PKR Long Story of my Battle with a Bad Knee

[Ghostpipe]

Agree that time is indeed the best healer. From 5 months things seem to move on a bit faster and strength seems to start flooding back. I think a lot of this is due to using the muscles more naturally as the pain gets less.

 

[beesknee]

Sounds like you had a good review and are doing very well. The size of your knee cap that you mentioned on another post is swelling?

Yes, my kneecap looks larger because of general swelling.

It is a slow process and my surgeon said the same thing bout quad strength i am doing Physio every day and working as well. It is getting easier but time is the best healer. Last week at work i only had one bad afternoon which is the best i have been since my PKR. Onwards and upwards.

It definitely is a balancing act doing stretches to gain ROM combined exercises to gain quad strength. Wednesday I did 4 sets of quad extensions on my multi-gym. Felt fine afterword. Did 4 sets Thursday, Friday I noticed extra soreness while doing my ROM stretches so I did only 2 sets of quad lifts. Friday evening knee was very puffy and I was limping around like 2 months ago.

Saturday I only did light stretches and Sunday felt much better so I did 3 sets of quad lifts and feeling pretty good today.

I think I will do my quad extensions every other day to allow for recovery and limit to 3 sets of 10 until I am sure I can do more. Then will slowly add weight.

I will be at 3.5 months on Thursday. Starting to have a few pretty good days each week. But I definitely need to get my legs stronger. It was about 2 years ago when my micro-fracture surgery failed after about 10 years. At that time my legs were strong. But then Covid hit and I waited over almost 2 years to get this surgery. During this time I had to cut back on activities and my legs got weak.

I wish I had a cortisone shot in knee so I could work out my legs more pre-surgery. It seems some of the best success stories here are those who go into surgery with really strong legs.

Two years pre-surgery my main exercise was walking. No biking, running or tennis for a few years. Every time I tried to exercise my legs at the gym I would tweak my knee and would limp around for 2 or 3 days.

Combine pre-surgery weak legs with 3.5 months of doing only gentle ROM stretches, icing and elevating with very limited mobility and my leg muscles atrophied. I feel I could have great ROM but if the muscles around knee are weak knee will continue to bother me.

 

[Jockette]

Jokette, what would you have done differently if you knew more? I know you had aggressive early PT. Do you think they did permanent damage to your knee?

I would have gotten more than one opinion if I’d known more. Since I hardly knew anything about knee replacement, I trusted the first and only surgeon I saw. It never occurred to me to get a second opinion. I had my partial done in a small town (most of Delaware is small towns) so I now suspect my surgeon hasn’t done very many. He said he could fix the pain in my knee. I believed him. My mistake.

I don’t think the PT did any permanent damage, but who knows. It sure didn’t help a knee healing from a poorly done surgery.

I wish I could go back in time and not have this surgery. My other knee that hurt just as much, and has not been replaced, is doing quite well. I’ve been taking ibuprofen regularly and it has done wonders for me. It makes me wonder if that’s all I really needed. And I do realize long term ibuprofen is not recommended, but so is constant pain. I‘m willing to take the risk and so far so good.

 

[beesknee]

Understood. I made a similar mistake. I did no research on a partial knee replacements and what I could potentially go through. Heck if I buy a $20 item on amazon I can spend hours research which is the best one. When my doctor suggested a medial PKR instead of microfracture again. "Fix it once and for all and be up and around in no time". I said sounds like no downside - Lets do it!

I am starting to believe with time I'll be back better than before, but if I knew that it would take me months to be fully recovered I may have made a different choice, or at least timed the operation better.

As I mentioned, many activities I planned this year have been canceled. This week I was supposed to be up north with my buddies hunt grouse walking through thick woods. Next month the wife and I were going to do an anniversary holiday in Jamaica - cancelled.

Yesterday, I mentioned to my wife we should look into escaping winter and go to Key West over Christmas. She said we need to wait and see what happens with "the knee" over the next few months. No fun going to Key West if you can't walk around and enjoy.

I am thinking a patellofemoral knee replacement that you had is trickier and involves more precise moving parts (kneecap) than a medial or lateral PTK?

Have you ever thought about telling them to start over and do a TKR on that knee? Can they even do such a thing?

With partials, it seems you want a very experienced surgeon because they do many more full than partials because just a part of the knee being bad is fairly rare. In my case, the guess is I had some type of injury when I was younger. The PT I was seeing said she very rarely saw people with PKRs. Fortunately my surgeon has done 1000s of TKRs and tons of PKRs over the past 20+ years. So I hope for the best.

Bottom line there is a decent risk that things won't work out perfectly or will take a LONG time to work out and I went into this without that knowledge.

 

[Jockette]

I did read up on partials, but they all had glowing information about how quick and easy the recovery would be. I honestly thought I’d be healed in 2-3 months. It’s been 4 and a half years now and I’m not “ healed.”

