TKR One year out and still hot and painful

The main thing to ask is if he can figure out what is going on. You have a test that shows a possible area of concern (the lateral side of your knee) and you want to find out if you are dealing with infection or a possible allergy.

Cortisone is useful in reducing inflammation, so might offer you some relief from your pain... but it's best used for things like bursitis or tendonitis (or arthritis, which is how most of us are familiar with it). Notice all the -itis going on. Inflammation situations. Should your surgeon propose cortisone again, ask him what the cortisone is supposed to accomplish. He will tell you if you have one of these conditions. If it's just guesswork, though, a "might as well try it" response, cortisone may not help anything.

I hope your surgeon gets you some answers!
 
Thanks so much Susie for your reply, I really appreciate it. I have a feeling he will give me the 'might as well try it' answer...as the fact that he had never heard of the propionibacteria got me a bit worried! My SPECT CT scan said that an infection was likely - but he skimmed over that. Since I heard about it on the forum, I have read quite a lot of articles about it in relation to joint replacement - so i would have hoped he was up on the subject! I will let you know what transpires. Meanwhile, many thanks again for your support.
 
@melfair - i haven’t posted in a while but I still check in sometimes. I totally sympathize with you, my friend, since I had total left knee replacement surgery on Jan. 2017. I still have pain, swelling and some heat on the lateral side when I roll over, go down stairs, walk very far or even ride the stationery bicycle in our building’s gym. At my one year check up, my surgeon said my xrays looked perfect, my range of motion was great, I was walking well and my knee and scar looked good. She said she would not “open that knee up again” to do a revision. She said she believed my pain was real. Then she told me to take Tylenol, use Voltaren, keep exercising and going to physiotherapy. And she added, “See you in two years.” So maybe she thinks that three years after my TKR, I will be happy with my artificial knee. I’m certainly not yet.

I have been frustrated and depressed at times about having worse pain than before surgery, but I continue to experience small improvements. I was discouraged because, after more than a year, I had to use a wheelchair in both airports on a January trip to a resort in Jamaica. I had to use my cane around the resort - and even down to the beach. I did actually dance one night, but regretted it the next day! I’m not icing my knee or taking Tylenol as much. I’ve also cut down on physio because of lack of any real progress there, an increase in the hourly rate and lack of health insurance coverage! My therapist does believe that most of my pain is coming from my IT band. But after months of physio and stretching exercises, I don’t know why there’s been so little improvement.

This is all a very long way of saying, “Hang in there!” I would not discourage you from checking out an infection, metal allergy or other cause of your discomfort. I’m actually on a long waiting list to see a totally separate orthopedic surgeon for a second opinion.

We are a minority, but there are still some other TKR patients who continue to have remarkably similar symptoms and similar reactions from their OSs (e.g., “perfect xrays,” etc.) many months after surgery. We all support each other herw through what has become a drawn-out recovery. Many people post here for a few months, then stop posting after three or four months when they recover. Some lucky ones claim they don’t even think about their new knee(s) anymore. And there’s that five per cent of us or so that are still having a hard time of it. (My OS said fiver per cwnt of TKRs will always have pain - I’m determined not to be one of them!) But most days I’m hopeful that some day I’ll be able to walk pain-free again. That’s the whole reason I had this TKR in the first place! I am using my cane less (but if I’ll be walking much I still wear my neoprene brace). I try to practice going downstairs, but I still have to hold on to a railing. I think I’m quite a bit better than I was at my one year review this past January. I will continue to do my exercises, but not overdo, and Inlook forward to a long-planned trip to Hawaii - maybe next year. I was hoping to do that trip on two painless new knees...but I’m not in a hurry to have my bone-on-bone arthritic right knee replaced
for some time to come! Maybe I’ll go after my three year review...when I hope I’m finally healed and without pain.

People like us are called “slow healers”. I just hope we do heal eventually. Then maybe we’ll say the surgery was worth it!

Please keep posting and letting us know how you progress and what your surgeon in the States has to say about your symptoms and recovery. Some of us on Bonesmart will be thinking of you - and rooting for your recovery!
 
