TKR PCL release post TKR<<

@IronGirl6 My MUA was after a different type of knee arthrotomy---ACI. I was one of the ones who DID get major adhesions following a 7 wk immobilization in a straight leg brace, even with using a CPM every day for hours. I'm still (Not so patiently) waiting on my TKR.
 
So I'm seeing my OS today. Knee is improving, except my patella is definitely not tracking properly. I have clicks when i walk or swim or do leg extensions, when I move the kneecap by hand it has clicks, and the tectonic shift creep feeling is my patella jumping and doing weird stuff. :shocked:

I used kinesiotape to keep it in the right place, which seems to be working about 90% of the way... I've been looking to see what things might have to be done for this, and trying to figure out of the torture I suffered in PT could be the cause of this (well i didn't have these issues BEFORE...).

Also I'm on day 2 of the prednisone pack, not as horrid as I'd expected. I must have timed it with my cycle because I don't notice being any additional level of bloated or crabby... :rotfl: But I could use some crossed fingers and prayers... I do NOT want anymore surgery. I was all ready to enjoy my summer with my new knee. I do not have any real level of pain after all the rest and rehab I've done at home, including acupuncture (which can reduce edema really well), so I'm hoping there are some alignment things that can be done from a therapeutic POV.

Its shocking how many tears and how much terror can go into all of this. I am hoping I can find some success stories for getting a patella to track better post TKR without surgery. @sistersinhim @Jockette @Celle @NavyGunns I have searched, but perhaps you know of some pertinent stories that might help me? :swoon:
 
@IronGirl6, hopefully your visit with your OS will help put you at ease. Be sure to ask about some focused PT to work on your knee cap concern. Not an expert by any means, but I’ll bet your “clicking” issue is related to inflamed tissues (ligaments and tendons) that still haven’t settled down from your other PT episode. Just be sure to have that very direct, very blunt conversation about your expectations and what you will and will not tolerate.

Please update us on your visit.
 
I'm sorry,but I can't think of anyone who posted that patella maltracking had been cured without surgery, although some people did find they had an improvement with taping and PT to strengthen specific muscles that help to move the patella.
@Pumpkln may be able to suggest which are the specific muscles involved.
 
Good news, my OS feels it’s the PT inflicted trauma causing effusion under the patella, which is causing this slipping and clicking, and that when the swelling goes down this circus will stop. I haven’t been that nervous since the morning we drove to have this surgery done! He was super supportive - apparently this wasn’t the first time a PT has done something totally idiotic and wrong to one of his patients... :hissy:

He also told me that due to my muscularity, athleticism, and size, he made it a tighter installation to ensure it would be solid and strong... that otherwise it might have felt weak or had a feeling of giving out when walking. 120 just might take a year. So, apparently part of this feeling I have that I’m trying to push against a brick wall makes sense, nice to know 6 months later...:banghead:

I’m still a bit unnerved that my patella catches upon lifting my leg. This doesn’t seem normal to me. I took my kinesiotape off to redo it and moved about a bit - sure enough it happened again. With tape - gone. Far less clicking too.

*Interesting side note - the tape is making my tkr leg warmer. I was concerned but found this:
https://www.ncbi.nlm.nih.gov/m/pubmed/27688220/

I want to believe I’m ok, though I still have some semblance of doubt... so I’ll finish this course of prednisone and do MY OWN therapy and cross my fingers. I will also incorporate some patellar modalities I’ve found online. Thankfully the pain part has passed, it’s jut the clicking (and concern for wearing parts out prematurely) and the catching (and horrid memories of excruciating pain when this happened when I had my injured bio knee prior to first meniscectomy - my patella dislocated 5 times and was put back in place by a team doctor manually - I’d say this was indescribable pain, but all of us here have TKRs, which cancels that argument).:holysheep:

Thanks so much to everyone who’s responded. I’m so emotionally exhausted by all of this, don’t quite know what I’d do without this additional support.
:console2:

Interested in the thoughts of the group. Part of me still feels like something is wrong. I’m going to try, but blind faith isn’t my strong suit. :shrug:
 
@IronGirl6 , I have endured many patella dislocations and they ARE excruciatingly painful! Nothing can give me the heebie jeebies quicker than someone wanting to touch my kneecaps :bolt:
I lived in fear of dislocations until my mpfl surgery on my left leg. My patella on my right leg never dislocated, but it had a severe lateral tracking problem for many years. It’s why I had the RTKR surgery. I would be distraught if my kneecap didn’t track right after the surgery. What the surgeon says makes sense. If there’s an effusion, it makes the kneecap vulnerable. If the taping helps, I would stick with it for a while (no pun intended).
Hoping everything resolves for you soon!!!
 
Thank you so much - what is MPFL surgery? Yah me too on the touching kneecaps thing lol! Ack!

Congrats on your new knee - 6 weeks out? The best thing about this experience is when the pain subsides and you realize all that pain is GONE. It’s such a miracle!

@IronGirl6 , I have endured many patella dislocations and they ARE excruciatingly painful! Nothing can give me the heebie jeebies quicker than someone wanting to touch my kneecaps :bolt:
I lived in fear of dislocations until my mpfl surgery on my left leg. My patella on my right leg never dislocated, but it had a severe lateral tracking problem for many years. It’s why I had the RTKR surgery. I would be distraught if my kneecap didn’t track right after the surgery. What the surgeon says makes sense. If there’s an effusion, it makes the kneecap vulnerable. If the taping helps, I would stick with it for a while (no pun intended).
Hoping everything resolves for you soon!!!
 
