Revision TKR Knee revision “1st night”

[FleuveStone]

yes copy that: happy anniversary, @Aussie Bill! look forward to hearing how things are going sometime.

 

[Aussie Bill]

Cheers - all good. I still have a constant ache in the joint (1-2 out of 10). Taking Panadol some of the time (mainly to sleep). It’s consistently a bit swollen, but not badly, just on the outside. Doing exercises and hydrotherapy later today. It’s going OK. Maybe expecting more improvement this week. Seems to be a bit stronger, but still hurts a bit to straighten it completely. More healing to go and I know it’s a marathon not a sprint to full recovery.

 

[Layla]

More healing to go and I know it’s a marathon not a sprint to full recovery.

This is true!
You're doing really well for only one month post op. Keep up the good work.

 

[FleuveStone]

@Aussie Bill , sorry i seem to have missed your beautiful photos and words about the amazing area you live in. really enviable!

setbacks are definitely par for the course for me, but i try to learn from each one and try to be as conservative as i can. för example i caught myself going upstairs normally instead of toddler style and decided that was a good exercise to incorporate, but not to do it all the time. going downstairs is a lot harder so there's immediate feedback and it's not tempting to take a shortcut!

have an awesome week, which must already be underway where you live!

 

[Aussie Bill]

Hi FleuveStone, thank you for the kind words: we love our area and fortunately have been here since 1996. Plan on going back to work in 14 days, need Surgeon to approve this in 2 days. Anzac holiday next week, Dr. Chen is booked up the whole week. I thought the hospital physio’s could approve this next week, but they told me today I need the surgeon to approve it. I’m doing well, but not yet ready to go back to work. Hope all is well with your recovery.

 

[FleuveStone]

look forward to hearing if and how you get approval to go back to work @Aussie Bill . I'm getting xrays and seeing my surgeon today so have my fingers and toes crossed he's happy about things.

 

[Layla]

Hey AussieBill, we miss you.
It's two months to date since your revision....Happy Two Month Anniversary!
We'd love to read an update on your progress when you have the time to share one. I hope you're doing well, increasing in strength and stamina and slowly getting back to all that you love.
Hope to hear from you soon!
@Aussie Bill

 

[Aussie Bill]

Hi Layla,
I’m doing OK, went to work after 6 weeks and have been seeing a physiotherapist to strengthen the joint. Unfortunately over the past 5 weeks the joint has stayed swollen even after icing and elevation. I’m walking and standing most of the day. I have started wearing a compression brace which is uncomfortable with the added pressure on the tender tissue. My physiotherapist recommended it to get rid of the swelling as my cryocast has not done the trick alone. Also new veins have popped up all over the joint which I don’t know if this is just ugly or an issue. Any advice would be appreciated. The muscles are stronger around the joint but the swelling is the problem.

 

[EalingGran]

Sorry you have swelling and what look like varicose veins to me. A lot of standing can certainly cause that after joint surgery.
I had a good recovery but I could walk 10,000 steps/ day a few months before I could comfortably stand for more than short periods. Does your job involve a lot of standing? If so, is there any way to get an Occupational Health assessment to get reasonable adjustments to allow more breaks/ sitting?

 

[Layla]

Hi Aussie Bill,
I'm not surprised by the swelling since you did return to work sooner than generally recommended. However, it is understandable that not all are able to begin a phased return to work at twelve weeks post op. Sorry you have to deal with this.

Is the swelling going down overnight? If not, your activity level is likely too much for your healing leg at this point. If the compression brace is causing you discomfort, it may be too tight, or a poor fit, which can worsen the swelling. Is there any way you can break up the standing time while at work, allowing you to sit and elevate your leg several times a day?

Continue icing and elevating at night and possibly even elevating your leg as you sleep, if you're able.
Consider checking in with your OS, or his care team, about your work activity, the discomfort of the compression brace and the prominence of the veins as you described. I'd be interested to hear their thoughts on all.

Thanks for stopping by with an update, Aussie Bill. I hope these issues settle for you soon.
@Aussie Bill

 

[Aussie Bill]

Hi Layla,
I have a referral from my GP. She had no idea about the veins or continued swelling. My specialist is gone the whole month of July and booked out till August. I have made an appointment with one of the partners for 8th July. Maybe get some answers from them. Work: unfortunately I work alone making printing plates (letterpress-offset). No real opportunity to change hours or conditions. Not going down overnight just same state most of the time. Still able to work, exercise, and do most things, but in the past 2 TKR’s different conditions: Desk job with walks at lunch and gradual improvement over time without this swelling issue.

 

[Layla]

Hopefully you'll receive some insight and direction from your OS's partner in three weeks. If you think you'll be able to get comfortable enough to sleep with your leg elevated, give it a try and see if it makes a difference. I'm unable to do that, but if you think you can, try it.

I'm wondering if you'd consider putting those PT sessions on hold for now and see if that makes a difference? Your leg is recovering from controlled trauma. Especially if you've noticed a change in swelling in relation to your physio therapy. Usually a revision is more difficult to recover from than a primary TKR and swelling can last up to a full year, normally easing over time. Your situation sounds relatively new so it's always good to get checked. I'm glad that you have an appointment scheduled.
Please keep us posted. Best Wishes!
@Aussie Bill

 

[Aussie Bill]

Sorry you have swelling and what look like varicose veins to me. A lot of standing can certainly cause that after joint surgery.
I had a good recovery but I could walk 10,000 steps/ day a few months before I could comfortably stand for more than short periods. Does your job involve a lot of standing? If so, is there any way to get an Occupational Health assessment to get reasonable adjustments to allow more breaks/ sitting?

