PKR Long Story of my Battle with a Bad Knee

[Ghostpipe]

I recognise all that you have written. I also had mine done before they seriously disabled me, as an investment for the future when (one hopes) post covid freedom is restored, and both done at once as I really don’t want to sacrifice any more of my active years. And many’s the time I’ve regretted it too.
5 months is a tricky time mentally. You can see the light, but don’t seem to be getting there, doing more but feeling old and weak. Don’t despair. As everyone says, it does get better. My strength started flooding back from around six months as I started moving around more naturally..
At 8 months now, walking downstairs properly is default mode, sometimes a bit sore, but still default mode. I can run back up them, jog (rather clumsily) across the road if need be. Still swell if I am on my feet without walking around, but did four hours the other day.
But…weighted leg extensions still cause problems!
I won’t waffle on any more as I will do an 8 month update on my thread. Just try to be patient, it is what it is, and there’s no going back, that’s what I have to keep reminding my frustrated self.

 

[Carol Anna]

Thank you for your post it helps to know that it really will get better but not to hope for perfection. The most helpful comment was 'it is what it is' and 'there's no going back' which is so true so I need to just get on with it and look to a time when I can almost put this behind me. Its no good thinking I wish I had never had it done because I have and need to accept that and move on.

 

[Ginger1210]

Hi beeksnee I feel your frustration I am 7 months post op now and I am slowly getting stronger but it is tough for the first time this week I worked and for two days I did not think about my knee this was a great improvement for me. I too suffer from a inflamed patella tendon but again it is slowly getting better. The mental side if this operation is a real test and I have sought help for this as well. At first my Wife also struggled with understanding my recovery but now she is my angel and without her help and support I would be a lot further behind.

 

[beesknee]

** Wow, this site is finally working normally when I am logged in. So much nicer. Thanks!


It has been a few weeks since my last update.

I figured I would get this in because over the past few weeks I have had very good improvement.

Not sure why things got better but I'll take it. A few days after last update I did my final leaf blowing. We live on a few acres with lots of trees and surrounded by woods. So in the fall we have unbelievable amounts of leaves. So I was outside for several hours two days in a row with my commercial backpack leaf blower and large Billy Goat push leaf blower.

After this legs were tired but not terrible. Then over the past week I have been on my elliptical every day. Yesterday I was on it and reading and lost track of time. Checked the time and I was at 22 minutes. Today no ill effects. Just a month or so ago, I could only do 5 minutes or less and would need to elevate and ice afterwards. Progress!

Also, last Sunday, I mostly sat around with my son who was in from out of town for the week and watched football. It turned out to be the first day since day 1 that I did not ice at all. Huge milestone. I still normally ice my knee for and hour or so while watching TV at night as a preventative measure.

I sat at Thanksgiving dinner table for over an hour without an aching knee.

I can take my dog on his normal 1.5 mile walk without having to ice afterward.

Now the bad.

I still can't go down stairs normally unless I hold handrails and take about 30% of my weight off my knee. Going up stairs is much better but still a struggle and I often grab the rails to pull up and make it easier. I can take one stair down without hanging on but if I had to go down 4 or 5 stairs without a rail I I would need to go 1 step at a time, good leg first.

Also, driving my jeep wrangler more than 30 minutes is a struggle. The seats do not go back very far so my knee when on gas or break is at 90 degrees. I am researching aftermarket add ons that will let me move seat back further. There are some options out there, apparently other tall people have the same problem, just not to the extent I have because of a bad knee.

I still have swelling- maybe a little less than normal.

Other than time the only thing that changed over the past 2 weeks is I added the supplement Magnesium Bisglycinate to my morning supplement stack on Nov. 19. I did not add this supplement because of my knee, I was reading how many people don't get enough magnesium in their diet so I decided to add it.

Probably a coincidence that I had a burst of improvement after taking it, but will keep it in my supplement stack for now.

Going to the club to work out now.

