PKR Long Story of my Battle with a Bad Knee

[beesknee]

When I was young and in my teens (late 1970's) I must have injured my right knee at some point as I have a hole in my cartilage on the medial of right leg.

In college during the early 1980s it really flared up after play sports. I went to the University health center and they scoped the knee and did not see anything..

Then for the next 10 years I could not play sports or run across a street without a swelled up knee. So I walked and avoided having fun playing any sports. I had a few doctor appointments with specialists and they would take x-rays and would never see anything. They would tell me to do isometric excersises to strengthen knee muscles. It never helped.

Then early 90s I decided to try running. I started running 10 yards then walking. Eventually built up to a solid jog of about 2 miles every other day. My knee felt much better on a daily basis and while I still could not play sports with uncontrolled lateral movement, I could run across a street like a normal person.

I even upped my running at one point and ran the 10 k Peachtree road race in 1996 which was an amazing accomplishment for me after years of problems with the knee.

Late 2000s I upped my daily running to 3 or 4 miles three times a week. Felt good and was getting in fine shape. I took a tennis class and did fine until the 9th weekly 1.5 hour session. I jumped for a ball and was back to a puffy sore knee and gave up trying to learn to play tennis and started my running again when knee calmed down.

Early 2010 I came in from running, sat down for a while and could not get back up. After a week, knee was about the same as usual but I decided to try a doctor again. I went to an orthopedic clinic, then took x-rays and the doctor said he thought he saw a shadow on the medial of right leg. Finally, a doctor saw something!! He ordered up an MRI for me and the saw the damage/hole in my cartilage I have been living with for years. It was great to have confirmation my knee issues were not all in my head.

During this time my son was playing youth baseball and one of the dads I would talk to a lot was recovering nicely from his second TKR. He was the kind of guy who only dealt with the best so I asked him who his surgeon was and set and appointment with the doctor. Turns out he was one of the Top Docs in the Midwest and only did knees.

He suggested a scope and he would clean up the knee and do micro-fracture where the missing cartilage was. The scope went great.

Afterwards I was in a knee brace for a week or two and on limited activity and PT for 3 or 4 months. Recovery was a breeze I tried a bit of running but anything over a mile and I would get a sharp pain where microfracture was done. So I decided to do other sports like volleyball, softball, and tennis.

I was able to get through a full 10 session tennis beginner drills and then started playing in beginner leagues and doing higher skill level tennis drills once or twice a week. I LOVED it, to play a game and get exercise, so much more fun than jogging for exercise.

During the next 8 years I became very good tennis player. My son took it up and I played him all the time and had a blast.

A few years ago we moved to a new home with wood stairs. I missed a step once and caught myself, no harm done. But then the next day I could not walk up or down stairs without sharp pain. Tennis was out.

I saw the same doc again Feb 2020. He said give it some time and gave me a prescription for and MRI. Then Covid hit and I put my knee on the back burner. I took it easy on the knee and it became pain free unless I pushed it, then sharp pain.

Finally in May after I got the vaccine and things opened back up fully in the U.S. I saw the doctor again, got an MRI, and he said the micro-fracture scaring loosened up and he suggested medial PKR. He said since my knee is completely healthy, once he plugged the hole in my cartilage with titanium I would be as good as new.

He said recovery would be much easier than microfracture because their would be only healing from incision and no time needed for micro-fracture scaring to take place.

I said lets do it since he has done 10,000+ PKR and TKRs and performed a miracle on my knee in 2010 giving me a life at 50 more active than my 20s.

Had surgery July 1 2021. It went smoothly and post op doc told my wife I should be up and around in a week and now have the knee of a 20 year old.

On July 2 I developed severe headache and hearing loss due to lumbar puncture from epidural. Head was way worse than knee pain and losing hearing was very scary. Called doc and he said go to emergency room to get a blood patch if not improvement in a few days.

July 4 I went to ER for 14 hours while I waited for an anesthesiologist that could do a blood patch. Finally got blood patch at 11 PM after waiting all day.


Good news is blood patch almost instantly fixed headache and hearing loss. Bad news I spent more time fighting epidural gone bad rather then my knee so I feel I am 4 or 5 days behind on knee recovery.

