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Revision TKR Here I go again - round three

Are you still icing and elevating? Your knee is still an infant at only 1 month old and needs gentle treatment. Don't do anything that causes pain. Doing so is just aggravating your already inflamed knee. This is causing a set-back in your recovery. Spent the next few weeks letting your knee calm down by just doing your daily activities and not adding any exercises. Your knee will improve and so will your ROM>
 
I would definitely call your surgeon’s office to report this. This much buckling is not good.

As sistersinhim said, 4 weeks is still such early days and it’s so easy to have an injury. Be very careful with any exercises, if you do any, or just let the knee rest until you see your surgeon about it.

I‘m so sorry you’ve had this setback. :console2:
 
Yes I still ice and elevate often. Im Still sleeping in the recliner, elevated and icing. The exercises I had been doing at physical therapy have been gentle. At home honestly the only exercises I do are the quad tightening exercises and gently bending my knee. I think this was just a fluke accident of my foot catching on the step and stretching the quads/tendons where it attaches on the medial side of the knee. Neither therapist thought there was a serious injury and no harm to the implant, just enough to stretch and muscle strain it’s aggravated the quads. there’s no bruising and no swelling. A nurse from my surgeons office calls each week to check on me, and when she calls this next week I’ll tell her what has happened. My next appointment with my surgeon is August 31. I’m scheduled to return to work on 9/11.
 
A new issue with my knee. More of an annoyance. This started last night out of the blue. One part of my incision just burns. It’s at the lower end of the scar. It literally feels like it’s stuck (adhering within) and feels like it’s tearing apart. I caught myself in the middle of the night feeling that spot to see if there was blood because it felt like I had been cut. It looks fine. I don’t remember having this issue with the other two TKAs. All part of the healing process I’m sure. Darn nerves.
 
Small sensory nerve fibers are cut with the incision. While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process. You may want to mention it to the nurse from your surgeon's office when she checks in with you this week. I am sure she'll be able to offer you some reassurance. Happy Sunday, midwest girl!
@midwest girl
 
@Layla even that pulling feeling? I’m sure it’s all normal. I just feel like I’m so hyper aware of anything with this knee. Happy Sunday to you also! I hope you have a restful day!
 
Yes, I believe it is normal for sure. Both @benne68 and @Susie-Q experienced the same and I'll let them respond here to offer you reassurance. Nothing like peace of mind, right? :wink:
@midwest girl
 
Yes, @midwest girl, I also experienced that sensation. As Layla said, and as I learned chatting with others here, it's normal.

For me the "pulling" continued on and off for months, and the longevity worried me. But my surgeon reassured me that, with time, it would disappear. And it did -- although I honesty can't tell you exactly when it went away because it disappeared gradually over time.

Interestingly, I recently had an episode of "zingers" (and I'm almost 2 years post op). Several days later, I noticed that one of the numb areas in my leg had feeling again. Our bodies are amazing and continue to heal for a long time, if we can be patient.

Hang in there! Sending hugs. :console2:
 
My incision burned so badly that I could hardly stand the sheet to touch it. My PA said to desensitize it by dragging a cloth across it, starting with a very soft cloth and using rougher materials as I could. After about a month it completely went away.
 
Thank you @benne68. Yes our bodies are amazing. Since this is a revision I’m just super sensitive and hyper aware of every little thing with this knee.

@sistersinhim yes once the scabs are gone and it’s completely healed I’ll start desensitizing it. I think that’s part of what is causing the burning too. Anything that touches that area starts the burning. Even bending the knee starts it burning. The only thing that hasn’t so far is when I’m icing it.

Thanks ladies for the reassurance. Means a lot.
 
The weekly phone call check-in with the nurse was this past Friday. I filled her in about the quad strain and buckling issue. She didn’t seem all that concerned. Asked if I was using the cane. I said I was back to using the walker. She said discuss all this with the surgeon on Thursday. This will be the last weekly call I’ll be receiving from her. It was for 6 weeks only. Makes me wonder if any of these issues are shared with the surgeons PA. At PT all the therapy has shifted to quad strengthening. Last week my flexion was only checked once and it’s still at 115°, which I’m fine with. Friday after PT I noticed that my knee didn’t buckle at all for the rest of the day. Those muscle were firing! But the muscles were pretty sore the next day. Feel fine today but the buckling has been more frequent today. Makes you wonder if I’ll ever get there, to where I was before this quad strain. This feels like a huge step backwards. And I have to have the quad strength to function. And I know this isn’t anything that will come with time on my own. I mentioned to the PTA I was working with on Friday that I can’t imagine being ready to go back to work on 9/11. In his opinion he doesn’t think I’ll be going back then. We’ll see what my main therapist and surgeon think. I’m a research lab tech. being at work with a walker isn’t the best situation.

Outside of the quad strain and weakness, my knee is doing well. Really no swelling unless I’ve done way too much. last week I slept in my bed all week, all night. Although very restless. I use only Tylenol for pain because it hasn’t been bad enough to warrant tramadol. And if there’s achiness, it occurs after PT or if I’ve done too much. Overall, everything was going well and on track until the quad strain. Discouraging. I hoping for some gains in improvement over the next two weeks. I’m praying that at my surgeons follow-up visit this Thursday that my x-rays will show that my implant is perfect with no loosening And that he can give me some encouraging news about the other issues with the leg.
 
