TKR One year post TKR pain

[hedgie79]

Hi, this is my first post, glad I came across this forum. I am 13 months out TKR. My recovery was brutal, but the surgeon was happy with my progress. I am at 130 flexion. The problem I have is I have pain every time I get up from sitting, and always with climbing stairs. I do not have pain otherwise, just feels like a "real/fake" knee! The pain is located just above the knee cap. A friend recommended getting a bone scan. Worried...

 

[Jockette]

Hi and Welcome to Bonesmart!

I’m sorry you are still in pain after a year. I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.

I’m also sorry your recovery was brutal. It’s really a shame that so many of us are subjected to this kind of rehab when many members have found a gentle approach to rehab brings about a very good outcome.

I will leave you the Recovery Guidelines we give each new member. 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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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.

 

[Pumpkin]

Sorry to hear you had such a difficult recovery, it is possible you were given too much too soon and your soft tissues are still irritated. You can try slowing down, icing and elevating and see if it helps.
You may want to seek a second opinion for your TKR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled knees. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!

 

[hedgie79]

Thank you for your comments. I am probably going to make a few mistakes being new to this. I apologize in advance! My LTKR surgery was April 13, of 2018. I appreciate any advice, comments. What I read about revision surgery sounds scary! I know, I should not get ahead of myself...
I will ask my primary to get the ball rolling for another opinion. My surgeon retired recently due to health issues. My insurance may not cover seeing a specialist, but I have to try.

 

[Celle]

What I read about revision surgery sounds scary! I know, I should not get ahead of myself...

As you said, don't get ahead of yourself.

However, in spite of what you've read, I can reassure you that my revision was no worse than the original recovery.
And if you can see a surgeon who specializes in problem knees, it may be that a revision isn't necessary anyway.

 

[hedgie79]

Thank you Celle, how are you doing since your revision surgery?
I made an appointment with my primary for next week. I have to go through the referral process, which can be time consuming. Since my surgery, my OS left practice due to health reasons. I really have my doubts that I will be referred to a specialist for problem knees, most likely due to my insurance limitations. So, I will most likely go to another surgeon in the same department, and go from there.

 

[Celle]

My revision was 7 years ago now and it works so well that I usually forget I have an artificial knee.

 

[hedgie79]

I just had an xray on my surgery knee (L) of April 2018. It showed everything as normal. I still have the pain (above the knee cap) each time I get up from sitting and going up stairs.

I just had an MRI on my opposite knee and my physiotherapist found a lateral meniscus tear which is extremely painful most of the time. I started PT in April, with my last appointment May 28th. My physiotherapist (same dept) is recommending more PT, but my insurance has not approved it. This gap in care is troubling. Coupled with the pain above the surgery knee, it's pretty painful. Should I ask for an MRI on the TKR - would this show if there is tissue damage?

 

[Josephine]

I just had an xray on my surgery knee (L) of April 2018. It showed everything as normal.

If I'd had a £1 for every time I've heard that on here, I'd be pretty well off by now! Can you get copies of your xrays to post for me? I have a talent for reading xrays!

I just had an MRI on my opposite knee and my physiotherapist found a lateral meniscus tear

Your physio found the tear? Where was your surgeon?

Should I ask for an MRI on the TKR - would this show if there is tissue damage?

Well they're unlikely to do it for the simple fact that MRIs don't work too well in the presence of implants. The latest procedure is to have a nuclear bone scan and take it from there.