Doc was way off on PKR surgery vs. Micro-fracture surgery recovery. I hardly remember much more than hobbling around for a few days after micro fracture. I am now, on day 13 and still using a walker and wife is getting sick of helping me and missing prime summer days. If I knew it would be this bad I would have scheduled surgery during the winter when we are all stuck inside anyway.

Seeing doc Thursday and he will get a piece of my mind about under-selling pain and recovery time. I start PT on Friday. At this point I feel about 15% better since July 1. What is driving me nuts is that I can't sit at my desk or in a chair without knee mostly straight and elevated.

I started doing research on PKR and I read that it is best for an 80 year old and not ideal for a young active person. I am 60 so not so young but I am in shape and like to be very active.

Sorry for the long post. This is my story so far..

 

[Ginger1210]

HI beesknee don `t be sorry for the long post i too have had a right medial P.K.R back in April i to believed the hype about a quick recovery i too have had micro fracture in the same knee but the P.K.R has been really tough to recover from. 12 weeks on i am still far from recovered. after about three weeks post op i began to panic and then i found bonesmart and soon discovered that i am not alone and a P.K.R. has a very similar recovery to a full TKR. I know this is something you may not want to hear but you have found the best place for advice and help.

 

[BBCG]

Oh, Beesknee, I'm so sorry for your knee troubles! I think there is a general tendency in the knee surgery world to under-advise and oversell the results of these surgeries, or so it sounds from everyone here.

I think you will soon hear from others here who have dealt with similar issues, and one of the Moderators will send you the list of articles, which I found very helpful when I first found Bonesmart in 2016.

It may be that, if you can wrap your brain around a longer recovery timeline, that you'll heal well and be back to normal sooner than if you push too much and are too hard on yourself. I've heard many here say that the timeline for knee recovery is nearly the same for a PKR as a TKR, so if you can modify your expectations, maybe it will be less frustrating?

Hang in there and know that there are a bunch of us here to commiserate with you and cheer you on as you recover!

 

[Wolvesfan]

Hi @beesknee ... Wow, you’ve had many adventures with your knee! I had a right medial PKR in March 2020, and my surgeon told me numerous times that complete recovery would take a full year. Of course, I thought that was ridiculous; that I would recover much more quickly...but he was right. My new knee felt pretty decent by the 12 week mark, and at six months, I was mostly back to my pre-op level of activity (hampered, of course, by Covid restrictions) but the tenderness and tightness wasn’t fully resolved until I was basically a year past the surgery. For me, the emotional aspects of recovery were almost as difficult as the physical challenges. I often felt frustrated and discouraged, and just wanted my life back. I was anxious about regaining ROM and worried that my limitations might be permanent. My husband was very patient with me, but I was often crabby because I didn’t want to rely on anyone. Now, 16 months post op, I’m so glad I had the surgery. I’m not an athlete like you, but I can fully enjoy my morning walks, along with so many other activities, because my new knee is strong, stable, and pain free. So hang in there, because a brilliant future is out there for you!

 

[beesknee]

Not sure if we can post links here. This is what I found on the Harvard Edu health site about partial knee replacements:


**Aren't there partial knee replacements that involve only one side of the knee?

Yes, and they are easier to recover from. It is the perfect operation for the 85-year-old who only has a problem in one portion of his or her knee and minimal deformity. The worst candidates for partial knee replacements are the people who often get them — young athletic people. They recover fast. They feel normal. And then they end up loosening their partial replacement in no time.**

It seems when I buy something I end up researching it for hours to make sure I get the best and what I need. The amazing thing is I really did no research on partial knee replacements until after it was done and I was suffering. At minimum I would have put it off until I had a slice of time not in the middle of the best weather of the year in Michigan.

I have a question on something that is of concern. When I had microfracture surgery I was given a knee brace that prevented me from bending too far back accidentally. I remember one time about a month or so after micro fracture surgery I was walking my dog through a field and stepped in a large hole with my repaired knee. I fell and my knee bent to the maximum where the brace stopped further bending. I withered around on ground in pain for about 10 minutes then got up and was perfectly fine. Disaster averted.