 

[hawk2go]

Great news @beesknee! Slow progress is still progress - 5 months down, 7 to go.

 

[beesknee]

I wonder if I'll ever be able to walk down steps without hanging on. Doesn't seem to be getting easier even and general pain and swelling go down in knee.

Doing leg extensions aggravate my patella tendon as soon as I push in the slightest. So I am doing elliptical and stationary bike to try and strengthen quads without too much pressure on patella tendon.

 

[Scaredycat10]

I wonder if I'll ever be able to walk down steps without hanging on. Doesn't seem to be getting easier even and general pain and swelling go down in knee.

Doing leg extensions aggravate my patella tendon as soon as I push in the slightest. So I am doing elliptical and stationary bike to try and strengthen quads without too much pressure on patella tendon.

Interesting.
I was a great advocator of leg extensions and I credit the prehab for my great [so far] rehab progress but, although I carry on with my right leg on the machine, my physio has said wait 'til at least 3 mths out before trying it out on the operated leg.
I might make it four months reading of your experiences.
I am using light weights on the seated leg press and that's helping, as well as cycling. Quads are SO important in having a stable joint.

 

[Ginger1210]

Great update beesknee I too have seen improvements almost at 8 months now. Doing more physio after work and returned to the pool I can mange 50 lengths font crawl now. I still have pain and stiffness but slowly getting better. I see my surgeon this Thursday and will see what he thinks. My main concern is i still have pain around my kneecap i hope they will give me a x-ray just to make sure everything is ok.

 

[beesknee]

Friday I had some friends over. We stood around and drank, played pool, and talked for 5 or 6 hours. They live about 50 miles away so they spend the night.

The next day, we went to a local park and walked around a few miles and took my dog swimming.

I paid for trying to be normal for a day with a swollen painful knee the rest of the weekend. By Monday I was back on track feeling about where I was prior.

I am wondering if pushing myself a little harder like I did with ADLs on occasion is good in the long run? It does give my leg some extra exercise.

Saturday and Sunday my mood was not good. Just depressed about "the knee" feeling worse than it has in a few months and it holding me back from living life.

Then my wife said we should go to Atlanta December 30 to watch MSU in the Peach Bowl. We used to live there and have friends we could stay at and hang out with. I gave a hard no, pre surgery I would have be all in. I could see me gutting it out during the game then be suffering the next few days and not feeling up to hanging around with our friends the next day and wanting to elevate and ice.

Edit:

I just took the dog for an icey walk for 1.5 miles around the neighborhood and now going to do the elliptical for my 20 minutes a day session. As long as I don't sit too long with leg bent, stand for several hours, go down stairs without hanging on, or do leg extensions with any kind of weight I am doing a little better all the time.

Not being able to do leg extensions is really slowing down the strengthening of my quad muscle.

 

[beesknee]

10 more days.

I would say at this point the PKR part of my knee is well on the way to being healed. Just a general soreness and weakness from so much laying around.

I can do my stretches each day without the need to ice after. Swelling still there, but knee not like a grapefruit size anymore. I ice at the end of each day while reading or watching TV at night.

I can walk and and stand around without an issue. My knee only gets tired and a little more sore if I over do it. I feel it is important to exercise my legs as much as possible. The time for resting them is over.

My main issue is patellar tendonitis. Going downstairs is a big problem. Never had issues with stairs pre-surgery. I would take it slow but no pain. Now stairs are a challenge. The worst thing is I can't exercise my knee like I should to gain full recovery. All knee exercises have to be done carefully to prevent aggravation of the patellar tendon.

I blame my doctor for this as he suggested I do weighted leg extensions to strengthen my quads on my all in one home gym. I started with 1 plate 5 sets a day for a week, then 2 plates, then when that seemed easy I did 3 plates and during the 3rd set of 10 sharp pain in patellar tendon. Since then I have been doing exercises to fix the tendon that the knee can also handle. On a good day if it is not bothering me, not thinking I'll do one step down down into our living room and bang, tendon hurts for the rest of the day.

