PKR My Drama Queen Patellofemoral Knee

My own personal opinion for my discomfort is that something went wrong with the lateral release that was done during my replacement surgery. Maybe he cut too much? Maybe damaged a nerve? I don’t know, but all my continuing discomfort is on the lower, outside of my knee, where I would think the lateral release was done.
This!! I’m so glad I stumbled upon your feed right now!
Prior to my PKR’s I had (combined) 3 scopes, 2 lateral releases, and a micro fracture. I can’t help but wondering if all the pain and weakness I’m still experiencing is from those stupid lateral releases. The PKR’s certainly didn’t help the damage that was already done. But I wish we could find a solution…
 
This!! I’m so glad I stumbled upon your feed right now!
I just posted on your thread. I’m going to copy the above post to your thread as it has important history of your knee. Sometimes I wonder if the more done to the knee, the harder it is to recover. Surgery does fix things, but the surgery itself causes temporary, controlled trauma, that also has to heal.
 
I can go up steps foot over foot, if they are shallow steps. I can’t even describe how bad/weird it feels if I try going down steps foot over foot, even on shallow steps. It’s like my knee just won’t bend enough with all my weight on it, going down, and yet my ROM is fine in all other situations.
Jockette,

Are you doing any type of leg strengthening exercises besides ADLs? I read through some of your thread but it is so long I had to skip through. I think you might have stopped structured leg exercises very early on?

Since I had a cortisone shot I have finally been able to push my knee hard enough the past few weeks to build some muscle back around my knee and and get rid of my noodle leg. In just two weeks have really have noticed a huge difference with leg strength and walking up and down stairs. Now my main issues are stiffness and gravelly knee which hopefully a scope can take care of...

If you have not been doing knee strengthening exercises I would suggest you at least give them a try for a month or so and see if you notice improvement.

Here are the exercises I do daily beyond ADLs:

Warm up on Elliptical trainer - 15 to 20 minutes

Quadriceps stretch (3 sets) - lay on my stomach, dog leash on foot and pull forward for a nice comfortable stretch hold 30 seconds

Eccentric step-up / step down (2 sets of 10) Find a stair with a side rail. Step up with op knee slowly then back down slowly until heal of good leg touches floor then back up. Hold handrail for support. This is my most difficult exercise.

Wall Slides (2 sets of 10) Back against wall slide down until knees flexed at 45 degrees, hold 15 seconds, slide up slowly.

Mini band Crab Walk ( 3 to 5 sets) - stretch band around ankles, legs apart at shoulder width and crab walk 25 feet one way then back.

Mini band side steps ( 3 to 5 sets) Stretch band at thighs, legs at shoulder width and side step one way then back 25 feet.

Bridge with mini band (2 sets of 10) Lay on back, band at knees, push and hold butt up for 10 seconds then down.

At health club I add these:

Warm up on Recumbent Bike (20 to 30 minutes) for warm up.

Seated leg Curl (3 sets) As much weight as possible, legs straight out then bend them down and slowly let leg go back up.

Weight pull (10 reps) I set weight to about 50 lbs. Bend knees, secure weight line to waist belt and take backwards steps pulling the weight all the way up, then slowly step forward back to the beginning. I love this exercise, feels good.

Seated leg press (3 sets of 10) I do a very low weight compared to pre surgery. I push and extend with both legs, then slowly back with OP leg only.
 
@beesknee Thank you for sharing your routine with me. I appreciate you taking the time to do that. :flwrysmile:
 
very sensitive to any angle it doesn’t like
I know what you mean. I told my ortho that when I step off a curb, my knee feels like it wants to break in two!!!
It is the same if I wear different shoes that are higher and a different angle, like a platform type....my knee lets me know it right away.
He said it is my kneecap. :hairpulling:
 
Could very well be. It's definitely something!
 
I can’t even describe how bad it feels when I try to go down steps foot over foot. It’s rare that I even try, even with a short step.
 
I'm sorry you are still having these troubles, Jockette...... :sad:
 
5 years and 7 months update.

Basically not much has changed. I rarely have actual pain, which is a good thing, but still a lot of discomfort at times, mostly when standing and leaning forward, and turning. So, my discomfort usually happens the most when I’m in the kitchen, leaning to load or unload the dishwasher, leaning in towards the sink washing dishes, and just turning from one counter to the other across the room. Making the bed will bring this on, too. It feels like the knee is out of joint. And, it’s not in the center knee area, where the patella is, or where my implant is, it‘s always on the lower lateral side of the knee, most likely where the lateral release was done during my Patellofemoral PKR surgery.

I was away this weekend, and I thought I had managed to go up and down stairs, foot over foot, fairly well, but…there was a handrail on each side, so that was great. Going up was ok, and I was excited that I had actually come down foot over foot, but in reality, what I was doing while coming down was supporting/lifting myself with my arms on the handrails, so that I didn’t put much weight on my replaced knee as I stepped down with the better leg. By the time I got home I had pain in the front of my left shoulder, from the stress on it. I then realized that’s the same shoulder that was injured at PT when I was one week post op, and the same pain, though not anywhere near as intense. I do get pain in this shoulder from time to time and apparently I did enough damage then that any new stress can make it flare up. I never made that connection until yesterday.

