Revision TKR Multiple Knee Replacements
- Thread starter Momma-me
- Start date
Honduras
Josephine
NURSE DIRECTOR EMERITA
An interesting observation. The truth of it is that our surgeons have no responsibility for our aftercare once we are discharged from hospital. In fact, there is letter sent by the hospital officially handing over the care to the GP and giving all the information about the patient's care and treatment in the hospital so he knows what's what. That aftercare includes pain management, wound care, suture/staple removal and anything else that might crop up. Only if there is something amiss that the GP feels should be brought to the attention of the surgeon would he then make contact the with him.
In Australia I find it similar. I have seen my surgeon twice (and in theatre for my MUA). He has zero involvement with what happens at PT, pain was controlled by my GP and work certificates too. He is basically not interested. He’s done his part - the rest becomes my problem. I might add he has a poor bed side manner but is considered by all to be the best in the area. Waiting list to see him are months long.
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Irish471
senior
Interesting to hear how different our health care systems are and how they operate!
@Momma-me , yes, I had lots of medial pain. The whole lateral side was numb, though, so maybe that’s why??? It’s starting to ‘wake up’ and I can feel more nerve type stuff happening on that side now. Every week, there will be a different pain in a different area. Just when you think you’re finally figuring it all out
@Momma-me , yes, I had lots of medial pain. The whole lateral side was numb, though, so maybe that’s why??? It’s starting to ‘wake up’ and I can feel more nerve type stuff happening on that side now. Every week, there will be a different pain in a different area. Just when you think you’re finally figuring it all out
Jolease
senior
My partial was all medial pain as that was where the partial was.This tkr it’s worse on lateral side, also behind the knee. I agree with Irish though, new pains seem to pop up each week.
It would be intesting to get a copy of your surgical report, it may explain why you have pain in certain locations.
I learned by reading mine that my surgeon had also done a lateral release during my surgery. If my surgeon ever told me that I don’t remember.
And I still have a lot of discomfort in that lateral area.
I learned by reading mine that my surgeon had also done a lateral release during my surgery. If my surgeon ever told me that I don’t remember.
And I still have a lot of discomfort in that lateral area.
OP
OP
Momma-me
member
Yes our healthcare systems are very different! Even GPs in the US though are afraid to prescribe any type of pain meds. A true travesty for them that are in need of it!
@Irish471 Yes, my lateral portion is numb as well. (??) And sharp, burning pain in the medial side. I wonder why?
It would be interesting to get a copy of the surgical report. Never thought of doing that. I feel a little better tho knowing that might be more common. I thought maybe something was wrong in the medial side. It truly feels like a shark bit into my leg.
I’m SO thankful that my surgeon stuck to his word though and did no scraping with this left knee arthroscopic. It’s actually been feeling better than I had expected it to feel one week out.
@Jockette my very first surgeon “attempted” a lateral release on me as well when he did the arthroscopic. Never even knew that until the MRI I had done before my second surgery which pointed that out. Weird. And wrong.
Small Update: PT came today. Again some gentle stretching. Gaining a tad more ROM. Went outside with the walker today for the first time with PT. The sun and light breeze felt like heaven on earth.
Doing well with small steps, heel toe and good extension on heel strike. I am having problems bending on the swing through, but that's because Im still in pain and of course, its super duper tight. But, overall, I feel pretty proud of that only 1 week out.
Doing good balancing between walking, light stretching, icing and elevating.
The pain is still there when I move, try to get in and out of bed, etc.. but at least I am close to pain free when I am icing and elevating. Last week, even that was unbearable. I'll be honest, last week was BRUTAL for me but thankfully... I'm moving forward slow and steady!
@Irish471 Yes, my lateral portion is numb as well. (??) And sharp, burning pain in the medial side. I wonder why?
It would be interesting to get a copy of the surgical report. Never thought of doing that. I feel a little better tho knowing that might be more common. I thought maybe something was wrong in the medial side. It truly feels like a shark bit into my leg.
I’m SO thankful that my surgeon stuck to his word though and did no scraping with this left knee arthroscopic. It’s actually been feeling better than I had expected it to feel one week out.
@Jockette my very first surgeon “attempted” a lateral release on me as well when he did the arthroscopic. Never even knew that until the MRI I had done before my second surgery which pointed that out. Weird. And wrong.
Small Update: PT came today. Again some gentle stretching. Gaining a tad more ROM. Went outside with the walker today for the first time with PT. The sun and light breeze felt like heaven on earth.
Doing well with small steps, heel toe and good extension on heel strike. I am having problems bending on the swing through, but that's because Im still in pain and of course, its super duper tight. But, overall, I feel pretty proud of that only 1 week out.
