Bilateral TKR Grinding in knee joint after 8 months<

[Roper1218]

9 weeks out -- I took your advice concerning backing off the PT and it's been 10 days. I don't see any ROM reductions so far. Still do weekly massages on the IT Band / hamstring/ quad and Chiropractor adjustments. No longer have pain on the outside of my knee when taking a step (when I roll from heel to toe and lift my foot). Instead I have pressure on the front and outside, Like a balloon that blows up on each step. One of the Bonesmart members suggested a compression sleeve, so I bought an inexpensive one at Walmart today and tried it. Amazing, no more of the balloon pressure when I walk. Not sure if this is good or bad for the long term, but it sure helps me get to a better gait. Hopefully it will reduce the low back pain that has been bothering me.

I am starting to go up steps like a normal person although much slower and not to many at a time.

How do you know when to go from healing to strength building (beyond walking). I'm an avid Pickleball player and already anxious to get back on the court. (I know-- I need to have patience...)

Getting up from a sitting position is still pretty painful, but I guess that is to be expected.

Have a visit with the surgeon scheduled for next week.

Thanks for all the great posts and guidance.

 

[sistersinhim]

We recommend 3-4 months out before any kind of strength training. You want to make sure you don't injure any healing soft tissues trying it too soon. Even then might be too soon. Your knee would need to be your guide.

 

[nell41]

Hello @Roper1218.
Just my sympathies, and interest in reading your thread. I also had prior back issues and these are all flared with new gait from my TKR making the surgical leg a bit longer, actually less short than the other leg. I had a prior ITBand that had needed to be worked years ago after 2 THR, (used to be big bicycler, runner.) It seems like I might be getting again, that ITB along with back of the leg tightness already.....so many places that act up in a short time! My PT explained each TKR should straigten the knee but also might add height if the knee had been compressed prior to surg. How impossible it is to predict these minor changes, yet what a difference they all make!
Good luck to you.
nell41

 

[Didot]

I’ve also recently used a compression sleeve, as recommended by my PT to help with swelling. Walking feels far less vulnerable, as you say. Is this an option for a while or are there concerns with its use?


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[Josephine]

9 weeks out -- I took your advice concerning backing off the PT and it's been 10 days. I don't see any ROM reductions so far.

It will take a lot more than 10 days - more like 10 weeks!

I bought an inexpensive one at Walmart today and tried it. Amazing, no more of the balloon pressure when I walk. Not sure if this is good or bad for the long term

If it works it will be fine.

I am starting to go up steps like a normal person although much slower and not to many at a time.

Jolly good!

How do you know when to go from healing to strength building

Well you're 9 week out now which is still the early days. I think you should wait at least 6 months.

Getting up from a sitting position is still pretty painful, but I guess that is to be expected.

Yep!

 

[Josephine]

I just noticed I never responded to your answers you gave in Jan 28th. Naughty me! Here they are, albeit belated.

1. pain levels: I have some moderate pain 4-5 in my right lower ham string. Knee pain is probably a 3-6

Not too bad for 9 weeks out.

2. Pain medication: I have oxycodone 5mg, take 1-2 as needed, Tramadol 50mg 1-2 as needed and Tylenol 500mg.
I also have edible marijuana that I use occasionally during the day. I understand not to mix it with opioids.
Right now I am using the pain medication on an as needed basis for my lower back. I pretty much need it to get through the day. Still a lot of squirming when I am sitting down.
I think my knees would be ok with Tylenol most of the time.

Probably okay.

3. swelling: my left knee is slightly swollen and my right knee is moderate. This is the knee with the IT Band pain.

Got it

4. ROM: Bend 130 deg for each knee, straightness -1-2 degrees from straight.

130/+2? That is excellent!

5. Icing: I have only been icing my knee once a day for about 20 minutes. I ice my low back several times a day for 20 minutes and all night.

You actually accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day. Perhap

6. elevation. I'm not doing anything to elevate my knees.

Don't think it sounds like it's necessary!

7. Activity level: I'm retired and have a wonderful wife taking care of me so I don't have to cook and clean. I walk around the house, walk about 1 mile each day, go up to our upstairs bedroom a few times a day.

Good!


exercises 3 times a day. Giving everything a rest now - pleased to hear it!
seated hamstring stretch 4 reps hold for 30 seconds - you only need these IF you have hamstring pain
Piriformis stretch supine - 4 times with each leg- hold for 30 seconds - same applies here
Hip abduction supine 3 sets of 10 - this is only for hips!
IT Band stretch supine (put a strap on my foot and slide it over the other foot until I feel a pull in the IT Band area - okay
Hamstring stretch supine put a strap on the foot and raise my leg until I feel the pull in my hamstring. The strap helps to pull my foot back - okay

PT twice a week - I'd quit that
consists of the exercises above - and that
resting my feet on a big ball and rolling the ball to my gluts - and that!

You had a seriously weird collection of exercises there! Weird! So I'm very glad you're not doing them any more. You'll notice I've not commented on anything to do with your back.

 

[Roper1218]

Hi Folks, you all have been a great deal of support and help to keep me thinking things are normal for a double knee surgery. I am 14 weeks out and my left knee feels good most of the time and it feels like I expected it would.

My right knee is a different story. I still have pain when ever I walk, sit, stand. I stopped all PT and just walked at a slow pace. I'm still having trouble ignoring the adage that more is better.

I got up to 2 miles a day: knees were worse, back hurt, and ITB area hurt around the knee. So, I stopped trying to walk that much. Currently I walk about a mile 4 times a week. I pretty much stopped using the compression sleeve as I started getting more pain (my guess is it is holds your kneecap to rigidly).

