TKR Left TKR - PT failure

sistersinhim

Staff member since March 2017
BoneSmart Staff
Joined
Dec 4, 2015
Messages
25,866
Location
Virginia
Gender
Female
Country
United States United States
One thing I have learned is I will not let the PT person push me too hard. I've paid the price for my own stupidity in thinking if I push I get well faster. Not true. You hurt way more is about all I can say.
This is so true. The thing is, if your exercises are causing you more pain and swelling then that's actually setting your recovery from the surgery back. Your body has the heal from the new trauma before it can get back to healing for that surgical trauma. Listen and watch your knee's response to what you are doing and have done. Don't take pain pills before you go to PT. You need to feel the pain and stop what you're doing if it is bad. A little discomfort is OK, but pain is not. You might even be fine during PT but afterward have increased pain and swelling that night or the next day. That means your knee was not ready for what was done to it. You shouldn't do it again for a week or two then try just a small part of it and see how your knee reacts.

Recovery is a commonsense thing. If your body gives you a bad reaction from any PT, then it's not ready for those movements yet. It's a logical conclusion. Slow and easy=a good recovery!
 

Mar

member
Joined
Mar 7, 2019
Messages
184
Age
70
Gender
Female
Country
United States United States
t is a balancing act in that I have good insurance now. When I finally switch over to Medicare I'm told it is no where near as good.


I have Medicare but I also have a ARRP supplement. Part F but it’s no longer for new people but part G has taken its place. It is great! I pay nothing out of pocket. I have literally been in PT going on a year. Other things have come up, not just my TKR last April but now ready to have my Rt hip replaced in May. They haven’t denied to pay any of it. G maybe slightly different, but I think close. Just Medicare alone would be a lot out of pocket. Of course you do pay monthly for it but with all the surgeries I’ve had it’s way better then what I pay out of pocket for my daughter with blue cross. I’ve been able to go to all good doctors as well. Just fyi.
 

Jockette

Staff member since March 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
29,747
Age
66
Location
Delaware
Gender
Female
Country
United States United States
I’m really sorry you had that accident at PT. Wow! I just don‘t even know what else to say. Sending best wishes for a complete recovery!
 

Sara61

Staff member since March 2020
BoneSmart Staff
Joined
Oct 1, 2019
Messages
2,869
Gender
Female
Country
Portugal Portugal
Although my case is not nearly as complicated as yours, at week 4, like you my first 4 weeks were excellent I had followed BoneSmart recommendation and didn't do any physio until my 4th week, having had, the experience of my other knee replaced two years previously and I only went as the center is run by the hospital and a friend worked there. Unfortunately I was handed over to a young not very experienced physiotherapist whom pushed my knee to beyond its capabilities ( sitting on a bench with legs dangling ) the young chappy lifted my knee straight up to as high as it would go, as I was highly medicated (Tramadol, tylenol etc) I didn't feel any pain, that evening I tripped over my crutch, I didn't fall but felt very uncomfortable, the next morning, I was unable to put any weight at all on my knee, the pain was undescribable, I contacted the hospital and was told to ice, elevate etc, I did this for a week, it appeared to have improved but I noticed every now and then it buckled, (whilst away on vacation) a few days later it buckled on a staircase, fortunately I was holding onto the handrail, upon getting to the bottom of the staircase, I was unable to put any weight on my knee, nor was I able to bend it at all, I had gone from a ROM of 120 to 0.
It has now taken me 4 weeks of rest, ice & medication, I've been going to the hospital twice weekly for gentle CPM sessions, Thankfully this has worked and I've slowly regained my ROM and I am now able to walk with a crutch but still have trouble bending my knee whilst standing.

The moral to my experience is never go to physiotherapy whilst on medication, as you won't be able to say stop or no if it hurts.

@MarkTKR Had what happened to you on my 1st replacement, I too would be inclined to think that I wouldn't do it again, but I'm proof no two knees are alike, I sailed through my first replacement, two years ago & I now have a good steady pain free left knee. Thinking my current knee would be just as easy, I had my right knee replaced in December 2021, just over 3 months ago, I'm now positive that eventually it too will be good, but am realistic its going to take a long time before I'm able to walk normally. Stay positive as positivity wins this battle, ( I've been depressed but it did me no good) look at all the little achievements and celebrate them. With time you will get there xx
 

MSN58

junior member
Joined
Mar 21, 2022
Messages
22
Age
64
Gender
Female
Country
United States United States
You have an amazing attitude. There are many recommendations I plan to make to my surgeon. You addressed several in a post. Best of luck with your recovery. I am 5 weeks post-op and this forum is a lifesaver.
 
