TKR Medial pain

[Jebsw]

I'm four and a half months post-op and doing okay except for medial pain at the knee. I hope I got the term right -- the inside side. At about two months, I think, it suddenly flared up there when I moved my knee sideways. Now, most of the pain is from that one spot. It's bearable but not pleasant. I'm told it's where there was a lot of hammering and such during the surgery, and is a common site of pain. Is that true? Will it eventually ease off?
Thank you.

 

[maryo52]

I developed a similar problem that turned out to be pes anserine bursitis. I had been biking and backed off plus took NSAIDs and it slowly went away. But then recently I was told I have an unstable TKR and that pes anserine bursitis is common with unstable knee. Here's a great bursa diagram of the knee. There are certainly a lot of odd aches and other sensations when recovering from TKR .

 

[kneesrus]

Hi Jebsw, first a quick description of the pes anserine. This is an attachment of 2 of the hamstring tendons and muscle that helps rotate the hip outwards. This area can be strained as the strength in leg is beginning to return. The other issue that Mary addressed was stability. Sometimes, the ligment on the inside or medial aspect of the knee can be stretched or even damaged. I recently have had a patient that the OS had to do some repair to that ligament during the TKR surgery. She is wearing a hinged brace for 6 weeks and we are not doing any side to side activities or pivoting.
I would hope you just have strained some soft tissue and it should recover. I would suggest to advise the OS on the event to keep everyone in the loop.

 

[Jebsw]

Thank you both. I see the doctor in a few weeks and will mention this then, and to the PT when I'm there in a couple of days. It was when I moved the knee sideways that it started, quite suddenly and painfully. What exactly does having an unstable TKR mean?

 

[Larosser]

Hi, Jebsw!

I had BTKR in January, and I've had some medial pain on the right side only. This is also the leg that tends to toe out when I walk and point outward to about 2 o'clock when I relax on my back. My PT suggested some exercises for the adductors, and they seem to help. As I've gotten to feeling better, I've added some of my own - McQ and I will do "trap and pass" exercises with a soccer ball for example, which give the adductors as well the MCL a workout. I wouldn't try this one unless you're feeling pretty good, just thought it might be worth considering working the adductors a bit.

Best
La

 

[kneesrus]

Ligaments hold bones to bones. In the knee joint, there are ligaments on the outside and inside borders. They help to keep the knee joint from bending inward or outward. There are also two ligaments that are located in the middle of the joint. They keep the joint from slipping forward (ACL) or backward (PCL).
There are degress of stability. If there is unusual movement in one of these directions, it is graded. The grade is 1,2 or 3 laxity. There are several other structures that do assist in keeping the knee stable. Muscle strength does contribute in keeping the movement of the knee on plane.
Hope this helps, it is complicated and many times the term is not used correctly.
Best of luck,
David

 

[Jebsw]

Thank you, David. I think I get it, though I'm not sure... I'll have to reread a few more times. I asked my PT about the pas anserine, and she felt the pain was in the wrong spot, explained quite thoroughly. Thanks for the thoughts!

 

[RunA42K]

HI Jebsw, I too had medial pain and still do from time to time at 15 months. I was diagnosed with pes anserine tendonitis at about 12 weeks post op. I was at the point where I didn't need my strong pain medication any more, but had to start taking it again with the pes anserine. It came back several times, at 6 months my OS gave me an injection for it which did not help. What did help was patches with dexamathsone applied with (I am going to spell it wrong) Ionsophrises, which my PT took care of each visit. Now when it flares up use Voltaren Gel which is an RX for inflammation.

 

[RestAssured]

Hi Jebsw!

I wrote a nice post but the darned internet kicked me off. Let me see if I can recreate it.
I was in an immobilizer brace for the first 6 weeks, and yesterday was the first day of PT with it off. My therapist "Killer" Katie as I have affectionately named her, said swing your legs up on the table. Well, I didn't think anything about it, and the left one swung with ease, and the right one started to swing when all of the sudden the kneecap and tendons and muscles on the outside of the leg tightened and the inside was like jello. It wasn't a pretty site. Morning Glory gave me inspiration for a great name for my knees, because my therapist calls me trouble, so I have trouble 1, which is an angel now and then there's trouble 2! It has decided to give me a run for my money! We did a lot of abduction exercises yesterday and I walked on the anti-gravity treadmill for 15 minutes focusing on keeping the foot straight! That is quite a feat (pun intended) when the foot wants to do its own thing!

I can relate to what you are going through. If you need any help, or just some comic relief, I am usually around!

 

[Jebsw]

Hi,
I can always use comic relief! What's an anti-gravity treadmill?
Having a very bad knee day today. I think I'm paying for overdoing the last few days. I get that my 'old' knee that's going to be done in August is bad, but I am surprised and kind of disappointed that the 'new' knee is misbehaving: a lot of pain, swelling, even some warmth on the scar. Took some pain killers and slept most of the afternoon. On the bright side, it's general pain, not just on the medial side! (And my wrist, which had surgery 11 months ago, is sore too.). I guess I thought days like this were behind me because things have been so good lately...which is why I overdid things! Oh well, five steps forward, one step backward. (pun also intended)