My knee feels like there is significant pressure in the little indentation below your knee cap (front and outside primarily). It's in the area where they tap to check your reflexes. Also still have quite a bit of pain sitting, standing, walking up and down stars (down is worse), and it feels like pieces are moving inside my knee when ever I move it.

I'm not on any pain medication for knee pain.

My inclination is to go see the doctor, but I suspect he will once again say everything looks normal for where I am.

Thank you for your help.

 

[maryo52]

I'll summon the expert for input on this knee pain, which you say is where they tap to check reflexes. I bet you're right about what your OS will say. Are you icing as @Josephine recommended, a minimum of 60 minutes at a time? I will say, from the OS view, they want to see what the Tincture of Time and conservative measures will do, and following Josephine's suggestions would accomplish that.

 

[Josephine]

My knee feels like there is significant pressure in the little indentation below your knee cap (front and outside primarily). It's in the area where they tap to check your reflexes.

Do you mean at these points - 3 and 4

 

[Roper1218]

I have been icing my knees for about a hour at a time, but don't get much relief. If I go for a mile or two walk at a slow pace I end up hobbling around for a few days. Going down steps is harder than up stairs, but neither is fun.

I think I am having problems at Bursa #1,3, and 4. I remember the Physician's assistant telling me they do cortisone injections to help with the Bursas, but the injection could slow down healing. That was only 6 weeks after surgery so maybe the risks are lower now that I am 3½ month out. I am scheduled to see the Physicians Assistant this week.

My left knee has a very audible click with each step and my right knee has a clunky feel with each step. Things are definitely moving around in my right knee.

I hate to be whiny, but my knees are worse now than before the surgery. I hate to think the surgeon messed them up, but the thought crosses my mind.

I have always been a very active person so this is very difficult. Your guidance helps put things in perspective and keep me semi-sane.

 

[kneeper]

I sure wasn't walking 2 miles at less than 3 months. Are you taking any tylenol or anything? My guess is you are forgetting that 3 months is the end of one stage of recovery, but that healing is still ongoing.

 

[Roper1218]

You might be right about 3 months being the end of stage one healing, but I have talked to at least 30 people in my neck of the woods who had TKR and were all active at 3 months. I haven't run into a single person who wasn't. Perhaps I just haven't run into the ones who did have problems because they aren't active.

 

[Celle]

I have talked to at least 30 people in my neck of the woods who had TKR and were all active at 3 months. I haven't run into a single person who wasn't.

I wonder, though, how many of them had both knees done at the same time?

The other thing is that, once you've recovered, your memory seems to compress and distort the time scale. What's remembered as 3 months could well be two months, or four months. Few people keep a detailed diary of what they could do, at what stage of recovery.

If you keep reading here on BoneSmart, you'll find plenty of people who were still concerned about their recovery at 3 months post-op.

It is a year-long recovery, a marathon not a sprint, and patience can be one of your greatest assets.
Your knees are about a quarter of the way towards fully recovered. They're still a work in progress, not the finished articles. There's plenty of time for them to improve a lot.

Your knees are recovering on their own schedule and there's no way you can alter that, even though it's natural to want to.
Where are you in recovery?? (TKR)

 

[kneeper]

You might be right about 3 months being the end of stage one healing, but I have talked to at least 30 people in my neck of the woods who had TKR and were all active at 3 months. I haven't run into a single person who wasn't. Perhaps I just haven't run into the ones who did have problems because they aren't active.

It's hard when you see others doing more than you are, but remember that each recovery is different.
I was back at work at 3 months and doing some exercise with my first knee but it took a few more months to hit what I'd call "normal" --as in my knee not placing some limits on me. Ex) achy with too much activity, some stiffness with too much activity. Month by month I thought less and less of my knee.

 

[Roper1218]

Thanks for the guidance. I do remember seeing a chart that said having both knees done at the same time slows the healing process 2-4 weeks. I also understand that the healing recovery curve is like a Bell curve with all of us scattered on the curve. I am probably just in the group that healing takes longer and try to get it through my thick skull.

Knowing that walking or bicycling will just bring pain and less mobility, what about walking in a pool?

Thank you

 

[Josephine]

I remember the Physician's assistant telling me they do cortisone injections to help with the Bursas, but the injection could slow down healing.

Another of those old wive's tails! It can delay healing a bit but really it's not so much that would be a concern. And much better to get the relief.

what about walking in a pool?

Problem with walking in water is that

a) one tends to feel greatly buoyant and able to do anything!
b) as a result of a) people tend to very quickly join the ODIC!​

 

[Atlas_aus]

Hey mate,

What a ride !

I know too well about sciatica and lower back issues (have had 2 ops) and I am hoping the BTKR will help this but after reading your story maybe it could make it worse !

Having been inactive to sport for so long I don't think I will have a problem laying back and taking it easy, after all BTKR is quite a big operation and the body is taking a fair beating, it makes sense it will take a while to recover.

Hopefully you start to heal soon. Thanks for sharing your story.

 

[Roper1218]

Hi Folks,

I'm almost 8 months post surgery. I still have significant grinding in my knee joints. When I bend and straighten them there is grinding (both internal feel, if you put your hand on my knee, and noise). The doctors office says it could be excess cement, but that should show up on an xray (which it doesn't) or bone pieces (that should be absorbed by the body). It is really quite painful on my right knee (left one grinds, but doesn't hurt). It doesn't give me a lot of faith when they say they haven't seen it before. Both knees are kind of klunky in the morning, kind of like the top part of the leg goes a different way from the bottom part. If it's still painful at 12 months they may want to go back in to look around.
Anyone else had this experience?

Thanks for your help,

 

[Celle]

Hi @Roper1218
You'll notice that I have merged your newest thread with your original recovery thread.
For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Celle]

I'm sorry you're still having problems with your knees.
I'm going to ask @Josephine to advise you.