I really understand how you feel , my knee worse now than before OP, I got DVTS -post DVT , cannot do anything about Main arteries has extensively damaged, so long term disability , damaged tendons underfoot of OP knee. 85 % rom so cannot bend knee so far and cannot ride my beloved cycle so even that out of the question know all this because of knee OP. so there are many of us out there who ae suffering after knee OP. I don't post so much Too on here now because I don't want to be so negative and now there nothing anyone can say or do that can change things.
My saying now is that "I used to walk with pain but now I walk with pain and two walking sticks "
Though we got to carry on and keep smiling and on with our life's , :thumb:
 
Thank you so very much, @Knees4Me! It was incredibly helpful (though of course, not so good for you!) to hear of symptoms so exactly like mine. It is a very depressing situation! -to have put so much hope in the fact that soon you'll have a wonderful new knee, and see other people doing so well after a few months ...and then to feel that your OLD arthritic knee was preferable and less painful then this new one! That said - I am so very sorry that you have had the same troubles, and that your vacation to Jamaica was impacted by the pain. I will very much hope that by the time your Hawaii trip comes, you will be dancing with ease! I will certainly let you know what the surgeon says when I see him - and I think, like you say you are doing - it may be good to have another opinion. Thank you again for your kind and thoughtful encouragement! On we go!
 
Oh! and now a message from @bland9 - how very terrible for you - I am so sorry to hear of all the problems. The doctor I saw here in England said that TKR's were about 85% successful - and I remember hearing that before my op - but being an optimist, presumed I would not be in the other 15%! As @Knees4Me wrote, let us hope we are just 'slow healers' - and in a while all will be well. I had planned to get my other knee done, but I think it has been talking to it's neighbour (!) - and so seems much less painful then ever it was - and certainly less then the 'done' one. In any case - nothing would convince me to go through this again. I wish you well, and that our 'slow healing' may eventually happen - and meanwhile thank you for your support and cheer in spite of your suffering!
 
@bland . Website.......orthopedal.com


They have an attachment to put on pedals for limited flexion. My friend got some and is now riding her bike!

I wish you well..OnYou have a lot to deal with. Keep posting here, you'll get help
I'm at almost one year.. Good ROM and can do all my activities but have ongoing minor pain and stiffness. Going to up my curcumin supplements ( an anti-inflammatory) , got new walking sticks for inspiration.. Nothing like shopping therapy when it's practical!

We'll see. I haven't given up hope of being more painfree..
 
Hopefully, when you see your surgeon in the States, you'll have more conclusive answers. My OS answer to my continued issues (very similar to your own) is: Time. "I've seen patients with these issues and it just takes time". I'm very active but yes... at 1 yr 4 mos. I still have heat, some swelling and pain/discomfort. The heat goes away when I've been doing nothing, and also when I first exercise (exercise seems to push the swelling and heat away - it comes back afterwards). I wish you well.
 
as the fact that he had never heard of the propionibacteria got me a bit worried!
I can imagine but this will most likely be one of the newly occurring gram positive superbugs as per this snippet I found

Propionibacterium is a gram-positive, anaerobic, rod-shaped genus of bacteria named for their unique metabolism. Several species, including E coli, are common causes of food borne disease. Staphylococcus aureus is the most pathogenic; it typically causes skin infections and sometimes pneumonia, endocarditis, and osteomyelitis. It commonly leads to abscess formation.
 
Thanks @jaschembra, that is very encouraging to hear. My pain also is better when I am walking (on the flat) but then it comes back in proportion to the amount I have walked later on, often at night, when it will wake me with a very sharp jab of pain. But it makes me feel better to hear that recovery can go on after a year or more - I had thought that a year was as good as it gets...! Interesting too about the pedal extensions from @Hopetohike - although I am not a cyclist (London too scary to attempt that!) But I also have upped my curcumin dose.
About Propionibacterium - here is a paper written about it https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940594/
also, one can just google 'Propionibacterium in joint replacement' for lots of references.
Here's hoping that none of us slow healers have it!
Best wishes to you all!
 

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