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Revision TKR My left knee story, revision complete 8/14/12, hopeful

I hear you about insurance companies. My surgery was post poned 3 years because my OS stopped taking my insurance 2 weeks before my appointment to schedule my surgery!:hairpulling: I went into total shock! Then I decided to wait till I went on Medicare and go to another OS for shots. Well the shots did not work and I eventually scheduled for him to do the TKR. I got shingles 2 weeks before the surgery and my GP (like yours is great and knows me well) said I had to wait 6 mo. to a year to have the surgery. So I turned 65 during that time and went back to my old OS and he did my TKR. And he started to take my insurance 2 months prior to me turning 65,:loll:
My insurance is a major company in the US and all of this never made any sense to me. On medicare the knee is totally covered. :yes 4:

Take care and enjoy that massage:thumb:
 
Don't worry about it, Dawn. You had a big day so there are going to be equally bit consequences. Doesn't mean you've had a set-back, just a little bump in the road. It happens. Best thing is to expect it and then chill out while it sorts itself out. Which it will.
 
Good Morning,

I took the weekend, tried to do very little and rest up after the challenge at the convention center. About the most strenuous thing I did was a little shopping, maybe 2 hours on my feet.

I'm a bit concerned as the quad is still plenty sore. A day into the Orlando trip I noticed that the quad really hurt, almost like something snapped. THat feeling is still there, and there seems to be a definite ridge or muscle band about a inch above the knee cap. It's hard and somewhat tender. I had to revert back to taking a pain pill during the day which I had not been doing, as it's a annoying pain that doesn't respond to OTC pain relievers. I have an appointment with the OS next week and hope by then this will have resolved.

I am trying to be patient and not get down about this. Its certainly a challenge to stay positive. Hoping a few more days will help.

Back to the work grind today, and not looking forward to that either!

Be well friends!

Dawn
 
That doesn't sound nice, Dawn. Do let us know what the surgeon says
 
Good Morning friends,

I am at 6 months and 3 days post TKR. I feel much stronger physically and mentally than I did even a month ago. I do find I get tired quickly though when doing a lot of walking/shopping/standing. I really need to work on stamina. Mentally, my focus is back to normal, being able to concentrate on my work for long periods without being too taxed.

I did have an appointment with the OS office on Friday. I saw the PA who has been with me along with my OS for about 8 years now. He knows my case well. He examined the knee and said he's happy about the progress I have had so far. He certainly can see that I am missing extension, maybe at 7-8 and in comparing the new knee with the other knee, a pronounced difference. He lifted and pressed down on the joint and it still does offer some give, with only minor discomfort. He was happy with that meaning there is still improvement to be had.

We discussed options at this stage; another MUA, capsular release on the back of the knee, or more PT. More PT is a no for me, it wasn't helping. I don't want to do the release as it will put me out of work again for a period of time that I'm not comfortable with. Another MUA is a real possibility, but I told him if we went that route, I would not be inclined to go to PT after as I think they screwed up after my last MUA with too much aggressive pushing.

I told him about a massage therapist who is a personal trainer and a massage therapy instructor at a local community college. This person comes highly recommended for situations like mine where there are issues post op like this muscle contracture I seem to have. We discussed this as an option and he certainly supports the idea. Next step is to meet this person and get an opinion.

In the end, the PA is leaving it up to me to decide. I asked about follow up with their office and he said he wants to see me at the one year mark but if I decide on another MUA or need anything at all, to call.

Functionally, I am okay. I am still stiff in the morning but that seems to be getting better. I am no longer using any narcotics at all except for celebrex, otherwise just OTC as needed. I am on my recumbent bike everyday between 25-30 minutes with resistance almost at the max. Just still missing the stamina, which is just going to come with time.

I do keep seeing small improvement, but at this stage its slow, to be expected. I am hopeful and looking forward to the summer months where I can get outside more and walk without fear of falling on ice.

If anyone has any other ideas/thoughts, I am all ears. Many thanks for your support!

Dawn
 
Hi Dawn

I like the idea that the PA is leaving you to decide on what happens next for you. Did your OS mention to you before the surgery that your extension maybe a problem to correct? My physio was concerned for me regarding extension as I had a limp for quite a few years prior to the op. I am doing all the exercises I can for it and it seems to be paying off but I do get a lot of tightness in my hamstrings from time to time.

The massage sounds a good idea and I would be inclined to give it a go. My physio is all for massage, so I will be giving it a go in a couple of weeks. You sound like you are doing great on the bike - that is a good workout you are getting. Bring on the summer :thumb:
 
:scratch: Would it be correct to say that the back of the leg is pretty much unaffected by TKR? This would match my understanding and certainly my experience.

This would mean that MUA or any kind of surgical intervention for extension would surely be inappropriate? That the correct way to gain extension is by daily stretching exercises? These are working for me, although I was at 2 not 7 or 8.
 
Hi Roy, contracture of the posterior knee capsule due to arthrofibrosis, which is my issue, is what seems to be happening. The release is difficult to do because of the location. The PA said they would go in through the tkr scar, take apart the joint, remove the spacer, and release that way. I asked if he would consider it a revision and he said yes, of sorts. The MUA broke up the scar tissue without invasion, which is best if possible. I am hoping the massage or another MUA will do the trick. I had a capsular release after my ACL repair and it was not fun. My knee looks like a science project!

Jo, happy with the PA leaving it to me as well. The OS and PA both know I am pretty deliberate in making decisions and will be cautious. I just want to be at a point where I don't have this limp. The knee itself has no pain, just the muscle issue and side effects of the limp, which like you I have had for years. They warned me extension would be a problem because of my history of issues with it, and they were right! I was completely prepared for it.


