TKR Lacy21's Recovery Thread^

[Celle]

Don't despair. You still have time. I know it seems like ages, but it is only 5 months into a year-long recovery. You can still continue to get more ROM, as long as all your PT therapy is gentle.
One of our members had a slow increase in ROM, but achieved it in the end. This is what she posted (thank you, @Campervan):
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months"

 

[Sad knees]

Hi Lacy, I am going through something similar albeit sooner than you. I had BTKR on 10/22. My ROM is -14 and -10. My surgeon is not happy and wants to do an MUA on both. I now have a brace I wear as much as I can stand it to straighten them. I have a massage therapist every other day and PT twice a week. I am now on NSAIDs. There is not much pain except when the massage therapist finds adhesions or tight hamstrings and works to loosen them. I too am afraid of an MUA and if it would do more damage. I hope you are doing better!

 

[skigirl]

Lacy, I had a friend who struggled with a knee like yours. She was a ski instructor as well and she just limped on for three years. Then, she began to research metal allergy. She had a metal test and it turned out she was allergic to nickel. She finally convinced our surgeon to replace her knee with a smith and nephew Oxinium knee. He sent away a culture from her knee and instead of just a seven day culture, he requested a 14 day culture.

It turned out that she had had an infection as well. She underwent three months of antibiotic treatment plus recovered from the new knee. I saw her yesterday---3 months from surgery and her rom was 130---after almost five years of 90 which ultimately became 60.

I am not saying that you have an infection or a metal allergy, but my friend wishes she had pursued a solution instead of just trying to make do with a swollen, hot and painful knee. I will give you the info on the infection she had---it is fairly new on the radar for those with knee replacements. the metal test has to go to somewhere in Colorado---there are only two places in the US that do those tests. @1ELISEA.

I hope you find something---I know from watching my friend how devastating this is to your life.






Biomed Res Int. 2013;2013:804391. doi: 10.1155/2013/804391. Epub 2013 Nov 6.
Propionibacterium acnes: an underestimated pathogen in implant-associated infections.
Portillo ME1, Corvec S, Borens O, Trampuz A.
Author information

Abstract
The role of Propionibacterium acnes in acne and in a wide range of inflammatory diseases is well established. However, P. acnes is also responsible for infections involving implants. Prolonged aerobic and anaerobic agar cultures for 14 days and broth cultures increase the detection rate. In this paper, we review the pathogenic role of P. acnes in implant-associated infections such as prosthetic joints, cardiac devices, breast implants, intraocular lenses, neurosurgical devices, and spine implants. The management of severe infections caused by P. acnes involves a combination of antimicrobial and surgical treatment (often removal of the device). Intravenous penicillin G and ceftriaxone are the first choice for serious infections, with vancomycin and daptomycin as alternatives, and amoxicillin, rifampicin, clindamycin, tetracycline, and levofloxacin for oral treatment. Sonication of explanted prosthetic material improves the diagnosis of implant-associated infections. Molecular methods may further increase the sensitivity of P. acnes detection. Coating of implants with antimicrobial substances could avoid or limit colonization of the surface and thereby reduce the risk of biofilm formation during severe infections. Our understanding of the role of P. acnes in human diseases will likely continue to increase as new associations and pathogenic mechanisms are discovered.

PMID:

24308006

[PubMed - indexed for MEDLINE]
PMCID:

PMC3838805

 

[skigirl]

Lacy, I am also going to tag @Josephine, she has so much more experience she might have some different advice for you.

 

[Josephine]

Hi @Lacy21 I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are .... The period I want you to focus on when you answer is between weeks 4 and 10.

1. what were your pain levels then? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications were you prescribed, how much were you taking (in mg please) and how often?

3. how often were you icing your knee and for how long?

4. were you elevating your leg, how often and for how long?

5. What was your ROM - that's flexion (bend) and extension (straightness)

6. what was your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home were you doing? How much and how often?

Can you describe them like these examples ....

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2