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Revision TKR Knee revision

Atlas_aus said:
When I asked my surgeon about it all I mentioned my knee cap and if it is also replaced. He told if it is bad they will replace it
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They don't actually remove and replace your kneecap. That would be an even more major surgery, involving large muscles and ligaments.

What they do is shave the damaged cartilage off the back of your kneecap, leaving bone still there. Then they attach a plastic button to the back of your kneecap. That takes the place of the cartilage that was removed.

Patellar resurfacing with a button
Sometimes the articular surface of the knee cap is arthritic as well and needs to be resurfaced.
[Bonesmart.org] Knee revision
 
Funny I was only thinking about it last night.. How they would do it being it seems to "float" around. Now I know, thanks for the answer :thumb:
 
"Float around"? That's not how it works Atlas. This is how the patella is fixed (very securely) in the knee

[Bonesmart.org] Knee revision
 
I am now at six months and making incredibly slow progress. This week I had knee and hip xrays and both joints look good. I have changed physiotherapist and she and the surgeon agree that the problem now is getting the last 5 degrees of extension so that the inner quad muscle can strengthen. I am on one crutch most of the time, but need two when I get tired or for steps. I am so so disappointed in this whole process, it’s hard to believe it will ever come right. Has anyone else been this slow?

Please could my topic be changed to 6 months and very upset
 
I'm the one who has had both kneecaps removed. It was explained to me afterwards that I'd have less strength than a person with kneecaps. It took a longer than normal for me to gain security in my tkr knee, but it is just as strong and the other one now. It's not totally pain free, but much better than before the trk.
dmichael21 said:
it is harder to rehab without a knee cap do you have to work harder than other patients.
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I didn't work at it at all. Never took one minute of PT. I just did what I needed to do in my daily living. I can do anything I want to do. Don't get discouraged and don't work so hard that you keep your knee inflamed. It will come. But, just remember that it won't be quite as strong as your other knee. Not because of your tkr, but because of you patellectomy. You will adjust with no problem!
 
I've changed your thread title for you.
 
Thank you both, I am trying to be positive. My physiotherapist lent me her muscle stimulation machine, am hoping it will work on inner quad muscle.
 
Almost 5 years ago I had right TKR, (I have no patella) but never felt it was right. I have never been able to walk properly, in fact I could not put any weight on my leg if knee was bent, so I walked very stiffly, slowly and painfully. The surgeon said
The knee was fine and said the problem was my back, and a muscoskeletal specialist said 3 facet joints were the problem and they were burned to stop pain messages to my brain. No difference. Then PRP injections. No difference. Then they said leg length discrepancy, spent $$$$$$$on orthotics, getting some shoes adjusted. No difference. Every time I went to Physio he would relax muscles, but by time I was at my car they were all tight again.
In January I asked my GP to refer me to a new specialist (we had shifted during this time) She was reluctant as she felt I was going to be disappointed again, but I insisted. Such a different approach! First of all an isotope scan showed a couple of suspicious areas. A needle aspiration showed no bugs.
Finally an anaesthetic injection into my joint which gave me an hour of pain free walking, and convinced the two surgeons to do a revision. Last Wednesday 15/11 they took the old joint out and found a 5cm (yes cm not mm) hole behind the cement. They were shocked as it hadn’t shown up on scan. That’s for later investigation. The good (I hope) news is that I have a new knee joint, with extra stability to make up for no patella. They have written to original surgeon very sternly, but to be honest I am just so relieved that something has been done and there is hope for me to be able to walk pain free. Am home now, using a walker, can get myself around a bit, using meds when I need them. It’s very swollen, and am using ice a lot.
My message is to never give up and to trust your intuition!
Hope you are all having a good day
Ruth
 
Hi, Ruth, welcome back to recovery. Wow, that’s wonderful the new doctors found something wrong and did a revision. I wish you the very best going forward!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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​
ice​
take your pain meds by prescription schedule (not when pain starts!)​
​
If you want to use something to help heal the incision, ​
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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 to these pages on the website
​

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.
 
By the way, I merged your newest thread with your original recovery thread, as there is some very good information in your original recovery thread, especially regarding the patella.

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.
 
Thank you. I can’t figure out how to edit my location from Auckland to Katikati and to add knee revision date….
 
I’ll add your revision date and inquire about changing your location.
 
Welcome back! I hope you'll share this latest healing journey with us, sharing concerns and celebrating all the little milestones.
 
Had a follow up with my surgeon on Wednesday (2 weeks). She is happy with the fact I am starting to bend gently and not forcing things. Am using a walker, and will continue to use it for a while longer before I switch to crutches. She changed my pain meds, and now having tramadol three times a day, and 300mg gabapentin at night and 100mg in morning. Pain is better, am icing a lot, foot swelling is down a lot. I have got awful diarrhoea which started when I increased the tramadol. Think I will just treat it and carry on until my next review on 12 December. I get IBS so pain meds are always tricky.
I am struggling to sleep comfortably on my back. I wake up with such a stiff and sore back. I tried a pillow under my knees, think it helped a bit, any other ideas?
 
I also have back issues and found that elevating my legs helped when laying on my back.

Be careful with where the pillow is under your knee:

bonesmart.org

Elevation: Doing It the Right Way

Updated June 11, 2024 by Jockette Proper elevation is one of the best ways to help with pain and swelling following either hip, knee, or ankle surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate...
bonesmart.org bonesmart.org
 
Hi! Sounds like overall things are going well.

Re waking up with back issues - the pillow under the knees will generally relieve lumbar strain, so if that's where your discomfort is you're on the right track. Make sure the edge of the pillow isn't pushing into the back of your knee!
If it's lower, at sacrum, or higher up closer to shoulders you might try a very soft overlay under your sheet, like a featherbed overlay.
 
I, too, found using the Lounge Doctor helped my back quite a bit when I had to sleep on my back. Once I was able to side-sleep again, the back got better.
 
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