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klinger

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Hello to my fellow TKR-ERS, Tis only me Klinger with a little question for my little forum friends. I,m now 3 weeks post op,doing well and not in a huge amount of pain. I can walk without sticks although if its any big distance I do use them as advised. The only real pain I get is when pushing it hard doing my physio workout. I,m still not much past 90 flexation but can walk without limping. So after all that waffling my question is....when bending the knee do most of us get the pain and discomfort in the same area/place, mine is not in the knee-joint itself, but I,d say a tightness about 3-4 inches above the knee at the top end of what I think maybe the quadricep tendon. I suppose this is a little poll type question really so a short and to the point answer might be of interest to us all, anyway cheers for listening all and I,ll catch up with you later,all the best Klinger
 
When I was at 3 weeks PO, I had that exact same pain, same place.
 
Welcome back Klinger, I posted the other day wondering where you were. You sound as if you are doing really well.

I am still only 90 degrees at 10 weeks, 88 at yesterdays physio session, so I may have to get a manipulation. I don't remember getting pain there as such, but it is very tight around my knee and and where my knee cap is all the time when I am trying to bend.

Anyway, don't be such a stranger. Sue
 
Hello Sue, yeah its been a little while, well afew days since I posted on hear,I dont like to mention every little twinge or ache cos I prefer to wait and see what happens might be gone next day so it could be a bit misleading.
Anyway one of my daughters is over in canada at present her name is charlotte and she,s staying with some mates for a while in vancouver, She says its a lovely city ,but quite expensive. Apparrently she off snow-boarding + snow-tubing within the next few days. We,ve had a tiny flutter of snow here in the midlands today lasted about 15 mins but its all gone now, well you know what the weathers like here in England...if you dont like it just wait half hour or so and it,ll change! Continued good luck with your rehab cheers Klinger.
 
Klinger,
I'm at nine weeks post op. The area you describe is my most frustrating problem area. It is very slowly loosening up. Other than the bones, this area, I believe, had most of the trauma. I have worked out for years including heavy squats,my Dr. laughingly told me that he had do a whole lot of cutting in that area to get to the femur bone. If I recall, you did rugby and I'm sure your in the same position. It does get better.
 
Yeah thanks Doug, the pain/tightness is right at the very top of the scar, dont think its caused by the scar itself as I said its virtually pain-free until we try go past the dreaded 90. But I,m not going to complain just wondered if my fellow TKR,s had the discomfort in the same place you know.Bit naughty really as I,m back doing some driving(short distance and I have practised an emergency stop) no probs. Cheers Klinger.
 
You seem to be right on track, Klinger....maybe even a little ahead of the curve. My best wishes for the rest of your rehab. Isn't it wonderful with no "joint pain" in that knee? I think about that every time I ascend or descend a staircase....my new joint glides effortlessly!

(I love to hear you type!!....I TRY to read it in your accent....Please don't read mine in my accent.....use yours...it'll sound better!!)
 
"Why thank you maam"(my effort at an american accent)Pretty rubbish hey? Actually we do have a lot of different accents here in the UK.I,m from middle England if I were to chat to someone say from the north-east 250 miles away ie Newcastle,it can be quite difficult to understand.If I try and talk with someone from glasgow scotland(350mls) NO CHANCE!!! good fun trying though.Nowt(nothing) wrong with accents me luv.Anyway tis good to hear from our friends across the pond,cheers all.
 
The spot you cite, is it about where this red line ends? Or where the line is pointing to the Quads tendon?

[Bonesmart.org] Opinions appreciated



If the former, I would suggest that it is nothing more than plain old muscle strain. If the latter, much the same except that it could be where the muscle is attached to the patella and that does get some welly when you are exercising and walking. Many people get that though not everyone. It will fade as the muscles get back into shape and you don't need to keep up with the PT.
 
Thanks for that jose,I wasnt too worried about complications just wondered.Would be interesting to know that when they make that incision do they cut through the quadricep tendon? or simply pull it to one side to gain access? cheers klinger
 
I am also 3 weeks post op, I am at about 85 ROM and get the same feeling of a sharp pain above my knee, my OS said it is just the Quad tendon stretching and it will eventually subside. I still use atleast 1 crutch but when I go out I use the 2 of them. Yesterday I managed to pedal for 1/2 of a mile in 20 minutes, ofcourse I had to take a few breaks but regardless I can see and feel improvement daily and I have only been to 2 out patient PT therapy sessions.I know my ROM is going to be the hardest part but I will do everything I have to to get it to where I want it.
 
josephine, does the size of the incision indicate whether they cut quad muscle or not? My os had said they wouln't cut muscle just spread out of the way, but now I wonder if the plan changed when I was out.
 
They NEVER cut the quads. Would be the biggest no-no going.
 
then what is a "Quad Sparing Incision"? Why is that a big deal if they don't cut them anyway? What are they talking about?
 
Yeah good question Beachcomber, my surgeon told me that he,s had to put right a few quad-sparing incision TKRs because getting the alignment correct is always more difficult.
 
Ok, don't say you didn't ask! Major gross coming up ....

When doing the routine procedure, the whole quads structure is everted meaning it is folded over and aside of the joint to give the surgeon access. This stretches and strains the muscles which is what accounts for some of the post op pain and stiffness. In the "quads sparing" approaches, the incisions are smaller and to the side - much like minimally invasive - and so there is no need to move the quads mechanism much at all. It's more difficult for the surgeon but the results for the patient are well worth the effort. And poor alignment of the prostheses is a particular downside to MIS TKRs which is why some surgeons are looking into robotics or Computer Assisted Navigation.

Well, that's my experience, anyway. There's always the (slight) chance the surgeons in the US do things a little differently but I can't think it would be the case here. Repairing the quads structure at any point is a major procedure on its own and usually requires the leg to be immobilised in a cast for some weeks afterwards.
 
like that lady who pops her eyeball out of its socket gross. Actually very fascinating and vital info we obviously don't get. I think knowledge is power and for me understanding the engineering of it all helps me heal and rehab my spared quads better. Thanks Josephine.
 
ref was kind enough to provide a link to this pic which displays the procedure nicely (well, nicely from my point of view!!).

You can see the little round button on the underside of the patella (kneecap) which has been everted to give the surgeon such excellent access to the joint.
 
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