Yes, it can be converted to a total knee replacement, and there‘s every chance I will need that eventually, but to say I don’t want more surgery is an understatement.

I‘ve had 2 second opinions and the X-ray looks fine so they didn't look further. Well, the second second opinion did run blood work but it came back fine. So, supposedly there’s nothing to fix. While I’m not happy with my knee, I’m glad it isn’t any worse, and I’m not desperate enough to push for a revision. I do have more limitations than I did before surgery, though.

What I also suspect, is that something went wrong with the lateral release that was also done during my replacement. That is where most of my discomfort is. My knee feels like someone took my leg apart at the knee, then stuck it back together wrong.

Oh well, nothing is perfect.

 

[Ginger1210]

Great report beeksknee. I had struggled for around 3 years with my knee. And my right quad muscle is like Jelly. I did research a PKR and chose one of the best surgeons in the UK he came in the top 10 in the country for TKR`s and PKR`s he does more PKR`s than anybody else in the country. My wife new someone who had a PKR a couple of years ago by the same surgeon and they could not recommend him high enough. I paid for a private consultation to see him and he examined all my scans and X rays from my previous operation on my knee. He explained why I was in pain and the fix was a PKR. I referred to him and could not wait for the operation so I could recover and get back to normal living. 5 1/2 months later I am improving but it is tough and I still overdo it I am writing this after having a pretty bad day at work my knee is not happy I am icing as I write. This is the first bad day in over a week even so I have done 4945 steps which is just over 2 miles. I just wish I could wake up in a years time and be good to go. It is the uncertainty of not knowing weather I will be ever right again or is this it? That worries me I am 48 would like to think I can return to normal.

 

[beesknee]

5 1/2 months later I am improving but it is tough and I still overdo it I am writing this after having a pretty bad day at work my knee is not happy I am icing as I write. This is the first bad day in over a week even so I have done 4945 steps which is just over 2 miles. I just wish I could wake up in a years time and be good to go. It is the uncertainty of not knowing weather I will be ever right again or is this it? That worries me I am 48 would like to think I can return to normal.

Yeah, the final fix for me was to be this PKR. One would think a PKR would be a fast fix. I am behind you at close to 3.5 months and still feel my knee whenever I move around. I wonder when will this be over and I can hop out of bed without gearing for another day of dealing with the knee. Each week I seem to get a tiny bit better but the gains are small. Now that I am trying to focus on my quad, I have had a few worse days than normal. But I think it is critical for long term recover to build leg strength back.

Those that went into PKR that were doing heavy exercises up to surgery seem to recover faster. Unfortunately, I took it easy for the year I was waiting for surgery so my legs were not in the finest condition.

QUESTION:

I have a knee compression sleeve I often use when on the move. My knee definitely feels better with it on. Just more of a stable feeling. I am wondering when I wear it too much are the muscles around my knee not getting natural exercise for stability since the sleeve takes care of it? Should I limit the use of the compression sleeve on my knee?

 

[Ginger1210]

Hi before my injury became to bad to train properly I wore a knee compression sleeve for a few years when training A physio did explain this could have a detrimental effect on my knee muscles. After my PKR I have not used one but my knee is still a little unstable so I can empathize with you there. I do think they help and also give you a little mental support to trust your knee more. At the end of the day we are all individual at what works for one may not work for another. I have just started taking CBD tablets everyday and this seems to help a little more with my pain and stiffness or again it could just be in my head. We just have to persevere and keep plodding on. This forum certainly helps though!

 

[Gingerbread]

As I read about your struggles, I wanted to mention a "funny" story.
My OS told me I could choose a partial, a total, or a "surprise" replacement. The surprise would have been when he opened up my knee, he would have both appliances ready to go. He would then determine, upon real time visual inspection of my actual knee, which would be better.
I didn't have to think much about it. That was a "NO THANKS".
I knew I would most likely, within 5-10 years, need a conversion to a total, so that was a no-brainer.
I wonder if anyone else has ever had a surgeon give them the same option I had???

 

[patriciad]

I was ready to schedule my TKR with a OS who had been treating me for the past 3 years. After researching I went for a 2nd opinion to the only surgeon in the area who was doing the Conformis custom total knee replacement as having been told I needed a TKR I wanted the Conformis as reviews are brilliant for less pain and faster recovery. So he brought up my X-rays and showed me why I was a great candidate for a PKR - he also said that I probably hadn’t been offered a PKR initially because they are only successful if a surgeon specializes in them and does hundreds - he teaches the surgery and has performed thousands so I went with The the PKR. He did say that on surgery day he would also have a standard TKR implant ready just in case there was arthritis he couldn’t easily see until he was in the joint so although unlikely I could have the “suprise” of waking up to a TKR.
No suprise the rest of my joint and kneecap were in good shape so I can expect 10 to 15 years with this PKR. If I had been told 5 - for sure I would have gone with a TKR.
It’s definitely a journey though.

