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TKR ironclm's recovery

The article about quad sparing is just a lot of advertising hype.
In the "bad old days", surgeons used to cut the quads.
Nowadays, most of them don't cut the quads.
 
@Celle my surgeon must be a good old boy because he said he couldn't spare my quad
 
They do try to spare the quad whenever they can. I guess your surgeon had to snip it, to get better access.
 
I had very bad arthritis and he had to get rid of what he called numerous osteophytes. Thank god the strength is coming back week by week
 
You're just about the point where I was getting cranky too. You think you should be farther along, you're sick of "recovery" and etc. Hang in there and know you're among people who get it.
 
@ironclm I read with interest your post. I had my right knee done on June 22nd and I felt like the poster child for TKR. Everything was going great. My ROM and extension were terrific and like you, I had very little swelling. However, right at week 6, I tore an internal suture which tore a patella tendon which set me back at least 3 weeks and I've been playing catch-up ever since. I'm finally able to walk longer distances comfortably, but I still experience pain and discomfort when in one position for a long period of time. Sleep is still difficult and I have nights where the achey-ness wakes me up multiple times.

There was a time during aquatic PT when I was doing a difficult bending stretch, that the tears just flowed. I think I shocked the PT as well as myself. Like you, I was so tired of it all. The therapist was so reassuring and when I saw the OS a few days later and explained how I felt, I was again reminded that I was only 3 months into a year long recovery. Sometimes we just don't want to hear it. But, in reality, it is what it is. And after reading and sharing with so many people here, I am convinced that I will be better off in the long run.

I can walk up the stairs without pain. That alone makes it worth it. The calf, hamstring and the other soft tissue healing will take time. Patience is there somedays and for the days its not, my friends on Bonesmart are here to listen to me vent. We're here for you as well. That's what makes this site great. We're here for you whenever you need us!!
 
I'm at 3 months, back on my bike, and just now starting to think I made the right decision. But certainly not always. The six-week point was tough for me and I for sure thought I should be further along than I was, even though I was probably where I should have been.

This recovery is slow, for sure. And slower for some than others, but hopefully we all get to the same place in time. Like Kneeper said, "Hang in there." It does get better.
 
@ironclm, I hate that you're having such a rough time. I have several Ironman friends and can only imagine the mental agony any of them would be going through given the same circumstances. I've done several 1/2 marathons and am a veteran C25K coach...the thought of not running again is enough to bring me to tears. I keep telling myself that if I can walk fast and do some serious hiking, I'll be okay. The jury is still out.

I'm sending you all of my healing mojo.
 
Both of my TKRs were quad sparing. My understanding was that was the difference between old school TKR where they honed out your femur and put a rod in vs the type I had. I had this type of surgery scheduled at first until a week before surgery when the Doctor told me I had to give up Mountain biking because I couldn't fall down. I promptly cancelled and found out about the Stryker knee and that's how I found my current Orthopedic Surgeon.
 
Very, very few knee replacements involve putting a rod into your femur - regardless of what the quad-sparing proponents may say.
I'll ask @Josephine to comment.
 
@joyful61 - I totally understand.

Thanks for the replies everyone. Patience has never ever been something that I possess. Ask anyone I know! I'm thinking about a big goal for November 2016. Need to do a bit more research.

And the quad-sparing thing? My quads are fine. In fact, their strength freaked out the in-home nurse/PT gal. I think she was used to working with frail elderly folks and not 56 yo bike racers.

I went out this afternoon and walked 1.1 miles at a speedy 22:30 min/mile. But that is an improvement over the 0.66 miles I walked at about 29:00 min/mile a couple of weeks ago. Looking forward to the pool tomorrow. I just hope I can get in/out.
 
Your walk sounds great! I shopped for three hours (Costco, Lowes, and Kroger)...that was enough to do me in.
 
Denmother said:
Both of my TKRs were quad sparing. My understanding was that was the difference between old school TKR where they honed out your femur and put a rod in
Click to expand...
I worked through those days and the designs were quite different to modern devices. Here are three examples which were very popular between the early 1970s and late 1980s. I have these very knees upstairs in my study! As you can see, they are fixed hinges which meant you could only bend your knee to 90 degrees and no rotation with the exception of the Sheehan which was beginning to look a bit more like modern knees and allowed just a little rotation.

[Bonesmart.org] ironclm's recovery


However, as regards the infamous "quads snip" way back when, there was a procedure where the quads where the incision was extended quite a long way up the leg to provide extra access to the joint. However, it very quickly became apparent that not only did this cause a lot of pain to the patient but it also interfered with the progress of recovery and very soon died out. Nowadays the incision is a lot shorter which therefore spares the quads. But the same happens with the skin incision in that it used to be 12-14" long and nowadays is only 6-8" long.

[Bonesmart.org] ironclm's recovery
 
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Don't the quads cover the joint space?

Do they have to be cut?
 
If you read Josephine's explanation carefully, you'll see that the quads don't cover the joint space and they don't have to be cut.
The patella and the quad tendon, which is attached to the patella, partially cover the joint space, but they are pushed aside as the patella is turned over, which then gives access to the joint space.
 
@Celle I know that some U.S. doctors are still cutting the quad tendon. A friend of mine had it done last year. Not sure if her doc cut the quad muscle as well. My doc used the subvastus quad-sparing approach and I was home in 28 hours. I think this is truly minimally invasive, right? He did not cut the quad tendon or any of the quad muscles. In the mid-vastus approach, isn't the muscle partially cut?
 
This is ironclm's thread. @Wanttobebiking , If you want to continue a discussion about quad-sparing and minimally invasive surgery, please can we take it to your own thread? i think we've derailed ironclm's thread for long enough.
Thank you.
 
Thanks @Celle! Those pictures of the metal pieces are freaking me out.


TKR 08/26/15

Sent from my iPhone using BoneSmart Forum
 
So today I made myself go to the swimming pool, after almost talking myself out of it. The Masters group that I swim with has a really great coach. She won a gold-medal at the Atlanta Olympics and is just one of the nicest best people ever. She emailed me and said to come to the session and when I got there I chatted with her a bit and she had me get into the warm pool that has steps that you can just go down (instead of the ladder). It's the pool where the seniors do their aqua aerobics.

I ended up doing some walking, some marching, and some swimming. Then a little bit of easy kicking at the very end to trying get a little more flexion.

Later I went to physical therapy and did have a little more flexion and was able to do a slow full rotation on the recumbent bike, so a good day. I'm going to ease into getting back into the real pool and doing a real swim workout.


TKR 08/26/15

Sent from my iPhone using BoneSmart Forum
 
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