TKR Lindylee's RTKR 20 January 2020

[Lindylee]

@Irish471 I don't get any pain at the back of my knee.

At first it ached a lot there and I still get swelling in that area from time to time. I'd say my pain is on the side going round to the front of the knee and from where the crease of the knee sits to about an inch below. It's a lot better than it was.

To begin with it was excruciating when lifting the leg or standing from sitting. It still catches sometimes and it can feel a little tender if I press that area so I have wondered if it is an IT band issue. The PT who did my original assessment said my hamstrings were very strong and gave me some hamstring stretches to do. Maybe I should do more of them instead of concentrating on strengthening my quads now.

I've always felt any problems I had bending the knee came more from the kneecap area than the back of the knee. One of my back exercises is to lie on my back and hug my knees to my chest (I've always hugged my thighs rather than knee's, so behind my knees in effect).

To begin with, my operated leg just stayed at 90 degrees, but gradually it's gained flexion and now if I pull my thighs in towards my chest I let my lower legs relax and just hang for a few seconds (not if there's any pain though) just to see what the difference is and it's now only half my foot's length. In other words, the toes of my unoperated leg can touch the middle of the instep of the operated one if that makes sense.

I feel more positive after Josephine's comments. It really didn't help that the registrar's 'complicated' comment kept sticking in my mind.

 

[Lindylee]

It's my 4 month kneeversary today. All in all I'm quite pleased with how the knee is progressing. It hasn't been easy, there have been ups and downs along the way, but it is improving. Yes, I still get some slight aches, pains and swelling, but not all the time and my knee feels a lot less alien. Some days I can come downstairs with no discomfort, but other days it's not so easy or comfortable. I can sleep on either side without pillows,but haven't got to the point that I can get straight out of bed and move immediately, although it's only a couple of seconds, if that. I'm doing Pilates, some dancing and a Get Active programme at the gym once a week, which is really helping. I'm happy with my ROM, no idea of numbers, but I can straighten it fully and lying down can bring my foot back to about 8" from my bottom, almost equal to the other leg. I avoid moves that involve turning the leg quickly, as the knee doesn't like it. I can kneel on carpet or a cushion, but don't do it for long. I don't need painkillers for my knee, only ice and elevate as needed, but my back is still giving me a lot of pain and that's limiting my walking, which is frustrating, and I'm seeing my chiropractor for that. People are keen to encourage me to go ahead with the other knee, as it may help the back, but I don't feel ready for it mentally.
Anyway, the purpose of my post is to, hopefully, show others that it does get better, it's just a slow process. To those who are really struggling, I hope things improve for you all soon.

 

[Jockette]

Only you will know when you’re ready to do the other knee. I agree, this recovery is as mental as it is physical, and I think you are wise to wait until you are ready.

You are actually able to do quite a lot for 4 months. At 2 years I still can’t do many of the things you can do now.

 

[Lindylee]

Thanks @Jockette I'm sorry you're struggling still. It must be so frustrating. I hope you can find something or someone to help you get over those final hurdles.

 

[Zommom]

@Lindylee your doing well and yes it doesn't sound like you are there mentally. Take each day one at a time, you will know when it needs to be done. I also struggled mentally deciding to go through this again within 4 months but I wasn't given the choice to hold off I am physically struggling now. I find looking to the future and what it will be like with both knees done gives me that boost to overcome the dread. You have come a long way and yes we have a long way to go but the end result will be worth it. Stay strong and take care of you

 

[Lindylee]

@Smokey253 Thanks for your kind words. You're so right about being ready and I'm sure I'd feel differently if my other knee was behaving like yours. I'll be interested to follow your progress. A year from now you'll be through recovery and I'll be dithering still I expect! I hope it all goes smoothly for you, wish you all the best for the surgery and an uncomplicated recovery. Take care.

 

[Zommom]

@Lindylee How are you doing? Think about you often.

 

[Lindylee]

@Zommom Aww, I think about you too, my knee buddy

I'm doing OK, rather cross with myself though. I've been doing this 12 week course at the local gym for people who have either had surgery, illness or just being encouraged to be more active and it was going well until last week. I mentioned I still felt as if I had a wonky wheel when walking and felt a pull to the right all the time. She watched me walk and agreed and gave me some new exercises. One was a single, seated leg raise with a 4.5Kg weight.

Remembering Josephine's advice, I said I didn't think I should be doing that with weights just yet, but she assured me it would be fine. It felt ok doing it, but by the next morning I had a swollen, painful knee, back on the lateral side of the knee again, and walking was uncomfortable, although I didn't seem to be drifting to the right all the time, so maybe it was stretching out this IT band? As the pain has improved I've noticed I'm drifting again when walking, but I won't be doing it again for a while.

Other than that, my reflux playing up and the back pain that's driving me nuts......... I'm fine

How about you?

 

[Zommom]

Glad to hear your progressing along - so much so you thought you could do weights that’s the problem when we start feeling good we go overboard. I too have these aches and pains in my back and hip but until this other knee gets done it won’t get well . Sorry about the reflux I find that mine flares up during those heavily medicated dates I use to take Prilosec but now that I have to take plavix I was switched to Zantac everyday. Now that the weather has warmed up my mood and outlook has improved! Gotta love that natural vitamin D

 

[Celle]

One was a single, seated leg raise with a 4.5Kg weight. Remembering Josephine's advice, I said I didn't think I should be doing that with weights just yet, but she assured me it would be fine. It felt ok doing it, but by the next morning I had a swollen, painful knee, back on the lateral side of the knee again, and walking was uncomfortable,

I guess you found out that Josephine's advice was right! Your knee is still too new for weights. Other than that, you're doing well.

