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Revision TKR Jolease's knee saga part 3<^

Jolease

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Hi, I had my first PKR in Oct 24th and my second February 26th.

I had a partial revision done as the plate was not sitting right and caused me awful pain when in extension. I was told xrays look great 3 times until I finally couldn’t handle the pain anymore. The surgeon got me in fairly quickly and revised the plate and shaved more bone.

My question is, I felt I was recovering so well in the beginning because I could straighten my leg without the pain. Now every time I am “living” my life I get excruciating pain and am back to square one.

Should I be feeling this much pain still at 9 weeks? It is when I’m on my feet to much. I’m 48. Am I just doing to much and expecting to heal to quick? Feeling super bummed. Also I have perfect ROM.
 
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SusieShoes

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Hi @Jolease and :welome: to BoneSmart.

I had my first pkr in oct 24 th and my second February 26th.
The second surgery is the revision on the first, am I right? Just want to get the dates right for a signature. :)

I felt I was recovering so well in the beginning because I could straighten my leg without the pain. Now every time I am “living” my life I get excruciating pain and am back to square one. Should I be feeling this much pain still at 9 weeks? It is when I’m on my feet to much.
You answered this yourself when you said you are on your feet too much. Too much activity -- be it exercise or errands or just daily living -- will cause your knee to swell more. Many people notice this especially at night. Nine weeks is still quite early in what will be a year-long recovery! Try elevating and icing your knee often, to help relieve the swelling and keep down the pain.

Here's the reading we give new members in recovery. The links lead to short articles that will help answer some of your questions. Also, take a look at the Activity Progression for TKRs. Partial knee replacements follow the same chart. PKRs share the recovery guidelines also, so you will find these links helpful, I think.

I'm quite certain you'll be hearing from some members who have PKRs to give you their perspectives. This is your recovery thread, so you can use it to share your concerns, ask questions, and even vent if you wish. We're here to help!

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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Jolease

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Thank- you. Yes first was oct 24th 2017 and revision was February 26th 2018. I think I’m frustrated as my surgeon said 3 months should be pain free and I’ve got just a few weeks to go. I’m guessing it is swelling inside also as it’s right where implant is that’s causing so much pain.
 

Jockette

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my surgeon said 3 months should be pain free
It is very disheartening when surgeons say this about partials. It doesn’t leave any room for individual recoveries and fosters frustration and disappointment if it does not come true for us.

I had a partial last year, a Patellofemoral. Which partial did you have? I am still not fully recovered. From what my surgeon’s office did and did not say, I expected a 2-3 month recovery.

I had a list of concerns at my one year check up and my surgeon was baffled as to why I still had these issues.

I found Bonesmart at about 4 weeks post op and learned for the first time that in reality recovery from a partial takes the same amount of time as a total, which is about a year. I was not happy to learn that.

Hang out with us here, vent all you want, ask questions and share your successes. We’re glad you found us!
 

Josephine

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Should I be feeling this much pain still at 9 weeks?
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?
 

Josephine

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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?
ai63.tinypic.com_eta39s.jpg


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.
 
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Jolease

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@Josephine
1 not much pain at rest,feels more irritated inside where implant is. Weight bearing a 7-8 when over do it a 10.

2 hydromorphone and tramacet. I have been taking just tramacet 3 times a day 37.5/325 mg.

3 moderate swelling

4 ROM is 130 and 0- no pain with either

5 icing 4-5 times a day for 20-30 mins at a time.

6 I elevate twice a day when icing

7 activity level is pretty high. I have been on my feet quite a bit , cooking, cleaning and few errands.

8
stationary bike 30 mins each day
Pool walking 30 mins continuous walking
Wall squats 2 sets x10 2 times a day.
Chair sit ups - quad strengthening 2 times a day.
No more PT as my ROM was achieved.

Also it feels almost itchy a awful sensation inside that’s hard to explain.
 

mlwreader

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Also it feels almost itchy a awful sensation inside that’s hard to explain.
OMgosh @Jolease I've experienced this too. It's the weirdest sensation. It hasn't happened in a while, but I definitely felt it. In both knees at different times. I'm pretty sure its just part of the healing process. I posted about it and that's the feedback I received.
 
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Jolease

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Thank- you @mlwreader . This has been awful. I’m quite worried as I seem to be getting worse. I get pain with most every step lately. It feels like the bone or something is really inflamed again. The surgeon said the bone was very inflamed with my last surgery. I hope whatever is going on subsides sooner than later.
 

Celle

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I think you're doing too much, and resting, elevating and icing too little.
Josephine will advise you in more detail.
 

