PKR Long Story of my Battle with a Bad Knee

I can find a knee replacement guy with google, but looking for a top notch guy.

Recommendations from happy customers will be my best bet I guess. I'll try and find some local forums or FB groups with lots of olds that might have had replacements for some recommendations.

My knee has been feeling pretty good most days lately. As long as I don't try anything athletic it feels fine.

I met 5 of my college buddies for a long day at the casino last week. 12 hours on my feet walking around and standing. By 2 A.M. my knee was aching a bit and both legs were tired from lack of real use over the past year. I thought I would be hurting next day but other then general leg soreness, I was good.

I was hoping for so much more than walking and standing around without pain after this so maybe my expectations were too high. If, pre PKR, I had bone on bone or arthritic knee pain I probably would be happy.
 
1 Year update. It seems I still am making some small improvements each month. I have had a few very good days where I could walk around and barely notice my knee and I have thoughts of playing tennis again one day. Going upstairs my knee still feels very weak but no sharp pain. Going down stairs slowly with careful form I am shaky but no pain. I am always waiting for that step down an wham knifing knee pain, but so far so good.

I still need to strengthen my knee so when I have to hop off of something unexpectedly I won't destroy any progress I have made.

I have done a ton of experimenting with different exercises and supplements and seem to have found a system that continues to strengthen my knee without making it act up too much.

Incase there are others that are stuck and making little progress I'll list what works for me.

Health Club every other day:
  • - All 10 of my standard upper body weightlifting exercises.
  • - 30 minutes at level 12 (out of 20 levels) for 6 to 6.25 miles on recumbent bike.
  • - 70 lb glute exercise 3 sets of 12 reps each leg.
  • - 100 lb leg press. 5 sets of 10 reps.
  • - 65 lb walking weight pull out and back. This exercise involves me holding onto the weight bar and take 10 steps back and then 10 steps forward. The resistance my knees experience during this exercise feels great.
    * I am increasing weights for leg exercises by 5 lbs each week. Right now my legs are at embarrassing weight levels and sometimes a skinny girl will get off a leg machine and I'll need to lower the weight.
    * I eliminated the leg extension and leg curl because I felt these exercises were occasionally aggravating my knee.
At Home on non health club days:
  • Stretch band around leg work doing forward and sideways crawl walks for about 10 minutes.
  • 3 to 5 mile dog walk.
That's really all I do - minimal low stress activity because I am trying to be extra careful taking my knee strengthening very slow to avoid injury.

A few months back I added vitamin K2 and magnesium glycinate to my daily supplements to help with bone health, pain and inflammation. I seemed to get a boost when I started these but probably coincidental.

Below is my weekly step count from July 1 the day of my PKR.

Interesting that I had good steady improvement for the first 4.5 months then fairly stagnant December to March when I had a cortisone shot in my knee. Activity levels definitely increased afterwards.

One thing to note is that this only shows steps and not what else I am doing with leg exercises.

steps.jpg
 
I am at the 1.5 year since my PKR. I have not updated because not a whole lot has changed and it gets depressing posting bad news all the time. Also, I tend to go down a rabbit hole here reading everyone's stories good and bad.

I saw my Doctor again 9/13/2022 14.5 months after surgery. He said keep exercising the quad. The PT guy I was seeing earlier in 2022 said avoid doing leg extensions. My doctor said leg extensions are the best way to strengthen the quad muscle. He told me to do start them again but do a light weight and do not straighten knee completely during exercise because that could aggravate the kneecap. 5 sets of 10 where the last set seems almost as easy as the first. I have been doing these religiously. I am up from 5 sets of 25 lbs to 5 sets of 65 lbs. I also do bike, elliptical, walking, leg press etc.. So leg and knee is getting stronger.

Only problem is stronger leg and knee is not helping with swelling and knee soreness when climbing or descending stairs. Any kind of running is still out of the question.

I stopped icing every evening after reading that icing can slow healing so I only ice when knee feels very swollen and sore - maybe one time a month. I found that my knee felt the same the next day whether I iced or not so nice not to deal with daily ice.

I finally got a second opinion and just got back from seeing this new doctor who did double TKRs for a retired NHL hockey player that lives a few doors down from me. My neighbor has been playing pickleball since 9 months out from surgery. I could only dream of such activity with one partial.


Anyway the new doctor took x-rays and looked at my MRIs. He said a PKR was the right move and I was a great candidate for it. Said he could see and feel I still have swelling still under kneecap. MRI shows maybe scar tissue and roughness under kneecap is could be causing my long term issue with knee swelling and pain.

He sees slight arthritis on meniscus side of knee but not much can be done with that besides full knee replacement. I have not physical pain or issues on that side of knee so no need for drastic measures.

He said knee needs be scoped to see more what is going on and hopefully clean up whatever is aggravating my kneecap. I said I would rather he do the scope because he is 60 miles and an hour closer - plus he gets high marks from a pro athlete.

So I will be getting knee scoped 3 or 4 months from now when I can get on his surgical calendar.


TL;DR

Knee is getting stronger but still ongoing soreness, pain, and trouble with stairs and can't run across a street if I had to avoid getting hit by bus. Getting knee scoped to hopefully clean it up. Will update again after that...
 