Doing good balancing between walking, light stretching, icing and elevating.
The pain is still there when I move, try to get in and out of bed, etc.. but at least I am close to pain free when I am icing and elevating. Last week, even that was unbearable. I'll be honest, last week was BRUTAL for me but thankfully... I'm moving forward slow and steady!
FCBayern
Former BoneSmart Staff Member
@Momma-me Completely agree the first week is really bad. 
My second week was pretty rough, but not nearly as bad as the first. By the end of week 3 I was getting by with Tylenol, mostly because my OS wouldn't prescribe any more narcotics. 
By the beginning of week 4 I would have stopped the narcotics if had any. It does get better.
My second week was pretty rough, but not nearly as bad as the first. By the end of week 3 I was getting by with Tylenol, mostly because my OS wouldn't prescribe any more narcotics. By the beginning of week 4 I would have stopped the narcotics if had any. It does get better.
IT's normal (and inevitable) for the lateral part of your knee to feel numb.
This article explains:
Numb area after TKR: how long will it last?
OP
OP
Momma-me
member
Need to rant for a second:
I texted my PT and told him not to come tomorrow. I felt really good during PT (well, not "good" obviously, but not worse) but today I am super sore. Sharp, stabbing pain in medial area is worse. I have been doing a lot of resting today. I have been in good spirits the past couple of days and actually not at all tired, but today... feeling pooped.
Anyway, PT texted back and said pain is expected and to counter it with ice and elevation. That we need to keep working to stay mobile and get good movement and strength back. (???)
UGH.. I know I can just say no, and forget it. And I might do that at some point, but I know the push back will cause my OS to be angry at me and right now, I need them to be helpful and I'm afraid, at even only one week out, they will stop my pain meds, which I absolutely still need at this point. So, it's walking a line.
The really obnoxious thing though is that because I wish to rehab in a different manner (more the BoneSmart way) my healthcare team assumes I'm just being lazy. I'm the least lazy person ever. I never sit still, never let grass grow under my feet, and "no pain, no gain" actually is a motto I stand by under most circumstances. But not in this case.
Just because I have a different opinion, and do not feel that PT one week out (or ever) 5 times a week is reasonable or effective, doesn't mean I'm lazy!!
Who prescribes PT 5xs per week??? Who on earth feels this is appropriate?
Already the OS wants to send me to a pain specialist!! What the heck! Why? There is nothing wrong with me. I just want everyone to relax.. and leave me alone!
I'm one week out from surgery!
Thank God for this forum because I would feel really bad if I just listened to everyone around me.
OK... done. Thanks for listening.
I texted my PT and told him not to come tomorrow. I felt really good during PT (well, not "good" obviously, but not worse) but today I am super sore. Sharp, stabbing pain in medial area is worse. I have been doing a lot of resting today. I have been in good spirits the past couple of days and actually not at all tired, but today... feeling pooped.
Anyway, PT texted back and said pain is expected and to counter it with ice and elevation. That we need to keep working to stay mobile and get good movement and strength back. (???)
UGH.. I know I can just say no, and forget it. And I might do that at some point, but I know the push back will cause my OS to be angry at me and right now, I need them to be helpful and I'm afraid, at even only one week out, they will stop my pain meds, which I absolutely still need at this point. So, it's walking a line.
The really obnoxious thing though is that because I wish to rehab in a different manner (more the BoneSmart way) my healthcare team assumes I'm just being lazy. I'm the least lazy person ever. I never sit still, never let grass grow under my feet, and "no pain, no gain" actually is a motto I stand by under most circumstances. But not in this case.
Just because I have a different opinion, and do not feel that PT one week out (or ever) 5 times a week is reasonable or effective, doesn't mean I'm lazy!!
Who prescribes PT 5xs per week??? Who on earth feels this is appropriate?
Already the OS wants to send me to a pain specialist!! What the heck! Why? There is nothing wrong with me. I just want everyone to relax.. and leave me alone!
I'm one week out from surgery!
Thank God for this forum because I would feel really bad if I just listened to everyone around me.
OK... done. Thanks for listening.
You're 100% right and I hope the rant made you feel a bit better. 
You don't have to blindly follow orders. You can do it your way. That is your right, because it's your knee.
Saying no to therapy - am I allowed to?
Not all surgeons think the same way as yours does.
My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
He is the "go-to" surgeon, to whom other surgeons send their patients with problem knees, so he knows what he's talking about.
You don't have to blindly follow orders. You can do it your way. That is your right, because it's your knee.