But, I did find one big improvement. I sat in a low beach chair, that’s all my friend had, and I did get out of it without any trouble! :happydance: It did help that the chair had arms, and that the sand did slope down away from me a little, giving me a bit more height, but I was very pleased about it!

So, there’s always the possibility of more improvement, in some areas, years down the road! :wowspring:

This is me in the blue sweatshirt:

EE3D7F21-1A01-40DD-B15B-87A3CA34E5EE.jpeg
 
I sat in a low beach chair, that’s all my friend had, and I did get out of it without any trouble!
I'm envious! I tried to get out of a chair like that last weekend and I had to get on my hands and knees first. What a production!

You go, girl!
 
You got out of a beach chair....by yourself? You go girl! There‘s no way I could! In order to get off the floor, I have to go on all four’s. I don’t know if that’s due to my hips or my knees or both! Great picture!

Marie
 
it’s not in the center knee area, where the patella is, or where my implant is, it‘s always on the lower lateral side of the knee, most likely where the lateral release was done during my Patellofemoral PKR surgery.
I just had a thought...could it be that you have now developed arthritis in this area? I have read that a lot of times that happens with a partial, that arthritis will develop in other areas of the knee. That would explain your discomfort at certain movements.
 
could it be that you have now developed arthritis in this area?
Maybe, but this discomfort has been there the whole time since my surgery. It’s not pain, it’s an out of place feeling. Or, like I used to describe it: like someone jammed a pole into the side of my knee and left it there.

I know most people would tell me to keep getting second opinions, but I just can’t yet. I‘ve had 2, and they were a waste of everyone’s time. I’m “managing” well enough for now, especially if I don’t do stairs foot over foot, which is why I was so happy to do them this weekend, foot over foot. But then I realized just how I was doing them, and it’s not a good way, not when it damages my shoulder.
 
@Jockette , I really think you should get another opinion, even though you are managing. That feeling you describe is definitely not normal. I worry it might get worse if you leave it. But I do understand why you’re reluctant!
 
I’m really ok with my knee. It’s been 5 and a half years. I try not to do things it doesn’t like. I’m able to do the things I have to. Thankfully it’s not actually painful. It really could be a lot worse. And, I’m so afraid that another surgery won’t work and I’ll be even worse off. I’m already worse than I was before this partial. I won’t do a “let’s try this” surgery. I know that no surgery has a guarantee, but I will need really good odds, or an emergency situation, to have more surgery on it.

For the time being, I’m hanging in there. And I got up off that beach chair just fine, more than once! :happydance: For now, it’s good enough.
 
I’m already worse than I was before this partial. I won’t do a “let’s try this” surgery. I know that no surgery has a guarantee, but I will need really good odds, or an emergency situation, to have more surgery on it.
I don't blame you in the least. You're still making it OK. Very few of us can expect to be completely without some pain. The chance of being worse off afterward is not worth it.
 
At almost 6 years post op, I fell the day after Christmas and landed on my PKR, which has been a problem since Day 1. Once I managed to get up off the floor and pull myself together, I thought, wow, I hope I did enough damage to get this knee fixed, finally!

That was Monday and I just monitored it all week (icing and elevating) but by Friday, December 30, I did call an orthopedic surgeon and the earliest appointment I could get was January 18, which I thought was pretty soon, actually!

By January 5, I decided I needed an X-ray, because of the amount of pain I had, so I went to a Rothman Urgent Care in Limerick, PA for an X-ray. The good news, nothing was broken. The bad news, in my opinion, is that once again the X-ray looks great and I have plenty of space in the joint, which means, no one is going to be in any hurry to “fix” my knee.

It’s been 5 weeks now since I fell and I still have some swelling and bruising and it’s still sore, but nothing like it was at first. I had quite a bit of pain the first 3 weeks and my ROM was really bad. After the 3 week mark the pain has gradually lessened and my ROM is improving, but still not where it was before I fell.

I did google bruising and apparently it can last for months, but I’m still a little concerned.

The January 18 appointment turned out to be more second opinion than checking the injury. The doctor was nice and somewhat thorough, but once again, he didn’t find anything concerning on my knee X-ray. My knee bent and straightened well, considering there was still a fair amount of swelling from the fall, and he said my patella was tracking well.

I‘ve had some concern for my hips for a while now, so he did X-rays of them, and they are fine, so that’s good. They don’t seem to be affecting my knee issues.

On the hip X-ray he saw the lower part of my spine, so I have a lumbar MRI scheduled for the end of February. He thinks maybe my spine is the cause of some of my knee issues. I do realize the spine can affect the knees but I want him to look further into my knee. I asked about a knee MRI but he wants to do the spine first. I’m not happy about this. I think we should do more tests on my knee before we go to other areas.

I came home from the appointment rather discouraged that once again, no one will really look at my knee. So many things don’t show up on an X-ray.
 

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