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PKR My Patellofemoral Makoplasty Ups and Downs^

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PegLegPeg

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Here is my update at 11½ weeks post op, with a need for advice/ reassurance specific to continuing pain:

I'm still struggling to sleep at night and am surprised by the wakefulness night-time pain continues to cause me. I've cut back on activities to just walking, and I'm still elevating much of the time when I sit. I have full extension and flexion, no visible swelling, no discernible heat in the knee and I've recovered my range of motion both easily and pretty quickly without any unnatural effort or "work"; it just came back as I healed.

My scar is great; the stitches that were causing inflammation successfully were absorbed, and no further issues. However, many times throughout the day I get random, stabbing, medial nerve pain near the underside of my (newly restructured) kneecap, and the pain is extreme and frustrating.

I am wondering if this is a normal part of the healing experience, or something I should be concerned about. Thanks!
 

Celle

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I'm sorry you're still having pain and I don't know why, so I'm going to ask @Josephine , Our Nurse Director, who has many years of experience in orthopaedics.
 

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However, many times throughout the day I get random, stabbing, medial nerve pain near the underside of my (newly restructured) kneecap, and the pain is extreme and frustrating. I am wondering if this is a normal part of the healing experience, or something I should be concerned about.
I believe what you are describing are what we call zingers. They are nerves that are repairing and reattaching. To me, they felt like 'lightning bolts' shooting through my knee. Sometimes the knee would even jump up by itself. I even have them now, but they are very gentle compared to what they used to be. Yours will continue for a while, but start to lessen in intensity. You still have a whole lot of healing to go through, you're less than 12 weeks out of 52 weeks. Please don't worry.
 

Josephine

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I get random, stabbing, medial nerve pain near the underside of my kneecap,
Can you show me the site of this pain using this chart?

aa knee-references-horz.jpg



After that, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
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PegLegPeg

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3.5 months post-op, I've got some great improvements and some concerns. On the up side, wow, I can do stairs with almost no pain (on the repaired side, anyway)! And while night time pain persists, it's significantly less disruptive and I'm taking no meds at all.
On the concerning side, my healing knee now makes a VERY noisy squeaking sound when I bend and extend my leg, and also has a concerning click during the same movements. Is this a normal side effect of having some slightly bionic parts in there, or should I be concerned? Thanks!
 

Josephine

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@PegLegPeg are you going to answer my questions (above) or have you decided not to? I don't mind either way but it would be nice to know.
 
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Sorry, I missed this! Thanks for your response. The pain did resolve, and I'm now 9 months post OP on the right side, and 12 days post OP on the left, with a medial meniscus repair and PKR (also patellofemoral). My most recent concern is straining my right knee, as the load-bearer. It has been okay up until yesterday. I'm doing very little walking (hopping, actually, with a walker; I've got 3 more weeks before I can begin to put weight on the left). I'm refraining from doing much hopping/walking because it is exhausting and I fear falling. Yesterday I noticed a spread of numbness in the right knee. I've had a bit of anterior/lateral numbness in my right knee since the surgery in January. But now the numbness has spread, I'm assuming from strain and over-use, to the anterior medial side of my right knee. Any thoughts or advice would be appreciated. Thanks.

PegLegPeg
 
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So, my meniscus was repaired and my second PKR (patellofemoral) on my left leg was done on 10/4. Things had been going pretty smoothly, but the weight on my right knee, hopping with zero weight allowed on the left seems to have done some damage to my right knee (9 months out from patellofemoral pkr). Now I've got medial anterior numbness all of the time and stabbing, nerve-shooting pain when I try to stand. My doctor's PA advised over the phone this is "normal" and to ice and elevate it, as well. Getting to the bathroom is challenging, and I'm concerned about sitting so much increasing my risk for dvt. I started thinking about dvt and am slightly scaring myself that my right knee issue could be a blood clot. If anyone has experienced this sort of compensation pain or has any thoughts, I'd appreciate it!

PegLegPeg
 

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@PegLegPeg
You'll notice that I have copied your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 
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PegLegPeg

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I've had a low-grade fever (avg. 99.7, as high as 100.1) since my surgery 23 days ago. I've been on an antibiotic for 6 of a 7 day prescription for a minor ear infection, yet the low-grade fever persists. Is this normal? Any thoughts?
 

sistersinhim

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but the weight on my right knee, hopping with zero weight allowed on the left seems to have done some damage to my right knee (9 months out from patellofemoral pkr).
Your older PKR knee wasn't completely healed yet and you added the stress of hopping on it with all your weight. No wonder it's angry. My old knee complained quite a bit when I was non-weight bearing on the right leg. As I was able to increase the weight on the new knee, my old knee got better. I pray yours improves, too, once some of its duties are lessened.
I've had a low-grade fever (avg. 99.7, as high as 100.1) since my surgery 23 days ago. I've been on an antibiotic for 6 of a 7 day prescription for a minor ear infection, yet the low-grade fever persists. Is this normal?
Running a low grade fever after a joint replacement is normal. My OS said to not worry unless it got above 101.5.
 
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PegLegPeg

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So, I'm 3 months out and concerned because my night time pain remains very disruptive to sleeping. Ugh. Any ideas?
 

sistersinhim

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Nighttime pain is usually a sign that you are doing too much during the day. I suggest you slow down a bit. Icing and elevating are good pain reducers, too. I iced for many months.
 
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PegLegPeg

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I had my second partial (patellofemoral) knee replacement on October 4, 2019. My first (right knee) pkr was on Jan 4, 2019. My first one had its ups and downs, but so far my second one is mostly downs. This may be because I had my medial meniscus repaired during the same surgery, and my recovery was complicated by the inability to bear weight for 6 weeks post op, which was required for the meniscus tear to heal.

Now I'm almost 4 months post op, and I'm pretty bummed by my slow, still swollen and painful, recovery. During this recovery, I antagonized my right knee due to over use/ load bearing on crutches, and developed a compensation injury to a nerve. So the right knee, at one year, also has discomfort.

After the first pkr, at about 6 months, I was very positive the experience had been worth it. The reconstructed compartment on the right is generally pain free and for the first time in 30 years I could (pre-second knee surgery) go up stairs without my old, familiar, bone-on-bone pain. The new discomforts on the right are less bothersome, though more chronic, than my old, acute pain.

The left pkr, which I dove into optimistically, was forewarned to be a different experience, and it has been a much tougher recovery. I've got no idea whether I'm healing normally or not, and need an MRI to determine if this is just a slow, painful recovery or if the meniscus repair failed. I dread the idea of another surgery.

With both knees, it seemed to take FOREVER to be able to (mostly) sleep through the night. At 14 weeks post OP, I'm finally not waking up yelling in pain when I change positions. It was 12 weeks with the first one. A confounding factor is, I am a stomach sleeper and I find myself- in pain- trying to turn over throughout the night.

I'm not sure my pkr experience is particularly relatable, but like you, I wondered if there were any people who had the same surgery and I was hopeful I could share experiences.
 

Jockette

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I had a Patellofemoral almost 3 years ago, and I regret it very much. It has never felt right and yet 2 second opinions claim my X-ray is fine and there’s nothing to fix.

While I am much better now than I was in my first year post op, I have more discomforts and limitations than I did before having this surgery.:bawl:
 

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