 

[beesknee]

Hi before my injury became to bad to train properly I wore a knee compression sleeve for a few years when training A physio did explain this could have a detrimental effect on my knee muscles.

I searched extensively on google and could not find anything that mentioned them being bad for knee muscles.

They seem to have many benefits:

- Proprioception - gives the brain a better sense of muscle action in knee.
- Increased blood flow to injured knee speeding recovery
- If used after exercise, swelling and lactic acid buildup will be limited.
- Increase stability

I have just started taking CBD tablets everyday and this seems to help a little more with my pain and stiffness or again it could just be in my head. We just have to persevere and keep plodding on. This forum certainly helps though!

I tried CBD tablets and have CBD/THC lotion. Could not tell if it made a difference. Probably not.
Standard MMJ gummies (legal here) help me sleep but don't do anything about pain. If I took one during the day I would obsess about knee and freak out about every ache and pain.

As I read about your struggles, I wanted to mention a "funny" story.
My OS told me I could choose a partial, a total, or a "surprise" replacement. The surprise would have been when he opened up my knee, he would have both appliances ready to go. He would then determine, upon real time visual inspection of my actual knee, which would be better.
I didn't have to think much about it. That was a "NO THANKS".
I knew I would most likely, within 5-10 years, need a conversion to a total, so that was a no-brainer.
I wonder if anyone else has ever had a surgeon give them the same option I had???

Why do you think you would need to go to a full knee replacement? Did you have the beginnings of arthritis in the more health parts of your knee?

My doc also mentioned that he would do a TKR if he found something he did not expect. I believe I even signed a form allowing him to make the decision.

I was ready to schedule my TKR with a OS who had been treating me for the past 3 years. After researching I went for a 2nd opinion to the only surgeon in the area who was doing the Conformis custom total knee replacement as having been told I needed a TKR I wanted the Conformis as reviews are brilliant for less pain and faster recovery. So he brought up my X-rays and showed me why I was a great candidate for a PKR - he also said that I probably hadn’t been offered a PKR initially because they are only successful if a surgeon specializes in them and does hundreds - he teaches the surgery and has performed thousands so I went with The the PKR. He did say that on surgery day he would also have a standard TKR implant ready just in case there was arthritis he couldn’t easily see until he was in the joint so although unlikely I could have the “surprise” of waking up to a TKR.
No surprise the rest of my joint and kneecap were in good shape so I can expect 10 to 15 years with this PKR. If I had been told 5 - for sure I would have gone with a TKR.
It’s definitely a journey though.

I also have any issues anywhere else with my knee other than damaged cartilage on the medial side of knee from a long ago injury. So happy to not have to get a TKR.

My surgeon is extremely experience in doing partials for 20 years so was not worried about that. The good news is with a PKR, if all goes well, one has a much better chance of returning to normal activity. I could walk for miles without any pain before surgery, my goal is to be able to run and jump again one day while playing rec sports. Fingers crossed.

 

[Ginger1210]

I asked the same question to my surgeon pre op. He replied the same when they opened me up they inspect all the knee for damage and will perform a full TKR if needed. I researched my surgeon as well and he does more PKR`s in the UK then any other surgeon. That being said I do wonder if my recovery would have been different with a TKR I do experience pain and swelling still but not under my kneecap. Its just below on the inside of my knee. My physio explained this was part of my patella tendon and it was very angry and inflamed. The only real cure is rest and try to regain quad strength to take the stress of from the tendon. I did have the same issue before my PKR because for 4 years I have not used my right leg properly and my muscles have gone south. The surgeon did say as well that if in a year of more if this was not successful then he would perform a full TKR . We shall see i will continue to try and regain my muscle strength and see where it takes me.

 

[beesknee]

What exercises are you doing to increase quad strength? I am doing leg extensions but they may aggravate your patella tendon. Maybe isometric type exercises ?

Since my doctor told me to focus on quad strength last Wednesday, my quad is already a bit stronger and more defined. Not sure if it related but my knee has been pretty good the last few days.

I cut way back on the stretching and bending for ROM as I am between 120 and 130. I only stretch to loosen up the knee and get some stiffness out. I now mostly focus on building back leg strength. I am doing very light weights and will increase weights and reps very slowly. It definitely is a balancing act to push, but not push to hard.

 

[Ginger1210]

Yes it certainly is a balancing act. I follow a program set by my physio who wants me to do it three times a day. I only do it once a day as I work full time and my knee suffers for this. The program has leg lifts with light weights and balancing on my operated leg plus stationary bike plus some light squats i can do them all with very little discomfort. Walking is still my biggest issue. My right quad is a lot less defined than my left and will take time to rebuild. I have done no formal exercise today, total rest. I worked over 50 hours last week and I think I deserve a day off.

