Revision TKR My Revision Journey<

[flyaway79]

@jaschembra I was reading your thread and decided to respond to you on mine so I wouldn’t highjack yours and to get this on my timeline. I haven’t been very active here lately but do check in from time to time.

You could be writing my story. I am about 2 months behind you and we have been so similar throughout. I went back to work at 6 months to a very physical job with lots of walking. I felt I had given my knee enough time. My knee was all “healed” up, no infections, or set backs. I did basic PT at the beginning but stopped at 8 weeks because it was just aggravating my swelling. After 4 weeks away from PT I was at 0/130 ROM. From then on I did every day living and my stationary bike. The swelling improved and I was left with the “tight band” feeling which I know is very common. I felt like I was well on my way to a full recovery.

I did however still have the internal swelling and extreme tightness in my knee and lower thigh area which has continued to date, although that has improved somewhat as well.

Right at the time I was going back to work at 6 months the crunching started. It has continued ever since. I feel it when I move my leg around and of course going up and down stairs and getting up from sitting down and even when moving in bed at night. I also get random pains around my knee area all the time. I do also have the clicking in my knee, and I know that is very, very common, however it’s the crunching that really gets to me. It’s not just annoying but it hurts and and gets so uncomfortable. It’s not just a little spot that is clicking from the implant but a crunching in my entire knee area, not unlike the bone on bone I still have in my other knee.

I’m still plugging along working and am fortunate that I don’t have to work every day and I have enough time off to recuperate afterwards. I can walk 10,000 - 15,000 steps while at work but that doesn’t mean it’s without pain and discomfort. I have totally differant pains now than what caused me to have this surgery in the first place. I feel like I’m back to square one, and am really questioning having this done. Of corse there is no going back now, but I’d like to figure out what is going on before I jump into the next one.

I have an appointment with my surgeon next week. This was originally set up to schedule my next knee, but with all that is going on with this one I’m not so sure I want to proceed yet. The majority of this appointment now will be spent addressing these issues.

I know we are supposed to give it a year and I’ve been trying to ignore all these things hoping that they will slowly go away but I haven’t seen any sign of it letting up yet.

Like you, if you look at me and see me walking you would think everything is healed up perfectly. Even my husband doesn’t understand when I tell him how frustrated I am with the progress or lack thereof. There is nothing visually wrong with my knee.

I’m sure my surgeon will do X-rays but I’m not expecting anything to come up because I had them done at my last appointment at 6 months before I returned to work and everthing was fine. Nothing like a fall or anything has happened to cause the discomfort I still have.

Just would like an answer to why I’m experiencing these issues this long after surgery. Hope I can get some answers next week.

 

[Jockette]

I’m sorry you are still not doing as well as you hoped. Your surgery was one week after mine.

I’m not too happy yet either. I am trusting that time will take care of things. But I still have a fair amount of discomfort, and actually with this extreme cold weather we are having my knee is starting to hurt, it SO does not like the cold.

I don’t have that incision burning that we get early on, but have much discomfort through the knee any time I have pants on, the knee feels swollen and like 2 pieces of wood are scraping together any time I have pants on. It does not feel like that when I wear shorts.

Still sorry I had this done. I had less discomfort before surgery with the arthritis I had.

 

[jaschembra]

Wow!! That is a huge amount of steps - I’m sure I would be limping or dying by the end of the day with that many steps. I haven’t checked my crepitus area lately. Just checked, yep... still there, same place. I seem to have a couple of tendons that don’t necessarily like to play nicely all the time. My oh my... this recovery.

Please come back and post an update after your OS visit. I truly hope we all see some great improvements in 2018. I really want to get this other knee done, but I’m afraid right now. I want to get to that stage where I’m saying, yes! I’m glad I had this done. . Good to see your post today.