@IronGirl6 , yep, almost 7 weeks! Mpfl stands for medial patellofemoral ligament. It acts as the tether (along with the quad muscles) to keep the patella aligned. After all those dislocations, mine was destroyed. The OS used Donor tissue to reconstruct that very crucial ligament. It worked great and has held up well!
 
do MY OWN therapy and cross my fingers. I will also incorporate some patellar modalities I’ve found online.
What wonderful news from your doctor. Doing your own thing is good, but remember, YOU can overdo, too, so be very careful. Listen to your knee and obey it.
 
My morning question - is it common for more muscular people to get a tighter tkr installation? I’d like to read about this but didn’t come up with much on my search last night.

Funny, from my world I don’t feel that I’m THAT muscular... but I guess by normal world / knee injury populations, I am. I’ve lost size since I had to quit seriously training, and the left had some muscle loss too.

I found this in my search - a rather positive article for younger athletes getting TKRs.

https://www.stoneclinic.com/blog/total-knee-replacement-athletes
 
@IronGirl6 I can't believe I forgot to tell you earlier I had a major patella tracking problem in my left knee after MIcrofracture surgery last year. Call me crazy with everything going on lately!!! :sos:

I hadn't EVER dealt with this in my right knee--the one with 7 surgeries-- so I was surprised it was such a problem in the left knee last year. My PT had to tape it every Mon/Wed/Fri, and I was told to do my strength-training only when I had it taped, as that's when I was most likely to feel it shift and damage the cartilage on the back (and I already have 2 cartilage defects there, not wanting them to get worse!!). Luckily the tape stayed on a good 2 days if applied correctly, so I always had the more experienced guy do it.

Since you're so far out from your TKR and super active anyway, I wanted to mention the specialized leg lifts I had to do every day to build the VMO part of my quad muscle faster. Think of a straight-leg lift, but your ankle/toes are pointed out to the side significantly. Apparently my surgery shut my VMO down significantly, unlike the "usual" response on my right leg. Regardless,it took 3-4 wks of constant taping and those exercises (3 sets of 15-20, every day for a month),plus the Russian E-stim to finally stop the tracking problem.
 
Wow @Rockgirl4 - thanks for this! My lateralis has always overpowered the medial - I’ll start this today! Makes total sense.

I’m taping myself but learned to do it when I worked in Pt - really helps a lot.

I have an Estim - what is Russian estim? Combo of frequencies? Do tell and I’ll do that too. Thanks so much again. Ready to put this past me!!!
 
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@IronGirl6 I'm really not sure what the settings/frequency are for the Russian E-stim, but at many of the PT clinics I've gone to over the years, most of the E-stim machines actually have a button with "Russian" written on it. :giggle:It's definitely more intense, but I don't know the exact numbers. I just know I usually end up needing it!:heehee:

I'm also one who's lateral side pulls MUCH harder than my medial side. I can lift loads more weight laterally, and can do Monster walks with bands, Bosu squats, etc for HOURS if my knees would just cooperate. That's just my build though--I've always had massive quads & hip muscles, but I've also struggled to stay balanced. We think that's part of all my knee/lower back problems these last 20 yrs.
 
My morning question - is it common for more muscular people to get a tighter tkr installation? I’d like to read about this but didn’t come up with much on my search last night.

Funny, from my world I don’t feel that I’m THAT muscular... but I guess by normal world / knee injury populations, I am. I’ve lost size since I had to quit seriously training, and the left had some muscle loss too.
I'm going to ask @Josephine if she can answer this for you.
 
I'm not sure what you mean by this

My surgeon said he had to do a tighter installation so my knee would be secure / not feel as if it would give out due to the amount of muscle in my legs. I don’t have more than that - it’s what he told me when I went for my 6 month.
 
I’m nearing the 8 month mark - and wow have things been good! I’m able to walk up and down steep hills, paved and dirt both, carry heavy objects (within reason and carefully), all kinds of stuff! We were working on our ranch, I did massive amounts of weed abatement and helped with building a metal fence - I averaged walking 5 miles a day where hills are 15-30% incline, according to my watch! Almost always while carrying something! :yahoo:

This activity led me to much better indoor cycling - I no longer hike my hip so my ROM must be increasing. Thank goodness! :biking:

While doing all of this I made sure to take 3 breaks a day to elevate and ice for precaution. Only on day 11 did I have true soreness, so I rested and am good today! :ice:

It is still tight - but I’ve found that putting my knee straight up while lying down, then coaxing my shin to relax down, is easier and more effective than slides. At least for me. I think I’m *finally* around the 120° mark! :happydance:

Having the ability to walk that much on hills without pain is so far beyond my rom limits though - I have my freedom back. It’s truly a miracle. I finally feel strong and capable again. I hope you’re all doing well too! :flwrysmile:
 
:walking:9 months and going... knee still feels strong and good for the most part. Still having occasional fibulae issues, which I’m learning stretches and PT for.

But I have a question:

Is it normal after a lot of activity to “feel” the metal in my tibia? There isn’t pain, just a sense of it being there. It’s quite odd. :shrug:

Happened after steep hill walking at my ranch, thr first long trail ride I’ve had in a year, and subsequent attempt at a figure 4 style stretch. The fibula moved and made quite the cracking sound - scary but again no real pain to speak of except in my brain. :cry:

I’ve found a few med articles about 40isb TKR patients having fibulae issues... and my knee was mess up for well over a decade... hoping I can get it all to calm down AND get to where I can to my yoga stretches completely again. :yahoo:

In other news, my “factory” knee is complaining quite loudly the last two days...:bolt: praying it’s just a phase. I’m backing way off and resting again. The iceman cometh. :ice:

There’s no apparent swelling or heat in either knee. Still a bit numb down my surgery scar, but it’s healed quite nicely!

Hope you’re all well. Praying someone out there has had some similar experience and turned out to be 100% fine. :prayer:
 

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