PKR One Year Out - Pleased With Outcome

[Susie-Q]

When could you manage do get in and out of a bath?

I tried to take a bath at around 4 months post-op and couldn't get out myself! It was partly because I put too much bubble bath in combined with a "bath bomb" so the tub was very slippery plus I just wasn't flexible enough yet. I had to get hubby to help me out, embarrassing! When you are able to will depend on you, of course, and how flexible you are. I'd wait until at least 6-8 months. I finally took another bath the other day and was able to get out no problem. (I'm 16 months post-op) I probably didn't need to wait that long but I was chicken to try.

 

[EalingGran]

Thanks- that is helpful. I think you are probably right- it's just that I really miss a nice hot bath. It also used to help relax me for sleeping and I could certainly use that!
Just another small query you might be able to help with.
When did you shave your legs post surgery? I haven't done it since operation because of not wanting to risk cut/ infection and also because it is Winter.
I noticed someone answering my question about the numb patch post operation said they found shaving unpleasant around the scar. It set me wondering when/ if to restart. No rush though- it is least of my concerns right now

 

[Susie-Q]

I started shaving pretty soon after, maybe a few weeks? I stayed away from the scar part for a long time and just made sure to give a half inch on each side give or take. I'm able to shave over it now and have for awhile but I can't remember exactly when I started that.

 

[JusticeRider]

EalingGran, I’m still too scared to shave over the scar! I tried again yesterday to convince myself to do it but I chickened out at the last moment. I shave around it, being very careful on the numb spot. For now it is an experiment…just how long would the hair on my legs be if I never shaved? It looks like I’m going to find out!

 

[EalingGran]

 

[EalingGran]

@JusticeRider @Jockette
I have a question about Zingers.
I have heard some references to these in various posts and wasn't entirely sure what was meant.
I now have had some sharp little toothache like pains in the numb patch- presumably some not very well structured regrowth in the cut nerve? Is that what are referred to as Zingers?
I am struggling again. Picked up yet another cough/ cold from my baby grandson and feeling very rough and not sleeping again.
Not helped by stopping my naproxen before I see my surgeon in a couple of weeks to try and see whether straightening my leg has improved/ cured my hip pain and whether I still need to go on the waiting list for hip replacement. The good news is that a week later my hip pain has not yet come back but the bad news is perhaps not surprisingly my knee is more sore and my lower lumbar arthritis is worse....

 

[sistersinhim]

I now have had some sharp little toothache like pains in the numb patch- presumably some not very well structured regrowth in the cut nerve? Is that what are referred to as Zingers?

I described my zingers as lightning bolts going through my knee. They were very quick, thank God, and the pain meds didn't touch them. They were really bad for a few months, but infrequent, about one a day. As time went on their intensity got less. Now, I have very mild ones only once in a while.

You are correct in stating that the zingers are nerves regrowing, reattaching, or rerouting. They really hurt, but are a good thing because it's proof that your knee is healing!

I still have a numb patch on the lateral side of my knee, but I've had 6 surgeries on it, so I am not concerned about it. Most people get complete feeling back in a few years.

 

[JusticeRider]

@EalingGran , I’ve been fortunate to not have many zingers (so far!). I’ve only gotten maybe three days of them scattered here and there. One day I got quite a few but mostly it’s just a couple. It feels like little fleeting sharp pains, not deep in my knee but closer to the surface. Just like @sistersinhim said, like little lightening bolts. They are quick, not lasting. Does that sound something like what you’re feeling?

 

[JusticeRider]

I’m so sorry you’re dealing with another cold plus having to skip the naproxen. Does Tylenol help you at all? I hope the two weeks passes quickly. At least it sounds like good news for your hip!

 

[Jockette]

Picked up yet another cough/ cold from my baby grandson and feeling very rough and not sleeping again.

I’m sorry you’re sick. I got every illness my first grandchild had, if I spent time with her! My immune system must have toughened up, it didn’t happen with her brothers.

I hope you feel better soon.

While zingers are uncomfortable, they are a sign of healing.

 

[EalingGran]

It feels like little fleeting sharp pains, not deep in my knee but closer to the surface

Yes @JusticeRider that is exactly what I experienced. I had them for the first time yesterday. Not pleasant and I would have been worried had I not heard about Zingers from this forum and figured out that is what they must be.
Thanks for replying and to @sisterfor the reassurances.

 

[EalingGran]

While zingers are uncomfortable, they are a sign of healing

Thanks!