I am wondering why I did not get a brace for partial knee replacement. I feel that one slip or fall and I will be in really bad shape if the knee bends farther than it will go. Should I ask for a brace next appointment with the doctor? Have any of you received a brace after surgery? What will happen if my knee gets bent accidentally way too far ?

Unfortunately I was cleaning out my closet not too long ago and threw out the brace thinking why would I ever need it and why am I saving it.

 

[beesknee]

Another question. I see my doctor Thursday I will ask for a third refill of 30 oxycodone. I have been taking 4 or 5 tiny pills a day, two after I get up and eat to knock down the pain a bit and then maybe one a few hours later, then two after dinner before I am going to do my PT.

I could definitely take more than that as I build tolerance and enjoy the short period of relief after I take them. However I know doctors are very reluctant to prescribe opiates nowadays. So I'm expecting some pushback on pain relief at this Thursday's appointment.

Any strategies if he tells me to just take Tylenol and suck it up? I don't have an addictive personality or tendencies but I do like a nice painkiller once in a while when in pain.

 

[Sisterpat]

beesknee, Welcome! Can you give us the date of your arthroscopy so we can add it to your signature? Best to have all the information on that knee. Though my 2 replacements were total, there are several people here (some have already replied) who have had PKR’s and they will have some input for you.

 

[beesknee]

Micro fracture was sometime in 2010 I think. Not sure of exact date.

 

[Wolvesfan]

@beesknee ... I smiled when I read the comment about a PKR being perfect for an 85 year old. My dad had a TKR when he was in his 80’s, and I commented to my surgeon that I couldn’t imagine going through this surgery and recovery at that age. He said that he loves operating on octogenarians, because they have realistic expectations. They don’t want to do an Ironman, but they do want to be free from knee pain. That was certainly true with my dad. Regarding the need for a brace, I’m sure the mods/medical pros on here will have good advice. My surgeon told me that the knee implant was extremely strong and stable right from the get go, and that I couldn’t really do anything to damage it. I think that with your micro fracture surgery, you had a repair (as opposed to a replacement) and so you needed the brace to protect it while it healed. At the end of January, I was walking with my dog on our very snowy and icy street. I tripped over a chunk of ice and went down hard on both knees. Of course, I was worried that I’d damaged the PKR knee, but it was just fine (bruised, but still fine). However, I shredded the meniscus in my other knee, and after hobbling around with increasing pain, I had arthroscopic surgery in April to clean it up. It’s really nice to have two pain free knees again.

 

[Celle]

Not sure if we can post links here. This is what I found on the Harvard Edu health site about partial knee replacements:

@beesknees , it's all right to quote small amounts of text, but we do need a link to the article, so we can read it too.
Please will you post the web site where you found this article?

Aren't there partial knee replacements that involve only one side of the knee?
Yes, and they are easier to recover from. It is the perfect operation for the 85-year-old who only has a problem in one portion of his or her knee and minimal deformity. The worst candidates for partial knee replacements are the people who often get them — young athletic people. They recover fast. They feel normal. And then they end up loosening their partial replacement in no time.

First, we have had thousands of people here on BoneSmart and from their reports, partial knee replacements (PKR) are no easier and no faster to recover from than total knee replacements (TKR).

In fact, many of the people who have had a PKR have been disappointed to find their recovery wasn't fast or easy and they complained that they wish their surgeons had not advised them recovery would be faster. It isn't.

Complete recovery from a PKR or a TKR takes a full year, although you will be able to do most things by about 3 months post-op.

Second, one of the main reasons why a PKR fails is because arthritis has spread to other compartments of the knee. While some PKRs do fail because of loosening, there are young athletes who have had a successful PKR and returned successfully to their sport.

Overall, a PKR is not likely to last as long as a TKR (which nowadays is predicted to last about 30 years).

You've already had several surgeries on your knee that have only been effective for a relatively short time.
In your situation, I would not be considering another "temporary" solution. I would opt for a total replacement.

 

[beesknee]

it's all right to quote small amounts of text, but we do need a link to the article, so we can read it too.
Please will you post the web site where you found this article?

I would be happy to post link but get this error:


Oops! We ran into some problems.
Sorry! You must have at least 5 posts to post link. Your curent posts count is 4.