I have started doing many of these exercises on youtube that strengthen quads and glutes without overloading the tendon.

I had tennis elbow real bad about 5 years ago. What cured it was stopping tennis for a year and doing specific tennis elbow exercises and stretches every day. Hopefully eventually my knee will have the same result.

 

[hawk2go]

I'm glad you found the combination of exercises to keep you in the right mindset. There's always so much to think about.

With my LTKR, I found that overdoing it was possible well into the 1st year and I thought I'd have to ice the knee FOREVER! I did not. Not quite 6 months out from your PKR, you may have to accept 75% of normal to keep feeling good (patella tendon notwithstanding).

 

[partialfixFeb]

I blame my doctor for this as he suggested I do weighted leg extensions to strengthen my quads on my all in one home gym.

FWIW, last week I asked my yoga instructor (who has been dealing with bone-on-bone pain for years) about the best exercises to strengthen my quads to gain strength to protect my knees. We discussed leg extensions but she cautioned that they can really stress the knee and that she only does micro extensions on the leg extension machine with very light weight -- she said she only bends her knee a couple of inches and then fully extends her knee. And, she does only one leg at a time. She told me not to do the full range of motion on the machine which never occurred to me but I have not returned to any weight machines yet so I am no expert. For now, I am just doing mini extensions with ankle weights. At your stage, my PT would never suggest weights...she took a very gradual approach and it worked for me. But my PT agrees that quad strength is crucial to protecting the knees but cautioned that the surgery trauma is real and that it takes time to heal the tissues, etc.

As for descending stairs, that was the very last obstacle for me to overcome and I was way further in my recovery than you are when I finally noticed that I could descend normally. Honestly, I thought that walking downstairs like a toddler would just be my new normal.

Also, FWIW, I elevated and iced far longer than I care to admit. As long as there was swelling I figured that whenever I sat down, I might as well ice and elevate. But everyone is different, just my 2 cents. It is a long, gradual recovery for sure and I hope you continue to improve.

 

[beesknee]

I had my 6 month check up December 28. Doctor said all looks good and said I am just a slow steady healer. He did a very quick ROM measurement. Not pushing at all I was at 125. This is after an hour + drive to his office so my knee was a bit stiff from the drive.

They took x-rays again and the implant looks good. One thing I noticed was the x-ray of my right knee bones were slightly lighter than my good left knee. My doctor said that is bone density loss from lack of exercise and movement in that leg. He said it is normal and as my leg gains strength through exercise I will gain the bone density back.

My Patellar tendinitis calmed down and I do 4 or 5 leg exercises to build strength. I looked on youtube for quad exercises that don't strain the tendon and found some real good ones. My last post I put a link here to some for others to reference but it was deleted by an admin, so I suggest if interested search youtube for patellar tendonitis exercises.

I started leg extensions again but do micro extensions at a low safe weight (as Partial mentions above).

I am also up to 30 minutes on the Elliptical and Recumbent bike on alternating days. I could do longer but don't want to risk over doing it. 2 months ago, I was at 5 to 10 minutes so progress.

I definitely am getting good muscle back to my my leg. If feels pretty strong. I need to be careful to not push it too hard with weights because while the muscles are strong, the knee is the weak link in the chain.

Stairs getting slightly better but still need the rails to push and pull myself up. My doctor says down steps puts a lot of weight on the knee and will be the last thing that comes along.

I can knee on carpeting without that very strange feeling in the knee which help me do home projects.

One thing I have noticed is while don't normal things around the house I forget about the knee and I'll take a awkward step (normal step for a good knee) and will get a sharp pain. Healing is still going on.

I am hoping by summer I will be able to go up and down steps without hanging on. Simple goals.

 

[craig1705]

Hi beesknee et al.

Your story is very similar to mine.