 

[beesknee]

It's been a few more weeks. Just past month 4.

Knee still stiffens up and I need to stretch it out a few times a day. Still have swelling. Knee is still a bit sore, especially going up and down stairs. With stretch ROM maxes out at 130.

Improvement is so slow. Perhaps the most annoying issue is I can't sit with leg bent for more than 20 minutes without knee pain. This limits my driving and getting out and doing stuff. When I sit watching TV or at my desk I need to have my leg out straight. I am much better walking and standing than sitting. I am forcing myself to walk the dog about 1 mile a day and do some yard work. I definitely can do things I could not do 2 months ago. However, until I can sit with leg bent for an extended time all travel plans are on hold.

For the past 3 weeks I have been working on leg strength. I feel the only way to get back to normal is getting my quad muscles back in shape. I am now up to 5 sets 2 plates leg extensions (up from one plate). I am hoping to be at 4 plates in 4 more weeks. While building back muscle is helping, after exercising my knee needs to be iced to keep the swelling and soreness to a minimum.

That's about it. Pushing through and getting sick and tired of such slow progress.

 

[FCBayern]

That's about it. Pushing through and getting sick and tired of such slow progress.

Understandable @beesknee but considering this is a 12-18 month recovery you are actually doing well. Unfortunately this recovery really is a long hall.

 

[beesknee]

Well, another week, going on 4.5 months in a few days.


I am also starting back at the health club, to strength knee on multiple machines, plus gain some upper body muscle back. Yesterday, I got on the exercise bike and instead of my normal 5 careful minutes, I started reading my phone and looked up and was going on 12 minutes. My knee not bad from this (just a bit of a sharp pain afterward) but this morning both my legs were very stiff and sore. Boy are my legs out of shape. I am a LONG way from mountain biking again.

I can walk a few miles at a time and even did some wooded paths on uneven ground without a problem.

My main issue: I cannot sit with leg down or bent for more that 30 minutes. This screws up driving and social life. Watching TV, sitting at desk, etc. I need to prop my leg up so it is straight. Is this normal at this late stage? At this point, no way could I take a plane flight. Even with two good knees, the seat in front of me jams into my knees and I am very uncomfortable.

Is there anything I can do to increase the time I can sit with my leg bent? Is this a normal issue? I don’t read about many people complaining they can’t sit normally after 3- or 4-months past surgery.

 

[Jockette]

It was a long time before I could sit for any length of time with my leg bent, but I don’t remember how long. Well past 4-5 months. I can now.

 

[beesknee]

Will be 5 months next week. A lot of unfamiliar posters here now from when I joined. I guess after a few months, those that have good recoveries move on and the next batch of newbies in pain move in. I would post more except site is way too slow when I am logged in so I'll scan posts while logged out.

Still not close where I was pre- surgery. Big mistake having this done and would not recommend to anyone without bone on bone pain. My knee still is swollen all of the time as much as it was 2 months out. I have very little pain when walking around, sitting with leg propped up. Flexion is at 130 with a few loosen up stretches.

Working out going well for whole body except for knee. I have stopped leg extension exercises. Even at low weights I get a sharp pain in the patellar tendon below my knee cap the next day. Not sure why I would have pain there as it was not touched by medial PTK. Maybe the swelling has something to do with it?

If I could do my leg extensions and push a bit harder each week and build up quads recovery would go much better. Really need to build leg strength back somehow. I have switched to cardio machines. I do 10 minutes on recumbent bike and elliptical each day. I also walk a mile or two most days. Jogging across street to avoid a car is a distant dream.

The pain in the patellar tendon makes going down stairs a challenge. I need to take it slow holding onto both rails. Up stairs ok except for very weak leg and grinding sound feeling during each step.

Sitting with leg down and driving and sort of distance gets painful after 30 minute with leg bent. I bought a new Jeep wrangler in April and have hardly driven in over the past 5 months.

I used to be able to notice improvement every week. Now I notice improvement in being able to do something easier or without pain after each 2 or 3 weeks. Very slow imperceptible progress.

I was a very active, healthy young for my age 60 year old when I had this done. My wife says this operation aged me 15 years. Depressing

6 month visit with doc 12/28. I was hoping I could cancel because recovery was going great but I am pretty sure I will go.

 

[FCBayern]

@beesknee, you are 5 months into a 12-18 month recovery and expecting to be normal by now. That's just not realistic. My son commented to me AFTER about 18 months that I was moving better than he could remember. Patience is tough for all of us, and this recovery is tough, but the years of moving pain free afterwards are worth the journey.