 

[EalingGran]

Does Tylenol help you at all? I

Not really but I must try taking it more regularly

 

[EalingGran]

@JusticeRider @Jockette Found this paper weighing up the pros and cons of PKR versus TKR. If you Google the title you can get the full pdf free and it is not that technically challenging to read.
One of the points of interest is that because PKR are easier to revise the revision rates may be artificially raised and more PKR than TKR are revised even if the Oxford knee score is the same i.e.- people may be told to live with a poor outcome on TKR whereas a surgeon is more likely to attempt a revision of PKR.
Another interesting point is because there are more revisions of PKR there is a perverse incentive to stop doing PKRs - as revision rate is seen as a marker of surgical ability or lack of it. Whereas in fact other outcome measures may be worse with TKR.
The only problem with nearly all the papers I have found on PKR is that they look at the most common type ( medial) rather than lateral or patello-femoral.

Unicompartmental knee arthroplasty: is the glass half full or half empty?
Authors:	Murray, DW Liddle, AD Dodd, CAF Pandit, H

 

[JusticeRider]

EalingGran, thanks for sharing! I will look this article up and give it a read. I read everything I can get my hands on. I really think we have to be our own advocates when it comes to our medical care. And you are right that most of the information on PKRs out there relates to the medial PKR. Very hard to find info about patellofemoral.

As for the zingers, thank goodness for BoneSmart! The dr’s don’t tell us any of this stuff. If I hadn’t already read about zingers on BS before they happened to me, I would have been in a panic thinking something was wrong! So much better to say ‘ow!’ but then almost be able to smile because you know it’s a sign of HEALING

 

[EalingGran]

JusticeRider - the second author on the paper is my consultant Alex Liddle. I think he is quite pro PKR. Just have to hope though that he has not been too optimistic in my case because the MRI definitely showed some arthritis in the other two compartments and I still have some medial twinges on stairs...
Mind you it is hard currently to know what is going on because of stopping naproxen and aching all over from cold/ flu like illness. Eased off on exercise as my ROM is good and just trying to rest before I see him on 18th. Hopefully will have a clearer idea of my progress and whether I need hip surgery. Suppose the good news is that currently my right hip doesn't feel any more achey than anywhere else right now!.
How are you doing? What's the weather like with you? It is really cold and wet here ( London) and that doesn't help with aches/ shivers.

 

[JusticeRider]

EalingGran, thanks for sharing the paper. So cool that one of the authors is your consultant! I read it and found it very interesting.

It makes sense that because revisions of UKA’s are easier than revisions of TKA’s, there would be more revisions done. And just the fact that UKA’s are more commonly done in younger patients makes it more likely that a revision will have to be done at some point too. And of course a very important point that @Jockette has alluded to before: the more UKA’s a surgeon performs, the lower their individual revision rate is.

So it’s really a very encouraging article for UKA patients! But also highlights the importance of finding an experienced surgeon. Not as hopeful if they are inexperienced.

Weather here was nice today, warmer and the sun was out. Very nice because it’s mostly been cool and rainy. I hope the weather doesn’t affect my knee because it’s cool and rainy here about 6 months out of the year!

Things are going well, continuing to make small but significant improvements. I feel like maybe the pace of improvement is picking up lately. I’ve been enjoying doing my own pt at home as opposed to going out for it, mostly because I get to do what I want and what feels right! Slow but steady!

 

[EalingGran]

Glad you are doing well and pace of improvement is increasing. I find it very encouraging as you are a bit ahead of me in the recovery journey. Fingers crossed that it is all plain sailing now!

 

[EalingGran]

@JusticeRider

Functional Outcomes, Survival Rate, and Complications of Patellofemoral Arthroplasty: Mid-Term Results From Independent Center​

Nuthan Jagadeesh, Rafael Sales-Fernández, Srinath Pammi, Ankur Kariya
Thought you might be interested in this article- full text available free.
It seems generally encouraging although it does say that only 1.1% of joint replacements in UK register are patellofemoral ones. It seems the older surgery had more complications.
This study uses Avon implant- not sure if that applies to you?

 

[JusticeRider]

Hey, thanks @EalingGran ! I did read, with interest! Very interesting and refreshing to get more in-depth info regarding patellofemoral replacements specifically. I think the rates are similar in the US as far as how infrequently it is performed. If I remember correctly (since, try as I might I can’t seem to find where I saw this figure!) I read that of all knee replacements here, only 10% are partials and of all those, only 10% are patellofemoral. Which is probably why information is so scarce! So I really appreciate you sharing this!