Revision TKR Knee revision right knee

[DLC1128]

I don’t know if I need to add this to my original post that started two years ago or start a new thread since it’s a new surgery. I’ll let the moderators decide. BTKR was originally completed in September 2017. The right knee never really recovered. Turns out there was a reason. On August 12, 2019 I had the right knee redone. Surgeon found the cement attaching the tibia to the knee joint was not attached correctly, thus the loose joint. He said when he went to remove that part of the old joint it lifted right out and he didn’t have to chip it away. So every time I stood up or walked a lot, the joint was loose and thus the constant pain. He put in the new joint and screwed it in as well, so I don’t think it’s going anywhere.
This recovery makes me wonder how I ever survived having both knees completed at once!
So far, the recovery has been fine, except for the last couple of days I’ve had muscle spasms in my knee and surrounding areas. Ouch!
I’m doing home PT right now and will progress to OP PT next week. At least I think that’s the plan. As much as I hate to, I’ve been taking the OxyContin for pain relief along with tramadol and Tylenol. As long as I stay ahead of the pain it seems to work.
I’m trying to be smarter this time and not do too much too soon. It’s a challenge for an over achiever but I’m trying to give it my best shot!
Any other knee revisions out there? Any special advice for the second time around?
Thanks!

 

[Jockette]

On September 12, 2019

Please confirm the date of your revision and we’ll add it to your signature.

I’m sorry you had to have a revision. Did your surgeon suspect a loose implant?

Here’s a list of other members who have had revisions:
https://bonesmart.org/forum/view/knee-replacement-recovery-area.9/?prefix_id=13

 

[Jockette]

And here’s a refresher of the Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[DLC1128]

Yes the revision was on 9/12/19
Thanks for the info

 

[Pumpkin]

@DLC1128,
Assume you mean 2018 as Sept 12, 2019 has not occurred yet.
I added your revision surgery date, revision prefix, and a link to your old thread to your signature.
If any of these is error let us know and a moderator will update your signature for you.

 

[DLC1128]

Well actually I mean August 12, 2019. I’m only a week out from the surgery. I’m on meds.. what can I say!
Diana

 

[LindaO]

Bless you! I am coming up to a revision Oct 10, 2019 so I will follow you to learn as much as I can from your experiences. I know each knee is different as I had mine 6 weeks apart and the left was much easier than the right but I probably had issues with the right from the beginning. You said you had BTKR....how does the revision feel vs the original surgery?
Hang in there....

 

[Pumpkin]

Surgery date, updated, Brain Fog is normal.

 

[DLC1128]

Yes, Jockette, he did suspect a loose implant. That’s why he did the surgery.
I’m on Day 8 (surgery day being Day 0) and it has been much different then the first BTKR. First off, I wonder how I ever survived having both knees completed at one time!
Second, the pain has been much different from what I remember. I’m taking the pain meds religiously and I had a knee block completed this time, so the pain in the first few days was relatively controlled. Now that the block is worn off and I have started PT, the pain has gotten more intense. Not unbearable, but certainly I know something has been done!
I am doing heel slides and leg lifts as well as various other exercises. Yes, it hurts. I get up and walk around several times a day, usually when I have to go to the BR I take a quick trip around the living/dining room a couple of times. And, I ICE, religiously, as well.
The swelling has started to go down and I know this takes time. The ice helps a lot.
I think the hardest part so far, and I know for the next few weeks, is the inactivity. I am crocheting up a storm and binge watching Netflix. The distraction helps with the pain as well.
so far, so good!

 

[LindaO]

Thank you for the explanation. I am impressed you can crochet after taking medication! I couldn’t stay awake long enough to do anything! Despite the pain, it sounds like you are progressing! I wish I could crochet but will stock up on some Netflix shows! Hang in there!

 

[Jockette]

Did your loose implant show up in a test, or did your doctor go by your symptoms to think it was loose?

I think my implant might be loose but my X-ray looks so good that no one will order any other testing. And I don’t want the revision bad enough to try to insist on further testing.

But my partial feels awful most of the time and it’s been 2.5 years.

 

[ArmyVet]

I am just over 8 weeks out from revision of my right knee. I didn't think recovery was that bad this time, and I spent a LOT of time with it elevated with ice. Didn't take too long for most of the swelling to go down doing it this way!!! I followed the Bonesmart way of recovery-- I DID go to 2 sessions of OP PT, but when I didn't see the same tech the 2nd time, and neither did the same things, I quit-- and instead rehabbed MY way(the Bonesmart way!!) !! Did the ADL, walked when and as much as I felt good. I have full range of motion and no pain. I just saw my surgeon last Tuesday, and he was VERY pleased with my recovery. He even laughed when I told him I stopped going to PT because it sucked and I wanted to recover MY way... He said I must have done something right because everything looked good and as long as I felt good, that was all that mattered!!!