Hi EalingGran, Never had varicose veins before, so maybe that's it. I was a pre-press Manager for a printing company before my current job as Plate Maker. Unfortunately in my current job I have no one to share the workload. My boss came out from Thailand to cover for me while recovering for the 6 weeks post op. At the moment I have my leg elevated and iced as I have a break in production, but normally trying to keep our clients happy with short deadlines which requires loading and unloading plates for different processes all day. Mostly on my feet. I did have an assessment done and at the time my situation was the same, but that was 4 weeks ago and was expecting improvement with the swelling to happen by now. Just so you know I chose this job because it was not a desk position. I wanted/want to be active all day not just sitting. I'm pretty happy with the results so far just this little swelling issue. i do walk 2 plus K's when I can after work and my leg strength is improving.

 

[sistersinhim]

Wow, that poor knee of yours. It is definitely inflammed and very unhappy. You don't need to be doing any exercises or extra walking after your work day. You're getting plenty of PT then! Ice and elevate as often as you can.

 

[Layla]

Hi AussieBill,
Happy Three Month Anniversary!

As we begin Summer today, I believe you're leaning into Winter in Australia.
Not sure what type of weather you have during the Winter months, but I believe it's not as cold as what we experience here in the US in the Upper Midwest.

Any change in your leg over the course of the week? Please let us know how your July 8th appointment goes.
I hope you have a nice weekend, AussieBill.
@Aussie Bill

 

[alex_mom]

I have started wearing a compression brace which is uncomfortable with the added pressure on the tender tissue. My physiotherapist recommended it to get rid of the swelling as my cryocast has not done the trick alone. Also new veins have popped up all over the joint which I don’t know if this is just ugly or an issue. Any advice would be appreciated.

Is the compression knee sleeve the correct size? Or perhaps too tight/small? Over here, we measure a few inches (several cms) above the knee to get the correct size.

Twenty years ago, I wore a Velcro style band for IT problems *below* my knee for some bursitis, and I had to have it quite tight so it wouldn't fall down my leg. A few months later, I developed the ropey-like varicose vein and had to have it removed by laser ablation. The doctor said it was caused by a faulty valve in the vein and I suspect my wearing that band too tight might have caused the problem. I stopped wearing the band and no more varicose veins. So, it is just a thought, and something to consider.

 

[Layla]

It's four months to date since your revision surgery. I hope you're doing well.
Let us know next time you're on the forum. We'd love to hear from you.
Happy Four Month Anniversary!
@Aussie Bill

 

[Aussie Bill]

Hi Layla,
I did see my Surgeon Dr. Chen last week regarding my swollen knee. He is having me take anti inflammatory meds to reduce the swelling and wearing a compression sleeve over the joint. The veins popping up over the knee he said was from pressure in the joint but so far the swelling has just reduced a little bit. He had x-rays taken as well, but no CT scan or anything that would show plastic outside the joint. Just wondering if a foreign object (piece of plastic left inside) would cause this issue? The x-ray report showed nothing unusual.

 

[Layla]

Hi Aussie Bill,
It's nice to hear from you. I'm sorry you're still troubled by the swelling. Since your surgeon feels the raised veins are related to pressure from joint swelling, there was nothing unusual on the x-ray, and the swelling has improved with the compression sleeve and anti-inflammatory meds, hopefully it will continue to reduce given more time.
He must feel the ongoing inflammation is due to the normal recovery process post TKR revision.

I do not know what you've encircled in red on the x-ray, but if it's a concern, consider calling the office to raise that question with your surgeon. Hopefully he'll be willing to view the x-ray again, relay what he feels it is and whether he feels further imaging is necessary. I do not believe you can see tiny pieces of plastic via x-ray.

I'm assuming he advised you to schedule an appointment if it doesn't continue to improve, and at that point he'll consider whether additional tests or imaging like a CT scan are necessary. As always, notify him of increasing pain or swelling, redness, warmth, fever, drainage, inability to bear weight etc.

It's easy to wonder if given the amount of time you spend on your feet at work is contributing to the ongoing swelling. Is it mostly gone when you wake in the morning, then worsens after you've been on your feet all day? Also, wondering if your surgeon understands the amount of time you're on your feet all day? Reading back through your thread, it appears you returned at six weeks post revision, which is early by BoneSmart's recommendations, but we fully understand not everyone can take twelve weeks off work, then slowly phase back in.

I do hope you continue to notice improvement with the swelling and you're able to elevate at work while on break as you mentioned you were doing, then again at home after work. I wish you the best and hope you'll keep us posted on your progress. We'll be here and we are interested in your recovery journey.
@Aussie Bill

 

[Legseleven]

Hi @Aussie Bill I’m sorry you have these issues.
I don’t know about the plastic or the X-rays where you’ve circled however I do know that the swelling can take a long time to diminish, and it’s 4m, which is one third of a 12 m minimum recovery. Being on your feet all day for work is both understandable and important however the way the body works could mean this is adding to the swelling. Layla’s queries about first thing in the morning and after work are spot on. As @Layla suggests please discuss this with the surgeon.
This morning I’ve been out and about much more for the first time (in 5 w) and after using my knee without any elevation for a few hours, the increase in the swelling is noticeable.
My only suggestion would be to try to properly elevate your legs in your lunch break, if you have one, in the evenings after work and I know some members of BS even sleep with their legs raised.
This page is all about how to best elevate post op. I certainly found it really useful.
I hope in time the swelling will diminish as the knee finds its own balance through healing.
We are here for you.