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TKR I think I have pes anserine bursitis. Is it OK to do modified zumba?

There seems to be conflicting information about whether it can be done. So who's right? These folks or my Dr? I am suspecting arthrofibrosis, although my ROM is good. It's the tightness and subsequent discomfort that is inhibiting my very basic activities.

Arthrofibrosis​

Last revised by Dr Henry Knipe◉◈ on 28 Sep 2021
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Citation, DOI & article data​

Arthrofibrosis is a complication of injury or trauma to a joint. It can also be iatrogenic e.g. post knee surgeries. It consists of excessive scar tissue formation within the joint capsule, resulting in pain, stiffness, and swelling, which are greater than expected in the given clinical scenario.
It has been most extensively studied in the knee, where it is one of the leading causes of failure of total knee arthroplasty.
Arthrofibrosis can be diffuse or localized. The cyclops lesion is a specific manifestation of localized arthrofibrosis and consists of a focal rounded mass of fibrous/scar tissue that occurs anterior to a reconstructed ACL ligament. Another type of localized arthrofibrosis is an anterior interval lesion, which affects the posterior aspect of Hoffa's fat pad.

Radiographic features​

MRI​

Scar tissue appears as a low signal intensity lesion in T1 and T2 weighted images and will appear mass-like.

Magnetic resonance imaging of joint replacements​


pubmed.ncbi.nlm.nih.gov

Magnetic resonance imaging of joint replacements - PubMed

An increasing number of joint replacements are being performed annually. Complications of joint arthroplasty are diverse and may involve the hardware as well as osseous and soft tissue components. Although modalities such as conventional radiography and scintigraphy remain the mainstay of...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
Ali M Naraghi 1, Lawrence M White
Affiliations expand

Abstract​

An increasing number of joint replacements are being performed annually. Complications of joint arthroplasty are diverse and may involve the hardware as well as osseous and soft tissue components. Although modalities such as conventional radiography and scintigraphy remain the mainstay of radiological investigation, in some cases these traditional methods of imaging may be negative or underestimate the extent of disease. Magnetic resonance imaging (MRI) has been considered of limited benefit following arthroplasty because of severe image degradation caused by metallic components. However, with modification of pulse sequences, artifact reduction and improved visualization of periprosthetic tissues are achievable, enabling a comprehensive assessment of articular and nonarticular pathologies. The common artifacts in the presence of orthopedic hardware, optimization of pulse sequences to minimize metal-related artifacts, and the clinical uses of MRI following joint replacement, particularly with regard to total hip arthroplasty, total knee arthroplasty, and shoulder arthroplasty, are reviewed.

Another one:

Magnetic Resonance Imaging of Complications in Total Knee Arthroplasty: A Pictorial Essay

Magnetic Resonance Imaging of Complications in Total Knee Arthroplasty: A Pictorial Essay
mss-ijmsr.com mss-ijmsr.com

ABSTRACT​

With the ever-increasing number of total knee replacement, the demand for early diagnosis of post arthroplasty complications has increased as well. The various complications associated with total knee replacement include bursitis, tendinitis, periprosthetic fracture, infection, instability, malalignment, loosening, prosthesis fracture, osteolysis, soft tissue impingement, and extensor mechanism problems. Radiographs and nuclear imaging, earlier the mainstays for evaluation of post arthroplasty knee, have vast limitations, especially in evaluating the soft tissue details which account for the symptoms in a significant number of patients. Magnetic resonance with special modifications, i.e. metal artifact reduction sequences, is of immense help in a detailed evaluation of these soft tissue complications and is advisable in all patients where the cause cannot be determined on plain radiographs.
 
@ihavetwins I can understand your confusion and concerns. However "Dr Google" is often confusing and the articles posted by licensed physicians and surgeons, while interesting, are not necessarily pertinent to you. After all those distant folks do not know you and your medical history. Nor do they know your current symptoms and concerns. I would strongly urge you to print out these articles and make an appointment to discuss the differences of opinion presented in them with your surgeon.

Your concerns are genuine and you need definite answers. And those answers should come from a physician or surgeon who knows YOU.
 
Sorry, posted by mistake. The radiographer that did my MRI rang today and said that the images are not good enough for her to write a report, and that they would refund the cost, a slight consolation.
Hi also said the an arthroscopy is not a lot of good because the cavities are so small to access, which seems to be inaccurate as I believe that folks on this forum have had them
The OS surgeon said that their job is to do the bone work successfully, which he believes they have,and beyond that he’s not showing any interest. So the next question is which doctor to approach next, a revision specialist or a soft tissue specialist?
Please keep posting, good to compare notes on doctors opinions, and we may be able to help each other.
 
