Revision TKR Four Months Out and Still Can't Walk

[Jockette]

My doc advises that if any surgery is done to repair/replace the tendon, it would likely be done in Columbus or Cleveland, not in my immediate area.

This is most likely because the bigger cities have more cases, which gives the surgeons there more experience with the procedure, which means a better outcome.

I’m so sorry your dealing with this.

 

[Layla]

Thanks for all the support. I am trying to remain positive.

Great attitude!
We're here anytime you need us for support. I hope you have a good week.

 

[Mensamama]

The "magic man" in Columbus thinks a revision is needed, that it's not a tendon issue. Great guy, Aldolph Lombardi.

Going to the "magic man" in my area next Thursday. I spoke with him today and he thinks it *is* likely a tendon issue, which can be repaired, and a revision might be needed, as well. Mind you, he has not yet seen me. He is going to examine my knee, and then have his two colleagues in his office take a look, as well. What a blessing!

However, now I have one specialist saying no tendon issue and another saying yes, a tendon issue. I guess I will wait until next week and see what the MSK ultrasound shows, and see what the three docs say after exam, then do some heavy thinking. I have a feeling that until someone opens up the knee, no one really knows, it's just a best educated guess.

I am so glad to have this forum to not only vent, but the support is great, and the experiences of others is very helpful and makes me feel not so alone. Thanks, all!

 

[Layla]

Good luck next week. We're happy that you appreciate the forum and also that you feel comfortable sharing your journey here with all of us. The good along with the not so good. You're never alone here. Know that. We do care!
Wishing you a peaceful evening and remainder of the week!
@Mensamama

 

[WFD]

@Mensamama , what is an MSK ultrasound? How is it different from a regular ultrasound? Thanks.

 

[CricketHip]

@Mensamama what a journey you've had so far. Nothing to add but wanted to tell you that I am rooting for the very best of outcomes for you.
Plus, based on my own experiences, don't let anyone tell you that you won't have full function. It may take time but it's still possible.
I was told I would never have much extension or flexion in my left arm/elbow after shattering it. It took time and 4 surgeries but I have no limits... none.

 

[Mensamama]

So, it's been a bit, and I've been to more appointments for tests and consultations than I'd like! The MSK ultrasound (musculoskeletal ultrasound, which takes still and video shots of muscles and tendons) shows likely the quad tendon is okay, may have degredation at kneecap.

The upshot from all doctors is that a revision is necessary. No one is sure why, and some are puzzled why my pain is where it is, given the frozen bent status of my leg. However, a revision may result in the leg "freezing" in a straight position, and there is some question as to whether or not my muscle tone will come back in my right thigh. Walking would be possible, at least, with it stuck straight. I hope scar tissue is not the main issue causing my problems, so that I can maybe expect a better healing from a revision.

In any event, a revision it is. So far, May 16th is the closest date, and way too far out for my liking. I still need a walker to walk, and can't drive! This, for almost 5 months now! The doctor with that date did say that, if I did go with him, he would fit me in, becuase he said, "I can't leave her like that!" What a refreshing comment to hear from a doctor! I have a call in, but don't have a closer date at this time than May 16th.

The local expert has May 26th, so we will have to decide if 2 weeks is worth the drive to Columbus for not only the surgery, but likely 4-5 follow up visits. If Columbus sets me in mid-April, like he said may be possible, then we will travel!

I am feeling much better since I got off all meds, had withdrawal symptoms from both the hydrocodone (knew I would) and the gabapenten (that was a surprise). I spent about 10 days after quitting each feeling like I had the flu. The nausea was awful. I even went to urgent care, and they diagnosed withdrawal from gabapentin. Since I got better each time after a bit, I assume that is what was going on. My February was spent being sick most of the time.

My mental state is better now, but now the forced inactivity is driving me nuts! I want to create, but can't easily get upstairs to my craft room. I want to work, but live 35 miles from the office, can't drive myself, and everyone I know works. I have one friend who has turned out to be my angel and is driving me to work 2 days a week.

I have been somewhat occupied the past few weeks doing theme and decorations (Glitz & Glam) for a surprise birthday party for my daughter, who just turned 40. I am not sure what I will be doing in the coming weeks to keep me from going stir crazy!

Thanks to all who respond and all who post. Sorry this rambled on and on, but it is nice to not feel alone, not blame myself for this situation in which I find myself, communicate with those who truly understand, and I feel the support that runs through this website.

I will update as news warrants it.

