PKR Ligament Sprain in GoodLeg

[marieltha]

I am requesting input about medial knee ligament sprain complication (on “good leg”, not recovering leg).

I had a great PKR April2018 in right leg. Planned to do left knee in the fall. Then, in August, I suffered posterior tibial tendonitis in left foot/arch (lengthy, painful recovery) and had to reschedule needed left PKR to May 2019. Then in late January, tore a shoulder rotator cuff on my right/dominant side and moved up the left PKR surgery to March27, 2019, so I would have 2 good legs to get around during the much, much slower and longer recovery from the shoulder RCR.

PKR in late March went very well, as did the shoulder RCR 6 weeks later (May22,2019). But then, 12 days after the shoulder surgery, the inside of the right knee (the “good leg”) started to hurt. I was due to see the ortho surgeon at day 14. That night, I bent down (to feed my beloved cat), and instead of bending at the waist - famous last words - I lost focus, I bent both knees and the right one screamed and then wouldn’t hold my weight.

Thank God my husband (the best caretaker anyone could ever have) quickly came to my rescue. Also, my ortho had urged me to do the balancing exercises a bit earlier on the new partial knee, which I had, so I was balanced on my left leg with excruciating pain in right leg and did not fall.

It calmed down a bit after a short while, so we opted to not go to the ER that night. Instead, I called my ortho doc’s RN who is on call 24/7 for pre and post-surgery patients. This service is a godsend! She has access at home to the Dr's schedule and added me for the next day.

Based on his “hands on” and visual exam (including xrays to detect breaks, fractures, etc), the doc concluded I had a sprain (not a tear) of the medial ligament in the right knee. This holds the knee in place.
Good news: Not a tear or worse. Can heal on its own.
Bad news: Very painful. Five days of bad pain. Followed by a healing period.

So my recoveries from the left PKR and the right shoulder RCR, now include a five-week recovery for the right knee medial ligament. And I have to wear an OTC knee brace when walking.

Please share input with these:
1) Knee medial ligament sprains
2) Wearing a knee brace
3) How to best position the knee in bed to sleep
Keep in mind, I’m sleeping propped up in the bed for the shoulder.

Thanks!

 

[marieltha]

I’m new at this. I thought I just started this as my Left PKR Recovery thread.
Might need Moderator intervention for correct placement? Help please?

 

[Jamie]

@marieltha .... one of our staff members moved your post to a thread of its own in the Knee Recovery Forum. This is where you should have started a new thread to talk about issues related to your PKRs. That way we don't mix up the recovery from your shoulder with knee concerns. So, please continue to post here about your knees and your shoulder recovery thread when you want to talk about your Rotator Cuff Repair.

I'll tag our forum nurse director, @Josephine, to offer some advice to you about the sprain.

 

[marieltha]

Thank you very much! For assistance with both

 

[Josephine]

1) Knee medial ligament sprains

What was it you wanted to know about ligament strains? It seems to me that your doctor has given you all the advice you need. But feel free to ask more if you wish.

2) Wearing a knee brace

I'd also comment here but again, you've not asked a specific question

3) How to best position the knee in bed to sleep

As to this, I'd say sleep any way you find comfortable. Personally, I was still sleeping on my back (for both knees) for about 5 months or more. It's entirely up to you.

 

[mainegirl1]

@marieltha I can't help you with your specific injury but I went and overextended my good leg four months after TKR.
So the Bad Leg became the Good Leg and the Good Leg was in timeout.. for four months.. hamstring strain.

Sometimes it does not seem fair , does it?

 

[marieltha]

Thanks, Josephine. Perhaps people who have had such sprains, worn braces, and found ways to sleep without further stressing the sprain in that leg can add thoughts.
MaineGirl1’s sharing of her hamstring sprain makes me think that perhaps the “good” legs are taxed more than we think—Before and after the surgery on the other. Your experience underscores for me the importance of strengthening everything around the joint to be fixed before surgery. Maintaining strength as well. Challenging.
Thanks, MainGirl1, and good luck w your hip surgery.

 

[marieltha]

Improving! More strength. Less pain.
13 weeks since the new left partial knee.
5 weeks since right shoulder repair & biceps release
3 weeks since right knee medial ligament sprain.
Everything feels a little better.
Completely off tramadol.
Taking Tylenol & Celebrex.
Taking a 1/2 Norco still to sleep. Must sleep.
New today: A new bed frame to enable head and foot adjustments (added to 10 yr old, beloved Sleep Number Bed). Heavenly so far for icing and resting. Will update after sleeping.

