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TKR Knee Wobble Question

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HokieGCC

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@patriciad the leg itself is the same. That was some artifact of the photo. I only saw the X-Rays at the 10-day point. I am going to ask to see them this coming appointment. My healing progress was excellent and I accepted the swelling explanation. I hit my 130 ROM around 6 weeks I have been going up and down stairs like a normal person and even riding my road bike some. The whole time PT kept saying "I would rather combat swelling than a poor ROM." I have even played a round of golf. So, I thought I was "golden".

Then, the last two weeks I have been having pain behind the knee on the outside of the knee. I started digging and discovered one cause is tendon irritation due to big implants. That led me to my "swelling" which may not have been "swelling" all along. It may have been an enlarged knee due to big parts.

My theory is that during the first weeks of rehab my activity level was low and it didn't irritate my tendon enough to cause a problem. Now that I have began acting more normally with activity it is irritating it.

I pray my Doc didn't make a big blunder. I don't know even where to begin to figure out what to do next.
 

beesknee

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Yes, your leg above your knee looks swollen. Or maybe it is bigger from all the rehab exercises.

That being said, I kind of have the same thought about my PKR. On the inside of my right knee of have two small but rock hard bumps when knee is bent. One is where they did the meniscus replacement and the other is to the left of the top of my knee cap. I have fairly thin knees, not those wide sturdy looking knees some people have. I hope my doctor knows to put the right size in!

At my 2 month visit I asked the PA about it and she said it was swelling and would eventually go away. I will see the actual doctor next week for a 3 month 1 week follow up and will ask him about it.
 

patriciad

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I hope you get the answers you need and that it’s not actually what you think it is. It’s wise to get the 2nd opinion and maybe that’s what you need to have confidence again in your OS. You could also search the threads here to find someone who may have experienced too large a prosthetic - there is such a huge range of experiences here. Meanwhile try not to worry too much your 2nd opinion is only a few days away. Take care.
 
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HokieGCC

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Well I didn't find where anyone else questioned their implant sizing. Maybe I didn't search the right words. I sure hope and pray I am not one of those 1 in a 1000 mess-ups.
 

Rain Dancer

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Well I didn't find where anyone else questioned their implant sizing. Maybe I didn't search the right words. I sure hope and pray I am not one of those 1 in a 1000 mess-ups.
Suggest you use the search term "spacer." Lots of threads show up.
 

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My theory is that during the first weeks of rehab my activity level was low and it didn't irritate my tendon enough to cause a problem. Now that I have began acting more normally with activity it is irritating it.
Your increase in activity most likely increased your swelling. Swelling can occur for months, depending on activity. Swelling can feel like a hard lump at times. At not quite 3 months post op you are still very early in this recovery.
My concern is that when I flex my knee a bulge develops on the lateral (outside) of my knee and I have perpetual swelling there as well. My Doc says it is fluid inside my knee that when flexed it builds there. To me it feels way too hard to be fluid.
As I said earlier, I had this exact same thing. It went away as I healed. Mine was definitely swelling, and at times I could feel the swelling pop into that place, with certain movements.

I hope you get the reassurance you need at your next appointment that your implant is the correct size for you.
 

Jockette

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By the way, which knee is it? We’ll add that information to your signature. :flwrysmile:
 
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HokieGCC

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@Jockette it is my right knee.

I am picking up my x-rays from my initial followup (11 days post op) later today. Is there someone on the board able to read them and give a "non-medical" read on them?

Thank you.
 