 

[EalingGran]

So sorry for your troubles. It must be really hard to wait for the revision. I hope it all turns positive afterwards.

 

[CricketHip]

Oh dear, so sorry to hear this and that it's now official that you need the revision. That on top of the need to wait! I am a former Ohio girl-so enjoyed looking up your Columbus surgeon and reading about him. His office is in a very nice area there.
He sounds pretty darn amazing. I love that both surgeons are trying to get you in sooner.
((Hugs)) to you, you've been through so much, in a short amount of time. Someday you will look back on this and marvel at how far you've progressed.

 

[sistersinhim]

It's good that you have finally come up with a solution. We are here for you through your upcoming surgery.

 

[Mensamama]

Thanks to all who responded - it really does help!

As of today, April 14, I have not gotten an earlier date in either place I am scheduled, so assume it will have to be May 15 in Columbus or May 26 in Toledo. I can't justify the extra travel time and expense for only 11 days earlier, so I guess I will have the revision done in Toledo.

It is very difficult to wait. I've been incapacitated since November 3rd! I am back at the office two days a week, thanks to an angel of a friend who drives me from BG to Toledo, but it does wear me out.

I've basically lost winter and spring, including my birthday and my husband's and my daughter's, and now am looking at losing most of my summer, too--grandsons' birthdays, trip to northern MI for 4th of July, camping. The walker won't fit in the camper hallways, the bathroom turn is too sharp and there are steps into the camper. I doubt I could even get in the golf cart. Anywhere I would walk is gravel or grass and dirt, and I certainly don't want to risk an accident if I have a few beers. I can hardly walk now, let alone under the influence! Not camping this summer is going to be awful! We don't vacation each year, we camp every weekend, in season. Now that is gone, as well.

It's really hard to be optimistic. I am not getting a great deal of light at the end of the tunnel, either, with all docs cautioning me that coming back from a revision is worse than from the original surgery, and none can really tell me how good of an outcome I will have. Sigh. Just, sigh.

 

[Layla]

My heart goes out to you, but I'm sure you'll handle it all like a champ.

Not camping this summer is going to be awful! We don't vacation each year, we camp every weekend, in season. Now that is gone, as well.

You may be able to get some camping in later in the Summer. Hold out hope that it's a possibility.
I am going to add May 26, 2023 to your signature as your surgery date, please let us know if this changes and we will edit accordingly. Best Wishes and lots of comfort to you!

 

[LaJudes]

l can sympathize with you ! l had to have a 2-stage revision due to a horrible infection last spring . Started in April . l had the second part done end of June , so l lost Spring Summer and part of fall . l missed my step granddaughter 's bridal shower and her wedding as well as a graduation party . l was stuck in a wheelchair for 3 months .
l felt so trapped, couldn't do anything . l did get through it and got better , but the time lost is really hard to accept . I'm sorry to read about your situation .

 

[Neecey]

Don’t give up!!!!! I can’t imagine nothing can be done about a ruptured tendon. I so hope you find a surgeon who can help. Please keep us posted.

I can empathize with your depression over this issue. Besides the pain, the abrupt change in lifestyle is devastating. I too had a complication two weeks after TRKR and was put in an immobilizer for 8 weeks. While in PT I got an avulsion fracture of the patella, which meant I lost the extensor mechanism that allows me to lift my leg at the knee. It happened while I was using a machine that bends the knee as I turned a crank. The pain was excruciating as was the “crunch” coming from my knee. I was only bending at 70 degrees.

I was told “almost nothing” can happen to the new knee in PT as it is made of titanium. But a lot can happen to the soft tissue!! I have a history of a shattered patella but that was 22 years ago, so that may have contributed. Either way, this complication supposedly has a less than 1% incidence of happening, and it happened to me. My surgeon called this a “potentially devastating injury.”

I was SO depressed. It’s so hard to watch other TKR friends who have their surgery and are driving and taking walks 6 weeks later. Listening to people say “best decision ever” when I don’t know if I’ll ever walk normally again. Not being able to drive is horrible. And my left knee needs a TKR too!

But after 6 weeks in the immobilizer I suddenly started being able to lift my leg up! The surgeon said I could return to PT but ONLY gentle PT and NO MACHINES. No straps. To pushing the knee. Gentle stretches and slides only. Last week (after 8 weeks) my surgeon said I could shed the immobilizer - FREEDOM!