 

[marieltha]

Big, happy news: I had my Checkups with my Ortho Surgeon today (6wks shoulder; 4 weeks ligament sprain; 14 weeks new partial left knee). He says I am doing fine, that I am right on schedule for recovery for all (even a bit ahead on one ROM measurement for the shoulder). Yippee!
Must increase stamina, though.
And I now have a set of shoulder stretches to do every day.
And different directions for walking. By time rather than #of steps.
And I can walk in the pool as long as my husband helps me in and out. (Note: I have an aquajogger belt and I wear watershoes—added precautions)
Plus, told to add Biotin 10,000 mcg for cartilage/tendon, as well as nail health.
Very, very happy!

 

[marieltha]

Also, I had the OS put the brace on me and it feels much better than before. I took a pic to make sure I get it on exactly the same way. Then I took some pale peach nail polish and marked the center of my kneecap (through the brace opening) and the lower and upper edge (on the inside of the leg). LOL, I’m a stickler for balance and symmetry, so I added some to the other kneecap as well. Worth it! My leg feels so much more comfortable now .

 

[Celle]

Must increase stamina, though.

You've had two big operations in the past 3 months - a double whammy of energy drain.
Energy drain for TKRs

It could take quite a while for your stamina to return. Don't worry about it. Just let your body rest when it needs to. Your stamina will return gradually, as you continue to heal, but even people who have only had one operation are still feeling tired at your stage of recovery.

 

[marieltha]

Actually, I’ve had 4 in 16 months (MOHS on face w reconstruction);rightPKR;left PKR;&Shoulder)!
So true!

 

[marieltha]

Celle, the Energy Drain article (Josephine and Tim) you shared in the link in your reply above, is not only interesting and informative, but also illustrative of exactly how my body feels.
Thanks again.

 

[marieltha]

winemama asked me about my CPAP in Tmgrl3s thread, so I have switched that topic here to my own thread.

Several of us were talking about meds and sleep. I mentioned that Benadryl will knock me out (in Tylenol PM), but it messes up my CPAP/sleep apnea results/quality.

I was prescribed a Phillips Dreamstation CPAP device and began using it Christmas Eve (LOL), 2018. So it is the new model. It has a built in heated humidifier.

HUGE IMPROVEMENT IN SLEEP QUALITY! Snoring instantly stopped. As did gasping, etc., which had made my husband think I was having heart attacks. I literally had never in my 67 years awakened and felt refreshed. I do now! It is heavenly. My md also said she had never seen my nasal/sinus passages look normal, and now they do—thanks to the heated humidifier.

My Apnea readings (AHI) stay low, in the normal range of 5 or below. Surgery and certain meds sometime make my readings a bit higher/erratic. So I pay attention to what I take or eat before sleeping.

When I got the device, the trainer told me the device would send my readings to my dr monthly (modem), and if I wanted to get them, I should download the free Phillips DreamMapper app. So every morning, after I get up, I open the app (I set it up to use Bluetooth to go to my iphone)
and see the AHI total as well as the breakdown (clear apneas, obstructed apneas, and hypopneas) . Gives a bar chart for 7 days and you can go in and see longer periods.

Hope this helps, winemama.

 

[marieltha]

I also went through some of the bonesmart recovery articles and found the one about pain meds helpful, particularly the graphic that compares the strength/amount of pain relief among the various types.

I have experimented recently with naproxen instead of celebrex (2x daily) and w tramadol instead of norco at night. I am only taking Tylenol during the day now.

I’m going back to the Celebrex (day) —better relief of inflammation and stiffness for me. And I’m going back to the Norco (night). I can only take 1/2 of a tram or a norco.

For me, the tram wore off too quickly so I had to take another 1/2 in the night. I can do the whole night now w just the single 1/2 norco. My OS says this is fine.

Note: My pain is primarily in the shoulder RCR & BicepRelease(6 wks ago)and sprained right knee ligament (4 wks ago) .

The left partial knee (14 wks ago) gets tired and stiff, and the ankle sometimes swells, and the nerves are still aggravated a bit, but that new knee does not hurt much (very sensitive to drops in barometer pressure, though).