I suggest you copy paste the text in google and you can find article.

You've already had several surgeries on your knee that have only been effective for a relatively short time.
In your situation, I would not be considering another "temporary" solution. I would opt for a total replacement.

I don't understand what you are saying. I only had one microfracture surgery before the medial PKR surgery I just had. I do not consider one as several and the microfracture lasted nearly 10 years. 10 of the best years of my life, health wise.

I would be very happy with 10 to 15 years out of this PKR. That would take me to 70 or 75.

PKR fills the same hole in cartilage with titanium instead of the scar tissue which micro fracture creates to take place of real cartilage. The rest of both of my knees are in perfect condition, no wear or arthritis can be seen.

Are you saying it would have best to have both the good part of my knee and bad replaced? Seems pretty extreme at this point. Throwing the baby out with the bath water as they say.

Since with full knee replacement, running and jumping are out I would have done nothing because I had no pain unless I did any running and jumping pre surgery. The hope is I will be able to play some tennis again, or at least pickleball.

 

[Celle]

it's all right to quote small amounts of text, but we do need a link to the article, so we can read it too.
Please will you post the web site where you found this article?

I would be happy to post link but get this error:


Oops! We ran into some problems.
Sorry! You must have at least 5 posts to post link. Your curent posts count is 4.


I suggest you copy paste the text in google and you can find article.

You now have 5 posts, so we'd appreciate the link, please.

Copying and pasting the quotation as you suggested did not find the article.

I didn't realise you had already had the PKR.
I know exactly what it is, as my first knee replacement was a PKR - it failed me after 11 years. Since then, I've had a revision to a TKR and a TKR on my other knee.

You might find this article from our BoneSmart library interesting:
Knee replacement surgery types and suggested videos

 

[beesknee]

Here is the link. When searching a large chunk of text it helps to use quotations around the text for an exact search.

Harvard Expert: What you can expect form knee and hip surgery - Harvard Health

Your knees and hips are your largest joints. They support your body weight and work in close coordination so that you can run for the bus, squat to lift a child, or play hoops.Over time, many of u...

www.health.harvard.edu

I think in general what you find in support forums such as this are the people with more troublesome journeys.

Those that are having an easy time tend to not seek out and post to a support forum. I know I never would have found bonesmart if I did not have a nightmare beginning to my journey.

Kind of like product reviews, people that have a negative experience are much more likely to leave a review then someone who has an expected positive experience.

 

[Celle]

I think in general what you find in support forums such as this are the people with more troublesome journeys.

Those that are having an easy time tend to not seek out and post to a support forum. I know I never would have found bonesmart if I did not have a nightmare beginning to my journey.

Yes, we're well aware of that and we often warn people about it.
I have been on the staff of BoneSmart for 7 years.

Thank you for the link to the article you quoted. Another way of posting it is this:
https://www.health.harvard.edu/heal...what-you-can-expect-from-knee-and-hip-surgery

 

[beesknee]

Day 16

Had my 2 week doctor follow up yesterday, I was disappointed doctor and main PA I normally would see were not in the office. I was going to give my doctor a piece of my mind about epidural lumbar puncture fiasco and him telling me recovery will be way easier and faster than microfracture I had 10 years ago. I recall something about I would be up and running in 5 days or so.

I know he is as good as there is at PKRs and TKRs and has led several physician conferences on knee replacements but he needs to slow his roll on over optimistic recovery times.

Anyway, a Physicians Assistant I never met talked to me. She said X-rays and scar looks very good. Not much ROM yet and scar is much bigger than I thought, no wonder it hurts. I mentioned that recovery much slower than told and got the everyone heals different line.

My next appointment is in 6 weeks and I made sure to pick a day when I could see the actual doctor.

I had first PT appointment today. He pushed me fairly hard with various stretches to get my ROM better. He set up appointments for the next 6 weeks, 3 times a week. I will go for a few weeks then probably quit going. Anything that he is having me do I can do at home or at the health club, I don't really need a PT to rah rah me.