OP
OP
M

MarkTKR

junior member
Joined
Jan 17, 2022
Messages
22
Age
65
Gender
Male
Country
United States United States
Thank you MSN58. I believe attitude is more than 1/2 the battle in just about anything we do. I didn't ask for this Patellar tendon thing but I really don't have a choice so just getting to the other side is all I want.

As of Thursday I'm 3 weeks out of the cast. The cast was removed on 03/03 and I was put in a locking brace with no bend for 2 weeks. During that time i could flex my knee about 10 degrees in the brace.

I started PT this week. 3 sessions down. On Thursday, I was measured at 46 degrees flex but that was after a full 40 minutes of stretching and him working the joint.

Friday morning I worked from home and did my heal slides with the strap. It is sure depressing because I don't get anywhere close to the 46 he had me at. I figure I'm getting to about 40, maybe a little less. It is so tight. It doesn't really hurt, it is just tight as heck.

But on the positive note:

The first few days with the cast off and walking in the straight leg brace I felt unstable and used a crutch to offload as directed by the doctor. Slowly, over this 3 week period I've gained strength and stability. Yesterday, i'm walking with a cane. I still have the brace locked straight on doctors orders when walking, but I have the strength and stability to do away with the crutch perhaps.

So I can measure some improvement in that I went from a walker putting virtually all my weight on it to stake a step, to a crutch were I probably offloaded between 30 to 40% of my weight, to a crutch just for stability and now to a cane, just for stability.

So progress!

Sleeping is still on/off. I had four really good nights, tonight just can't sleep. And the swelling still drives me crazy. I do elevate but I just want that to start reducing and I will be much happier.
 

glidefloss

senior
Joined
Jan 14, 2022
Messages
294
Age
65
Gender
Male
Country
United States United States
Hi @MarkTKR , good steady progress! I especially love the way you address adversity and push forward with spirit and a great positive attitude. I, for one, will be using your postings as a way to "reset" my outlook whenever it starts heading south. Thanks!

All the best on continued progress with your recovery/rehab!
 

Susie-Q

Staff member since February 2022
BoneSmart Staff
Joined
Jul 20, 2010
Messages
1,869
Age
54
Location
Washington
Gender
Female
Country
United States United States
Glad you are seeing some progress! Slow and steady.......

:flwrysmile:
 
OP
OP
M

MarkTKR

junior member
Joined
Jan 17, 2022
Messages
22
Age
65
Gender
Male
Country
United States United States
Hi all,
A few of you have commended me on my attitude and perseverance through this process but I can't seem to catch a break with this Left TKR and Patellar Tendon Repair.

On Wednesday the 6th I met with my surgeon and he was extremely happy with progress and told me to lose the leg brace I've been wearing. It was a triumph to finally not have to wear that thing 24/7 and now I can wear it when I feel I need it.

My wife and I celebrated that night is a nice dinner at home and just a happy feeling of progress.

I'm doing PT three days a week. It is hard. I'm slowly making range of motion progress and got to 69 degrees of flex.

I worked from home on Thursday the 7th and was looking forward to being in the office today with no brace. I'm trying hard to be careful but today, Friday the 8th after PT in the morning followed by a pretty full day of work at like 3pm I was walking through a hallway in our building and totally forgot about a 5 inch step down.

To be honest I was distracted by a noice and turned to look. I should have stopped but I stepped right off that small step and it was a disaster waiting to happen.

However this time as I felt my left foot come down I didn't try to stop anything. I just let myself fall. Still my left knee bent further than it has bent since the surgery. There were luckily no painful pops but I heard what could only be described as a slight tearing sound. Very small with no pain associated with it.

My knee definitely hurt but I rolled over and carefully contracted and extended it and had no issues or pain with that. I could hold my leg straight against gravity. So what did I tear?

Two co-workers helped me up to my feet and I gingerly put weight on it and I have no trouble supporting my weight. So I'm pretty sure that I just took a slight painful jump in Physical Therapy and achieved about 75 degrees of bend. My quad muscle is definitely sore. And of course things are kind of swollen.

My doc had told me that the repair of the tendon by this time was very strong and I still have a wire in it so I suspect the patella tendon repair is just fine. From what I can tell based on my own experimentation is that I just stretched the hell out of things in my quad, maybe tore loose some scar tissue. But everything still functions.