 

[marieltha]

In my RCR shoulder recovery thread, Jamie, the moderator discussed experimenting w the meds. Very helpful. Recovery is a process.

Took Celebrex (after a snack) between dinner and bed last night (instead of with dinner). Took 2 Tylenol and valerian (otc) at bedtime. NO NORCO Yes, kitty, just put that norco back in the bottle. Thank you.

I get my best night’s sleep if I do not use the iphone/ipad/go online/ watch tv right before bed—and never ever during the night.

Mea culpa, I did that last night—and went to bed later than usual. Two mea culpas.
I find a routine during recovery is essential, and going to bed earlier than my normal is better for overall stamina.

I ice for 20 minutes when I first go to bed, and I do not want to fall asleep with the ice cuffs on. So I do read from a Kindle paperwhite which does not (supposedly) interfere with your brain’s normal sleep stages. The quality of my sleep seems better if I do this.

Does anyone have some good sleeping tips?

 

[Benay]

I'm inclined to iPad the night away. Nothing to do with knee or pain. The hours just fly by, I've got to manage it. So I'm no help with any sleeping tips in fact in desperate need of some myself.

 

[Celle]

I think tips for sleeping are just a mater of trial and error. What works for one person may not work for another.
Sleep disturbance after knee replacement is inevitable. If you can accept that and try not to worry about it, you just may find that you've removed one barrier to sleep - worry.
The worst thing you can do is lie awake, watching the clock and worrying.

I moved into the spare bedroom, so that my waking in the night wouldn't disturb my husband. I would doze for a while, then wake up, make myself a cup of tea, take a bathroom trip, refresh the ice packs, and watch mindless, boring TV. I'd often fall asleep with the TV still going and wake up a couple of hours later.

 

[marieltha]

Monday, July 15,2019
My stamina has shown noticeable improvement the last few days. Better sleep now that I am off the prescription pain meds.

Pain is noticeably less also. The sprained “good leg” ligament (June)hurts the most, the shoulderRCR (May22)is second. The recent left leg lateral (outside)PKR (Mar27) rarely if ever hurts, but it gets stiff and resents having to slow its recovery because of the right leg ligament sprain—-hahaha, if you believe your joints communicate with each other. My hips and feet seem to, constantly! Would be able to walk more if the ligament sprain was not still healing.

I always tested normal for vitamin D and never took a supplement, until my OS saw my labs and noticed the normal range for a woman my age is 30-90, and I had tested 30 for years. He had me take 5000 for awhile, then 2000, and now 3000. Now I test around 75! Vitamin D3 is the only supplement that I have ever taken that I can say I felt better(energy, skin, sleep, calmness) after adding it.

Recently, I added biotin 10,000mcg per my OS, and I think I feel better with that also. Might be covariant, of course with my improved sleeping, and honestly, just the passage of time allowing all the parts to heal.

PS I had a surprising (to me) technological reminder about how easy it is to do more than you think you are doing. I decided to use the bedtime feature on my iphone to wake me up in the morning. It links to the apple Health app, which I had set up to track my daily number of steps. I forgot about doing that, as it only is counting when I am carrying the phone, so I didn’t use it (other than for marathon 10,000+ step days in Epcot/WDW before my recent surgeries).

Yesterday, I went for a ride with my husband to a tile store. I walked into the store, to the restroom, a few steps outside (to look at their displays), and back into the car. Last night, when I turned on the alarm feature, my phone said I had walked almost 2000 steps yesterday! Many more than I would have guesstimated. Plus all the steps yesterday when I was not carrying the phone.
Yowza!

 

[marieltha]

I put this on my RCR shoulder surgery thread and decided to share it here as well, because it helps w stress and I’m now also using it under my feet and on my calf and hamstring muscles affected by the knee surgery.

LOL, I saw lavender-scented therapy clay advertised on thegrommet.com, and thought that might help the hand pain after shoulder repair, but it was pricey.

So I got out my play dough! I actually like the smell of it (Proustian childhood memory?), but it would be easy to add lavender oil to it.

The left hand loves squeezing it as a stress-reliever as well as ROM aid. I think it is helping the right hand, too; and now the feet and legs, as well.

I use a small ball and just gently squeeze it or roll it over wherever needs it.

Gentler than tennis/yoga balls. Easy to adjust the size and shape.