I truly feel that what I learned here from the group has made my recovery simpler and easier than if I had followed all the other **** I was told!! I sure don't think being told that I "must get full revolution on the bike" at my 2nd PT appointment was good advice!! Lots of rest, ice, elevation is the key!!! And stay ahead of the pain!!!!

 

[DLC1128]

Jockette, actually he took the bottom half of my leg while it was straight and wiggled it around. Real scientific, huh? Said it was much too flexible. He also saw on x-ray that the joint and knee cap were not aligned. He thought maybe the angle of the implant was wrong as well. My knee did not do well with lots of walking and was stiff and painful when standing up from sitting down. It was not a good way to live. My husband and I travel a lot and walk a lot, so the idea of a revision, while not fun, was certainly better then getting old way before my time! At this point I am glad I had the revision.
I did see a different surgeon then the one that put in the original implant. It was well worth the time to seek out that second opinion. And he’s the one that did the second surgery.
Too bad your not in the Dallas area! I’d refer you to my surgeon! He is great!

 

[Jockette]

I’ve had 2 second opinions, one in Baltimore and one in Philadelphia. No problem on the X-ray, therefore, no problem. They are sorry for my discomfort, for all the good that does.

 

[DLC1128]

Okay I am on Day 11. My knee is moving right along with very little pain. I am having peripheral nerve pain down around my ankle that is very painful. It feels like my leg is on fire. Believe it or not, lotion helps and I am hoping this is temporary from the knee block.
Otherwise, I am doing pretty well with 0/100 ROM. much better then where I was at this post op BTKR. Heel slides are my new best friends (not really but hey I have to feel that way!) as well as the ice machine. So looking forward to the six week mark...
My husband is a stickler for believing in “doing what the doctor says”. I’ve tried to get him to realize that pain is not necessarily a good thing, but gave up trying. guess I will have to figure that out on my own with my PT.
Diana

 

[LindaO]

That is so promising Diana! Keep doing what you know you can do and don't let others convince you otherwise! Your ROM is really good and you are doing everything you should be! If lotion helps that nerve pain, do it! (Good to know for future needs!)
Congratulations on everything so far!

 

[Jockette]

It is your knee, your recovery and your decision.

 

[DLC1128]

I am three weeks post-op at this point. My ROM is very good at 0/120, though sometimes stiffness and swelling will cause this to vary somewhat. I have my last home PT visit tomorrow and then transition to OP PT. I have been walking outside and yesterday I walked for 15 minutes. Probably too long. I need to learn to pace myself and not get in a hurry.
My pain ebbs and flows. Some days, I am essentially pain free and other days it hurts all day. I quit taking all pain meds other then Tylenol, but last night I barely slept so I think it is back to Tramodol at night at least. Today, I am uncomfortable, stiff and tired. I also think the cabin fever is getting to me. We have ventured out to eat a couple of times and I have been to Mass, but otherwise I have been home.
I am anxious to get this show on the road. I have to keep reminding myself that I am ONLY three weeks out!

 

[LindaO]

Absolutely! You are ONLY 3 weeks out...but what an awesome ROM! You are doing great but remember when you push too hard, you set yourself back. It is better to be steady instead of trying to jump too fast. Hang in there and remember to give yourself permission to take it easy!

 

[Carole4815]

My TKR, while not a revision, was on October 13th which is pretty close to yours. So, I thought your post was very interesting and encouraging! Here are my thoughts as I read it.

I am three weeks post-op at this point. My ROM is very good at 0/120, though sometimes stiffness and swelling will cause this to vary somewhat.

Wow!!! You are doing wonderfully. Mine is 90 but I think it will improve with time.

I have my last home PT visit tomorrow and then transition to OP PT. I have been walking outside and yesterday I walked for 15 minutes. Probably too long. I need to learn to pace myself and not get in a hurry.

Same here, about the PT. I have not been doing anywhere near as much walking as you have, because I do not have much strength yet and need to rest after about 5 minutes. However, walking gets easier every day.

My pain ebbs and flows. Some days, I am essentially pain free and other days it hurts all day. I quit taking all pain meds other then Tylenol, but last night I barely slept so I think it is back to Tramodol at night at least.

Same here, except that I am still taking (my only) pain med, hydrocodone+acetaminophen, at bedtime so that I can at least get a few hours' sleep. I almost never need any during the daytime. When I see my OS tomorrow, I am going to ask him what other (prescription or OTC) medication I could take that would be less addictive but would just let me get to sleep.

Today, I am uncomfortable, stiff and tired. I also think the cabin fever is getting to me. We have ventured out to eat a couple of times and I have been to Mass, but otherwise I have been home.

We went out to eat twice, and my sweetie drove me around town on a pleasure drive after lunch each time. But that's been all for me, too.

I think your recovery is going wonderfully! Especially all that walking that you have accomplished.