 

[flyaway79]

@jaschembra I guess I should qualify the 10,000-15,000 steps. I only do that while I am on an overseas Asia flight and it’s from the time I leave my house to the time we arrive at the hotel some 20+ hours later. Long days, and long flights but we do have down time during the flights where I do get off my feet for about 4 hours or so. The rest of the time is up and down and lots of walking in small spaces around the plane. Then I get a long nights sleep when I get there

Normal days at home I do around 5,000-6,000 steps a day.

I can’t say I’m overdoing it because I’ve only been doing two trips a month since I’ve been back. Just frustrating that on my days off, which have been a lot, I feel just a much tightness and discomfort as when I’m flying. I stopped icing a month or so ago since it made no difference at all.

I will check back after my appointment next week and let you know what my surgeon says. Looking forward to your report tomorrow!

Hoping for the best for both of us in 2018

 

[flyaway79]

@Jockette Funny that the cold doesn’t seem to bother my knee at all. I don’t notice any difference since winter has set in. I don’t spend a whole lot of time out there though that’s for sure!

I can tell when the swelling acts up because I do still get that burning feeling on my incision. My pants don’t seem to bother it much and I always wear long pants and never even wore shorts in the summer, just capris.

Hopefully as the year mark gets closer, both you and I can see some more progress

 

[flyaway79]

@jaschembra I had my appointment with my surgeon today. I’m just coming up on 10 months. He took X-rays of both my knees.

My revision implant is perfect. He said there is no loosening of the cement and he moved it all around and said I have great movement and my ROM is just as good as pre-surgery. He is very, very pleased with everything.

Now, why do I have what I call crunching and discomfort. He said that the implant is still trying to get settled into the knee joint. I still have internal swelling that will continue to cause friction on the implant making it click and crunch. That will hopefully go away with more time. Since i have no actual pains, just the uncomfortable feeling of it hebis not concerned at all about it. I have actually noticed over the last week or so it has improved somewhat. It’s going more towards a clicking rather than crunching, which to me a a good sign.

He said I do need to ramp up my strengthening exercises to get the quads stronger to help support the new knee and pull everything all together. I know I have been lax in that area and he said that the stationary bike is great for that. I have no excuses as it’s sitting right in the middle of my office! He also said to start some short arc quad exercises with light ankle weights. So that’s exactly what I’m going to do!

He said my left knee is definitely bone on bone and I am a candidate for replacement of that one as well. He said technically I could get away with a Patella Femoral PKR (just like my original surgery) but given the problems I had with my first one and subsequently having the revision that he would suggest going straight to a full. I’m glad he is on the same page with me on that one because I would not do anything but a TKR on it. This is basically considered my 1 year appointment and I don’t have to see him again until it’s surgery time again!

All I have to do is give a call and schedule it when I want to have it done. I always thought I would have it at the one year mark of my original surgery which would be March, but some other non-health related issues have come up which would delay it until summer or fall. Not a fan of being laid up during the summer and then work issues start to play a role so I’m actually now going to try and stick it out until next January if my knee will agree to that plan!

For now I’m going to try and relax and let the healing continue and nudge it along with some exercises.

I feel much better after my appointment

 

[jaschembra]

Sounds like a great report. Couldn't ask for a better one! Maybe we'll be knee twins on the next one lol. I figure I'll be ready come fall or next Jan. My left knee needs to be stronger, pain free or at least close, and my dominant knee before I'm willing to go forward. And as it becomes better, my right knee is hurting a bit less. My memories of last Jan. are still to vivid in my mind but when I think of those first 2 weeks, I often think of how wonderful my sister was taking care of me. I agree with you on your decision for the total and from what I've read hear those recoveries are so very similar why not. Here's to some continuing recovery! Now that I've passed the one year mark, I no longer look towards a date... just a day when the knee is feeling really good.

 

[SusieShoes]

Well, that sounds like an excellent report to me! I've noticed that with more exercise (walking and swimming), the occasional clicking in my knees has gone down to almost nothing. I think it's because the knee muscles and all are, like you said, supporting the knee better. I hope your clunking soon resolves and goes silent.

Going straight to a TKR makes so much sense in your case. The recovery is no different and the results the same, if not better, given your history.