Reader525

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@HokieGCC You and I are only a few days apart in our surgeries. I was July 7th. I, too, am impatient and also analyze every twinge and difficulty and worry about something being wrong. I have pain/ discomfort behind my knee as well, at first, it scared me because no one told me that could happen, so immediately I decided I had a problem. After many people reassured me here that it's a fairly common response of the tissues and muscles after this huge surgery, I accepted it. I am continuously surprised by the length of time and difficulty this recovery is taking. Who would know any of this because the surgeons do not tell you that. They allow us to believe it's 6-8 weeks, because that's what they generally say about us walking around.
I know I am a petite person, small boned and thin, and I have some hard swollen areas around the lateral area of my knee, I wondered too what it could be, but for me, I think it's probably swelling. Even though it is minimal, it's there, and I attribute my stiffness to that swelling.
I expected to feel better by now than I do, and that causes me to worry about everything and become discouraged. I fight that in me and try to stay positive!! It's tough, but, there's no alternative.
I hope you are relieved at your appointment and you continue to be able to do more and more!
 
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HokieGCC

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@Reader525 thank you for the kind words. Yea ... the recovery is not 6-8 weeks. Although, I did recover very quickly which is why my possible discovery is a real shocker. I really haven't had pain until recently. I got a good ROM early. I have been on my bike for a couple weeks, played a round of golf, mowed the lawn, ..., going like gangbusters until the lateral knee pain hit and discovery that it appears that my surgical knee is physically larger (maybe as much as 1/2 inch) than my non-surgical knee. So much so that it causes a bulge on the outside of the knee that I thought was swelling the whole time.

I hope your recovery goes well from here on out and you don't get a scare like the one I am going through.

I am about to jump in the car to go get my x-rays. Not sure if I can read them well enough to see if there is a size problem but at least I will have them for next steps.
 

Jockette

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You can take a photo of your xrays and post them, but we may not see the detail you are looking for.
 
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HokieGCC

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Here are the X-rays. It doesn't look oversized to me. Is there a way to tell about rotation etc?

I do see a little overhang on the Tibia (and underhang on the other side).

If anyone has some expertise here I sure would be grateful.
 

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Reader525

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@HokieGCC Not being an expert, I can't hazard a guess, but it doesn't look like it's an oversized implant to the untrained eye. At the very least, it's not a glaring dissimilarity to your nonsurgical knee.
I, too, did especially well at first, in spite of my being uncomfortable. I had perfect ROM, 140/-01 almost the next day. I still have that, but I'm a sensitive soul, and I notice all twinges and pains that,perhaps, other people don't. Therefore, I'm reluctant to walk freely, because any twinge makes me hesitant, and I then limp. I also have that stiffness and tight feeling inside my knee, which from everything I read, is swelling. So, I'm trying to be less hypervigilant and to move with more laissez-faire.
I hope you get a good report on those x-rays!!!
 

patriciad

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@HokieGCC Not an expert by any means but your X-ray looks very similar to the ones I have from my first TKR including the overhang you mention. Hopefully one of the more medically experienced moderators can comment but realistically the only way you will get peace of mind is from your 2nd opinion from another surgeon. I think you said that was Friday?
Good luck!
 
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HokieGCC

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Ok I am pretty sure the parts aren't too big so I am still searching for what may be happening. I did notice another striking difference in my two knees when flexed. My left (non surgical) knee bends and goes pretty much straight down my shin to my foot. My right knee (surgical) seems to have a big ball that causes a curve starting down my shin. I have encountered the term "overstuffing". Could this be that?
 

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HokieGCC

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Here is a pic that you don't need to open. I really don't think it is swelling as that curve is as hard as rock as is the ball that is my knee.
 

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HokieGCC

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Well met with my surgeon today. He said I just wasn't healed yet and what I am experiencing is inflammation. I am certain that at least in part that is correct. My knee still runs warm. We reviewed the x-rays and near the end of the meeting I was starting to feel a little more comfortable. Then I asked him what size implant did he use and he looked it up and said 7. Supposedly the sizes are 1,2,3, ...9. That got me worried a little again as I am not a big person. I am about 5' 11" and 185lbs which is bigger than average but not "big" as a size 7 would suggest. Tomorrow is the 2nd opinion visit. Maybe females typically use sizes 1-6 and males use 3-9 and a 7 is really not that large. We shall see...
 

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