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PKR Left knee patellofemoral arthroplasty

sistersinhim

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I am amazed that you can work at two weeks out. My brain fog was so bad I couldn't even concentrate on a book, much less work! You will find that having your leg down will increase your swelling so taking lots of ice and elevation breaks makes sense.
 
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zdclimber

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I never felt my ability to concentrate was compromised after my surgery. Maybe it is due to the fact that I stopped taking narcotics on day 5 post-op. Luckily for me, pain was not a issue during my recovery (neither is poor quality of sleep).
 

marieltha

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I have partials, but not in the kneecap. Sometimes looking back, I think my early joint recoveries were better than I expected, but then perhaps because of that, I misjudged/ underestimated the trauma to all the soft tissues. Sigh. And the painful experience of bending too low too soon--without anaesthesia as @sistersinhim so humorously noted. Time really does heal.
I couldn't tolerate narcotics either, so got off those very quickly.
My joints loved icing and elevating, but didn't like compression at all. My md had me remove the stockings 24 hrs after the surgery. I used manual gravity feed cryo cuffs and adjusted the cuffs to avoid compressing too much. I didn't get the electric icing cuff because it auto compressed. No doubt there are others now that you can auto ice and turn off the compression.
Your mention of your post-surgical nausea brought back some uncomfortable memories. One anaesthesiologist finally advised me to never ever get gas anaesthesia again, and never ever allow anyone to give me versed again. The latter is quite common, it turns out, allegedly to "relax" you. But both trigger nausea.
So my anaesthesia is now simply propofol (sp?), very lightly administered. This method requires very close monitoring of my breathing, but I wake up quickly and clear-headed, and without any nausea!!!
Someone on here said he uses a marker and writes NO VERSED! prominently on his body before surgery.
Good luck!
 
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zdclimber

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Week 6 update -

Overall good progress over past 2 weeks. ROM improved to about 0 - 130. Now I can ride my road bike, which makes me quite happy. I can walk upstairs with normal gait, but walking downstairs is still a little jerky when the surgical leg is the trailing leg. Leg extension, which I had difficulty with 2 weeks ago, is no longer a problem. Now everyday, I either walk 2.5 miles or bike 20 miles.

The only issue I have now is swelling. It does not seem to have much improvement over the last 3-4 weeks. I spend much more time lying in bed with my leg elevated (that's how I work now with a laptop computer) than sitting or standing during the day, but still the swelling persisted.
 

Sisterpat

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Swelling can persist for many months, even a year! Sounds like things are going great for you!
 

Jockette

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You are doing amazing! I can’t do any of those things and I’m 4 years since my Patellofemoral, as I did not get a good outcome.

Yes, swelling can last a long time. Maybe you should consider cutting back on the walks and bike rides until you heal a bit more. Sometimes just because we can, doesn’t mean we should, at least for now.
 

MARYCOOL

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You ride your bike 20 miles per day? Wow!
I know everybody is different, but if I go over 8 miles, my knee swells. And, I am 12 weeks post op.
Some days ( like today) both knees hurt, and my motivation goes way down...hope I see some progress soon!
 
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zdclimber

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@Jockette, I am considering the same thing. I will see my surgeon in a few days. If he thinks the amount of swelling I have is concerning, I will cut the distance I walk/bike and reps of PT exercises.

@MARYCOOL, if it's not raining, I am alternating between walking (2.5 miles) and biking (20 miles) everyday, and walk only if it is raining. As you said, everyone is different. My knee swells and stiffens quite a bit after PT or walking, but not much after biking. On the other hand, I feel pretty tired (and want to take a nap) after biking, but not at all after PT or walking.
 

liam2015

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Hi ~ glad you're doing so well in your recovery. I was wondering what your initial symptoms were and what the diagnosis was? My husband has had relapses of a high school football knee injury, most recently, but also in the past. He did work out and eventually he participated and completed around 3 half triathlons; not sure how long ago, 10 years ago maybe, but he has kept up his fitness, either on his own or for a few years with a personal trainer and a fitness class (he's a avid golfer).

Recently, just before Christmas and just before my accident, he had to go to e.r. for excruciating pain in his knee (couldn't make it home walking the dog); had blood drained from his knee; surgeon said it was hemorrhaging. It happened a couple weeks before that and then again a couple times after, all while out walking our dog. He went to surgeon for a follow-up and has also been going to physio and both said that it was unlikely they would do arthroscopic surgery at his age (68). Anyways, he's been committed to doing the home exercises and going to physio and has not had a relapse since sometime in February. Ambulance wouldn't come for last relapse; (lucky we had some hydromorphone). His MRI for May 3 was cancelled due to pandemic, re-scheduled for June 16, so he can find out exactly what is going on.

Just wondering what your experience was. Thanks in advance.
 
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zdclimber

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Thanks @liam2015. My pre-op symptom was anterior knee pain when running, jumping, skiing, hiking downhill, and biking steep uphill. Walking and biking on flat, even for many hours, did not bother me. (I did bike touring with an unloaded bike for almost 1500 flat miles, averaging 70 miles a day with my "bad" knee). Initial diagnosis based on X-ray and MRI was a small full-thickness cartilage defect behind knee cap. It turned out the size of the defect was much larger, as shown in the attached picture, when my knee was opened up.

Note that I did a partial knee replacement. I think that's probably part of the reason my recovery to this point appears to be faster than a lot of people here. That I am relatively young at 52 and relatively fit may have also helped.

Hope whatever procedure your husband decides to do with his knee, if it ever comes down to that, the outcome will be great.
 

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liam2015

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@zdclimber ~ thank you so much for your reply; I will tell my husband. at this point they have no idea what the problem is. thankfully, he's a lot better and walking the dog again. p.t. wants him to ride his bike outside ~ yikes ~ one of us has to stay healthy.
 
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zdclimber

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Month 2 update - Again steady improvement over the last 2 weeks.

ROM is now at 0-140, increased from 0-130 at week 6. My pre-op ROM was 0-145 (active) or 0-160 (passive), so there is still some room for improvement.

Swelling comes down quite a bit during the past 2 weeks. Compared with the non-surgical side, it is still visibly swollen, although not by too much. Swelling would increase after PT or walking, but quickly subsides to pre-activity level after elevating my knee for just 10-15 mins.

Main activity these days is either walking for 2.5 miles or biking for 25-30 miles. It's interesting that unlike walking, which would cause more swelling as I mentioned, biking does not increase the swelling of my knee at all. Going forward, I am planning to increase my biking distance for one day every week, so I will have a long ride once a week, eventually reaching 100 miles.

Going upstairs or downstairs is no longer an issue. I can do it easily with normal gait. I can even run a few steps going upstairs. It seems I will be able to start hiking soon.

Before surgery, my expectation was that my knee would be back at its pre-op level at month 6, which means I can bike 100 miles at moderate pace or do easy hikes (no more than 6 miles round trip and 2000 ft elevation gain) with a light pack. By 1 year, I would be able to climb or ski with multiple consecutive days. I think so far, my recovery met and even slightly exceeded my expectation.
 

Jaycey

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Great update @zdclimber ! Sounds like you are doing very well. And you will continue to see improvement as this process can take one year or longer. Enjoy your bike rides!
 

Ginger1210

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Wow zdclimber your doing great i had a medial right PKR on April 19 so far so good i am not at your level of activities but today i washed my car and yesterday cut my grass i still get swelling but i no longer have bone on bone grinding in my knee on wards and up wards.
 

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