Revision TKR Multiple knee replacements

[DEL2021Feb-17]

Update: Its been awhile since I wrote something partially felt whats the point and really does it even matter. So decided to write something positive. Knee is getting better but at a Turtles Pace. If I limit activity I can be in the 5's pain scale wise now what causes it get ugly PT ( started outpatient ) first day was all about base line measurements towards the end a few exercises not bad but had to make a couple errands which killed it once I got home. As far as pain pills now I am trying to take just 2 a day does not always work out that way but its better not great a bad day is 3 so even with a bad day still taking less then before. My usual problems are still there if I sit for too long with knee bent then get up no fun walking for 10 minutes okay 15 NO. Changes in weather can be trying. To describe how the knee from hell feels now instead of sharp intense pain its a strong ache well okay real strong the kind that no matter what its hard to get in comfortable position. Overall yes improvement not going to imply greatly improved but I knew from last surgery odds of healing quickly were pretty much thrown out the window along with ever being pain free.

 

[Celle]

Knee is getting better but at a Turtles Pace.

At least it's getting better - and that's good to hear.

 

[DEL2021Feb-17]

Maybe I should rephrase turtles pace to turtle with 3 bad feet!! Inspite of bad weather ( lots of rain!!! ) and making a few errands today has been a 2 pill day. As long as I do not over do it I can maintain. Tomorrow is PT in the afternoon my guess when I get home from that the knee will not be feeling so good.

 

[Celle]

Tomorrow is PT in the afternoon my guess when I get home from that the knee will not be feeling so good.

So why go? Do you feel that PT is helping at all, in spite of the bad feeling afterwards?

 

[DEL2021Feb-17]

Unlike some PT does help yes it maybe sore after I am done but in the end its worth it to me. I look at it somewhat the same as if you go to the gym to work out if it was not a good workout your not sore tired etc. PT is not designed to make things worse in the long run I for one can attest to the results. Yes I will be sore yes it will hurt more then likely for 1 or 2 days but as the knee gets stronger the soreness after PT will not be as bad. Most of what I will be doing is for extension and for the quad both are lacking. Not asking you or anyone else to agree or disagree been thru this way too many times I know what works for me.

 

[Jockette]

Not asking you or anyone else to agree or disagree

Ok, here’s my neutral comment:

TKR recovery and an analogy to athletic training

When we begin recovery, most of us cannot wait to push ourselves to show the world that we can not only beat the odds, but also regain our lives as fast as possible. We must add many PT's into this equation, as well---many feel the need to push us to the point of pain and beyond---and many of us...

bonesmart.org

 

[DEL2021Feb-17]

Everyone is entitled to his or her way of doing things which is okay. This is the only forum or group of people who suggest taking a different approach to PT. Whether is right or wrong is not for me to decide but lets consider with 19 surgeries the odds that one of my surgeons would have suggested a different approach should have been brought up by now but it hasn't. This site is good to voice the good and the bad concerning recovery since its a long and painful process but I for one will put more faith in my surgeon and actual therapist then a moderator. Really not complaining but reserve your thoughts on PT towards others.

 

[Jamie]

You are misunderstanding BoneSmart's approach to activity and physical therapy following joint replacement surgery. We definitely do not promote a "one size fits all" approach. Some people do fine with aggressive therapy and that is okay. We usually don't see a lot of those folks here as they tend to have their surgery, go through recovery, and just move on with their lives.

Others need to take things more gently and allow for healing to take place before trying strength building exercises. These are the people who will seek out help from BoneSmart and may need to try something different. This is why you'll see a lot of advice here to slow down and get the pain and swelling under control. When people are in a lot of pain, it can be beneficial to put on the brakes for a bit and let things settle before starting to increase activity and therapy levels again.

The approach we DO take is that a person should listen to their own body and respond accordingly to serious pain and swelling.

This is the only forum or group of people who suggest taking a different approach to PT.

Sorry, but we are not the only group of people who promote the idea that there can be different approaches to a successful therapy. BoneSmart has the support of surgeons and therapists who agree with the idea that, when a person is experiencing significant pain and swelling with an activity or therapy, it can be helpful to back off a bit and try something else. Keeping your body in a constant state of inflammation and pain is never good.

One of our jobs on BoneSmart is to offer help and guidance to the people who come here with a problem. People are free to take our advice or not. It's always a person's choice to weigh information and make the choice that works best for them. I hope your choices eventually work out for you.

 

[Roy Gardiner]

Really not complaining but reserve your thoughts on PT towards others.

That's pretty much what's going on here. Many people read your thread, and they (and us) will of course be pleased that your recovery is successful. A central tenet of the BoneSmart philosophy is "It's what works for you that counts." But it's possible (maybe even likely) that you are an outlier.

So the comments here are largely aimed at other readers. We believe that the vast majority of people will react better to a relaxed approach to recovery than a challenging one.

 

[DEL2021Feb-17]

Overall improvements actually better than I thought possible. At first I was taking 5 to 6 pain pills following surgery then down to 4 to 5 and so on now 2 to 3 so far today just 1. As far as PT goes really thought the day after was going to be rough but it wasn't. Today while its aching and have had moments where it really hurt overall not too bad. Maybe this was dumb but considering a decent day went for a walk 6/10 ths of a mile ( this was farthest since before surgery ) and too my surprise yeah the knee is sore but not horrible. This might be the last surgery for awhile things are improving believe me this is a welcome surprise!!
I spoke too soon I got a delayed reaction the pain is at the moment BLAH!! So okay I over did it and yes I am paying for it the pain while crummy is still not as bad as it has been. Pain scale wise solid 6 but not near a 7 currently have it wrapped in ice and took a 10mg Oxy so with an hour or less pain should ease up.

