Bilateral THR Mar2016 - Right Knee Objecting Now<

[Irish Joe]

This is Nit-picking a little but My Signature reads
Bilateral TKR March 3, 2016
It should Read
Bilateral THR March 3,2016
My Mistake but I cant change it for some reason.

 

[Irish Joe]

If anyone is taking a look at my thread could I respectfully ask them to have a look at my post previous to the last posting above.

Thanks. Joe.

 

[sharonslp]

I'll report it for you, Joe. A mod will fix it soon.

 

[bottomshollow]

@Irish Joe, you now have a corrected

 

[Irish Joe]

Hi Guys.
I
posted this yesterday on page 2 put I've jumped onto page 3 at this stage so I'm going to post a shorter version now.
My OS ( also my hips surgeon ) examined my MRI report yesterday and he said it shows " significant osteochondral disease in the lateral patellar facet consistent with degenerative change " basically I have arthritis at the back or underside of my kneecap. The rest of the knee is entirely normal he says. He told me he has it himself for the last couple of years.
He gave me an injection of cortisone and a little local (anaesthetic
I presume) into the knee cap.
He said we'll check it out again when I'm in for my 1 yr hips check in march.
He made no mention of Surgery except possibly " tidying up the back of the kneecap " at some point.
Maybe this should be on the knee forum.
Does anyone have or had this and where did it lead to.
Thanks in advance.

 

[Krista]

I googled it, and there is info online. Hope you get some relief from the cortisone, although that is usually temporary, as I understand it, and has to be repeated. Good luck with this condition, @Irish Joe.

 

[Red's Mom]

Just an interesting comment from my 3 week follow-up with my OS. He advised me to look at all of my shoes and discard any that had signs of wear, "before your hips or your back start hurting". Maybe new shoes are in order?

 

[Josephine]

significant osteochondral disease in the lateral patellar facet consistent with degenerative change

"Degenerative change" is just another way of saying osteo-arthritis!

Knee felt "different" straight away but I think the cortisone takes a few days to settle perhaps @Josephine would know.

Well, I've had cortisone injections in various places numerous times over the years and generally find the effect is almost immediate. Of course the presence of the lidocaine does help with that but overall, I find them very helpful. So far I've had them in both shoulders (every 3 months for about 12 years) and trochanteric bursae twice on both sides (last time was last week!).

 

[djklaugh]

@Irish Joe YES either new shoes or have old ones resoled!! Old worn down soles will keep you walking in the gait pattern you had before surgery - and you don't want to be replicating that limping non-normal gait!

 

[Irish Joe]

Hi There.
Thanks guys for fixing the signature.

If the injections are as beneficial to me as they are to you @Josephine then I'll be happy enough for some time to come. OS said it could take 4 to 5 days to settle in. I'm going to lose a bit of weight also (I'm 6ft and 15½ stones ).

Hopefully @Krista I'll get a good stretch out of the cortisone and I hope your glutes are coming along.

I have more shoes than Imelda Marcos all in various stages of wear so @Red's Mom and @djklaugh it's off to the shops after the turkey for 3 new pairs of shoes and chuck the old ones out.

I wish everyone on BoneSmart a very Happy Christmas .
Joe.

 

[Jaycey]

Hi Joe, fingers crossed your injection works even if it's only temporary. I have had 3 injections for spinal issues. One worked for months the other 2 didn't. But do give it time. They can take awhile to settle.

 

[Irish Joe]

Ta @Jaycey.
Fingers crossed for sure.
Now where did I put that brandy butter.
Happy Turkey.

 

[Cas]

:merry christmas:merry Christmas to you

 

[Irish Joe]

Hello Bonesmart People.
I would just like to wish you all a happy, contented and healthy 2017.
This is an excellent asset for all of us on our journey and I'd like to thank you all.
Sláinte (cheers) and Happy New Year.
Joe......

 

[Irish Joe]

Good afternoon Guys.
I have a question. Maybe I should post this in the knee section of Bonesmart but I'd rather not have 2 threads going together. My hips are great but as some of you know I had a cortisone injection for OA in my kneecap on Dec 23rd. I feel that the improvement if any is minimal. Perhaps someone could pass this on to some of the knee people. The arthritis is at the back of the kneecap only and the rest of the knee is fine according to my MRI.
Firstly would I be correct in saying that whatever effect the cortisone would have should be felt by now ?
Would the next step be to have the back of the kneecap "cleaned up" to quote my OS ?
I'm not averse to a PKR or TKR ( partial or total knee replacement) but I'd like to try all other avenues first.
I'd appreciate very much if I could pick the brain of someone who has or had this Patellofemoral Arthritis so that I can get a handle on where I'm going with it. I'm early 50s and enjoy being active and do not relish this limited mobility which I thought would be sorted by now.
I'm exercising my legs with very light resistance and making sure all my leg muscles and tendons are stretched and supple.
People ask me " how are the hips?" I say "fine", then they say " why are you limping then?" Grrrrr.
Thanks in advance guys and best wishes on your journeys.
Joe.......

 

[Jaycey]

So sorry you are suffering with that knee. Must be mega frustrating as you can't really see the benefit of your THR if there is other stuff going on!

Firstly would I be correct in saying that whatever effect the cortisone would have should be felt by now ?

I would think so but when I had my spinal injections they said it could take up to 10 days.

I'm going to tag @Josephine about the next steps. Lucky for me, I have no experience with knees (yet).

 

[Irish Joe]

Thanks @Jaycey.
Your absolutely right about the frustration. I have as good as full Range of Movement in both hips I can Cycle, Squat, sit yoga style(almost) and get up from the ground without help. But I can't walk properly yet.
Hopefully 2017 sees me sorted.
Thanks.
Joe.......

