TKR Pain in back of knee

koda

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Just want to first thank everyone for all the encouragement and valuable insights, so helpful. I am 6 mo. post R TKA. I had 12 wks of successful therapy with 0 extention and 125-130 flexion. However, an on going intermittent issue is pain, soreness, and tightness on the posterion medial aspect of my knee below the bend. Recent xrays showed excellent fit, alignment, and petella tracking. Therapy kept saying it was related to hamstring tightness and keep doing the exercises, which I do. When I hyperextend my knee I do not feel any pulling sensation above the knee, just below as descibed above. Is there any other issue that could cause this, if so, what can be done? Surgeon says every thing looks good.
 
Hi and Welcome!

Surprisingly, for some of us, it is better if we cut back on the exercises we are told to do. Your ROM is great, so you don’t need them anymore. Are you back to a lot of your pre-surgery activities?

Even though it’s been 6 months I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Particularly read number 4, about the PT exercises and see if you are doing any that might be keeping your knee painful.

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
5. At week 4 and after you should follow this
6. Access to these pages on the website

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.
 
Thank you Jockette for you quick response. I read the Knee Recovery Guidelines and found them most helpful. I have been back to my pre surgery activities for several weeks. This issue has been on going since surgery so I dont feel I've done any particular "thing" to initiate the problem. I was just concerned if it was going to be chronic and if it might be related to a ligament or tendon shorting, if such a problem was possible.
 
@koda I have a similar situation. My pain has a snapping sensation that is associated with the pain. I also have had this since my RTKR in April. It has been diagnosed as a problem with my Popliteus muscle rubbing across the back of the implant. You may want to do a search on problems with the Popliteus muscle to see if it applies to you. By the way, for me it take another surgery to repair.
 
I had a weird feeling behind my knee for several months. It just seemed to gradually go away. I don't know what it was.
 
Koda,
Welcome to BoneSmart, :welome:
It could be tight hamstrings or tight gastrocnemius muscles. Has your PT suggested any gentle stretching?

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!
 
Hello @koda - and :welome:

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:

You're back to all your normal activities and your ROM is excellent. I think it's time to stop going to PT and just let your normal daily activities be your exercise. At this stage, that's all your knee needs. Stopping the exercises may also help to relieve the pain you're getting. Stop hyper-extending your knee as well.

Complete recovery from a knee replacement does take a full year, so you are still only half way through this time. It's normal at this stage to still have some residual pain from time to time.
There's still plenty of time for improvement.
 
I had my right TKA Surgery March 11, 2019 and was discharged from therapy first week of July. Mainly just been doing the on going exercises as my surgeon's NP instructed, nothing strenous. Thankfully I have had no complications. Just experiening the issue in the back of my knee below the bend on the inner aspect. I do still ice it and take Ibuprophen when it gets uncomfortable.
 
I think you just need to allow yourself more time for everything to heal and settle in with your knee. The fact that you are able to go back to your regular activities is wonderful. Remember your knee didn't get bad over a period of months. I'm sure it was much longer than that. You need to allow plenty of time for things to continue to improve. It's a process....and sometimes a long one. As long as you're not in severe pain and pushing your knee with exercise or activity or exercise, I doubt you will have a chronic problem with this discomfort.
 
Thanks to all of you for your encouragement.. Guess I'm just in a hurry to quit having it on my mind every day and thinking something might be wrong. You know how all the ''war stories'' can cause concern. I just need to embrace time and go with the fact that at least now I'm able to do things that were a challenge before. Thank you guys, y'all are great!
 
9 months post op R TKA, have been doing great until the past month. I started feeling soreness which is mostly in back of knee that has not been bad but has been consistant . Also, some slight swelling that had not been present till past 2 weeks. Knee feels warm (not hot) to touch. I can feel "something" move out and back on both sides of my patella when I flex and straighten my knee. Xray in July showed everything looked good. Like I said, this only started about month ago. I have not injured or done anything beyond my normal daily activity. Any Thoughts?
 
@koda you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. If you would like a new thread title just give a shout.

In terms of your new issues - are you still doing PT? Are you icing regularly? This all sounds like normal recovery. Starting any new activity is going to make that knee complain. Ice and rest. If this doesn't settle with rest do follow up with your OS.
 
I am now 18 mo. post R TKA, I fell twice on my knee about 2.5 mo. ago and since have been having soreness around the entire circumference of my knee. Most of the discomfort is in the back at the bend. some tightness at times. I thought at first that it was just bruising and would be ok in a couple weeks. I play keyboard at church and practice daily so when I have to keep it in the bent position for that length of time I have to slowing extend it because of discomfort. It feels almost like it did a few weeks after surgery but without the bad pain. I have full ROM and extension with no instability with standing or walking. My question is, would it be possible to displace the spacer from a fall that wasn't "that bad".
 
@koda
I’m sorry to hear about your falls. I hope you just have some soft tissue damage that will heal soon. I’d like to know more about the behind the knee pain you had early on. I too have terrible pain behind my right knee. I had bilateral TKR 12 weeks ago, and straight from the beginning I had the behind the knee pain in my right leg. Left leg is fine - no pain. My therapist says it due to a shortened super tight hamstring. I’ve been doing stretches and exercises to fix it for 2 months, and I’m still in pain from it. It is driving me crazy, and the swelling is preventing me from gaining the same ROM as I’ve gotten in my left leg. How long did it take for your hamstring issues to resolve? Did you do anything special to make it better?

@tylermit
How did your doctor diagnose your behind the knee pain source? I did look up Popliteus muscle and TKR. If my pain doesn’t resolve in a couple more months, I’m going to have my surgeon investigate this. I’m tired of living with the pain and want it to go away!!! I just don’t know if what I’m experiencing is due to a shortened tight hamstring tendon or due to the Popliteus muscle catching/rubbing.
 
I went back to my surgeon in Feb. for the ongoing issues. X-rays showed no problems and there wasn't any indication of "loosening" so I wasn't given any definitive diagnosis. Still have the problem months later so I guess its a matter of going back "again" and insisting on more test. I have just learned to live with it. It very frustrating. I kept thing time would take care of it but it hasn't and now there is an added issue with the straightening after I had it bent for any length of time. Sorry, I wish I could be more helpful, but not even sure what's causing the problem. I hope you can find better answers than I've been able too.
 
@koda,
How are you doing with your knee?
It may time for a second opinion of your knee has not improved, 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.
 
@koda I have a similar situation. My pain has a snapping sensation that is associated with the pain. I also have had this since my RTKR in April. It has been diagnosed as a problem with my Popliteus muscle rubbing across the back of the implant. You may want to do a search on problems with the Popliteus muscle to see if it applies to you. By the way, for me it take another surgery to repair.

@tylermit - How are you doing now with the pain from your popliteus? Did you end up having surgery - did they do a release? I've recently had a couple of steroid shots in the popliteus, and my pain in that area does seem to be improving. Any info on your condition and what you've done would be great! Thanks.
 

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