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TKR Fireball's TKR recovery

fireball84

junior member
Joined
Oct 15, 2024
Messages
21
Age
40
Gender
Female
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United States United States
Hello everyone. After reading many of the stories here I figured I would add my own. I had total knee replacement on my left knee on August 29th at 39 years old. A little history on this wonderful knee of mine. I had ACL reconstruction on it in 2001, which recovery was fine for. I chalk that up to kids heal quickly (I was 17, and this was my second ACL reconstruction). After I graduated high school, I joined the Army and was in there for 10 years. My back ended up having issues with degenerative disc disease, so I was medically retired from the military. While trying to get back into shape after having my 3rd child, my knee popped during a 5k run. This started my journey with meniscus issues and osteoarthritis. It's been around 6 years of dealing with the pain, moving from mild to moderate to server arthritis. Then it started doing this wonderful thing where it felt like it was dislocating. At first it was very uncommon. Then it started happening more often, and then started happening at work, or picking my kid up from daycare and other random places. Then it started locking and I couldn't get it to release on my own. Nothing helped with that, not even wearing a brace. My medical care comes from the VA, and my normal ortho doc did not want to do a replacement because of my age. I was sent out to community care, and this doctor recommended knee replacement due to the massive amount of issues with the knee.

August 29th, had the surgery that I thought was going to solve all my problems. When I woke up, I couldn't lift my foot and my toes were numb. 6 weeks later, they are still numb and I still cannot lift my foot. The knee itself is doing well overall, I've been working through PT twice a week since the week after surgery. I hit 120 ROM today, which was a push and I think my PT was trying to make me feel better by kinda pushing me for it, and it's sore now(I know, not good). The main issue I'm having so far is the pain from the nerve issues. My God, that is the worst at night. They have me on gabapentin for it, but I've never found that it does much for nerve pain. I tried another one, but it made me nauseous and dizzy. I still have pain meds I take at night to try and help with the nerve pain, but honestly it doesn't really help. This has been quite the struggle, emotionally and physically. I normally have a high pain tolerance, but this has been a completely different level of pain. It's been a crazy ride. I will say the incision looks fantastic!
I figured I would post on here since I woke up with foot drop, so I could document things and maybe help others if they come across this in the future.
When I woke up, the foot just felt swollen. Pulse was fine, and it was swollen, but they said they thought the numbness was from the nerve block. They kept me another night in the hospital to see if it resolved the next day before sending me home. It did not.
The entire outside of my leg is numb from about the knee joint down. After the ACL reconstruction, I never regained the feeling on the outside of my knee, so I didn't have that to begin with so that can't be from this surgery. The numbness tends to migrate across the shin and to the inside of the knee/down the inside shin if I do too much, and then the migrating numbness goes away over night. It's weird for sure. For the foot, it started with a patch of the area under my big toe and the toe next to it, almost in a V shape. I cannot stand anything touching it other than a sock. The toes were numb on the top, with the pinky and toe next to it completely numb. I could feel the whole bottom of the foot when I got out of the hospital, but some time around week 4 the outside edge of the bottom of the foot went numb. And oddly enough the top edge of the foot (with the exception of the toes) has feeling now while the rest is still numb. I have an extensive amount of pain around the big toe at night. It ranges from feeling like a bruise to feeling like lightening to burning all at varying intensities. It feels swollen in the morning, even though it's not and has been elevated and iced. It has gotten worse since the onset, and I have not found anything that gives it any kind of relief. Around 4 weeks, I did receive a custom AFO that has allowed me to walk more normally, but it is bulky and squeezes my foot in my shoe (has to be worn in a shoe) which doesn't feel good. I have some time to wait before we will do any type of nerve study, but we will see how it goes.
 
Welcome to the group. This sounds very challenging indeed for you. I hope things will settle down for you.
 
I am so sorry you are having a tough recovery. If you put foot drop into the search bar you will see some articles on foot drop and the experience of others in the past who have had this complication.
Do you know why you have been told to wait for the nerve study?
 
EalingGran, my doctor said that while it can be done before 3 months, it is best to do after because it gives a better picture of what is actually going on. He also said it's not the most comfortable thing to have done. What I didn't know before that conversation was that he also has foot drop. Needless to say, my issue has really confused him as to why it developed. My guess is retractors or going through motions while testing fitment, because that's the only thing that seems to make sense. He was also wondering if it had something to do with my back, although I have never had issues on my left leg from the DDD before, and there is no issue from hip to knee, which I would imagine if it was from there, I would feel something, but that's just a guess on my part.
 
Hello and Welcome to BoneSmart and recovery. Thanks for joining us!
Sorry for all you're dealing with, fireball.
Not sure if you noticed the article in our Library on Foot Drop, but I will leave a link in case you didn't -

I hope you'll stick with us so we're able to support you as you continue healing.
Best Wishes!
@fireball
 
@fireball84, I'm so sorry to read of your nerve problems. Even though your surgery was about 6 weeks ago, I'll leave you your very own recovery articles. You might find these helpful in your recovery.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY 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.

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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 Care In Hospital

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 a 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 history before providing advice.
 
@fireball84 Gosh, you must be feeling so worried! As you probably already know, nerves heal very slowly but they can heal and recover.
I have a good friend who had drop foot. She experienced this after her LTKR. She said it was very difficult and said the same as you- that the nights were the worst. Nerves seem to complain so much more at night!