Sorry to hear you’re still struggling with your knee. But I’m glad you have a different surgeon now with new ideas to help you. Will await your next update after the scope.
 
Thanks for the update beesknee it good to hear from you. I am glad you sought a second opinion. The scope sounds like a good idea.
I am in a similar position to you. My PKR is not great 18 months on. I have returned to see my surgeon and he is frustrated at my continued pain and discomfort. He has sent all my scans and results to another surgeon for a second opinion. He believes i may need to have a camera put in to find out what is causing my pain. But is very reluctant to do this as the risk of infection out ways the possible benefits. We shall see.
I swim 3 times a week and use a stationary cycle every other day this helps me physically and mentally.
I wear a TENS machine most days and use this to help manage the pain while i am at work.
Good luck with your scope.
 
Glad you have found a doctor who is willing to see what is going on inside the knee. I know how frustrating it is to not have a full recovery. I see a surgeon Tuesday to see whether she can do arthroscopic surgery to release the popliteus, which I believe is the cause of my continuing pain on the lateral side of my knee. I wish you lots of luck in getting to the root of your problems.
 
I'mmm bacckkkk.....

Ok, I had my knee scoped and cleaned up yesterday.

My knee has been basically the same since last update in January 2023.

My wife spoke to the doctor and took notes after the scope. I will have a post op visit in a few weeks to talk to him while not drugged up and get anymore details that I will share if anything new.

He said he removed a few loose particles under the kneecap along with some crystalization similar to what one sees when they have gout in a joint (I do not have gout). He cleaned up those crystalizations.

He also smoothed some grooves under my kneecap that may have been causeing tracking issues and excess friction under kneecap.


Meniscus looked good, cartilege looked good, very little artheritis to be concerned about moving forward. No need for a full knee replacement. He is confident that this procedure should get me on the road to full recovery.

Fingers crossed. I hope after 2.25 years after my PTK I will finally be able to run off a street to avoid a bus if required :). Maybe play some Pickleball. I have given up on the idea of tennis as that would require a miricle in my mind.


One good thing about scope as compared to PTK. Pain level is about 10% as bad. I can hobble around already but will baby it for a week icing and elevating. I want this to heal up so I can be done with thinking about my knee anytime I need to do anything physical.


It sounds like if this does not fix things there is not much else that can be done since he says the knee looks in good shape now.

Maybe I will be able actually excersise my knee fully and get it strong and sturdy again without it getting swollen and agrevated everytime I push it a little too much.
 
Good to see you back on the forum, @beesknee! I hope yesterday's surgery makes a difference for you.

Please do keep us posted. I know other members who are considering arthroscopy post PKR or TKR will find your experience helpful.

I've updated your signature to include your latest procedure.
 
Boy I hope this works for you. Do let us know how things go.
 
Boy I hope this works for you. Do let us know how things go.

On paper it should clear things upa and I will finally be on the way to a full recovery but we will see. The photos he gave me to to the untrained eye looks like lots of junk was under my kneecap.

I took ace wrapping off and changed bandages just now. 3 holes around the knee for the scope and fixin' tools. A fair amount of swelling. I can bend the knee and lift it without blinding pain like after the PKR. Only thing keeping me from fully bending is the swelling and stitches pulling.

Follow up appt October 4. Will update after that.
 
Way to early update...It could be the swelling giving the inside of my knee extra cushion, but the crackling, gravel sound and vibration is gone when I extend and contract my knee. It is nice and smooth like my good knee so far.

This gives me some hope that I'll finanally be able to fully strenthen my knee without pain and swelling once I heal up from the scope.
 
All sounds good beesknee. I really hope you can return to normal duties with out the pain and swelling.
I am scheduled for the same procedure this coming Friday. your report gives me hope as well.
We have very similar conditions and reading your posts has helped me a lot.
I wish you a speedy and trouble free recovery.
 
Had my post op visit yesterday. Went over photos from inside my knee. Doc explained before and after photos.

Other than cleaning out the junk and shaving the bottom of my kneecap, he said the biggest issue was "there was a prominent scar tissue just above the medial component of the unicompartmental knee on the femur." This was causing the kneecap to catch and not track properly. He removed the scar tissue which he believes was the main cause of the irritation that has prevented me from healing 100% since the PKR 2 + years ago.

He said he is completely confident my knee will now be fine once it fully heals from the scope in 6 to 8 weeks and I strengthen the quad and other leg muscles.

Since I know all the PT exercises he said I can skip PT but let him know if I need any extra PT help.

It is two weeks after the scope. My knee is very weak and still a little sore from the cleanup. However, 90% of the crunching and grinding in the knee is gone.


Also, hard to explain, but even though the knee is very weak and hurts more than right before the scope. My knee feels like it is functioning normally for the first time since the PKR. It never felt right after the PKR, now if feels like my knee and I am excited to strengthen it and get back to an active life.

Will update toward the end of the year. Hopefully, it will good news.
 
Excellent news!!!
 
Awesome update! It must be reassuring. Thanks for sharing and I hope to read more good news at years end. Take care!
@beesknee
 
This sounds very promising. Glad you feel this may have helped.
 
The knee feeling like a knee is a wonderful thing. Good for you. Now, do not over do.
 

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