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PKR Not sure what to do

Coach Mike

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I had PKR on Aug 24th 2020 . When the nurse got me up for my first walk with the walker I had a problem. I walked a few feet with the walker and when i turned to go back to bed my knee buckled badly , so badly that I had to lean over the walker to stabilize myself. On the way back to the Bed my knee felt as though it was dislocating and the pain was immense even through the nerve block. The nursing staff called the surgeon up to my room. The Surgeon came and looked at my knee and did the side to side pressure test and said knee was ok and probably had buckled due to nerve block and my muscles and ligaments were not awake yet due to nerve block. They sent me home in a knee stabilizer and assured me that my knee would stabilize and that it would be Ok.
When i got home , on the way in the house my knee felt very unstable even with the stabilizer on. Over the next few days my knee felt unstable but seemed to be getting better. Physical Therapy was happy with my progress and pain in knee was slowly going away. At this time I noticed that there was alot of fluid on my knee. At physical therapy about 10 days post op my insission broke open and about a cup of bloody fluid drained off my knee. Contacted hospital where surgery was done and I was advised to put a compression dressing on it and keep it straight for the next few days in which I did. The incission continued to leak fluid in much smaller amounts but was never the less still leaking. Contacted Hospital again and went to see PA at Hospital. He looked at it and decided to drain it. Drained about 20 cc of fluid off it. No infection just fluid. Continued to have drainage so went to see Surgeon on Sept.15th 2020. Surgeon decided to open it up and see what was going on that Day. When they opened it up Surgeon discovered that my inside sutures had failed and the meniscal bearing piece had moved. The Surgeon replaced meniscal bearing with a larger one and repaired sutures. Since that Surgery my knee has felt Super Tight and the pain is not going away. Pain is on inside of knee where repaired. Its now 6 days past second surgery and my knee pain is semi severe and foot is partially knumb.
My question is What to do ? The surgeon i used came highly recommended and does alot of PKR. I dont think it a question of incompetance, but more think its bad luck but never the less I still need my knee fixed. I am 52 and own a Construction Company and need to be back on job not to mention still be able to golf ect.. . I have had injury before and feel i know my body pretty well and I dont believe I am being wimpy about this. I think the meniscal bearing he replaced original with is to big and is causing joint to be to tight and pushing against new parts to hard causing the pain. Just not sure what to do, Start back up with physical therapy tommorrow. Should I call Surgeon and discuss ? Should i get another opinion ? What to do ?? Very frustrated and want this fixed and over. Any Words of advice??

Thanks Coach Mike
 

allin1

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That is a tough one. I'm far from any kind of expert, just wanted to express my sympathy and my hopes that your recovery improves. I would say the second surgery started your recovery all over again, so I would recommend that being patient will be a virtue. If you really feel like something is wrong, I would make another appointment with the surgeon and lay out your concerns in no uncertain terms. Doing it without assigning blame would be most fruitful, I suspect. "Look Doc, I don't think you messed up but is it possible that menisical bearing is too big? I'm no wimp, but this hurts worse than everyone thinks it should."
 
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Coach Mike

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Allin 1 , Thanks for reply. That was the route I am considering taking , I also agree on not assigning blame, As I said I think the Surgeon is a good one and everyone heals different in many different ways and factors. Just sometimes feels as though I have been herded through a cattle branding with all the different PA's , Nurses ect... . The advice you gave was the route I was thinking of going. I just want what is best for my knee and me and I know in the medical field you now have to advocate for yourself. Thanks Again.
 

Jockette

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Hi and Welcome to Bonesmart.

I‘m sorry you’ve had such a rough beginning. Which partial did you have? We’ll add that info and your dates to a signature for you.

Under all these circumstances it’s important to be very gentle with your knee a
right now. It is highly upset from all the surgical intrusions. The newest tightness you are feeling could be more inner swelling and very angry soft tissues.

Ask your doctor about how you are currently feeling but don’t be surprised if he suggests give it a bit of time to settle down. It may be too early to do another procedure.

Go really easy with PT. Don’t ever let anyone push on your knee, either to bend it or straighten the leg, especially when you suspect something is wrong.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

Jockette

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I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Pumpkln

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@Coach Mike
Welcome to BoneSmart, glad you joined us!
Sorry to hear about all the difficulties you have had with your PKR.
With two surgeries so close together your knee may need more time to heal.
The best thing you can do for your knee is rest, ice, elevate, and take your medication on time as prescribed.
A PT may be able to help you with finding ways to reduce pain and swelling with ice, elevation, and TENS, gait training, gentle exercises, and how to pace yourself so you do not cause additional irritation to your knee while it is in the very early days of healing.

Call and let your surgeon know what is happening with your knee.
You can start looking for a second opinion, unfortunately most surgeons will not see you until a year after your surgery. You will have to be persistent in finding a second opinion this early in your recovery.
You can find surgeons in your area using our surgeon locator at the top of the page.
When my TKR was painful, I was able to obtain second opinions around 7 months after my surgery.

Drained about 20 cc of fluid off it. No infection just fluid.
There are infections that they cannot detect that require several weeks on incubation, you may want to ask if they are running long term cultures of the fluid that drained from your knee.

Good Luck in your search for answers.
 
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Coach Mike

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Thank You all for the advice. It was my left knee that was operated on. Went to physical therapy today and her aprroach was same as suggested here. I had a long conversation with Physical Therapist which by the way is a close aquaintance (Coached her kid in Football) and is someone i very well trust. Filled her in on every detail of everything and she said she believed its ok and that a slow steady approach is the way to go here. Pretty much what you guys have suggested. I feel lots better this afternoon after the comments here and discussion with my Physical Therapist. Thanks Again All.
 

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