TKR Two Stage Revision Surgery Scheduled

I’m 17 weeks since RTKR. Sleeping much better but still have the tight Band sensation. I have been using the CBD roll on on my knee and helps a lot. There is not THC in the one I use. I take 2 Tylenol ES before bedtime. Swelling and burning sensation has subsided. I ice after walking.
 
@Teeboxx What brand CBD roll-on do you use? And how often do you use it? Does your tight band sensation inhibit your walking? Mine does, as I start to bend my knee the tension seems to actually twist my knee, and the discomfort inhibits me from bending it normally. What has your Dr said about it? The steroid shot I got 2 days ago has significantly reduced the soreness, but hasn't reduced the tight band feeling. I hope the good effects last. I am sleeping much better. The burning has subsided for me too.
 
I am around 14 weeks and have the tight band as well as a tight lateral muscle. I still have pain walking up and especially down stairs. I don't see my OS until April 1st (if we are even allowed outside by that time). I have some noises coming from my knee also, these must be the clunks people talk about.
 
Moderator, please change title to "Tight Band persists at Week 24"

Well, it's been 8 weeks since my last update, and there has been progress, but the tight band feeling around the knee persists. There are brief periods when it is almost completely gone and there are other times when it feels like my knee is in a vice. I haven't been able to figure out the cause and effect. Overall its not as tight as it had been and it doesn't inhibit walking as much as it had. I can walk a mile in 40 minutes with a cane without too much discomfort. I couldn't do this with my old knee. I'm not needing ice or pain pills. I'm still having problems sleeping comfortably on my sides, If I could only stay on my back my knee is quiet and comfortable. I've resigned my self to accepting what I have with the hope that by year end it will be fully healed and comfortable.

Best wishes to all in the face of the corona virus threat. Be safe and careful.
 
Moderator, please change title to "Tight Band persists at Week 24"
I changed it for you.
There are brief periods when it is almost completely gone and there are other times when it feels like my knee is in a vice.

That tightness is internal swelling. That's a small space inside our knees and it doesn't take much fluid to fill it up and make it feel tight. Sometimes we can find no reason for it. I think that we might do something in our sleep to make it swell and not even know it. Weather also affected mine and probably does yours, too.
 
I was always a side sleeper, until this recovery. I was able to adjust to sleeping on my back by elevating my legs when I’m laying on my back. I haven’t gone back to sleeping n my side.
 
Thanks for the feedback. @sistersinhim I too think it is fluid because it can go from feeling ok to feeling tight in a matter of minutes. @Jockette Thanks for the tip about the leg elevation. I'll give it a try. @ginr Let me know what your Dr says about the tight band. I was scheduled to see mine next week but canceled due to the corona virus.
 
Here’s an article from the Bonesmart Library about the tight band feeling:


Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/
 
Hi-I was wondering if you were still using the CBD roll?
 
@Jewlz1 Hi, I never got around to using any CBD products. I'm still interested in suggestions by BS members.
 
Members - please remember BoneSmart is an international forum. In many areas of the US and in many countries CDB products are not legal.

Here are BoneSmart's rules for discussing CBD and THC:

* CBD must be legal in your location
* You must only discuss your experience with the product (does it work or not)
* If CBD is purchased legally without a prescription and not under a doctor's care, it must be hemp (CBD) oil without THC
* If it's any type of product with THC it must be legal in the area where you are AND you have to be and say you're working with your doctor to use it

* Non-THC CBD oil applied externally. CBD oil discussions are fine as long as it is a hemp product that has little to no THC in it and you are not taking it orally. If a member talks about successfully using CBD oil and they don't specify that it is the hemp-based, it is appropriate for moderators and advisors to post and ask for clarification. Hemp based products used externally don't need to be coordinated with a doctor.

* CBD oil that contains THC. If the CBD oil has THC (the chemical that makes you high), it is only okay to discuss it if you are in a state or country that permits sale of the product over the counter and you are not taking it orally. If a member is talking about successfully using a CBD oil and they don't specify that it has THC or not, it is appropriate for moderators and advisors to post and ask for clarification. CBD oil used externally in states or countries where over-the-counter sales are legal don't need to be coordinated with a doctor.

* CBD oil or cannabis products taken orally. If the product is being taken orally (with or without THC), members need to be working at a minimum with their GP in order to discuss it on BoneSmart because there are possible interactions with other medications.
 
Moderator, please change title to "One Year Report Card - D"

Its been 7 months since my last post. I resigned myself to put off judgement of my TKR until my year anniversary on October 14. The tight band syndrome which started in week 4 post op continues along with tenderness on both sides of the knee. I've been able to resume recreational walking, but not golf. During the last 3 months I've been walking several times a week for an hour or so, about 2.5 miles without too much discomfort, a feat I could not do pre-op. Based on this I have to give my TKR a passing grade. But considering the continued tightness, tenderness, and trouble sleeping I can't give it more than a D. On the best of days, maybe a C.