Josephine

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1 not much pain at rest,feels more irritated inside where implant is. Weight bearing a 7-8 when over do it a 10.
3 moderate swelling
Did you note that swelling should be counted as pain? So did you factor this in to your pain score?
2 hydromorphone and tramacet. I have been taking just tramacet 3 times a day 37.5/325 mg.
You could add in Tylenol to that. I suggest you take 2 regular Tylenol (325mg) with each Tramacet and another dose of Tylenol of 1,000mg for the 4th dose. I think you'll find a lot more relief with that.
4 ROM is 130 and 0-
That's excellent particularly at only 8 weeks out!
5 icing 4-5 times a day for 20-30 mins at a time.
You accomplish little or nothing in 20-30 minutes. Ice for at least 40-60mins and more than 4 times a day.
6 I elevate twice a day when icing
Elevate as much as you can. You still have swelling to deal with.
7 activity level is pretty high. I have been on my feet quite a bit , cooking, cleaning and few errands
Not good. Did you read the recovery guidelines Susie left ou earlier? It contained this article Activity progression for TKRs which you should read again and apply!

stationary bike 30 mins each day
Pool walking 30 mins continuous walking
Wall squats 2 sets x10 2 times a day.
Chair sit ups - quad strengthening 2 times a day.

No more PT as my ROM was achieved.
Quite so - so stop these as well!
 
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Jolease

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I am now 14 weeks post -op from my partial (medial) revision. Things are just awful. I feel something is wrong again.

When I walk more than 10 minutes or so my knee gets so inflamed and painful, like something is rubbing and it gets very irritated. I get a itchy terrible feeling inside along with warmth too. Sometimes it hurts to the touch from the inflammation. My muscles in the leg since this surgery have remained so tight. It feels like the muscles were pulled tight and won't release.

I’ve done physio, stretches, tens machine. Nothing seems to help. Will this inflammation ever calm down?? I have an apt with my OS in August for my 6 month check. I asked my GP about seeing a different surgeon and he thinks they will have each others back. In other words it all looks good on x-ray!

I feel something is not right again. He fixed the initial issue but now I am worse off. I'm so depressed as 2 surgeries within 4 months takes its toll and I did this surgery so I could walk pain free. I wish he just did the full instead of “ fixing” his error the second time.

Has anyone felt this in their thigh? If there is anyone that has or had these symptoms I’d love to hear from you.
 

Jaycey

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@Jolease So sorry you are still struggling after your revision. I am from the hip side of this board but I a sure one of my colleagues will be along soon to give you input.

Are you icing your knee regularly? Elevating?
 

Jaycey

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@Jolease you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. If you would like a new thread title just give a shout.
 

Celle

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@Jolease - If your knee doesn't settle down, I think you do need to consult another surgeon - one who specializes in problem knees. This surgeon should be one who has no contact, either professional or social, with your current surgeon. That's so that he/she can give a completely independent opinion, without being influenced by the opinions of your current surgeon.

Because of professional courtesy (not wanting to steal someone else's patient) you may have to wait for about a year post-op before another surgeon will see you.
And you may well need to go out of your area to get an unbiased second opinion.

Under no circumstances would I let your current surgeon operate on your knee again. He/she has made two attempts and it's still causing problems.

Meanwhile, to try and help your knee to calm down, can you stop as much physical activity as possible and, instead, spend as much time as you can resting, icing and elevating your knee.

Remember that it does take a full year for complete recovery and you are still near the beginning of that recovery. There is still time for things to improve. Taking that time is another reason why another surgeon may be reluctant to see you at this stage.
 
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Jolease

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I am now 7 months post surgery from my second partial revision wich was only 4 months after first,and still have terrible pain. My leg does not feel like it belongs, my thigh is so tight and the muscles dont seem to be working right. I’ve expressed my concerns and the conclusion seems to be soft tissue damage. I had a cortisone shot last week to see if that would help, so far its hasn’t.I am an active 49 year old that would like to be out of this pain and have my leg feel like its mine again! Has anyone else has symptoms like this? I fear if things don't improve a full replacement may be nessasary. Also I stretch daily.
 
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threads merged 1.jpg
@Jolease, You may notice that I have merged your two threads. We like to keep our members' recovery posts all in a single thread. That way it's easy for us to go back and read your history before responding to a question or concern. In addition, the thread becomes a journal of your recovery for those who come along later and want to read about you. So, please post in this thread from now on when you want to give an update or ask a question. If you have questions or concerns that need an immediate answer, please tag an admin, a mod, or other members or all three. How to tag another member; how to answer when someone tags you

If you decide you'd like a different thread title at any point, you can just post what you want here and we'll get it changed for you. THANKS!


If you are having a problem locating your thread, here is a link with how to do it: How can I find my threads and posts?
 

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