My pain is about 22.5% better since day one. Swelling is still pretty bad once I start shuffling around. I can walk very slowly and carefully without walker. Steps are still one at a time with my good leg doing all the work. I feel I am starting to make some slow progress. Unfortunately I am losing weight even though I am hardly doing anything, I expected to put on a few pounds. I have a hard time staying at my ideal weight of 195 and am now down to 190.

Good news is I sleep like a baby on my back even though normally I am a side sleeper. I should say that I have always slept like a teenager. Also, I have minimal leg pain while in bed. My back aches more than my leg from being in the same position all night. I guess I am lucky as I have friends my age that wake up at 5 or 6 AM and can't fall back asleep. If I have to get up at and early time like 8 AM I hit the snooze at least 5 times.

Right now my main goals are to start improving ROM and getting swelling down when I stand up. When I wake in the morning I can see my knee cap but as soon as I get up my knee gets puffy and roundish. Hopefully with better ROM and less swelling I can ditch the walker and start driving and start living life again.

 

[Irongirl56]

Hey Beesknee, I had R medial PKR on 17 June, so am just at week 4. I hear your frustration and impatience. Every day I wake up hoping I am moving better. my OS decided on a PKR as my other parts of my knee were ok and I am (or was?) an Ironman triathlete with an intent to still race at that level but probably wont run ! I will be 65 in a few months so I am ok with this PKR until it isnt then convert to a TKR. My ROM has been very slow going, at Pt yesterday I was at 105/0 with a little help from my PT but I am good with that as last week it was only 88 and at wk 2 it was only 60 ish, so as long as I am making some sort of progress I am good.
I have been off pain meds since day 3 as could not handle the nausea but still take tylenol or Advil at nite when pain seems to be most bothersome.
My OS told me up front that full recovery would take up to a year but like many I have been in pain and limping for several years so ready to be done. We are missing a lot of summer as well but really just wanted to get on with it. I was hurting and limping so bad summer wasn’t going to be much fun anyway.
Hang in there as they say it will get better!

 

[beesknee]

Wow same knee, same type of PKR.

Pre-PKR I had very little pain when just walking around, doing yard work, waterproofing the deck etc... However, I could not do anything athletic without a sore knee for a week. I haven't played tennis in over a year and became obsessed with it after my micro-fracture cured my bad knee 10 years ago. I am hoping to get back to that level or better with this surgery. I probably won't do any straight line running that will pound away at the PKR. Things like tennis, pickleball, badmitten, volleyball, and table tennis are much easier on the knee.

Today after first PT session, knee feels the best it has since surgery July 1. I think my rom is only about 40 or 45 so 105 is amazing. Today was the first day I did serious stretch exercises to improve ROM. My PT goal is to get to 90 in two weeks. Then I could sit on a chair with my leg straight down. Today I can walk very carefully around without the walker the best yet.

Why do you think you will need a TKR in the future? My knees besides the one hole in the cartilage on the medial side of right knee are in perfect condition so I am hoping this will be all I need.

If I just wanted to stroll around the rest of my days I could have done nothing so I will be very bummed out if this ends out worse than before surgery. Definitely never want a TKR based on some of the recovery stories I have read here.

 

[Jaycey]

Definitely never want a TKR based on some of the recovery stories I have read here.

As you said previously on this thread, the stories here are probably more worst case. People who don't have post op problems don't tend to stick around. For every member here there are hundreds out there getting back to living again post TKR.

 

[Sisterpat]

And there really ARE lots of happy, success stories here. Look for them. TKR can be a wonderful, life changing experience.

 

[beesknee]

Definitely never want a TKR based on some of the recovery stories I have read here.

As you said previously on this thread, the stories here are probably more worst case. People who don't have post op problems don't tend to stick around. For every member here there are hundreds out there getting back to living again post TKR.

Yes, thanks for reminding me. I got sucked into a thread spiral reading few multi-month/year *KR struggle treads that got me depressed. However, @Irongirl56's thread makes me jealous . I may need to stay away for a month before checking back in.

Yesterday, after first PT was the best I felt yet. This morning not so great. He basically gave me the same exercises to do daily as I did with him so I am hoping I feel same improvement after my self PT today.

I am finding recovery for me is best marked week to week and not day to day. Daily I seem the same, but when I think back a week I realize the things I can do now I could do last week.