As luck would have it this happened at 3pm on a Friday so I can't even get into see my doc until next week. I have PT on Monday and I will tell my PT about the incident in full and get his recommendations. He did tell me to not push hard on stretching this weekend that I would likely be sore from walking on it without a brace.

Well now I am definitely sore. When I first fell the first thought through my mind was "oh god... not again..." I fully expected something to be torn or damaged to the point I'd need a wheelchair and yet another surgery. But in my limited experience and based only on what I can do with the leg/knee I think I dodged a bullet. I suspect I will be quite sore this weekend but I didn't do major damage. Anyway one can hope.

But my point about my attitude is that based on my luck with my left TKR, and considering the patellar tendon issues and now this fall and the pain involved, I think there is almost nothing someone can do to convince me to get my right knee replaced.

It is going to be a very very long time before I am open to that idea. This is where my positivity has left me. I now am going through a depression based on this fall, totally my fault, that I have set myself back again in my recovery.

Knee replacement might be good for those that are retired and certainly for those with no other options, but I think I did mine way too early.

Anyway Ill post a follow up here to see how I fair through the weekend.
 

Jockette

Staff member since March 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
29,747
Age
66
Location
Delaware
Gender
Female
Country
United States United States
So I'm pretty sure that I just took a slight painful jump in Physical Therapy and achieved about 75 degrees of bend.
I am so sorry you had another incident. Hopefully no damage was done. We usually call this kind of thing a manipulation without anesthesia. As you said, I’m sure you’ll see a bit more soreness, through the weekend, your body did take a hit.

Don‘t blame yourself, any one of us would have been distracted by a sound, and not thought to stop moving before turning.
 

WFD

member
Joined
Oct 29, 2021
Messages
167
Age
62
Location
Massachusetts
Gender
Male
Country
United States United States
As luck would have it this happened at 3pm on a Friday
That is one of the fundamental laws of the universe - things only go wrong late on Friday, and you cannot see the doctor or dentist until the following week. I've suffered through the weekend with a toothache more than once :).
 

Rubybegonia

junior member
Joined
Mar 12, 2022
Messages
44
Age
69
Gender
Female
Country
Canada Canada
Ugh that sounds frightful. I can't imagine. I only have 72 degrees of flex ion at five weeks and sometimes in the night I have unconsciously bent my knee, likely just slightly, but it hurts like hell. Not sure manipulations sans anesthesia would be a good idea. Ha ha.
Question for you. Do you , your physio and doctor believe full flex ion will be attainable?
 
OP
OP
M

MarkTKR

junior member
Joined
Jan 17, 2022
Messages
22
Age
65
Gender
Male
Country
United States United States
I am no stranger to pain in my life. So I understand and expect that it will occur.

For me, this journey, while only 4.5 months into it, is draining my resilience. Yes, I caused the flex problem on Friday, and I expect pain from it, but it just feels this morning like any sense of "normality" is a very very long ways away.

I'm in a very down mood this morning and wish strongly I had not done my LTKR which led to the tendon rupture and repair. in the last 4.5 months I've suffered worse pain than I ever had before having the knee replaced. But again the pain is a minor issue. What I am struggling with is my inability to do many "normal" things.

I know this will get better but it just seems so hard to do a simple thing like put on a sock. I've spent a small fortune on sock and shoe tools for the injured. They help but on mornings like this morning I really regret doing this to myself as before Dec 23rd I could put my own socks on just fine.

Sleeping at night is tough. I find myself having these incidents of "clinching" where I'm asleep and for some reason will clinch various muscles including my hamstrings and my left knee just lets out a howl of pain and I'm wide awake.

I've been through three Rx of Tramadal and I am not sure the doc would want to give another. I can ask. But sleep is a treasured thing especially when you are trying to heal and I don't think I've had a great nights sleep in over a week. I think I'm sleeping just enough to keep me from crashing. But I'm not waking up feeling good and rested.

Anyway, I'm just venting. I'm pretty depressed and searching for ways and reasons to carry on. I don't have a choice but it always helps to have a purpose. I've got to find one.

My one summer purpose I liked was being outside, yard work, camping, golfing, and the way I feel this morning I'm not sure any of that is gonna happen this year. I might have to abandon that purpose except on a very limited scale.

I hope my down posts don't dissuade someone looking to do their TKR from doing it. My case is unique with the Patella tendon rupture added on. My LTKR actually went great. It has been hell since the tendon rupture and repair.

I hope the rest of you that are recovering are doing well. I'll be ok. Just a down day I think.
 