 

[DEL2021Feb-17]

It amazes me and really is shouldn't considering how many times I have been thru this. While the walk was not bad until after I got home then well not fun but within a few hours after the pain med kicked in it was tolerable. Then there is today had PT this morning nothing out of the ordinary no added weight nothing that I would not be able to do at home with the exception of recumbent bike and BOY DO I WISH I HAD A GAME READY!!!!! at home. What started out okay after PT yes sore but nothing extreme ( to me sore is okay ) but the weather went from partly sunny to overcast and rain along with the change in weather knee pain went up. Currently knee is at a solid 6 took first pain med after PT at 1030 just took second 30 minutes ago. I am stretched out on sofa with knee elevated and wrapped in ice. In general it seems when something is too good to be true it usually is, in my case spoke to soon about knee.

 

[Roy Gardiner]

Well your last 2 posts perfectly outline the problem and the solution, things should get better now that's sorted.

 

[DEL2021Feb-17]

Its been awhile ( since Feb. ) would really like to say it was a rough ride but well worth it but that would be a lie!! Knee pain did get better and then started getting worse. Now I have increased swelling on left side along with being rather painful with any pressure applied ( laying in bed on left side, driving car with knee against door panel ), other symptoms include lots of pain getting up from sitting position whether from car home etc. ( takes a few minutes for pain to settle down to actually move once standing ), knee gives out not to where I fall but its enough that you would notice. This has not happened overnite but since this past summer its been getting steadily worse. Had a CT scan done last week which confirmed my symptoms and today the surgeon went over results. The report wrote they suspected I had periprosthetic osteolysis. Had to look this up and it described my problems pretty much exact including the instability / knee giving out as a last resort the DR. suggest to try a hinged brace however due to the swelling I could not wear it due to pain it caused. So now it looks like surgery # 20 is coming. I was told while I may never be pain free the next surgery would replace the existing one and replace with a hinged knee. There are pros and cons a pro would be no more instability issues a negative will not last as long as a typical TKR. In my case having been thru 6 TKR's last revision 12/13/19 not one has lasted over 3 years I am not even worried about that in fact if I can get 2 - 3 years where it feels better I will take it!! The Dr. has a meeting with fellow surgeons this week to discuss complicated knee issues with patients and hopefully next week I will get a surgery date sometime early January. What fun

 

[Celle]

Hello again,
I'm sorry to read that your knee is still giving you problems. You've given many other prosthetics a chance and it does sound s if a hinged knee could be the way to go.
I know that @Pumpkln has a hinged knee and she's happy with it.

By the way, I've merged your update with your previous recovery thread, so we keep your history all together. Please continue to update on this thread from now on. Thank you.

In the past, both Jamie and I tried to to make a signature for you, with previous surgery dates. If you could help us with that, I'd appreciate it. For now, I'll just put your last revision date and add you've had 18 previous surgeries to that poor knee.

 

[DEL2021Feb-17]

I think the previous surgery dates are close enough as many as I have had kind of hard to keep track!! You did make 1 mistake the last surgery 12/13/2019 was #19 once I get a confirmation from surgeon that will be # 20 YUCK!!

 

[Pumpkin]

I am happy with my hinged knee, I have had it for 6 years, and it is very stable, no giving out. I have no problem up and down stairs, getting up from sitting or the floor.
If you have a revision knee with posts, the removal is more complicated and will take longer.
I was never told how long a hinged knee will last, reality is they only have a general idea of how long replacements will last. There are people walking around with 30 year old implants, who were told their knee replacement would last no more than 10 years.

Be sure to ask your surgeon what is the chance of the periprosthetic osteolysis reoccurring?

Sounds like you are working with a surgeon who is approaching your knee surgery very carefully to ensure the best chance of success.

I hope I have answered your questions, let us know what the surgeon says at your next appointment.

 

[DEL2021Feb-17]

As far as I know there is no appointment but I will be getting call or sent a message via the patient portal concerning surgery date. Having been thru this way too many times my biggest concern would be an infection ( been thru that on #4 ) complications resulting from removal of last implant reason being considering how many times the knee has been operated on there has to be some bone loss. Besides that unfortunately I know the routine.

 

[DEL2021Feb-17]

I am in a unique position most are either pre-op or post-op in my case both. Dec. 13th 2019 was last knee revision ( approx. 10 months post-op ) and now I am also pre-op as well Dec. 31st getting a hinged knee replacement. May sound like I am excited not even close this being surgery # 20 and the 7th time I have had a TKR on the same knee. What scares me considering the amount of surgeries I have had it only makes sense there is bone loss plus the last prosthetic they used longer implants. A normal TKR is pretty major hope this one goes okay meaning no infection ( had one back on 4th replacement ). What a way to start the New Year!!

 

[sistersinhim]

Yes, 2021 is going to be your year of a successful revision!

 

[DEL2021Feb-17]

The odds of this being successful based on my history with this knee are slim. That is not saying I want this to fail either but after 19 surgeries which include 6 total and 1 revision and now I need another odds are not looking good. This may seem negative but I have read and been forewarned by surgeon a hinged knee does not last as long as a regular TKR and yes there are exceptions on here Pumpkin and from what I read online there is a percentage that do well years after so yes fingers crossed this will turn out okay. If it doesn't last but a few years as long as it addresses some of the issues currently having with instability swelling pain tenderness to me that would be worth it vs the way it feels currently.