TKR More front tightness after 18 months

[keith55]

I had my physio session today and she has discharged me. I'm doing all my housework and can get up of a chair etc. However, though I can do the basics, the knee is still swollen and stiff. This means my walking speed and distance tolerance is still far from what I want. The bend is really good now - virtually as good as the non operated knee so I can draw both my knees under my chin in bed. I still get tired and if I walk too fast or too far the knee complains inc pain on kneecap.

The heat has gone out of it (a bit warm but I'm not aware of it unless I put my hand on it) and it doesn't ache so much if I'm sat normally (foot on ground) for a while. I'm seeing my GP about this and something else tomorrow morning and I'll be asking about icing and elevating. I tend to think that this might be as good as it gets though I know I should really wait till next spring for full recovery.

 

[lookingforward]

Ok, I am 6 days post op LTK. And i have to say I feel great. I am very happy with where I am in my recovery. I am at -3 and 110. My Pain is very well controled and My home PT I do twice a day with a therepist coming twice a week to adjust my excerises. I will be monitored twice a week with a visiting nurse, so i plan that my pain meds will be managed well. My husband takes over all things that involve thinking and physical activity.I can say my hospital stay was excellent and my husband and i thank the staff as they only answered all our needs they had all the answers to all our questions and needs. I will post again in a few days with updates. Nanc

 

[keith55]

Hi lookingforward,
I hope you have read and used the info from this excellent website - there is a list of links in the reply to my OP on the first page: well worth reading and re-reading. Your bend and extension is great so early in recovery. Keep doing the P/T and the bend should get better. Don't overdo things - right now it's the basics of living plus P/T and not much else. You'll probably find any slopes outside quite challenging so be careful when you first start walking outside - you may well need two sticks even if you are using just one indoors.
Long term recovery takes longer and my surgeon and GP both say a year before I won't think about the knee. I'm 4 months out now.

 

[keith55]

I've just passed the 6 month mark. Bend is brilliant. There's still some swelling and stiffness which means my walking speed is still slower than I want and I'm still single-stepping up and down stairs. My main concern is the sudden sharp pains I get in the kneecap associated with heat. Would this be something to do with the button in the back of my kneecap?

 

[eaglesnest]

Hi keith55, I'm also 6 months out, and also have swelling and stiffness, my walking isn't too bad and stairs good going up but hard coming down.
Had a visit to the physio last week and he said I'm doing really well. Still having little niggles with regards to pain, but they come and go I had bilateral, so my knees are both different on each day, but I do feel as thou I'm getting there.
Take care

 

[keith55]

I'm 9 months out from single LTKR. The knee is looking more normal now. I wanted to ask about stairs. I'm going up step over step now but still feel the need for a banister rail to pull myself up. This does increase pain in the knee but only to be annoying. I have done one or two steps step-over-step down but I have a distinct feeling of lack of control as well as it feeling strange and stiff. What is the advised course of action for this?

 

[saltyal]

Well this might seem like a crazy idea, but the stairs were a challenge to me too until I started walking up them backwards! .... I just did a few at first, just went up 3 or 4 step over step, then back down step over step. It's good quad exercise and trains you to put the weight on your toes rather than going down flat-footed.... & restores confidence in your balance too! Pretty soon I made it a habit of doing all the stairs in our house (we have 3 levels) like that, 2 or 3 times a day. It really does look goofy so something you should only do in the privacy of your own home or the neighbours will be after you with a net! .....At 4 months post-op my quads are still improving and it's something I still do occasionally: makes my wife (and Dog!) look at me sideways so it's worth doing just for that

 

[keith55]

I'm just back from a 3 week holiday in Australia (I live in the UK). I had LTKR in May 2013 and it's enabled me to do things such as this that were impossible before. However, now I'm back I've noticed what seems like deterioration. The tightness at the lower front of the knee (which I had kinda got used to) has got worse and going down stairs is more awkward -> painful. I also noticed a weird clicking type pain in my front shin once or twice this week.

Is this deterioration in the TKR or something else? I was more active than usual in Australia doing a lot of walking etc. but I don't think I would notice the knee so much there as I had other (good) things filling my mind.

Btw I'd like to put on record how valuable this forum is to all TKRers. The medicos don't tell you how hot your knee will be during recovery - and how important ice is in that recovery. In fact I would say that ice and elevate is the one key thing in recovery - do that even if you do nothing else. That doesn't mean don't do the physio (you need to get that knee to bend) but I found the physio trivial compared to the need to keep the knee cool with ice. That was a 24/7 6 month job.

 

[skigirl]

You can always get your knee checked by your OS, but in my case the clicking and pain on going down stairs were from some swelling in my knee. I elevated and iced for a few days and the symptoms disappeared. I also noticed that my knee was a little swollen after a long airplane trip. So, there are things which might have caused some swelling---ice, elevation taking it easy for a week or so will probably help. I find that riding a bike seems to "work the sorness out" of my own knee. I ride a bike for about 20-30 minutes each day and it really does help.

Finally, I noticed that I had lost some of the rom that I had after PT. I asked my PT about it and he said that if you don't keep stretching and working the knee, it can loose rom. So, I have gone back to some of the early stretching exercises---like sit with your bum next to the wall and your leg up the wall. Bend the knee as far as possible, even using gentle pressure from the other foot. I have noticed that I have regained the lost rom after about six weeks of stretching.

 

[keith55]

Hi skigirl,

Yes thanks for what seems like good advice. The soreness pain is where the swelling is (though not the lower shin pain). It was a long plane journey though I had an aisle seat and walked around a lot. I'm one of those people who don't sleep on planes though I do snooze a bit. I also got out of the way of doing physio during the holiday as I was busy doing holiday things. My next check up with OS is May 2015. ROM is fine.

 

[skigirl]

I have called and asked my doc for a refurral to PT---he always does and the PT is able to see what I need to do to bring the knee back into line.

 

[Josephine]

I also got out of the way of doing physio during the holiday as I was busy doing holiday things.

And so you should after 18 months! Your normal activities of daily living should be more than sufficient.


You might also tell me the exact site of your pain using this chart ....
Please note the instructions in the smaller image

 

[keith55]

Hi Josephine,

Sorry I missed your post. The front tightness isn't so bad now but the knee gets warm sometimes and on the outside of the knee (DRF1) I can feel something loose like the bone spurs I had before the OP. I put my fingers on the outside of my knee, bend it and can feel something clicking under my fingers as if there is something loose there. I've got a GP appointment this week and was going to ask to see an Orthopaedic Surgeon - preferably the one who did the OP. I did get up awkwardly from kneeling down for communion on Sunday and afterwards wondered if I had done anything.

 

[Josephine]

I doubt kneeling or getting up from kneeling would cause such a problem. But if you want to make sure you see your surgeon which isn't a given as follow-ups are usually seen by the registrars - I suggest you phone his secretary ASAP and ask her to make sure you see the consultant. She can have a word with him for you and arrange it.

Bone spurs are loose and generally, the surgeon would trim them as part of the procedure so it's unlikely they are still there. Any clicking or other strange noises or sensations are generally due to one of two things 1. air bubbles in the tissues or 2. movement of the implants against one another. However, given the time since you had this surgery, I would also rate both those as unlikely!