I’m now working on my ROM and am scared to death the closer we get to that 70 degree mark (where I was when the patella fractured). But I have to keep going. Time will tell but I am encouraged and less depressed. X-rays look good. Hoping and praying for the best.

While I may be way off, I blame the focus on getting back to full ROM too quickly for what happened to me and maybe you. Two days before this happened to me I had an appt with the PA who told me “oh, you’re WAY behind-you need to step it up or you’ll need an MUA”. I was around 70 degrees but he said I needed to be at 90. That’s why I was pushing that machine the day the fracture happened.

I’m not out of the woods yet but Im hopeful. If this happens again I don’t know what I’ll do. But I know I wont give up. It looks like you won’t either. Keep us posted and try to keep your chin up. Try to get out of the house as you can and—if you are so inclined—pray a lot. Those of us with serious complications are a minority but many eventually come out with good results.

 

[JusticeRider]

While I may be way off, I blame the focus on getting back to full ROM too quickly for what happened to me and maybe you. Two days before this happened to me I had an appt with the PA who told me “oh, you’re WAY behind-you need to step it up or you’ll need an MUA”. I was around 70 degrees but he said I needed to be at 90. That’s why I was pushing that machine the day the fracture happened.

Wow. I’m so sorry this happened to you, @Neecey ! I don’t know what it is specifically about TKR (and PKR) recovery, but some of these medical professionals reeeally don’t trust our bodies to know their limits. It really makes me mad.

 

[JusticeRider]

@Mensamama , I’m certainly no expert and each person’s recovery is different, but there are lots of really successful revision stories here on BoneSmart. Lots of them mention that their revision recoveries are easier than their first unsuccessful replacement! That could be your experience too! I wish that for you and am sending you good vibes.

 

[Mensamama]

It is amazing how much hearing of others' situations and outcomes encourages me! For so long I felt like the only one in the world that didn't have a nice, simple recovery from a routine procedure. It really does help me hold out hope that my outcome will be good. As Neecey said, it's tough to see friends/acquaintances up and walking at 4 weeks and driving and back to work at 6-8 weeks, when I haven't been able to walk or drive for over 5 months.

I am, however, so disappointed in doctors! We saw Dr. Lombardi in March. We scheduled May 15th with him, but he indicated, twice, that he would get me in sooner. I was told recently that, no, my situation is not urgent and therefore I wouldn't be squeezed in. I was also scheduled with Dr. Vovos in Toledo for May 26th. As Lombardi was not getting me in sooner, I was going to cancel that appointment and go with Vovos. Thankfully I did *not* cancel that appointment, as I got a message from Vovos' office Tuesday saying he could not do May 26th and now it would be the end of June! I understand doctors are just human and they are extremely busy, but I feel like I was lied to, and I don't like that. I don't need a pat on the head and a "good girl"! I need to know the truth.

I am now scheduled, and confirmed, for Dr. Lombardi in New Albany on May 15th, a full 2 months after my original appointment with him, but that's better than late June. (I do hate having to lower my expectations at every turn.) I also will have to travel there for follow up visits, so I hope all goes well and those trips are infrequent. I was impressed with him and feel comfortable with him, but it's such a trip. It will be worth it if my situation improves dramatically after the revision. I believe he designed the implant he will be using, so he's certainly familiar with it, and he enjoys a nationwide excellent reputation, especially for difficult cases, which is also a plus.

Thanks to all for listening and for the support. I will update after surgery. Wish me well!

 

[Jockette]

Best wishes for success!

 

[Mensamama]

Just wondering...I am almost 6 months out from TRKR, getting a revision May 15th, and I am always cold, when prior to surgery I was almost always too warm! I don't even own many sweaters as I could never wear them as I would get too warm.

I mentioned this to a friend whose husband also had knee replacement (both at the same time!) in Feb of 2022, had some difficulties afterwards and is still experiencing pain over a year later. In any event, she mentioned that he is always cold now and never was before. Anyone else experiencing this? I would understand the feeling cold for a few weeks or even a month out for various reasons but, as I said, I am almost 6 months and he's over a year out. Also, I would expect the toes on my right foot to be cold due to somewhat impaired circulation, and they are, but so is everything else! Thanks for any insight.

 

[WFD]

I experienced the same thing. I believe it was caused by lack of activity and deconditioning. As I was able to do more and more and return to some of my workouts, the problem has largely gone away.

How is your activity level compared to before? Given your issues, I suspect it is much lower now, and this probably can't be avoided until the problems are fixed.