She did say that the custom foot brace with the spring loaded assist helped her while the nerves and foot recovered. She was a very busy executive and needed to wear dressy shoes, etc. I think she mentioned that she had a couple pair of shoes fitted to allow for the brace in a more comfortable manner. Since it will most likely take some time to heal, maybe look into that option? She stressed that getting proper treatment for her problem helped.
She saw a good PT plus the orthotic helped keep her gait a bit more stable which helped her with her body mechanics.

That knee is now over 20 years old and still doing okay. That should give you hope, plus she doesn't limp at all now. Her foot bothers her somewhat but she is also now 77 years old, too. So that could be arthritis in her foot, or some other issue.

So, I hope this gives you a little boost. It's only one person's story but from what I've read and researched, a very large percent of patients do recover.
I also want to mention that she began eating healthier,too. She followed an anti inflammatory diet. Mentioning just in case that had anything to do with her healing.. couldn't have hurt.

Good luck with your recovery.. and I hope you begin feeling relief soon!!
 
@CricketHip, I have a custom AFO they gave me. It's quite bulky, but it actually allows me to walk. One of the main issues with it is I have to wear a shoe with it, and that's not comfortable after a bit. I even bout a bigger size than I normally wear and a shoe stretches to try and stretch out where the tongue meets the shoe. If this ends up being a long term thing for me, I have my eye on a different type that goes around the shoe, but I'm going to suffer with what I have since insurance paid for that already.

It does help to hear success stories, I've done an exhaustive amount of searching on line about foot drop, reading all kinds of studies and stories on it. Most of the studies say around 2/3rds of complete palsy recover, and recovery after nerve decompression rates are higher than that. For right now, I'm trying to hold it together to make it to 3 months to see if it either wakes up, or we investigate it more.

I'm trying to focus on the knee and the recovery there, and contenting myself with the things I can change and impact. At least during my rational times. I have cried an excessive amount about this foot issue in the last 6 weeks, but even if the worst happens and the foot drop doesn't resolve, as long as the knee is good and I can figure out the nerve pain (spent 4 hours last night wanting to chew the foot off from it), I can live with that. Don't want to, but it would not be the end of the world. Never saw this on my 40 year old bingo card, but here we are, and some how I'm gonna make some lemonade out of these lemons.
 
Just catching up on your history.
I'm glad at least the knee itself is doing well - definitely be patient with its healing timeline and respect its complaints via rest, ice, and elevation.
It's super common among our members to get the blues along with crying jags just from the normal stress of the most smooth recovery. The nerve pain and foot drop sure give you ample reason to have that wave of emotion hit out of left field.
Know that we're here for you - to celebrate your every little milestone and to support you through the rough patches. Even when it's the wee hours for you, there's likely to be someone somewhere online here for you.
 
I'm trying to focus on the knee and the recovery there, and contenting myself with the things I can change and impact.
This is the best attitude, for sure. Things take time.. that sounds so trite but is so true. Then all of a sudden it's a month or so later and hopefully then you will be able to see some improvements and gains..
It sounds like you are doing all that you can to navigate your healing journey and I think you are handling it well!
 
Can you tell me exactly what you’re taking to address the nerve pain. The name of the medication, strength, and how frequently you take it may help to advise you. @fireball84
 
@Jamie They have me on Gabapentin, 100 mg, 4x a day. I can't take a lot of it at once because it makes me incredibly tired (found that out when my back issues were at their worst). They tried me on lyrica but it makes me feel dizzy and nauseous.
 
7 weeks today! Met with the head PT today, he said everything is doing great. Strength looks good, and the best news is I get to ditch the walker! I feel like they were kind of babying me a bit because of the foot drop, but with the AFO, I am getting around pretty good these days. They are keeping me in PT for now, to continue to strengthen my muscles and work on balance a bit more. And hopefully this nerve will wake up and we can address that.

Last night, I did have some nerve pain in my shin. This was a first, it felt like the same nerve pain from my toe area when it started, then felt kind of like someone hit me with a hammer for a bit, then stopped. I always hate when they ask if there have been changes because I swear the numbness changes by they hour. Sometimes it's more, sometimes it's less and it tends to move around a bit. I love when I confuse them with the bottom of the foot too, because that isn't the same nerve.
 
That’s a pretty low dose of Gabapentin, which may be at least part of why you’re not able to get on top of some of that nerve pain. But it sounds like an increase might not work for you. It may be that you just will need to continue to work with your doctors and therapist and give yourself time.

It’s not unusual to have numbness move around following surgery. This happens with pain as well sometimes. It also gets better with time. Hang in there.
 
I've been testing the use of a product called Biofreeze on my foot before bed to see if it would help with the nerve pain in my foot at night. I've used it the last three nights, and I won't say it's 100% gone, but maybe 95% after use. I think the issue may be in my application, maybe I just need a bit more around the toes, but so far, testing has gone well. Has anyone else used Biofreeze for this? My PT uses it on my knee when it's getting warm or doesn't feel the best during the sessions, so that's how I found this. Happy to have found it in stores. I will be doing some more testing, but so far, so good.
 
I have nerve damage in my right foot. I’ve used Biofreeze lots of times for muscle aches but never thought to try it on nerve pain. I’m glad it’s helping you!
 
I like Biofreeze, too. It helps with my cervical radiculopathy (pain and itching in my arms.)
It has Arnica in its formulation which is known for helping to ease pain/inflammation.
There’s also a professional strength of the Biofreeze, too.
Maybe your PT can help make sure that you have that level?
Another effective one is Cryoderm.

So happy to hear you have something that’s helping you!
 
Biofreeze is super concentrated menthol. The so called professional version is sold OTC - I get mine on Amazon. Only thing that reliably helps my chronic neck pain.
 

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