Bilateral TKR On the other side too--finally!

[Simplicity]

Hello everyone-it has been a long time since I posted, but have been reading and keeping up with the progress of many of you. I, too, was doing fairly well, until May 30 when I fell on my back and 3 days later began having muscle spasms in my lower back and a burning pain on the outside of my right hip (my chiropractor says it's bursitis). They keep me from standing up for more than a few minutes at a time, and at night it takes me a long time to fall asleep from the discomfort.

I've been taking ibuprofen and tylenol for that. I thought these things would gradually diminish but they haven't yet. I'm going back to physical therapy twice a week starting next Monday and I'm hoping this will help. I can't stand up straight anymore. Also, as far as my knees go, they still hurt when I go to stand up. I have to have a higher chair and push the arms to get up.

My biggest complaint is that my left leg feels very heavy and I can hardly lift it when I walk. Also the outer side of that leg below the knee and across the top of the foot feels very tight and somewhat tingly. My surgeon said he's not sure but believes this is from all the extra work that needed doing on that knee as compared to the other one and the prosthesis goes down quite a bit further on that leg.

Since the fall, I am using the walker all the time, as opposed to just at night before the fall. On June 15th, I also fell again (due to catching my slipper on a board, not being able to pick my foot up very well) and went face forward on the floor, giving myself a big swollen black eye, but seems like no real damage from that fall.

On a more positive note, the very bad swelling that I was concerned about before is gone, still slight swelling but nothing unusual.

I am hoping that someone here might have some encouragement or advice for me. Has anyone been in a similar situation? Or had that tight, tingly feeling down their leg after TKR? I am beginning to feel that I will never recover from all of this.

I hope everyone here is doing well and having a great summer. Thanks! Patricia

 

[skigirl]

I had bursitis on my hip as well. I went to my OS and he gave me a shot of cortisone which did help, and, in fact, the pain did not return. Kelly

 

[maryo52]

The thing is, there is nothing here demanding action. And to tell the truth, the period between when we believe we "should" be mostly better and one year is fraught with worry. It sounds like nerve issues, and many of these resolve (very slowly) on their own, but a neurologist doing an EMG might be needed to sort it out.

 

[Simplicity]

Many thanks to both of you..I appreciate your thoughts on my condition. I know I need to be more patient...I still have almost half a year to go. I will see what they think next Monday at PT. Maryo, have you always lived in Maine? My husband and I have always wanted to go there, and hope to at soon point in the not so distant future. We're in upstate NY, about 30 min from Canada.

 

[Simplicity]

@Josephine I would very much appreciate your input--thanks so much.

 

[Josephine]

My biggest complaint is that my left leg feels very heavy and I can hardly lift it when I walk. Also the outer side of that leg below the knee and across the top of the foot feels very tight and somewhat tingly. My surgeon said he's not sure but believes this is from all the extra work that needed doing on that knee

I'm going to ask you some questions and it would be very helpful if you would answer each one individually in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[Simplicity]

@Josephine Hi, sorry it has taken me a few days to respond..I had to figure out how to quote your questions..hopefully I'll get it right.

1. what are your pain levels right now?
During the day when I can sit and move around as I please my pain level is at 4 or 5, esp. when I first stand up or if I sit too long and the swelling gets worse. At night the knee pain wakes me up and the pain level is at about 8.

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
Ibuprofen 600 mg with Tylenol 1000 mg 2-3 times a day.

3. how often are you icing your knee and for how long?
I have not been icing regularly in awhile, I was wondering tho if I should ice my knees or my feet where most of the swelling seems to be.

4. are you elevating your leg, how often and for how long?
I am elevating my legs about 5 times a day for about 1/2 hr each time.