By the way, please will you break up your long posts into paragraphs? A big block of text is hard to read and many people just don't bother. Thank you.

 

[Lindylee]

@Celle Yes, I learnt the hard way. I should have stuck to my guns and refused, but I'll know next time.

Sorry about the large block of text. I've edited it so I hope that's better.

 

[Celle]

It's much better. Thank you so much.

 

[Lindylee]

I have a question: I'm getting still what I assume is IT band pain on the lateral side of the knee round to the lower front of the knee and, when I remember, I'm doing some stretches, massage and using a TENS machine. I've been placing the electrodes diagonally across the knee as shown in the post on here, but I'm wondering if I should be placing them more on the side of the knee as that's where most of the pain is. Is it better to position them so that the centre of the diagonal is the painful spot or by placing them as shown does that target the whole knee and is that better?

If anyone can point me in the right direction I'd be grateful.

 

[Denny39]

Catching up on reading this morning, and I just read of your unfortunate and premature encounter with leg weights a few days ago. Weights should be reserved for the strengthening phase after the pain and swelling have subsided. After my first TKR, I suffered 2 significant setbacks by doing something I was assured that although painful, it was “necessary”, for a complete recovery. On my second day in Rehab PT this time, the first thing they wanted me to do was suspend my heel, and let gravity “do it’s thing”. In one of the Bonesmart articles, there is a photo of exactly what they wanted me to do, with a great big red “X” across it. That also just happens to be the cause of one of the 2 big setbacks of my first go-round. This time, I knew enough to say no. She didn’t really push it, but made it clear that she felt that I was making a mistake by not following her professional guidelines. Oh well . . .

You are about 5½ months now, and it sounds like you are overall, doing quite well. I’m happy to hear that. I recognize almost of the little glitches, annoying and sometimes unexpected pains or stiffness and limitations as you described them. They tend to hang on for awhile. At that stage, I had begun to notice improvements that could be recognized sometimes even from one day to the next. It was a very exciting and encouraging stage, and I hope it is for you as well.

 

[Lindylee]

@Denny39 Thanks for the advice and encouragement Denny. I'm my own worst enemy at times, although I have learnt now to take the lift/elevator if there are lots of stairs . I was talking to a GP acquaintance who happened to ask how I was doing and when I mentioned the setback she just looked at me and said: Would you have tried to lift a newborn baby on your foot?'. Errr nooooo...... Needless to say I felt suitably chastened.

If I could rid myself of the pain on the lateral side of the knee and the back pain I'd be a very happy bunny, as everything else seems to be doing well. Sometimes it's hard to remember that years of wear and tear and the additional complications are not going to be corrected in 6 months. That's why it helps reading other people's stories. It puts it in perspective. Hurrah for Bonesmart!

 

[Denny39]

@Lindylee If the pain on the side of your knee is on the lower half, it is probably where the implant was installed into the Tibia. That is a “press fit”, which means I’d doesn’t wanna go, but does anyhow. After they do that, they put 3 screws into it. That pain will not go completely away until the bone has healed, and forgiven you for doing that to it. I still have it at 6 months, but it is very mild most of the time.

The back pain is most likely due to the change in posture and gait which is the inevitable result of TKR. I have had a chronically bad back all of my life, and for 4 months after the first one, my back pain was often more severe than my knee pain. My first 20 - 30 minutes after getting up were horrible. I went to a Chiropractor, and he helped quite a bit. Surprisingly, after this one, there has been almost no back problem at all.

As your leg becomes stronger, and you walk more normally, hopefully your back will regain its natural alignment and start behaving itself. You also may find it beneficial to see a chiropractor. Hope your recovery continues on a smooth course and you soon forget this ever happened.

 

[Lindylee]

@Denny You're right Denny, the altered posture is causing other problems and the back pain is worse than the knee now. Like you I've suffered chronic back pain most of my adult life and have to exercise and stretch it every day, I have degeneration of the spine with spurs and scoliosis in the lumbar area now and see a chiropractor regularly. She's working on it; it's not improving much at present, but I'm hopeful in time it will.

The knee pain is all around the lateral side of the knee, across the lower front, which makes me think it's the IT band. Reading about others with valgus knees it seems to be a common problem. I'm seeing a new PT .Thursday so will see what, if anything, they suggest.

Things could be a lot worse and I'll get there in the end I'm sure.

 

[Josephine]

That is a “press fit”, which means I’d doesn’t wanna go, but does anyhow. After they do that, they put 3 screws into it.

@Denny39 This is a common misunderstanding amongst patients, thinking that because they had a 'such and such' type of implant, it's standard fro everyone. But it's not. There are many other press fit (uncemented) knees on the market than the one you described. The use of screws is solely due to the design of the implant and nothing else.

 

[Lindylee]

@Josephine Would you be kind enough to let me know whether I'm placing the electrodes for my TENS in the correct place for the pain on the lateral side please? I'm placing them diagonally over the knee as shown in the post on pain, but wonder if they should be more on the side of the knee to target this specific pain?

 

[Josephine]

If you notice, they are in a formation and with the leads attached diagonally so the treatment is applied in such a way that the maximum pulse is through where the red and blue lines cross.