TKR Hinged knee replacement after broken tibia plateau with all lateral ligaments torn

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Newbai

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Today is exactly three weeks since my RTKR. I am very happy with my recovery and progress so far. Getting better walking normally on the stairs using the hand rails. This week, I also started riding my stationary bike at really low resistance without any pain in the knee. I am only using the bike for motion in knee joint, will increase resistance for strength in a couple of weeks. I am icing every night even if I don’t have increased pain or swelling, just want to soothe the knee after daily activities, stretching and exercising. I never thought my knee extension and passive flexion would get to where they are today in such a short time (see pictures). Using a goniometer app on my phone, I measured 126 degrees passive flexion (probably have a +/- 5 deg error). All of this came from no formal PT, just at home exercises and stretching. All and all, I am happy. Fingers crossed, no setbacks going forward!
 

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Cjackso21

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Congrats on what looks like a successful surgery. I would love to hear if you’ve found any limitations with the hinged knee. Not sure if I can, but if I can I will definitely get a hinged knee.
 
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Newbai

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@Cjackso21 No limitations so far, but then again it’s still early in my recovery. I am not doing too much on the knee as yet. From what my OS told me, there aren’t any limitations compared to a regular TKR. They have made great strides in the development of these prosthesis today.
 
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LaJudes

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Your recovery sounds similar to mine, l too have the hinged knee replacement . Mine final surgery was done on Jun 28 , and other than the first few days , l haven’t had an real pain . Walking on the surgery leg fine . I had a 2 stage revision because I had an infection that needed to be treated first , so my first surgery was back on April 19 . Being 5 weeks out from the last surgery , I am getting around with a cane , got the staples removed last week , so I feel finally an end to this nightmare . The next orthopedic visit is in 2 weeks and a PT is going to go over the hinged knee replacement with me as far as any special precautions etc. I am looking forward to that because the only information that I have received about the hinged knee was taken from this site . I am able to bend to 90% and straighten out flat . I was told l would not need PT , unless I want it , and that the hinged knee will bend really easy , and it does !
 

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@Flowerfloosey69 Thanks.
I did not and will not do the ligaments reconstruction. This is the reason I am getting a Hinge Knee Replacement. Ligaments aren’t need with the hinge knee replacement, in fact my OS said they usually cut the ligaments when putting in a hinge knee.
Is this just the ACL/PCL they cut and said you don't need? If you have a problem with loose LCL/MCL, for example, would a hinged TKR fix that?
 

WFD

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I once discussed this with my surgeon. They r remove all the ligaments, both crucials and both collaterals. The hinged knee doesn’t need them and in fact there is no space to run the collaterals through the knee joint because of the construction of the hinged knee prosthesis.
 
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Newbai

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If you have a problem with loose LCL/MCL, for example, would a hinged TKR fix that
They removed the MCL and LCL. With my injuries, I tore all the ligaments on the lateral side of my knee and well as a crush tibia plateau.
 
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Ayse

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I once discussed this with my surgeon. They r remove all the ligaments, both crucials and both collaterals. The hinged knee doesn’t need them and in fact there is no space to run the collaterals through the knee joint because of the construction of the hinged knee prosthesis.
Thanks
 

Cjackso21

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Thanks @LaJudes and @Newbai ! The hinged knee looks encouraging. I am not sure I could do another full TKR revision due to loss of bone but I think it might be better than wearing a brace forever. I was told I have one more increase in the poly lining thickness that they can try but before this they want to try to strengthen my atrophied muscles so the ligaments don’t stretch again. Also feel that I should have been put in the brace after the last 2 surgeries but was not told to. Ended up in it after both due to stretching. Now in it until we figure out what to do. But my Doctor does not take insurance any more and we are moving back to the San Diego area, so will search for an expert revision specialist there. If anyone knows of any, please let me know. Thanks and good luck to the hinged knee folks!
 
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Newbai

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Been a few days since my last update.
I am completely off all medications. Pain is pretty much gone, every now & then maybe a 2-3 on the pain scale. I am walking 1 mile every other day and riding the stationary bike for 10 minutes on the days I don’t walk. I continue doing my the stretches. I haven’t measured ROM in a while since I am already at 125-130 degrees. Walking up the stairs improving everyday. The “clucking” I felt initially has gone away. Every now and then, I will feel it but for the most part it’s not there. Swell is also down a lot, I have been doing massages on the thigh and knee to help lymphatic drainage and it seems to work well.
Overall recovery has gone great so far. Fingers crossed it continues!
 
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Does the hinged knee restrict rom in your leg?
No. Currently my extension is 0 deg, ROM is about 130 degrees.
I am having lots of pain in revised knee and am still on picc line antibiotics from hip revision/ then debridement surgery for infection. Am going back to revision specialist
From 2nd hip r the end of Oct. asked them to take exrays of rt knee and plan on a discussion of hinged knee. Thank you all for responding!
 

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