Really feeling the fatigue dropping away, spent four days in the garden, about 5hrs a day, before I needed an early weekend, then recovered in a day.
Had a check-up with my GP not interested in ROM, shared my concern the next milestone was overall muscle recovery in my right leg. He cautioned against any weights, just ADL until I hit the wall then wind back.
He opined that with robotic assistance because the knee capsule healed so well the weakest link, excuse the pun, was overall muscle recovery. This has certainly been my experience with the RTKR compared with my LTKR, 9 years ago! Acknowledging of course my pre-surgery muscle atrophy was worse because of natural aging.
Sleeping thru the night, restless leg almost gone, early morning pain continues to diminish.
Had another deep tissue remedial massage which really fired up flexibility at the back of the knee, albeit with a little discomfort.
Will attach some picks of leg in extension and flexion.
Best regards for all recovery.
Probably my last progress report.
Visited OS for 3 mth check up.
All positive, summary "looks like most recoveries at 6 mth".
No ROM evaluation.
A brief conversation about robot assisted, this one, and traditional LTKR 9 years ago. By all performance measures this was a better result.
Muscle structure progressing very well.
Happy to answer any questions.
Thanks for the support from Bonesmart.
Over recent weeks energy levels are starting to consistently rise, both number of hours in the day active and back to back days.
Last week I was able to spend three days working on my boat, some flexibility related issues limited what I could do. For example moving from a ladder to scaffolding could only be done in one direction.
When getting up from kneeling I still need something to hold. Getting close to a clean jerk stand up!
Have no pain in knee capsule, but if I skimp on icing over time the fluid does slowly build up and the joint tightness quickly returns and flexibility drops.
Paradoxically the more you do the less time you set aside for icing and the less you can do!
Surprisingly after four months I can still feel my calf muscle, serious fluid accumulation immediately after surgery, it is still not quite right, getting there.
All in all continuing good progress, reinforcing the long journey and the importance of rest and icing.
For only 4 months out it sounds like you are doing quite well. You are well aware of the cause and effect of actions on your knee and reacting appropriately. I had to ice off and on for at least 6 months to keep the swelling down. It's amazing how well it works!
5 month update and Happy New Year.
At 5 mths ongoing incremental progress.
Fatigue seems to be really dropping, can be active four days in a row then a day of rest then back to doing what I love.
ROM has not changed 0-140.
Getting about doing stuff, bending, squating, working on knees all good.
Still cannot alight from kneeling without holding something. Issue is quads still getting there.
I really have no pain only mild discomfort when I over do it. Still get first thing in the morning stiffness, which quickly loosens up thru ADL.
Still ice twice a day it simply makes my joint feel better.
A rather bazaar thing happened when I slipped on some plastic sheeting, gave myself a self inflicted MUS, Manipulation Under Stupidity. The slip really flexed my joint, and it hurt like all get up, luckily damaged nothing. After I caught my breath and rested I seemed to have gained some added flexibility. Would not recommend this as part of a recovery regime!!!
My goal at the end of 2020, apart from kicking it into oblivion, was to alight from a kneel without any support. Nearly got there but no cigar!
In summary all my challenges, in perspective are trivial, relate to muscle recovery across my whole leg structure. Time.
Wishing all a a fantastic, Bonesmart 2021.
PS Hope to launch my 5m power boat over the beach tomorrow, a risky, physically demanding exercise. The biggest challenge will be loading the knee laterally during the manoeuvre. Have my children and grandchildren as willing helpers!
6 month update.
Post operative fatigue really now only a minor issue.
Back to part time boat building "A hole in the water into which you throw money"!!
Towel dried my feet standing up this week.
Crawled on the deck of my boat whilst using a sander.
Am able to stand from a kneeling position from either leg.
Still ice daily, tried skipping a day and whammo the fluid builds.
Driving more than two hours generates fluid build up discomfort.
Quad muscles still stiff no matter how much ADL.
The calf bleed I suffered during surgery still causing stiffness.
No issues sleeping.
Starting to get lateral flexibility in the knee joint, I can move my lower leg inwards almost as much as my 9yr LTKR, does not like moving outwards. This is important to me as it is part of a stretch routine for lower back. Patience.
Stability across all range of motion really good.
Outcome really good.
Still a ways to go.
Proof the knee is still healing is that after 6 months the right knee consistently runs 2 deg Celsius warmer than the left!!
The thing that stands out most is how pain, fluid build up and general discomfort leads to fatigue and a general feeling of blah!!
This journey is so worth it.