 

[Josephine]

Maybe I should post this in the knee section of Bonesmart

That's okay - we prefer you to post wherever is appropriate for the surgery you've had.

Firstly would I be correct in saying that whatever effect the cortisone would have should be felt by now ?

After 9 days? I would say so.

I'm exercising my legs with very light resistance

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Irish Joe]

Hello @Josephine. Here are the answers. Please bear in mind that I had BTHR last March 2016 and its my (R) Knee that's concerning me know. I may answer some of your questions separately for Hips and then for Right Knee.
Here Goes. I hope its a little clearer than mud.
1/ Direct Posterior Approach Bi-lateral Hip replacement.

2/ Hips Pain 0 to 1
Knee Pain 3 to 5 and Zero at rest.

3/ Hips Nothing prescribed now. Don't need any pain medication for Hips.
Knee. No prescribed medication but taking 1000mg Paracetamol x4 times daily. Occasionally ibuprofen 400mg x2 times daily OR diclofenac 75mg x2 times daily. I don't like taking the Ibuprofen or Diclofenac for too long though I've never had any adverse effect from them. Knee seems to be always stiff no matter what I take.
( There's an OTC med here called "Solpadine". Its 500mg Paracetamol+8mg Codeine. Your Opinion Please ).

4/ Hips. No need to ice now.
Knee. Once daily for 30/40 mins. Usually after work. I "forget" some days.

5/ Hips. Again no need.
Knee. Not really. If I'm sitting down I'll rest it on the foot rest or on the coffee table and at night I put a large pillow under the right knee/leg.

6/ I'm back at work ( shop and café owner ) though I stayed off for longer than I had planned in order for the hips to recover properly. I spend quite a bit of my time on my feet though I sit now at every opportunity. My knee began to concern me more as I increased my workload. Standing, walking and light to moderate manual activities would describe my day.

7/ This one is difficult to answer.
At home I mainly do Gentle Yoga Stretches within my range. Don't know the yoga terms but Cat and Camel, Cobra, Child Pose, Glute, Thigh, Hamstring and Calf stretches. I'm also a recreational cyclist though not in the winter. If I'm tired I do nothing except maybe a little walk up the road.

NO PT. Though I go to the Gym. I'm done with impact exercise but oh I loved it so.
If I'm tired then a Gentle Swim followed by Jacuzzi and Home in 1hr. If I'm not then. Abduction, Adduction, Leg Extension, Leg Curl and Seated Leg Press 1x10 Reps of each all on machines with low resistance then a short swim and Jacuzzi and home in 1½hr or so. I've learned long ago that less is best.

Hope there's enough info here. If not I'll be more than happy to provide additional information.

Thanks Josephine.
Joe...........

 

[Josephine]

Thank you - your answers are very clear.

Hips Pain 0 to 1
Knee Pain 3 to 5 and Zero at rest.

Okay, I understand

Knee. No prescribed medication but taking 1000mg Paracetamol x4 times daily. Occasionally ibuprofen 400mg x2 times daily OR diclofenac 75mg x2 times daily. I don't like taking the Ibuprofen or Diclofenac for too long though I've never had any adverse effect from them. Knee seems to be always stiff no matter what I take.
(There's an OTC med here called "Solpadine". Its 500mg Paracetamol+8mg Codeine. Your Opinion Please).

I'm familiar with solpadeine. It's a trade name for co-dodamol. You could save a lot of money by buying generic co-codamol. It's is fine but the dose of codeine is quite small. I suppose my first question would be that if you are taking two of these 4 times a day instead of the paracetamol then does it help any? If not, then you'd be better asking your GP for some codeine which will be 30mgs per tablet. These you could take with your usual paracetamol.

Hips. No need to ice now.
Knee. Once daily for 30/40 mins. Usually after work. I "forget" some days.

Even in this situation you accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and more than 4 times a day.

Hips. Again no need.
Knee. Not really. If I'm sitting down I'll rest it on the foot rest or on the coffee table and at night I put a large pillow under the right knee/leg.

Okay. But putting your heel on the coffee table surely requires your knee to be dead straight, does it not? That's not good for a knee in pain. You need to elevate something like this.

I'm back at work (shop and café owner) though I stayed off for longer than I had planned in order for the hips to recover properly. I spend quite a bit of my time on my feet though I sit now at every opportunity. My knee began to concern me more as I increased my workload. Standing, walking and light to moderate manual activities would describe my day.

Come now! I know the catering trade and it's not easy work!

This one is difficult to answer.
At home I mainly do Gentle Yoga Stretches within my range. Don't know the yoga terms but Cat and Camel, Cobra, Child Pose, Glute, Thigh, Hamstring and Calf stretches. I'm also a recreational cyclist though not in the winter. If I'm tired I do nothing except maybe a little walk up the road.
Though I go to the Gym. I'm done with impact exercise but oh I loved it so.
If I'm tired then a Gentle Swim followed by Jacuzzi and Home in 1hr.

Gotcha

Abduction, 1x10 Reps
Adduction, 1x10 Reps
Leg Extension, 1x10 Reps
Leg Curl 1x10 Reps
Seated Leg Press 1x10 Reps

I seem to remember you saying this in an earlier post "MRI report shows " significant osteochondral disease in the lateral patellar facet consistent with degenerative change " basically I have arthritis". Then all the painful symptoms you have are being exacerbated by these exercises. I suggest you stop them for a few weeks - like 2 or 3 - and see if it improves.