Bilateral TKR Icing the knees<

[hhaze]

Maybe I can get a reply this time.

I am now officially 6 months post op. In September the surgeon was ready to release me until June. I was not OK with that since I have MUCH pain and issues still. So he appeased me and saw me again December 4. He agreed that something isn't right.

Lateral pain when moving in that direction, such as stepping out of my car or out of the bath. It is a stabbing pain that permeates behind the knee and in to the calf. I can't walk without a limp because it catches when walking.

Surgeon thinks it might be the popliteal tendon catching on the prosthetic at fibular head. Ordered a MARS MRI screening and he couldn't "see much" (it's 2019 and we can't find a way to screen post op metal prosthetics??) so he wants me to "wait it out". He will see me again January 10. Keeps hoping it will "fix " itself.

ZERO improvement for months. I regret this double knee replacement every waking moment. I would've rather lived with torn ligaments for life. I am in tears as I type and multiple times per day ... every day.

 

[NavyGunns]

@hhaze, I wish you weren’t going through these problems and that your recovery had been much more positive. I don’t have any personal experience that gives me any insight to offer you but I’m sure someone here can. I’m tagging @Josephine as I’m sure she will have some questions as well as opinions to offer.

I do have a question though. If you aren’t happy with the response you are getting from your OS, have you considered a second opinion? I know that many times they won’t consider taking on a new patient until their original TKR is at least a year old, but maybe you could approach your current OS about it? Sometimes doctors are willing to have a peer provide input if the patient insists.

Have you looked into options through your insurance? My carrier has a program where free second opinions can be arranged where critical surgeries or conditions exist. Might be worth looking into.

 

[Josephine]

I regret this double knee replacement every waking moment.

I'm so sorry to hear that. So let's start at the beginning:

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[hhaze]

@Josephine absolutely

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[hhaze]

@Josephine

1) left knee with the issue...sitting still, no pain. Walking (limping), pain is about a 4. Stepping to the side, stabbing pain is about a 9.

2) ibuprofen 600mg as needed every 4-6 hours

3) slight to moderate for both knees

4) I haven't been measured in a good bit, I do NOT have full range yet; but I am about 115-120

5) not icing

6)elevate minimally, but usually at night

7) activity level is pretty active. housework...laundry, grocery shop, and I also have been trying some pilates to gain some strength and stretch this pain out.

8) no exercise at home since working out outside home
no PT as that caused me more pain
Would be happy to learn some that may help this issue if you have any recommendations.

 

[NavyGunns]

@hhaze, I noticed that @Josephine hasn’t replied to you. I wonder if she didn’t get the alert so I tagged her again. I’ve noticed I’m not always getting update alerts for various member threads I’ve tagged (like yours). Not sure why.

Hope you had a very Merry Christmas and that your knees are doing better.

 

[Josephine]

Thanks @NavyGunns Don't know how I come to miss this. The only day I missed was Tuesday!

1) left knee with the issue...sitting still, no pain. Walking (limping), pain is about a 4. Stepping to the side, stabbing pain is about a 9.

Gosh that's a lot of pain considering you've had them for 6 months!

2) ibuprofen 600mg as needed every 4-6 hours

For those pain scores you need more than ibuprofen! I suggest you take 1,000mg Tylenol 4 times a day at 6hrly intervals.

3) slight to moderate for both knees

That's not so good for 6 months out

4) I haven't been measured in a good bit, I do NOT have full range yet; but I am about 115-120

I can do the flexion for you if you'd provide me with a photo of your knees in one of these poses

And you can estimate the extension yourself like this
1. put your leg on a bench, seat, bed, floor or anything similar but preferably something fairly firm.
2. with not too much pressure, press the back of your knee down - use your leg muscles, not your hand!
3. slide your hand, palm down, under the back of your knee

a) if you can get your entire hand under easily, it's probably about +10 degrees
b) if you can get just your fingers under, it's about +5
c) if you can get your fingers under but it's a push, it's +0
d) if you can't get your fingers under at all, it's -5 or more​

Here's a graphic to explain the degrees involved

5) not icing

I think you should - at least a bit, say 30-40 minutes 3-4 times a day.

6) elevate minimally, but usually at night

Same here

7) activity level is pretty active. housework...laundry, grocery shop, and I also have been trying some Pilates to gain some strength and stretch this pain out.

Okay.

 

[Celle]

I wonder if the Pilates could still be a bit much for your knees?