TKR Now two years post op and still recovering from nerve damage

[Diney]

Hi Margaret
I imagine you are mostly relieved about the ultrasound. I really hope the quad lag sorts itself out in the one year time frame.
Yes, I have been on the trans alpine train to Greymouth - more stunning scenery! Today I went on a really moving tour round Christchurch - in the earthquake red zone. I think it's amazing how everyone is just getting on with everyday life. Tomorrow it's off to Kaikoura and hopefully whale watching!

 

[Randi]

Oh Margaret -8 months and still no certainty. That's hard. Maybe it is just a matter of time . Let's hope. My 8 month old has suddenly decided to behave again- no rhyme or reason why it went off or why it's happy again..so maybe time is the answer...hang in !

 

[Campervan]

Hi Randi, Diane (Diney) did say to me last weekend when we met that it was at 9 months that all of a sudden her first knee felt "normal". She could certainly move her first knee done 10 months back further under the chair than her second knee which was done 7 months ago, which was about the same as mine at 8 months.

 

[Campervan]

Now I'm CONFUSED! I just got a phone call from my physio. Ultrasound report says "quad tendon intact, thickening around the patella tendon". But physio says they've not reported on what we asked them to look at - "the medial parapatellar approach" so to check the muscle not the quad tendon. I do remember the sonographer saying she was looking at the scar so there should be images of the area they were told to do. CD of images has gone to surgeon, so physio is emailling him and asking him to take a look.
Orthodoc;

 

[Orthodoc]

Now I'm CONFUSED! I just got a phone call from my physio. Ultrasound report says "quad tendon intact, thickening around the patella tendon". But physio says they've not reported on what we asked them to look at - "the medial parapatellar approach" so to check the muscle not the quad tendon. I do remember the sonographer saying she was looking at the scar so there should be images of the area they were told to do. CD of images has gone to surgeon, so physio is emailling him and asking him to take a look.
Orthodoc;

Margaret,

The initial reading is promising. The most important statement here is that the quad tendon is intact. If there were a discontinuity of the tendon from the patella (knee cap), that would have required surgical management. The thickening around the patella tendon is not a significant finding. I would assume that the patella tendon is also intact since there was no reading of a rupture.

In the medial parapatella approach, the VMO (vastus medialis) would be detached (to some degree), then reattached. Follow the blue line on the diagram. This would be a particular area of interest on your ultrasound. Ignore the red line.

The rest of the dotted line that follows next to the knee cap is how the parapatella approach is extended down to the tibia (the non-labeled dotted line). This area would be of less interest on the the ultrasound because if this area were not to heal then the complication would more likely be a dislocating patella rather than an extensor lag.

I am not sure if your surgeon will be able to interpret the U/S very well. Most OS are very experienced with reading the images of MRI/CT/X-rays, but less so with ultrasounds. However, your surgeon could call the reading radiologist to ask him specifically to look at the VMO attachment and give his comments.

I hope this helps.

Orthodoc

 

[Campervan]

Thanks Orthodoc. Help immensely.

 

[Campervan]

I've got a cold and sinus bacteria infection. I'm worried that it's this a threat for starting an infection in my knee. Going to doctors today and hopefully get antibiotics.
Josephine;

 

[Josephine]

Not at all! Upper respiratory infections don't migrate to implants.
Read this Infection: peri-prosthetic infection - also known as late onset infection

 

[Campervan]

9 month report coming up!

I can:
- walk 2 hours up and down hills withOUT knee braces and tramping poles
- I can shop till I drop
- I can stand in my kitchen for an hour or so to cook decent meals
- I can sleep without pain
- I can run (yes RUN) but only a few steps and rather weirdly!
- I can ride my exercycle starting on tension 2
- I can put on my socks and knickers standing up
- I can stand to put my shoes on and bend down to tie my shoe laces
- I get up and down from my desk at work without thinking about my knee

My El-Cheapo E-Stim machine works and quads jump wonderfully now. ROM dropped back somewhat as I got a bad sinus infection that lasted three weeks and I felt so grotty I did very little. Been back exercising and riding exercycle this past 5 days. ROM measures 108 before exercise and 116 after exercycle. I use an app on my android phone. I don't take any pain medication for my RTKR but sometimes take paracetemol or diclofenac for my other knee (which is packing up!)

Issues:
- I still have extensor lag and can't say its getting any better
- I still have pain in the "medial parapatellar approach" region (see Orthodoc's post a few above this one) when I do quad sets or try to straight leg raise.
- knee gets stiff over knee cap when walking up and down stairs
- still get, albeit minimal, "start up" pain if I don't straighten leg first before weight bearing
- steeper downward inclines can be tricky because quads still not that strong

So there we have it.

 

[Diney]

Hi Margaret

That's a great report. Walking for two hours is very impressive! The continued extensor lag must be frustrating but your positive attitude is obviously not letting it stop you do anything - even running!

Sorry to hear about the sinus infection but glad you are now over it.

The wedding in Auckland was great. The bride arrived in a yellow campervan! It was a low key but memorable service outdoors with the bride's best friend treating us to some opera!
I finished my stay in New Zealand with a flourish. I went to the maritime museum and they offered me a trip on an old sailing boat round the harbour. I was the only passenger with seven crew!
Then had a lovely time with my daughter in Vancouver.

Unfortunately the labrynthitis is sticking around and I am still unbalanced and a bit dizzy. My ears still feel blocked and ache. I am beginning to think I won't make the walking holiday as it's an effort at the moment to get to the end of the road!

At least the knees are getting a well earned rest.

 

[Campervan]

Jamie; Could you change the title of my thread as current one no longer seems appropriate. Perhaps, Slow, Slow, Quick Quick Slow

 

[bottomshollow]

I was here, Margaret, so I have changed the title for you.

 

[Titianlady]

LOL I just love when you run a few steps but it looks weird. I looked weird when I ran with normal knees!!

 

[Jamie]

Thanks for changing the thread title, Judy!

 

[Campervan]

I just walked 8.77km in 2.25 hours - not a hard walk just long. Muscles and ligaments complaining but otherwise the knee performed well. So for those of you just starting down this journey of recovery, take note, it does get better.

 

[tashia]

WoW. Thats great. I can't help but think, How can you have any complaints. I am sorry about your problems. It seems we make good process than it goes slow then OW. Have a good weekend and do take care. Tashia

 

[kneeper]

 

[Campervan]

One depressed lady here. I woke up today and feel so annoyed that I can't get more than 107 flex (I have once been measured by physio at 116 so I know more is in there but I just can't gain it). I can walk for a couple of hours, anymore than that and I pain in some of the muscles up the inside of my leg and down the outside of my calf. And I still have quad lag. Most days I'm reasonably positive about it all and tell myself that I haven't reached the magic one year mark yet. But in my heart I feel this is going to be my lot and I'm not happy if it is.

 

[Pumpkin]

Campervan,
Sorry to hear you are feeling so low. A slow recovery is so frustrating when you think you are doing better, your knee will say not so fast partner. I am past the magic one year marker, and my knee continues to improve ever so slowly. We all must be tortoises, we will cross the finish and we will win eventually.
Guessing the soreness is from overdoing, I try to stop and rest before the tipping point when I will pay later for doing too much.
Take good care, and give it as much time as it needs,

 

[speccybecky]

Oh Margaret, think back to how you were 8 months ago and you are doing great! I spoke to one of my customers and i didn' t know hed had tkr and when I said a year he countered that with more like 18 months!