TKR Injury at 7 weeks out from TKR

[referee54]

He is not concerned about infection but that I am overdoing it. In short, Josephine was right about everything!

Absolutely---she is our Forum "Mother Hen" and is amazing!

 

[Josephine]

 

[Reich4313]

I received the official results of my knee sonogram from the injury nearly three weeks ago. @Josephine or anyone else know how to interpret this?:

"Acute partial-thickness insertional tear of the distal quadriceps' tendinous complex, limited to its
deep lamina, the vastus intermedius tendon, avulsed off its superior patellar polar insertion,
accompanied by a moderate-large suprapatellar joint effusion; the dynamic shelp get my full function back. onographic examination
demonstrates relatively preserved extensor function of the quadriceps' tendinous complex during knee
extension."

Does this sound like the type of thing that can heal back to normal on its own? It has been over two weeks since the injury and my leg is so week it often seems to want to buckle beneath me. I often have a hard time bending it and straightening it. Swelling and stiffness is constant after any activity.

I am so depressed over my lack of ability to do anything and don't know if I should request surgery to get full functionality back. My patella is way out of place and I was told by the second opinion doctor that it never will come back without surgery. Does this likely mean I will never be able to kneel again? If I try to kneel, all the pressure would be on the edge of my patella, forcing it more to the right.

I also need to lose weight, anyone have any success there post TKR?

Any thoughts, Help or advice? I am going crazy!

Thanks!

 

[Josephine]

Acute partial-thickness insertional tear of the distal quadriceps' tendinous complex, limited to its deep lamina, the vastus intermedius tendon, avulsed off its superior patellar polar insertion,

This means that the tear is not a complete tear which is good news. A partial tear should heal without surgical intervention. The vastus intermedius tendon is also attached to the patella at this juncture and appears to have been torn off as well.

accompanied by a moderate-large suprapatellar joint effusion

Since the place where these two tendons are attached to the patella is inside the joint, and when the tear occurred it inevitably caused some haemorrhage, there is bound to be fluid and blood in the joint (effusion).

the dynamic shelp get my full function back. onographic examination demonstrates relatively preserved extensor function of the quadriceps' tendinous complex during knee
extension."

Can you check what the report actually says as I am quite sure it doesn't say 'shelp!

 

[Reich4313]

Hi @Josephine,

Unfortunately it does say "shelp". Clearly a typo on the part of the person doing the entry... I'm at a loss save for what the Doc told me verbally. Which is that there was a partial tear and partial disconnection from the patella. The worst thing for me is that my kneecap has shifted so far to the right it just feels wrong and I don't think I'll be able to kneel again. It also pops and clicks as I move around - kind of a sickening feeling.

Thanks again.

 

[Josephine]

In that case I think it means shelf.

my kneecap has shifted so far to the right it just feels wrong and I don't think I'll be able to kneel again

Of course it will feel wrong and will continue to do so until the tear has healed. This can take several weeks. But no harm in you getting a second opinion in the mean time.

 

[Reich4313]

I am SOOOOO frustrated and depressed!

It has been four weeks since I fell and injured my quad. It is still so very weak and painful it feels like I will never be normal again. I can't walk any sort of distance or stand for long without feeling like my knee is going to collapse. Part of my frustration is not knowing if this is from the original replacement or subsequent fall at PT. I was advised by second opinion Dr. to only do quad sets, hamstring stretches and stationary bike. I have been doing this but it does not seem any better. Now I have a big indent/crease in my thigh and the soft tissues around the knee are very painful.

The area where my patella was - before it slipped to the right - feels very sore and jelly like. Patella clunks around in a sickening sort of way.

Any advice? @Josephine, is there any end in sight? How long should this last?

I hope you all are well.

 

[Josephine]

Well never think anything like this is going to get better in 4 short weeks! That's just unrealistic.
And please tell me you've not been doing quad sets, hamstring stretches and stationary bike while you've had this injury?

Now I have a big indent/crease in my thigh

How about a photo?

 

[Reich4313]

I have been doing those things. That's what my Dr told me to do!!!!

I've also attached a photo. Blech!

And a photo of my other knee for comparison

 

[Reich4313]

I should have tagged @Josephine so she'll see the above.


Sent from my iPhone using BoneSmart Forum

 

[Josephine]

Great photos! Though I've reduced the size for better viewing.

Those creases are easily explained. With the one in the red circle, when the surgeons are stitching up wounds, it's often possible for them to pick up a little too much tissue so it tethers the skin to the suture point.

As for the one in the blue circle, that might be the same but I cannot fathom how he would have made a stitch quite so high in the thigh. I have to admit I've never seen anything quite like that before but I don't think it's of any particular significance. When do you see your surgeon again?

And please tell me you've not been doing quad sets, hamstring stretches and stationary bike while you've had this injury?

Can you answer this question for me please?

 

[Reich4313]

@Josephine I have been doing those exercises at my dr's direction. I have not been going to PT but doing them on my own.