I asked, again, about an MRI seeing that it is actually possible. My dr replied, again, it is “useless” and let’s do another x-ray since it has been 6 months.

Is it possible to have full ROM AND still have that tight feeling and minor pain after trying anything on that knee???
 
I had an MRI , they use a “metal sparing “ MRI machine , not every place can do it . It’s still not as good as with out TKR , but a lot better . They identified where my infection was at , even though they had notes about metal obstructing .
 
I honestly don't know why my dr REFUSES to do an MRI. I have Kaiser so I don't have many options outside of their system...
 
I have excellent Rom on both knees, but pain every single day. I can do everything, but it hurts. I asked for an MRI last week, but the results were so bad that the radiologist said that she was unable to write a report. At least I’m getting a refund.
 
@Ghostpipe

How are you doing? I had another x-ray and it's completely normal. I'm at the point of just giving up, doing my activities (biking/hiking etc) and just deal with the knee I have now. Very, very disappointed in this surgery...
 
ihavetwins said:
@Ghostpipe

How are you doing? I had another x-ray and it's completely normal. I'm at the point of just giving up, doing my activities (biking/hiking etc) and just deal with the knee I have now. Very, very disappointed in this surgery...
Click to expand...
I wish I read through this forum before my PKR. Lots of poor outcomes. However, I think those with excellent outcomes never bother with looking for a knee forum. Or they come here and disappear from posting because their knee feels so much better they have nothing to post about.

Its either... "I am a year plus out and still have pain".

Or... One week out: "I am suffering".... One month out "Knee hurts but so much better" ... Two/three months out: "Going back to work and should be able to do that 10k!"... Three plus months out: Crickets.

:)
 
Sorry for the long post…

I am now 16 months after my right TKR and I am worse than before my surgery. I was recovering well at the 6 month mark and resumed hiking and biking. By December I was unable to ride my bike without heavy clunking and discomfort. My dr advised me to stop biking and see what happens.

I’ve been back to the dr several times because my activities have become extremely limited. His response was every knee is different and to rest for several months. He said I overdid too early and the tight band/heaviness/discomfort has caused inflammation and I need another 6-8
weeks of no stress on the knee.

It seems by now everything should have “calmed down” but it’s worse. The dr said there is loud crepitus but everything is in order and sent me to PT.

I feel hopeless and miserable. What’s worse is my left knee, done 2 yrs ago is hurting—a sharp pain on the inner part of the knee. PT said I’ve been “compensating “ and need to build more muscle in the right knee.

Somebody pleas help me. I want to just hike and bike.

Thank you.
 
I think it’s time for a second opinion.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.
How can I find my threads and posts?
 
I agree with Jockette. You have given your current doctor many chances to find out what's wrong with your knee and he hasn't. It's time to find someone new. Someone that is far away from your current doctor and not affiliated with him in any way. You need a doctor who deals with problem knees and has a new, fresh set of eyes.
 
@Jockette @sistersinhim

Thanks so much for the reply. I’m at Kaiser, which makes it difficult to go outside their system without incurring significant cost.

But…can you recommend anyone in the San Jose/Palo Alto, CA area?
 
@ihavetwins .... I probably have some recommendations fairly near you, but they are likely out of Kaiser's network. Kaiser does not allow anyone outside their system to access their providers. It's a VERY closed system.

Do you still want the recommendations even though it may be self-pay? Sometimes you can get an opinion from someone outside and then take the information to a Kaiser doctor for any treatment, if money is an issue.
 
@Jamie

Yes, please. I can at least call and find out the consultation cost.

Thank you very much.
 
@ihavetwins Kaiser does allow you to get a 2nd opinion! And it can be with another Kaiser doctor - you would need to ask either your current surgeon or your primary care physician for a referral. Go to your Kaiser online medical records site and look through the doctors list for an orthopedic surgeon who specializes in knee revisions ... perhaps someone at a different clinic in your region. I worked for Kaiser for a long time and have some familiarity with physicians in the NW region ... but alas do not know of any in other regions. IF there is no Kaiser doctor who has this specialty in your area you might be able to petition for a referral to a non Kaiser doctor. Most departments have a list of contracted out side providers who they refer to when a service is not available in house. But those do require specific criteria and a specific referral.
 
you can get a fairly good MRI if they use a specific type called "metal sparing MRI " l had it done twice and it works . Not all facilities have the capability , l had to go to a different hospital . The first MRI showed a tear in the muscle after a fall 4 weeks after the TKR , l had to go back to surgery for fixing . The second time it identified a sinus track infection in the joint that was only showing up as a sore below my knee cap . They do work !
 
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