Thanks for chiming in,

Dawn
 
That really is a tough situation to figure handle. The MUA would be pointless as supported by reports and I can see why he is being leery of scoping it as it really is "tiger country" back there. But the intervention he described would seem somewhat counterproductive as the adhesions can readily reoccur after such surgery. Not an easy choice.
 
Dhare63 said:
Hi Roy, contracture of the posterior knee capsule due to arthrofibrosis, which is my issue, is what seems to be happening. The release is difficult to do because of the location. The PA said they would go in through the tkr scar, take apart the joint, remove the spacer, and release that way. I asked if he would consider it a revision and he said yes, of sorts. The MUA broke up the scar tissue without invasion, which is best if possible. I am hoping the massage or another MUA will do the trick. I had a capsular release after my ACL repair and it was not fun. My knee looks like a science project!
Click to expand...
:blush::blush: That would be the Roy what knew nothing prior to reading this, now knows a bit more so almost nothing, which is better than nothing I suppose. Is being ignorant better than being patronising...? dunno, I shall creep away to think about that.
 
Josephine, you are so right in this is not an easy choice. I have to try the massage therapy first to see if there is any improvement with a non-invasive procedure. I hope to hear back from their office this week. I will keep you posted.

Roy, no worries on the post 8-)) I have been dealing with this knee for thirty years and been through the ringer with it, procedure after procedure. When I had the ACL repair done, I also had an MUA and after much investigation by the OS, a capsular release. I actually had forgotten a lot of that experience until the TKR, now wishing it was a distant memory still. Even though I am a financial planner by trade, I have become an armchair physiologist!!

Thanks for the replies, hope to have some kind of update in a few days.

Dawn
 
Dawn,
Man, I don't know what to say. I'm glad you posted that explanation to Roy's comment though because I think a lot of us have no idea about those kinds of issues. I do know that you are knowledgable about them, however, and will be thorough in exploring all of your options--and then make the best decision possible. You have had a tough road, my friend. I hope that one of your possible options will give you the results that you need--and that you so deserve. Niki
 
Dawn, I think you will do the right thing for you. Looks like you have been through many procedures and know what works for you. As for that extension, at 6 months I was where you are now. Through stretching, pool stretching and walking exercises, and every day walking and riding a stationary bike, I have gotten it to a "normal" range. I need to go and be measured one day. That number is not important though. What counts for me is that my walk is great and the knee is strong and happy:biggrin: That is my wish for you and hope it comes to you soon. :friends:
 
Thanks Niki and Mimi, I hope I can get the missing extension somehow or other. I am way to young to settle for a knee that limits what I can and can't do.

I hope when I get to the point that you are Mimi, I will have as good a result as you have achieved, something to shoot for!

Thanks for being out there, feeling a little isolated again. Now that six months have passed everyone assumes that I am done with recovery and back to normal. Wish that was the case!

Dawn
 
Dawn, I think that after a TKR we all come to a "new normal". And that new normal is in constant flux for a very long time.

At six months I was happy to be walking without any assistance or limp. I was happy to have quads that worked well, and most happy to finally be PAIN FREE!! :yahoo: I was forced,by the circumstances of my very slow recovery, ( as my OS reminded me today that it was a very slow one :DOH:) to find the good parts of my recovery and not dwell on the slower issues I still had. This helped me get past them and work for more progress in my "new normal". :friends:
 
Hi Mimi,

The new normal for me is definitely in flux, still working for it. I finally have an appointment tomorrow with a massage therapist who has experience dealing with issues like mine. He will do an assessment and then we can decide if working with him offers any hope of improvement. No guarantees but it sure beats the idea of more surgery!

I am still limping, but no crutch or can, and although I have no joint pain, I do have pain around the joint, in the lowest part of the quad. We have a storm rolling in today and the barometer in my knee is surely predicting it!

I know over time this will resolve, it always does. Just patiently waiting and working toward where you have landed! Thanks for the encouragement, you have no idea how much it is appreciated!

Be well,

Dawn
 
Dawn, you are only 13 days from the MUA, try not to look at time as your enemy, but as your friend. :friends: Like I said before this "new normal" takes plenty of time and patience. Go about your life with these recovery issues on the back burner. If they are constantly the first thing you think of each day, it will wear you down. If you have little or no pain, then you have accomplished alot.

I hear you about the weather. I got a cortisone shot in my left hip yesterday just as a front was going through, not fun. But today it is better! And with each new day you will be gaining in your recovery to the day when it is not thought about at all.:thumb:

I am off to my daughter's next week for the birth of my new grandson. :biggrin: I have no dread of all the steps in her home as I did 18 month ago when she had my granddaughter. And I will be able to chase her around and play and have fun. Fun was not on my plate 18 months ago due to constant pain. Anything that I have gone through with this TKR was worth it all just to play with these kids and be pain free.:happy dance:

Wishing you the patience to get through this time of flux to your NEW NORMAL. It will come! :flowerysmile:
 
Hi Dawn

I hope your massage is a success tomorrow, I will have my fingers crossed for you :thumb: Have you decided to have the MUA? I have decided that our knee journey can definately feel like a roller coaster ride at times. Wishing you well Dawn.
 
Hi Mimi, I had my MUA in November, no plan for another until I explore the massage first. I appreciate the encouragement and I have tried to not let the knee dominate my life. I have gotten very busy at work so there is little time for anything other than 10 hour days at the office.

I see the massage therapist tomorrow at 8am. Will update after!

Thanks guys,

Dawn
 
Sorry Dawn, I read the 11 as a 1:DOH: Hope you get relief from the massage. My PT guys gave me some of the best massages ever when I had days full of pain. The massage helped to relax my poor knee and enable me to get out from under some horrific pain.
Good luck tomorrow:yes 4:
 
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