The creases only showed up after my injury seven weeks after my TKR. It has now been 11 weeks since TKR but 4 weeks since injury.


Sent from my iPhone using BoneSmart Forum

 

[Josephine]

Oh really? I misunderstood that. Can't help then.

 

[Reich4313]

Ok I am still really swollen, stiff and in pain. Is this normal? My OS, who I saw yesterday seems reluctant to say anything might be awry, it's like he's paranoid of being sued. I had the injury at seven weeks in which I partially tore a muscle and avulsed a tendon from the patella. But that was six weeks ago now and my leg is still weak. It swells immediately after walking and gets stiff after sitting in a regular desk position for any period of time. So, for me, it's either stiffness or swelling - both of which stink. My OS says most of this is from the injury - of course he does- but some stiffness may still be the result of the TKR. Anyone else having this much trouble at 14 weeks out?

I also just had my IVC filter out yesterday, which was nice but the area hurts and is swollen. I've also had a damnable head cold for two weeks and my nose just won't shut off! AAAAHHHHH!!! I thought once the weather improved and some longer days came that I'd feel better but this hasn't happened.

Am I being a baby? When will the stiffness and swelling subside?

 

[appaloosa girl]

Hi @Reich4313
At 14 weeks out you will still be stiff and sore. You are still early in your recovery. With the injury added it will take time to heal. This is a long process without an injury. It will heal. You will so need to give this the time needed for that. As far as the injury goes, give that the time needed also. If it continues and not getting better then that will be addressed.
No you are not being a baby. This is major stuff that you are dealing with. Be nice to yourself!!
Dana

 

[katiejarr]

Hi @Reich4313,
I've been reading your posts and I'm so sorry that you had to go through all of this! I am at 16 weeks, with no injury, Bilateral TKR and I still have pain, stiffness and days where I feel like the pain will never go away...this is a process and from everyone I have talked to here on Bonesmart and in the world around me that have had TKR they all say it takes a year to feel normal and pain free. I too push myself too hard....exercise too much and then I pay for it! Take it easy and let your knees lead you!!!!! Hang in there...this too shall pass!

 

[Josephine]

I am still really swollen, stiff and in pain. Is this normal? I had the injury at seven weeks in which I partially tore a muscle and avulsed a tendon from the patella. But that was six weeks ago now and my leg is still weak.

Of course it's normal! That injury is akin to a fracture which can take upwards of 12 weeks to heal. And if you're still doing those exercises, you can add another 3-4 weeks to it. They will delay healing to such an injury. What they don't do is help it get better.

 

[Reich4313]

I am still having a lot of pain on the inside of my right knee. It feels like it is in the joint and it clicks every time I move it. I went and saw my OS who says everything is fine. He X-ray the knee and said it looks good. Some days later I happened to look at my online medical records and there were test results from the X-ray.

The results read, and I quote, "kneecap shoes excellent position and alignment. There is a small piece of bone or cement in the intra patellar area."

I was stunned and sent a message to my OS asking about this piece of bone or cement. His response was "your continuing problems are the result of the quad not the replacement. Let me know if you have any questions."

I was so mad. What kind of an answer is that?! @Josephine and others, given my continued joint pain and clicking, do you think this object could be to blame. Or worse that my new joint could be loose? Where would cement have come from and what are the implications of that. I am tired of being in pain and walking impaired!

Thank you all for your continued help and support.

God bless and Happy Easter! I hope everyone is feeling good today.


Sent from my iPhone using BoneSmart Forum

 

[Josephine]

Thanks for your Easter greetings. I wish the same to you!

I was stunned and sent a message to my OS asking about this piece of bone or cement. His response was "your continuing problems are the result of the quad not the replacement. Let me know if you have any questions."

How dismissive. I bet you wanted to say 'something'! I know I would have.

given my continued joint pain and clicking, do you think this object could be to blame. Or worse that my new joint could be loose?

I don't suppose you have a copy of the xray you can post? I can often spot a loosening with one eye closed! But I doubt the fragment is to blame. Such items usually get sucked into the soft tissues where they can do no harm.

Where would cement have come from and what are the implications of that.

The cement would have gone adrift when they were fixing the implants in place. Part of the procedure is for the surgeon to carefully go around the edge of the implants with a small instrument and smooth down the cement and lift out any loose fragments before it sets. But its not unknown for small fragments to get missed and mostly, as I said,they tend to get sucked into and then stuck in the soft tissues. There is a lot of loose stuff around the knee joint, bags of capsule that allow the knee to move, so plenty of hidey holes for such fragments to let lost in.

 

[Reich4313]

@Josephine, alas I do not have a copy of the last xray. Any ideas on why my knee would be wanting to buckle forward lately? It didn't even do that when the quad injury was at its worst.

Quad is feeling pretty good, not 100% but getting much better. I am getting a brace from my PT to stop it feeling like its going to buckle. That is no fun!

I feel so lucky to have found this site, just reading it has been a real blessing!