Jcx

junior member
Joined
Jan 28, 2022
Messages
63
Age
66
Location
Newcastle
Gender
Male
Country
United Kingdom United Kingdom
Hi MarkTKR. I had my TLKR on December 1st what a roller coaster ride of a recovery it has been. I've had no problems with the replacement everyone says I'm doing well. But every day is different log leg tight bands and rubber bands seem to be the norm. I've never said out loud that I wish I had not went in for the operation. But it's always in the back of my mind. Recovery is a very slow process and hopefully by the summer we will get there. See you on the first tee and in the 19th hole. Take care Jcx.
 

Jockette

Staff member since March 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
29,747
Age
66
Location
Delaware
Gender
Female
Country
United States United States
Yes, it is indeed frustrating to have such an accident happen when the recovery was going so well. I’m so sorry that happened to you. It’s also frustrating that the healing process can take so long. Vent here all you want, we’re here for you.
 

sistersinhim

Staff member since March 2017
BoneSmart Staff
Joined
Dec 4, 2015
Messages
25,866
Location
Virginia
Gender
Female
Country
United States United States
I know what you are going through. My pain and swelling after my patellectomies took quite a while to go away. The bend slowly came back, but remember I did it without PT, just normal daily activities. As I healed, I was sure to respect those patella tendons because they would yell at me for hardly anything. I learned what I could do and could not do without causing extra pain and swelling. As busy as you are, you don't need to be taking PT. That could very well be slowing down your recovery. Your bend can't improve until you get the swelling and pain down. Exercises are not helping you to flush out the fluid, it's causing it. Why don't skip your PT and exercises for a few weeks and see if you don't have some improvement? I bet you will.
 
OP
OP
M

MarkTKR

junior member
Joined
Jan 17, 2022
Messages
22
Age
65
Gender
Male
Country
United States United States
I want to say I'm sorry to the readers of this thread for my negativity. That post above was during a very dark time where I was very stiff, very sore, generally not feeling good at all and everything hurt.

The last two days have been like a significant improvement! I told my PT about my pains and he went very easy on me at my last PT on Friday but still we made ROM to 78 degrees. A couple more than I'd been before.

But something else happened. My quad soreness toned down some and I have felt so much better. Yesterday and today I have had a lot more ROM and strength and feeling a lot more stable than at the start of last week.

I told myself yesterday that now is when I cannot get cocky and do something stupid and re-injure myself, so it is business as usual. But walking is easier, I did my bike and I feel like ROM is better. So I'm excited for PT on Monday to see what progress I have made.

I tell I've made some because sitting in my dining room chair I can almost put my foot flat. Not at 90 bend yet but much closer it feels like.

So I've learned yet another thing during this journey: Recovery happens at its own rate. You cannot plan on when things will feel better, but you can have confidence that unless you re-injure yourself that you will get better and you will improve. Patience is key here.

Anyway, I apologize for my negative post, I hope all here are doing as best they can. Keep your chin up, look forward to each new day because one thing is certain: It will be different from the day before!
 

Jockette

Staff member since March 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
29,747
Age
66
Location
Delaware
Gender
Female
Country
United States United States
So I've learned yet another thing during this journey: Recovery happens at its own rate. You cannot plan on when things will feel better, but you can have confidence that unless you re-injure yourself that you will get better and you will improve. Patience is key here.
I agree!

No need to apologize for being negative, we all feel that way, and when we read about someone else feeling like we do, and then they post an improvement, like you just did, it is such an encouragement, that “ where we are now is not where we’ll end up!”

I’m glad you have had a boost of improvement, and I agree, don’t get cocky, slow and steady will win this recovery. (I dare not say race! :heehee: )
 
OP
OP
M

MarkTKR

junior member
Joined
Jan 17, 2022
Messages
22
Age
65
Gender
Male
Country
United States United States
Hi all,

After my left Pateller tendon repair I had a wire between my shin and my knee cap. I had to have that removed last Thursday as it was threatening to poke through the skin. So yet another minor surgery.

It went well and I must say with the wire removed the strange diagonal pull across my knee when bent is mostly gone!

Continuing with PT and getting stronger. There are still days I wonder what alien life form has come and attached itself to my left leg from the knee down. There are just some days it feels strange.

But I'm walking, mostly without canes and I can play some golf, gently but I can plan.
 

BoneSmart #1 Best Blog

Staff online

  • Elf1
    Staff member since October 2019

Forum statistics

Threads
59,748
Messages
1,504,518
BoneSmarties
36,517
Latest member
Tower6brkrs
Recent bookmarks
1
Top Bottom