Happy New Year.
PS forgot to mention we did launch our 5m boat across the beach, no issues until a wave surge lifted the boat just as I was climbing aboard. Made my eyes water momentarily, mostly a coordination thing muscle memory still relearning as nerves heal!
7 month update.
Was able to stand from a two legged kneel without using hands!
Very happy with my RTKR!
Proof this is a 12 month program, last Friday I had an Afib cardio ablation that required my right leg be immobilized for about 10 hours. The only issue I had with the surgery was swelling and pain in my right knee! Think my extension improved.
A couple of days of icing and elevation and back to normal. Anecdotally recovering very well from the ablation!.
Really not much to add.
Really happy with result.
Seven month OS update.
Penultimate visit to the OS, last visit will be Aug supported by X rays.
Really nothing to report, very good outcome.
It's time to compare, I guess as best you can, the quantifiable difference between traditional surgery 2011 and ROSA robotic mid 2020!
Same surgeon. 9 years older, maybe I am lot smarter on how to manage.
Upon reflection I surmise the following:
Overall pain management regime superior, was it the drugs and regime or the ROSA I am not sure you could quantify;
Hospital stay longer this time, not the knee rather low BP, maybe 9 years comes into play;
ROM was always good my judgement is extension is about 2 deg better, possibly in the noise though;
Woodiness, or what my OS calls it, ROSA significantly better in fact the above the knee area, in way of quads is really flexible, pain free and you can poke all the way to the bone, my crude measure;
Muscle recovery and flexibility, particularly, lateral movements, much better, this is important as my muscle wastage was worse this time, age;
Post operative fatigue really hard to measure a difference, this is important as have been on beta blockers due to recent onset of AFib recently;
In summary am I comparing apples with artichokes? Not sure how you can tell.
The single important positive reason for ROSA is my surgery adds to the body of knowledge that will help the future maturation of this technology. When will see a 5 axis medical router preparing the bone for direct placement of the prothesis, not sure but I am confident it will happen.
All the best and this will be my last post unless a significant event presents.
Thanks Bonesmart for providing a real world body of knowledge that helps in real time.
9 month update, orginal surgery late July 2020.
All performance measures very good.
Can even let the grandchildren rugby tackle me without wincing.
ROM is very good with some extension still got a few degrees to go.
Only get discomfort no pain, usually linked to how hard the joint is worked, and lateral motion.
Getting about boat building now is only limited by turning while kneeling, this is a pretty extreme undertaking, could not do it at all prior to surgery.
Weight bearing is more limited by general fitness rather than knee.
Still get stiffness after sleeping and during long drives, thanks for adaptive cruise control!
Starting to recover some aerobic fitness.
All this should be read in the context of recovery from a cardiac ablation (AFIB) two months ago, this did set my recovery back. Energy levels started to return after about 7 weeks and I am getting back to normal can now be very active for 10 hours day 3 out of 4 days. Still recovery to go, and importantly no AFIB.
Again thank you Bonesmart, always a positive sounding board.
10 month update.
Best described as really well recovered! Pretty much followed all the Bonesmart principles.
Three topics, extension, flexion and fatigue!
Extension, I jam my feet under the gap between the bed frame and the floor, so i can use my muscles to drive extension, just to point of discomfort. Best extension I have had in forty years! Still got a little bit to go, never a limitation on ADL though.
Flexion, no idea what my number is, suffice to say I can sit on my heals and almost rise without aid. Limitation is still muscle strength. Stability is good. Just a little strength to go.
Fatigue, my expectations are probably a tad unrealistic as I had a Pulmonary Ventricular Isolation (ablation) three months ago, worked really well, no more paroxymal AFIB.
Still feel like I am running on a half full tank though!
Patience I surmise.
I can regularly achieve 7000 steps just walking and ADL. Cannot quite back to back this day to day, still get some tight band feeling, not pain, just my knee saying enough is enough. Have not iced in about a month, only take 2x665mg paracetamol twice a day for other joint issues, price you pay for a very active life!!
Only had two PT sessions, OS never concerned about ROM!
The best thing is I now sleep pain free!
I think I can now say confidently my robot assisted RTKR has led to a better outcome than my LTKR 9 years previous. Especially noticeable is the flexibility of the tissue immediately above the knee compared with the LTKR.
What a great report, Geoffa! Very encouraging for us newbies who are still struggling with sleep issues, tightness, etc. You had a great OS who never pushed you about ROM. Can’t wait to hear your 1-year report. This is what BoneSmart can do, folks!