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PKR knee implant bone pain

spockman

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i had a partial knee replacement 4 weeks ago, left knee medial side . I I wake up up about 4 am with bad bone pain where the implant is . It seems sleeping causes knee to swell and get stiff . I take celebrex 2oomg 2 x day. after i get up walk a little feels better. loosing sleep over this. Going to pt 3x a week . Why does sleeping cause knee to swell and hurt at night. Should the bone from cutting and implant put in still hurt a lot after 4 weeks. is this normal. Hurts even worse at night after pt that day

after 4 weeks can bend knee back 120 degrees and bend leg straight.
 

Roy Gardiner

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:welome: to BoneSmart
It seems sleeping causes knee to swell and get stiff
It's quite possibly a delayed reaction from the day's activity. It will improve with time, 4 weeks is early days.

Meanwhile:

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 

Jaycey

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Is your PT aggressive? That's excellent ROM for so early out. But was it accomplished by forcing your knee?

Recovery from PKR can take one year or more. Ice and elevate as much as you can. It will reduce the swelling.
 
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spockman

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had partial knee replacement 4 weeks ago left knee on a tuesday, left hospital wed started out patient pt on the friday. That next week my therapist started aggressive knee bending exercises to make leg straight and bend my knee to get most degrees of bend. This caused a lot of heavy pain as I was doing the exercises at home also. She insisted that if you wait too long you will get scar tissue so you will not able to bend knee . i was getting so much pain i am scared i would loosen implant. Dr took xray after 1st week looked okay. still next weeks more aggress exercises.

My question is can aggressive thearphy damage my implant and did she start it too soon. Is that why knee hurts more when sleeping. iI it true if dont do aggressive bending right away knee knee you will not ever able to bend properly due to scar tissue. Now go 3 times a week and exercise on the other days one time a day and use stationary bike. Do I need more
 
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spockman

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cementless vs cemented knee replacement. Which will last longer and have less problems. I ask my dr and he said for partial knee replacement he uses cement only. I may be repeating from another post but can cemented implant withstand aggressive pt. So has anybody had problems with cemented knee replacements getting loose in first few yrs and what are the signs of loose implants. what are doctors using now
 
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spockman

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yes was aggressive . I should have known better . Now I am scared this therapy did not loosen my knee replacement. my therapist wants me to start leg press using the one leg with the partial knee replacement. I did a little of it and my quad hurt a lot. I hear clicking on bending my knee , so is this normal
 
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spockman

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4 weeks from partial knee replacement. Hear clicking.. is this normal. does it go away. thanks
 

WFD

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My first TKR (October 2020) was cementless, a press fit.

in July of 2021 when I had it revised due to scar tissue, the surgeon found that the femoral prosthetic came right out with no force required.

The new parts put in as part of the revision were put in with cement. The cement reaches full strength very quickly whereas the bone must grow into and onto the surface of pressfit parts, and that takes months.

in the future I personally would insist on cement being used.
 

Booger

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I cant really hear it but I do feel a click most times. Im about 10 weeks in almost. Doing better than when I was at 4 weeks. But I also have a total knee replacement.
Good luck
Booger
 

Pumpkin

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She insisted that if you wait too long you will get scar tissue so you will not able to bend knee . i was getting so much pain i am scared i would loosen implant. Dr took xray after 1st week looked okay. still next weeks more aggress exercises.

My question is can aggressive thearphy damage my implant and did she start it too soon.
Aggressive therapy will not hurt the implant, but it can do damage to your soft tissue, causing increased pain and swelling. Which blocks your ROM.
Suggest you cut back your exercises and locate an up to date PT, who knows that your soft tissue needs to heal first, and that aggressive therapy is counter productive.
Saying no to therapy - am I allowed to?
TKR: Ceasing aggressive physical therapy after surgery

4 weeks from partial knee replacement. Hear clicking.. is this normal. does it go away. thanks
Clicking is normal, here is an article about clicking knees. Clicking/clunking knee joint after surgery
cementless vs cemented knee replacement.
Cemented and uncemented hips, this article also applies to knees.
 

Pumpkin

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@spockman ,
You'll notice that I have merged your three new threads with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?
 

Pumpkin

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Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!
 