At month 4 my OS said that usually the tightness is gone by now and it could take up to year to resolve. At month 8.5 with no progress my OS said I was doing fine and he was 90% sure it would resolve by a year. He attributed it to scar tissue and fluid. Last week, at month 12 he aspirated it, and injected it with a steroid. Lab results came back with elevated white blood count, and elevated neutrophil %, but negative culture for bacteria. I next see him on Nov. 17 to discuss. But I have a serious concern about a possible infection.
 
I have changed your title for you.

I am so sorry to read that you are still not happy with your replacement. Some people find that it does take longer to heal from this surgery than others do. It's good that you are seeing your doctor next week.
 
Sorry to hear about your unsatisfactory progress; hope your OS has some good suggestions. We are pulling for you.
 
Some people find that it does take longer to heal from this surgery than others do.
I am someone who took a really long time to recover, though I never did recover completely. I still have issues at 3.5 years post op, but, I am much better now than I was at the one year mark. I had improvement in my second year, and in my third.

I’ve even had 2 second opinions but neither doctor found anything to fix, in spite of my long list of complaints. I hope you also continue to improve. I’m at a point that it‘s not great, but it is manageable.

It might be worth it to get a second opinion, from a surgeon in a different practice, a distance away, so that he has no association with your surgeon, to get an unbiased opinion. My surgery was done in Delaware and I went to the Philadelphia and Baltimore areas for second opinions.

My first second opinion told me at the beginning of the appointment that not everyone gets a good outcome, doing it over can sometimes make it worse, and some people’s bodies just don’t like the implant. At the time I was annoyed that he would say that, he rushed the appointment and I thought he was just not interested in my case. However, at this point I think those statements might have some merit.
 
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Moderator, please change my title to "Suggestions for a Second Opinion?"

In October I had my one year visit with my OS and told him I continued to have tightness across the front of the knee and discomfort when walking. He aspirated the knee and sent the fluid out for analysis. The lab work showed elevated white bloods cells and elevated neutrophil %. The bacterial culture was negative. When I saw him again in November he told me that despite the negative culture I could have a low grade infection, and he was going do a more complete workup to assess the possibility of an infection. He did another aspiration and repeated the synovial fluid cell count, had a Synovasure test done, and a bone scan. Within a couple of days I got the cell count results online and they were again elevated. Since October I've been sweating bullets at the prospect of an infection which would necessitate a two stage revision. Last week I had my follow-up visit during which he said he ruled out an infection based on negative results of the Synovasure test. I was greatly relieved. But he had no solid explanation for my continued tightness and discomfort, other than swelling. He went on to say that if he were to "open up" the knee he might find something that would explain the problem and could be adjusted. I told him I'm not inclined to go thru that right now particularly with COVID surging. We agreed to "follow it" and scheduled an appointment for March.

I live in Allentown, PA and I'd be interested if anyone has suggestions on who to go to for a second opinion in the Lehigh Valley, or Philadelphia area. In particular. someone who specializes in revision surgery. @Jockette, who did you see for your second opinion in the Philadelphia area?
 
These are the two surgeons I have in mind if I should need one. I have not been to either of them, but I’ve heard good things about them from members here.


 
Thanks @Jockette. I'll keep these two names in mind. I will wait till I get my COVID vaccine before I get a second opinion.
 
Moderator please change my title to "Two Stage Revision Surgery Scheduled"

Since my last update in December 2020, my 19 month old replacement knee continues to be stiff, sore, and painful upon walking. In April 2021 my OS repeated synovial fluid analysis and bloodwork to assess the possibility of a low grade infection which he had ruled out in November 2020. The serum CRP and ESR were within limits, and nothing showed up in cultures of the synovial fluid but WBC and neutrophil % were higher than their limits and a Synovasure analysis was positive, although with a cautionary note that it could be a false positive. With these mixed results my OS consulted with several other orthopedic doctors including a prominent expert in periprosthetic joint infections at Rothman Orthopedics who suggested a low grade biofilm infection. They recommended a 2nd generation DNA analysis called MicroGenDx to confirm an infection and its pathogens. The test turned out to be negative! Nevertheless my OS remained convinced I have a low grade infection and recommended a single stage revision utilizing antibiotic cement. At this point I decided to obtain a second opinion from a Rothman doctor specializing in revision surgeries. Without additional testing, he confirmed the infection diagnosis and suggested I had the best chance for success with a two stage revision. So I'm scheduled for the first surgery on July 12 at Jefferson University Hospital.

I dread the thought of going through 2 more surgeries and would appreciate any words of encouragement, especially from any veterans of this double procedure.
 

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