I have a history of knee problems dating back to the 80’s, post a nasty football ️ injury to my left knee and I’m now bone on bone lateral side. This didn’t really prevent me continuing to play football into my 40’s, play tennis, golf and snowboard 2/3 times a season.
However the turning point was an injury to my right knee 5 years ago, playing tennis, when I stood on a ball on court. Obvious meniscus damage, but I still went snowboarding 2 months later (big mistake, that was my last to date). I’ve had 2 clean ups & stem cell treatment, hampered recovery due to bursitis.
I have continued to play golf, but at 15/16 that begins to hurt and can’t imagine playing 36 in a day anymore.
So I spoke with a well known local UK surgeon and stressed that I was desperate to return to a tennis court and dreamt of hitting kickers again! To be fair he highlighted that because I was active sporting wise, any surgery would likely need redoing in 10-15 years…..I explained I was more interested in what can be achieved now than when I hit my late 60’s.
So I’ve bitten the bullet and gone for a right knee partial, I can still handle the left lateral pain, but the right medial was hampering any thought of tennis, snowboarding or long walks with dog, wife and children.
Anyway I’m almost 5 weeks in and I’ve been concentrating fully on flexibility with zero PT to date. I’d guess I’m at circa 120 ROM, moderate swelling, no meds. I have zero pain on the area of the PKR medial side, but am experiencing pain in the lateral side when walking up or down stairs. Which worries me hugely (say it’s bone on bone lateral) although my surgeon did emphasise that he checked the whole knee before surgery to make a decision TKR or PKR.
I am seeing my physio again next week and my surgeon on the 18th Jan & will explain this to them both. I am heading back to the gym tomorrow BUT no strengthening, it will be purely flexibility and walking in the pool.
I suppose what this ramble is trying to say is that perhaps we should listen to our bodies, take advice from those that know best, don’t expect too much but certainly don’t try too little. I am determined to build slowly to a return to the golf course and gym in spring, tennis court in summer and snowboarding next year . But I can just about live with the fact that the last one is a big audacious goal.
Anyway good luck, stay strong and listen.

 

[Ghostpipe]

It took me 8.5 months (bilateral TKR are always a bit behind) to do full arc extensions with the lightest weight, at 10 months going up 5kg is still sore. Doing weighted leg exercises with new knees sure indicates which put a lot of strain on the joint. As I want my knees to outlive me, I have decided never to go heavy on some of them, so I just hold the extension until my quads are screaming, same with some of the others. Been back to full weight and reps on the ones that don’t hurt for a few months now.
I came across a picture of a spacer that had been badly damaged, hence removed, by doing heavy weights, that was enough to stop me!

 

[beesknee]

I suppose what this ramble is trying to say is that perhaps we should listen to our bodies, take advice from those that know best, don’t expect too much but certainly don’t try too little. I am determined to build slowly to a return to the golf course and gym in spring, tennis court in summer and snowboarding next year . But I can just about live with the fact that the last one is a big audacious goal.
Anyway good luck, stay strong and listen.

My original goal was pickleball at 4 months and tennis this spring at 10 months. Now my only goal is going up and down stairs without using the railings.

If and when I can do stairs hands free I'll start thinking about playing sports. But now just not being handicapped is the goal.

In reading here over the last 6 months it seems those that go in with strong knees heal the fastest. I feel I should have spent a few months of rehab to strengthen my knee before surgery. Because after surgery, once my ROM came back and knee pain subsided my leg was like a noodle.

It took me 8.5 months (bilateral TKR are always a bit behind) to do full arc extensions with the lightest weight, at 10 months going up 5kg is still sore. Doing weighted leg exercises with new knees sure indicates which put a lot of strain on the joint. As I want my knees to outlive me, I have decided never to go heavy on some of them, so I just hold the extension until my quads are screaming, same with some of the others. Been back to full weight and reps on the ones that don’t hurt for a few months now.
I came across a picture of a spacer that had been badly damaged, hence removed, by doing heavy weights, that was enough to stop me!