Saying no to therapy - am I allowed to?
Not all surgeons think the same way as yours does.
My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
He is the "go-to" surgeon, to whom other surgeons send their patients with problem knees, so he knows what he's talking about.
“Pain is to be expected”-done, you have that.
Increased pain from exercise is not what you consent to.
The more you go along with PT, to any extent, the more likely you will need those meds.
Not letting the PT come will allow your knee to not be additionally irritated, and by default will help lower your pain level.
Maybe you’d actually do better with a pain specialist? Just a thought.
Increased pain from exercise is not what you consent to.
The more you go along with PT, to any extent, the more likely you will need those meds.
Not letting the PT come will allow your knee to not be additionally irritated, and by default will help lower your pain level.
Maybe you’d actually do better with a pain specialist? Just a thought.
I had discomfort in that area for months. After my 6 month checkup I requested my surgical report. When I read that I found I had, had a medial release. That explained that extra pain. Why didn't my OS tell me that? So many of them are good surgeons but bad communicators.
I join in with the others. Don't let PT push you around. You are the one that has to deal with the pain and swelling, not them. The main thing is that exercise at your early stage causes more inflammation and that causes more swelling and pain. It is counter-productive. If you feel you have to have the PT, then do about 1/10 of what they want you to do.
OP
OP
Momma-me
member
@sistersinhim that is so interesting. I have never really heard of a medial release. I've only heard of lateral release. I mean, I'm sure it's the same concept. I find it interesting, because my incision is straight down the middle (for the most part) but then veers off toward the medial aspect of my knee toward the bottom. As if they were doing something over there and needed more room
BTW.. I did ask for my surgical report so maybe that will give me some answers, or at least know that it is normal. I have mentioned it to the PA twice that something doesn't seem "Right" about it, and her response is "well, you DID have a very complicated revision" I guess I don't know exactly what that means. Maybe a lot of patients are OK with that response but I wanted more details.
BTW.. I did ask for my surgical report so maybe that will give me some answers, or at least know that it is normal. I have mentioned it to the PA twice that something doesn't seem "Right" about it, and her response is "well, you DID have a very complicated revision" I guess I don't know exactly what that means. Maybe a lot of patients are OK with that response but I wanted more details.
I dislike how general their statements are. It's a very few that will actually explain what they did during their surgery. Their bedside manner stinks. Hopefully, you'll get some answers when you read your report. I assume the medial release is the same thing as a lateral release but on the other side. @Josephine, is this true?
I understood my surgical report better than I thought I would. I got it right after my one year check up.
I read it again at the 2 year mark, and understood even more, after being on Bonesmart for 2 years. I’ve learned lots since being on Bonesmart.
I read it again at the 2 year mark, and understood even more, after being on Bonesmart for 2 years. I’ve learned lots since being on Bonesmart.
Jolease
senior
I have just made a apt with my gp to request a copy of my surgical report. I actually am asking for all three. Maybe I’ll understand things a bit better.
I only asked for mine because I thought it would be fun to read. I was very surprised to read that he’d done a lateral release during the surgery.
The second time I read it is when I noticed that he said my other knee compartments were satisfactory. (or something like that, I can’t remember the exact word) I would feel more confident if he’d said they were better than that.
The second time I read it is when I noticed that he said my other knee compartments were satisfactory. (or something like that, I can’t remember the exact word) I would feel more confident if he’d said they were better than that.
OP
OP
Momma-me
member
@Jockette exactly. What does "satisfactory" mean exactly?
As you know... I had my left knee scoped with this RTKR. On my MRI from this past Feb on the left knee, the MRI report states that I have grade 3 arthritis, close to exposed bone". When the OS went in there to scope, he said I had a plica stuck in my patella that was causing it to lock on me, but said everything else in my knee was "pristine". (his words). I don't feel like grade 3 under patella close to exposed bone is "pristine" (??)
It's all slightly confusing.
As you know... I had my left knee scoped with this RTKR. On my MRI from this past Feb on the left knee, the MRI report states that I have grade 3 arthritis, close to exposed bone". When the OS went in there to scope, he said I had a plica stuck in my patella that was causing it to lock on me, but said everything else in my knee was "pristine". (his words). I don't feel like grade 3 under patella close to exposed bone is "pristine" (??)
It's all slightly confusing.
OP
OP
Momma-me
member
@Josephine I am looking at my OP notes and it says "significant ligamentum patella and plica excised"
I tried google searching the ligamentum patella part and didn't have much luck. Just curious if you know what that meant exactly?
I tried google searching the ligamentum patella part and didn't have much luck. Just curious if you know what that meant exactly?