5. What is your ROM - that's flexion (bend) and extension (straightness)
Flexion is about 100 on each knee; extension is 0 on L knee and 6-7 on R knee. Can the lack of good extension on the right knee be the reason for my limp?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc.
I am fairly active (up and down frequently from the chair for 10-15 min at a time), at which time I might fold some laundry, wash up some dishes, put things away, do some prep work for cooking. I go shopping with someone else who brings groceries in etc. I am still unable to do anymore than this.


7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)
I am not doing any specific PT exercises at home, altho yesterday I started formal PT again which will be twice a week for about 1-1/2 hrs each session.

Thank you so much for your help!

 

[Josephine]

I just noticed your surgery date - January 9th - that's 7 months since! I'm staggered!

My surgeon said he's not sure but believes this is from all the extra work that needed doing on that knee as compared to the other one and the prosthesis goes down quite a bit further on that leg.

What was this 'extra work' that needed doing?

During the day when I can sit and move around as I please my pain level is at 4 or 5, esp. when I first stand up or if I sit too long and the swelling gets worse. At night the knee pain wakes me up and the pain level is at about 8.

Gee - that's high!

Ibuprofen 600 mg with Tylenol 1000 mg 2-3 times a day.

Well obviously this isn't enough for your pain. And you need to take something extra just before you go to bed.

I have not been icing regularly in awhile, I was wondering tho if I should ice my knees or my feet where most of the swelling seems to be.

Wherever it feels best.

I am elevating my legs about 5 times a day for about ½hr each time.

You accomplish nothing in 30mins. Do it for at least an hour.

Flexion is about 100 on each knee; extension is 0 on L knee and 6-7 on R knee. Can the lack of good extension on the right knee be the reason for my limp?

I'll say! What does the OS or the PT say about your lack of extension in the right knee?

I am fairly active (up and down frequently from the chair for 10-15 min at a time), at which time I might fold some laundry, wash up some dishes, put things away, do some prep work for cooking. I go shopping with someone else who brings groceries in etc. I am still unable to do anymore than this.

I'm sure this is not the outcome you hoped for. But I need to know about this 'extra work' your surgeon referred to. Do you have an xray you can post for me?

I am not doing any specific PT exercises at home, although yesterday I started formal PT again which will be twice a week for about 1-½hrs each session.

Okay but do NOT let them cause you pain or give you programmes with 20+ reps!

 

[Simplicity]

@Josephine thank you for your input. Apparently my left knee had much more deterioration and the surgeon had to "build up" something and also the prosthesis is put down lower in that leg. I will try to attach the x-ray for you to see. I thought I'd be able to do more at this point in my recovery than I can. The PT at least so far has been aimed towards my back..she has been massaging it and using electrostimulus on it...if the muscle spasms in my back stop, I think I will be more mobile and able to gradually do more. I am trying to be patient with myself. Do you expect there's still opportunity to get more extension in my right knee?

 

[Josephine]

The xray would certainly help. Just please post it as "Full Image" and not "thumbnail" as that reduces the quality of the image and makes it unreadable.

Here some help
Uploading a Picture in a Post
A few tips on posting xrays

 

[Simplicity]

X rays
@Josephine

 

[Simplicity]

@Josephine Just realized these x-rays were pics of the real x-rays that my husband took in the OS office. You probably won't be able to tell much from these? This is the size they show when I click for full size image.

 

[Josephine]

Yes, you're right. They're only 320x240 pixels which is far too low a resolution to see anything of value. Sorry about that. At least it's shown me the longer stemmed implant.

I'm still a bit puzzled about why he used a longer stem and what was the 'extra work' he needed to do and why?

 

[Simplicity]

@Josephine Thank you so much for trying...when I go back to him in another month or so I will ask him for more details--I want to know myself!! Have you had any experience with anyone with peroneal nerve problems after this surgery? From my chat with my physical therapist and some reading I've done, it seems like this is my problem. I don't know what prognosis there is for this. Leave it to me to get something crazy lol

 

[Josephine]

Well it's not common but neither is it unknown. So far as I know, most cases resolve in time.