 

[flyaway79]

@jaschembra It would be great to go through our next one together! I’m hoping, and the doctor has said, my next one “should” be easier than this one since I’m going straight to the TKR without all the issues I had with this one throughout the years.

The added benefit of riding my bike to exercise my new knee is it will also help strengthen my next knee as well for surgery. It also fits in well with my new quest with Weight Watchers.

I recently joined again and am already seeing good results. I had done WW about 15 years ago and was very successful but then all these surgeries took place and the weight slowly crept on again :-(

I don’t have massive amounts to lose but 20 pounds would be awesome. The new Freestyle program is right up my alley because it focuses on lean proteins and veggies which are my favorites anyway. For me it’s not a diet but a total change in my eating habits. It holds me accountable for each morsel I put in my mouth and makes me make the good choices rather than just the easy choices!

I have a whole new outlook this year than I did at the beginning of the last!

 

[kmak81230]

I'm glad you got a good report and have a good outlook for 2018 flyaway! Hopefully the discomfort and crepitus will continue to fade away. I am also trying to figure out #2 - was thinking late July but want #1 to be stronger than it is now. I also have very weak quads which have been slow to respond, even with biking and a few exercises . . . more patience required! Here's to a stronger, leaner, less painful 2018!

 

[zakmick]

Hey Carol,
I just popped on to see how my fellow surgery buddies were fairing as mine is giving me trouble. I’m glad to read you feel better after the surgeon apt. I’ll start my thread again so not to bombard yours.


Sent from my iPad using BoneSmart Forum

 

[flyaway79]

@zakmick

So good to hear from you!!! I will be interested in reading your update!

Even though I came away with a positive attitude from my surgeons appointment, I can't say that I'm happy yet.

He gave me the assurance that medically all is fine, which gave me a piece of mind, however I'm still having lots of tightness and discomfort issues along with crazy random pains that come and go.

It isn't so bad that it affects how I live my life, but it's always nagging me saying "you just aren't there yet......"

The tightness and crunching I have seems to come and go randomly without any real rhyme or reason. I can never pin point what I have done to cause it.

Am I better off than before the surgery? Well it's different. Before I had to wear a knee brace/wrap all day because I had pain all day along on the medial side of my knee. That pain is now gone, but it has been replaced with an overall tightness and soreness along with the crunching that is quite annoying. I'm still holding out hope for the continued healing at the year mark and beyond. I also have to make a real concerted effort to do the strengthening exercises he suggested to see if by strengthening my quads that I can finally move forward with more healing. I am not, and never have been an exercise type person other than walking so this is something that I literally have to force myself to do. And by that I mean I have to set reminders on my phone to actually do it or I will completely forget about it LOL.

I have decided to wait until next year to have my other one done. I had all intentions doing them a year apart which would be in March, but I'm just not ready to jump into it while this knee is not ready to go it alone. I want to give her all the opportunity to complete the healing process before I go forward with it. To be honest, now that I've made this decision I'm looking forward to spring and summer not being laid up again like last year.

 

[Jockette]

That pain is now gone, but it has been replaced with an overall tightness and soreness

I'm still holding out hope for the continued healing at the year mark and beyond.

Same here!

 

[jaschembra]

ha! We're all in the same boat on the same journey... "Come sail away... come sail away..."
Ugh.

 

[sistersinhim]

Even I'm still having discomfort and concerns. It is a slow recovery process!

 

[flyaway79]

One year post revision update.

My first patella femoral PKR was in 2011. Had microfracture surgery in 2013 and had this revision in March 2017.

Am I happy I had this done? Not so sure. Am I better off since I had the revision done? Maybe, maybe not. I still have discomfort and definite issues but they are different than before the revision and I’m not so sure it’s actually better now.

I did my due diligence before going into this revision. I got several opinions which all said the same thing and I opted for a surgeon who was highly skilled at revisions. This was a different surgeon than my original two surgeries. The surgery went great with no complications.

