happier.

 

[Jaycey]

@LTKR4Xmas What a great update! Well done. I am so glad your revision was a success. Finally, you can enjoy life again!

 

[FCBayern]

Great update @LTKR4Xmas! Glad you are finally getting the results that you started this whole journey for.

 

[bland9]

Wow- reading thee top paragraph its was like reading my concerns with my current difficulties and then reading the rest of your post has given myself hope for the future .