Yeah, I will never use huge weights doing leg exercises. My goal is leg strengthening. For example, when able instead of doing 2 sets of leg extensions at 150 lbs, I would do 5 sets at 50 lbs.

My patellar tendon was bugging my after my leg workout on Saturday. So I am removing micro leg extensions completely from leg exercise routine for now. I am sticking to controlled bodyweight isometric exercises that don't flex or limit the flex of the tendon under weight.

If anyone has exercise suggestions I am all ears.

 

[partialfixFeb]

If anyone has exercise suggestions I am all ears.

I will be seeing my PT for a pre-hab appointment in a couple of weeks or so and will let you know what she says as it is applicable to me as well as I'm fairly certain I've forgotten some of the exercises I will need to do pre-op and then post-op.

I get your frustration about the pace of recovery. I was okay with being patient (well, mostly) but that what was bothersome to me was that persistent nagging feeling that maybe something didn't go perfectly during surgery and would permanently inhibit me reaching any reasonable athletic goals. I suspect you have some of that same anxiety that I had and it is frustrating because you don't know for certain until time passes and you do or don't achieve those goals. I am hoping things work out well for you of course.

 

[Sara61]

In reading here over the last 6 months it seems those that go in with strong knees heal the fastest. I feel I should have spent a few months of rehab to strengthen my knee before surgery

I worked quite hard at strengthening my right knee prior to my surgery in December, thinking that my recovery would be easier, in my case not so, as more work was needed on this knee as it had been the weight bearing knee for the last couple years, after the surgery my knee/pain/healing is exactly the same as my previous replacement in 2019 which I hadn't done any pre-surgery exercises or strengthening at all.
Patience and time is what helps our knees to recover.

 

[beesknee]

7 month update. After my doctor appointment on Dec 27, about a week later my knee started to really bug me. I did not do anything out of the ordinary, just my normal leg strengthening exercises. This went on for 2 weeks so I set an appointment with the UM sports PT department to get me on some kind of program that would allow me to strengthen knee without hurting it. I don't like going backward.

Pretty much everything I have been doing was suggested. A few stretchy band exercises (crab walk, forward walk with band at knees), specific quad stretching exercises, and glute exercises were added. I cut back on elliptical and recumbent bike from 30 minutes to 10 to 15 minutes stopping as soon as I feel discomfort. I may have been overdoing it.

Going back for 2 week checkup at PT next week so they can check progress. I can do all exercises on my own at home or at the health club.

Patellar tendon pain is better but I still need to hold on to the rails to take a step slowly down each step. Up steps mostly grinding with occasional sharp pain. Very afraid to take an unassisted step down a stair because from past experience a careless step has resulted in patellar pain for 2+ weeks.

My leg is much stronger with muscle definition, the knee is the weak point, always stiff, swollen and sore. I still have a knot of scar tissue where they replaced meniscus.

I feel this knot may be giving me some of my trouble. PT guy said knee cap is tracking slightly away from the scar tissue knot and exercises will hopefully get it tracking properly.

ROM is almost all the way back. I thought when I got my rom back it would be smooth sailing.

Wish I had better news but looking at my past updates it seems progress stopped a few months ago. Next doctor visit would be after one year, July 1, but if I still have issue in a few months I will see him sooner. So tired of being 10 times worse than before surgery.

 

[Ginger1210]

Hi Beesknee sorry to hear you are still having difficulty with your PKR. It seems we share a very similar recovery. I still get quite a lot of pain and stiffness in and around my knee cap area. I am still taking pain medication in order to work. Originally this was my goal to come of medication but at this moment it is a long way away. My last visit to my surgeon (December 2021) They suggested if i was still struggling when a hit the one year mark further investigation will be needed they were concerned i was not progressing well and mentioned my implant may just be settling into the bone. All we can do is keep plodding along and see where this road leads to. I know this does not help you in recovery but you certainly are not alone in the struggle.