Jockette

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That next week my therapist started aggressive knee bending exercises to make leg straight and bend my knee to get most degrees of bend. This caused a lot of heavy pain as I was doing the exercises at home also. She insisted that if you wait too long you will get scar tissue so you will not able to bend knee .
I seriously don’t understand how they think aggressive PT (I refuse to call it “therapy”) helps a knee replacement. All it does is injure your soft tissue that is trying to heal from the onslaught of the surgery. Please find another office with a gentle, more updated approach to this recovery. Call offices and be sure of their approach before you make an appointment.
my therapist wants me to start leg press using the one leg with the partial knee replacement. I did a little of it and my quad hurt a lot.
This is not good for your new knee, this early in recovery. Please find another office, or do your own rehab at home, which some of our members do, and they have great outcomes!
 

Jockette

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This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!) :egypdance:
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" :yes:

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 

kneeper

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yes was aggressive . I should have known better . Now I am scared this therapy did not loosen my knee replacement. my therapist wants me to start leg press using the one leg with the partial knee replacement. I did a little of it and my quad hurt a lot. I hear clicking on bending my knee , so is this normal
Yeah, I don't know why PTs want people to use the leg press, but I know a lot of them do. You can just say no. Or do what I did, which was to say "no for now." They can have you do something else.
Clicking is normal. I didn't hear the clicking, though many do, but could sense it. A bit of a strange sensation, but nothing is wrong. For me it gradually went away as the knee healed.
 
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spockman

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Had medial partial knee replacement left leg 11/9/21. I have tingling vibration in my foot only way before this surgery from back issues. Now since the partial knee replacement 4 weeks ago I get tingling some burning pain in lower leg including thigh muscle and bone and of course knee cap and tingling in foot is now worse.. This is worse when I sleep at night. .Could this nerve issue in lower leg only and worse increase in foot come from the knee surgery as the knee is swollen and the nerves going through knee are getting irritated Why is it bad after sleeping at night. Also side of hamstring is sore . I am trying deciding if the knee replacement is has irritated the nerves or it is my lower back from some disk issues and why at night when sleeping. does knee replacement irritate leg nerves. Anybody with nerve issues with knee replacement.
 
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Pumpkin

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You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

How can I find my threads and posts?
 

Eire1

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@spockman Nerve pain is a natural occurrence after surgery, due to what your body goes through. It always feels worse at night because there are fewer distractions unlike during the day. Pain and swelling in your knee at night can also be a result of your activities during the day, for example pushing yourself too hard doing PT.
I do understand how you feel as I am currently battling nerve pain myself , my surgery was the 28th of SeptemberI and I am currently taking Gabapentin for it. In my case the pain starts behind the knee and shoots down the outside of the leg to the foot. I am based in Ireland so treatment may differ in your location.
I would suggest you discuss this with your GP or OS and see if they can offer anything. I would also suggest you check out the links provided by Roy Gardiner, Moderator- I found them very useful and learned a thing or two; you can also read other posts by members who are going through something similar. Just put nerve pain in the search area.
One more thing, regarding physio- if your PT hurts when you do it you might be aggravating the knee and the nerves, what is recommended here is to take things slow and steady, if it hurts don’t do it and don’t let anyone do it to you. I was a member of the “No pain No gain“ club and learned the hard way that I needed to develop patience with my knee and it’s progression. Most people on here also suffer with sleeplessness, it’s a common side effect of the surgery.
It will get better, I promise, at the moment it’s all good days and bad days:good-bad:
 
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spockman

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first thanks for all your responses to my posts. I have another question starting on my 6th week from my partial knee replecement medial side left knee. I am now getting good range of motion from the strong therapy but I still get annoying sometimes burning pain lower side of the implant toward kneecap when walking as the leg straightens vs leg bending and worse after exercises. IS this normal for implant to hurt and burn feeling after 5 weeks especially after some exercise. Tends to be in one area
 

Jockette

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Yes, this kind of pain is normal only 6 weeks after a joint replacement. The surgery caused a lot of trauma to your leg and it will take an average of a year for complete healing, even for a partial.

I am now getting good range of motion from the strong therapy but I still get annoying sometimes burning pain
This strong therapy night be a bit too much for your knee at this stage. If you go a bit gentler you might have less pain. At this stage of recovery, you are healing/recovering, you are not training. Give your knee more time to heal, then you can go a bit stronger.


By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery! :flwrysmile:
 

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