Sorry to read that you are still struggling with that quad, @midwest girl. I'm sure it is frustrating.

midwest girl said:
I’m praying that at my surgeons follow-up visit this Thursday that my x-rays will show that my implant is perfect with no loosening And that he can give me some encouraging news about the other issues with the leg.
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:prayer: Sending up prayers and positive thoughts for you as well.
 
Lifting a prayer for your visit with the surgeon tomorrow. I hope you receive encouraging news and leave there reassured that all is as it should be. :prayer:
@midwest girl
 
My follow-up with the surgeon was discouraging. He thinks I may have a quad tear and has ordered an ultrasound to confirm his suspicion. He ordered the ultrasound STAT but he uses an outside imagine facility to do the imaging. I made the appointment as soon as I left the office and the soonest I could get in was next Thursday. So really not all that quick. I may call tomorrow and ask if it’s possible to have the imaging done in the city I live in instead of the city where he is located and where the imaging will be done. It’ll save me a 90 mile drive for a 1 hour appointment. If the quad is torn I will have to have surgery as soon as possible as he will be out of the country at the end of the month. He also ordered a full leg length, locking brace for me to wear to give me stability for the buckling I’m experiencing. Still have to use the walker also. it’s locked at 0° extension and I don’t like it at all. When he was telling the PA to order the brace I could have sworn he said to have it at 115° which doesn’t make sense either. I just know when I was fitted for it the DME guy had to help me stand up from the chair. With your leg straight out in front of you it’s not easy to get up. And I live alone so that makes me a bit nervous. So I’m going to ask if I can unlock it to give it some flexion to rise, and then lock it again. The brace doesn’t stay up and slides down within a minute or two of walking. And he had it strapped tight to the leg. And this brace has foam padding that wraps around the leg under the brace, so I think that also contributes to it sliding down. And it’s hot. I’m allowed to take it off at bedtime. And I asked the PA if I could take it off to do the 90 mile drive home. Which she was fine with. Any suggestions how to cope with this brace? It’s not going to work to have it fall down and just rub on and sit on the ankle.

He said I could continue with PT but it had to be gentle. Exercise but not to the point of pain. And I need to talk to my therapist to see if it’s even worth it to continue. Or at least limit it to once a week. My insurance will only pay for so many sessions and if I have to have another surgery I will need those session for rehab.

On a positive note. The only positive I saw with this day. X-rays showed that the implant was stable. No problems with it at all. Before my mishap 2 weeks ago my extension was at 0° extension and flexion at 115°. The last two weeks all we have done at PT is quad strengthening exercises. Last week she checked my flexion, just to check it. It was still at 115°. They checked it this Wednesday and my flexion was at 122°. I’ve done absolutely nothing the last two weeks to work on flexion. Saying all this to say, flexion does come just with activity. Even if it’s the limited activity I can do walking around with a walker.
 
midwest girl said:
On a positive note. The only positive I saw with this day. X-rays showed that the implant was stable. No problems with it at all. Before my mishap 2 weeks ago my extension was at 0° extension and flexion at 115°. The last two weeks all we have done at PT is quad strengthening exercises. Last week she checked my flexion, just to check it. It was still at 115°. They checked it this Wednesday and my flexion was at 122°.
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It's good news that the implant is stable.
I really wouldn't worry about PT or exercise for the quads right now.
If it is torn it needs rest until the extent is determined- and whether it needs surgery.
A week or twos rest won't harm your eventual ROM.
I had an episode of Strep A septicaemia at about 5 months and was pretty much bedbound for 1-2 weeks. It didn't affect my ROM at all. My knee enjoyed the rest.
I would skip the PT and just do very very gentle movement of the leg/ foot until you have the scan
 
midwest girl said:
Any suggestions how to cope with this brace? It’s not going to work to have it fall down and just rub on and sit on the ankle.
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When I had each of my kneecaps removed, the patella tendons had to be shortened and I was put into an immobilizer for 6-8 weeks, not a brace. Maybe you could ask your doctor about this instead. It still keeps your leg completely straight but doesn't fall down. It's still hot, but everything is hot to me in the summer time!
midwest girl said:
He thinks I may have a quad tear
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You should not be doing quad-strengthening exercises if you have a tear.
 
@sistersinhim this brace is hinged so I’m able to unlock it to give it a bend when I’m sitting. Makes it so much easier to get out of chairs. Just figured out this morning on how to make this work for me. Still doesn’t help with the brace sliding down.

Physical therapy was still on the order from my visit yesterday. I trust my surgeon and therapists. All the quads are not torn. If I’m laying on my side and doing side leg raises, I have absolutely no problems doing these. It’s the quad in front that is the issue. Regardless, at my session today we decided to stop physical therapy mainly to keep my insurance covered sessions available for future therapy if I have to have quad repair surgery. My ROM is good and I’m having no pain. My ultrasound is scheduled for Tuesday and Im able to get it done here in the town I live in. Which is great news. They said they could get me in this afternoon but then called 30 min later and said that tech isn’t in today. Bummer. Could have had answers today.
 
I am sorry to read your update. Thankfully your implant is stable and you're not in pain.
I wish you the best for your ultrasound on Tuesday. I hope you receive a favorable result / report.
Please let us know how it goes.
A pleasant rest of the holiday weekend to you. :wave:
@midwest girl
 
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