My recovery went very well, no infections, nicely healed incision and my pain was very well managed. I followed the Bonesmart mantra regarding non-aggressive PT and lots and lots of icing and elevating for the first 6 months and beyond. I gave myself 6 months before returning to work giving it more than enough time to properly heal.

I had several X-rays through out the past year the most recent about 2 months ago and they have all shown a well seated implant with no loosening or other apparent issues. My ROM is great 0/130 and has been since week 12. Also had great ROM prior to my surgery.

At the suggestion of my surgeon, I have been doing non aggressive, quad strengthening exercises with light weights to see if that will help with some of the issues I still continue to have. So far I have not noticed any improvement.

So the question is, why, a year later, am I still second guessing whether this revision surgery was a good idea? Was I expecting too much? Maybe. I never really expected to be pain free because I have experienced too many issues over many years to realistically think that could fully happen. But I guess I did expect to not have this much pain/discomfort at the one year mark.

I do feel fortunate that I can do daily activities and my active job, but it’s not without random pains and sometimes more than a little discomfort and a constant reminder that my knee still in full recovery mode. I have come to accept and live with that.

I know now that this is the final surgery on this knee. I will not be looking for any other opinions about it and will continue to be optimistic that maybe it just needs more time to finally settle in and become less bothersome.

As for my other knee, that one is bone on bone as well and again just under the kneecap area and definitely in need of a replacement. I will most certainly go for a full TKR this time and skip the partial (and my surgeon agrees totally on that front) and hopefully will have a better outcome than this one. He seems to agree that will most likely be the case.

I’m planning on the first part of next year to complete that and by then I will have given this one more than enough time to continue healing before I go forward with another surgery.

But for some good news, I started the Weight Watchers Freestyle program in January and have lost 15 pounds so far Love this program!

 

[Jockette]

Your update sounds a lot like how my outcome has been with my PKR. I remember you saying that on my thread when I posted last week.

Your revision to TKR experience is exactly one of the reasons I’m not in any hurry to look into a second opinion yet. It’s only been a year since this major surgery. I don’t feel miserable enough to traumatize this knee again. I think there may very well be a revision in my future but I think I want the knee to heal as much as possible before that, if it will, considering it’s issues.

We’ve read that some people can take as long as 18 months to 2 years to really fully heal and the more work done on the knee the more it has to recover from. Maybe both of us are in that category.

I hope you will continue to improve and come to at least a place of satisfaction with your revision.

And yay you for losing 15 pounds!!! I did their program back in 2011, which was Points Plus. I really liked that one, had an awesome leader, lost 23 pounds and made lifetime. Alas I have gained it back and I just can’t get my head back into it even though I want to. Unfortunately I guess I don’t want it enough.

 

[Jockette]

I must admit your success with Weight Watchers is tempting me to go back. I’m not sure if I will try their current plan or do the Points Plus that I know worked so well for me.

 

[flyaway79]

@Jockette The Freestyle program just works for me. I am a very basic eater and don't really care for a whole lot of variety LOL. With the Freestyle program lean chicken, turkey, eggs, fruits and veggies are all 0 point value and I love all those things. I very rarely eat meat, maybe sometimes pork and have cut way back on my carbs, and very little sugar, so I find it very simple to follow. Works great for my husband's type 2 diabetes as well. I have always said, just tell me what to eat and I will eat it. I get 23 daily points on this program and my biggest problem seems to be eating enough points for the day because of all the 0 value foods. I hate making food choice decisions and this makes it very easy for me! I know it's not for everyone but I'm very happy with the program.

I start off each week making a crockpot of shredded chicken and use that all week long for different meals and recipes. There are several facebook groups that I have gotten some great recipes from. My husband is happy because I am doing more cooking these days LOL. I tell him that now I am cooking "with a purpose" and it's much easier for me to make choices.

 

[Jockette]

With the Freestyle program lean chicken, turkey, eggs, fruits and veggies are all 0 point value

I’m not much of a vegetable eater but I like all those other things!