TKR Update

It sounds like you had something more than a sprain in your back way back then!

You had a lot of jazzy cars! I told you once that my husband also had a motorcycle when I met him. I was 19 and he was just turning 24 and I thought he was so cool! I do think it pained him a bit to let me drive his challenger when we got married, as I didn’t come with a car of my own. It was less than a year before we sold the challenger and got a Toyota Corolla. Big difference! We had a lot more expenses as a married couple than he did when he was single!
 
From a Challenger to a Corolla is a reality slap!! A Corolla is of course much more practical, but DANG!!!

Ya know he loves you!! :)
 
So today my knee actually felt a little bit better, then....

My dog has an ear infection, trying to clean it with peroxide then put bacitracin on it. Put the bacitracin Down & it goes straight to Ride Sterling !! So I get on the floor to see if it landed under the recliner. On the way down I smack the center of my incision with a sharp piece of the metal frame from the recliner!! I Hope I did not break something in there because it is screaming now!!

I need a nice big rubber room!!

Good night all
 
Oh, ouch! I can imagine the words you thought like saying! You are probably fine, just angered some of the soft tissue that is still in the early healing stage. Did you try icing it?
 
It is better today, I don't think I damaged anything. I did ice it right away

PT today she was finding more stretching for me to fo yo work on my glutes. She believes I will take some of the load off of my knees if my glutes are stronger. It doesn't seem to be aggravating my knee so I am game, maybe it will help.
 
I'm glad you're better today. Stronger glutes should be a big overall help.
 
Hi Doc, I'm just catching up after a while away and I'm SO glad to hear your wife's results were ok (I know it's old news to you but not for me...) And I'm hoping that you haven't posted for a bit because things are a little better? Maybe backing off of everything (including PT) that hurts has given your knee (and leg) the time and rest it needed to stop "yelling at" you so much? I'm going into month 8 (TKR right on 4/29/19) and can offer you hope for the long haul, but maybe not the good news you might want to hear.

I still have pain. Lots of it, mostly going down stairs, walking fast, getting up after sitting for any length of time, and doing lots of things that "stress" my knee either in force or direction. But THE GOOD NEWS is that I scuba-dived (without much pain) on vacation early November, swam almost 3/4 of a mile (ocean so buoyant and easier than pool), and after my 5th day trying to return to skiing, I actually enjoyed the run down. I should point out that my pre-op knee(s) were fine skiing gently with perfect form (they prefer to be bent, as long as the knees and toes are pointed in the same direction at all times). My "old" knee is still fine skiing (although not so much walking), but the new knee needed a very slow on-ramp and lots of convincing that it still likes to ski. Translation: it hurt like :censored: the very first time down, which was half a run and the only one that day. It still hurts some of the time, but each time out it gets better. The most I've done so far is 3 full runs (Sunday), and it may take most of the season before I will be able to resume a full day of blissful gliding, but I'm here to tell you that based on my experience, TIME IS ON YOUR SIDE! It does get better, just so slowly that you can't believe that it actually is.

I was where you are now several months ago - angry, discouraged, resentful of the surgeon and in pain way too much of the time. As I write this (seated) I have a dull, aching "throb" in my upper thigh so I will have to shift, get up or massage it to alleviate it. And getting up means 45 - 60 seconds of debilitating pain followed by some pain as it works it way back to moving. Not fun, but much better than 3 months ago. And when I wake up it very painful on first moving but it does improve, but that's way better than months ago (maybe August) when I was not reliably sleeping through the night.

Everyone here has great advice and it's pretty much the same: don't be aggressive, avoid anything producing a high pain level as much as possible, and focus on healing supports (elevation, rest, nutrition, hydration, gentle activity/exercise). Most important, I think, is to be patient, both with your "rehab activities" and also with yourself. Had I found this board and followed this advice sooner I know I would not be in the place I am now. My in-home PT was a disaster, so 5 weeks later (when I returned to work prematurely but at least got my great PT) I basically had to start over from the beginning. FWIW, my PT only made "the switch" (not technically, but conceptually) from ROM work to strength work a couple of WEEKS ago. That's a full 6 months of ROM to get from 95 to about 120, with the primary goal of achieving less pain. It has helped me to use PT as a benchmark to gauge my snail's pace progress, which helps me remain encouraged. For the longest time I couldn't pedal the bike all the way around and just went back and forth. Then, when I could do a revolution it was with the bike seat at 5, then 4, finally 3, and then now 2. But the point during all of this is not the seat height - it's that I can do these things without pain. Discomfort, yes, but not pain.

As for surgeons, you are absolutely right that they are just the technician (carpenter), but going to Boston won't necessarily change anything. I went to Boston and my doc is now chief of arthroplasty at "the knee place", so without naming names suffice to say his technical skills are pretty unassailable. But I haven't even bothered to go back to him (in part b/c he changed hospitals) primarily because of what you said: he's the "bone guy" and his priority was "getting a good fit" and making sure you do not get an infection, and the joint doesn't fail. Soft tissue is NOT his department. Relying on an OS for PT/rehab guidance is like asking an oncologist for nutrition information during chemo - they don't know (or comparing to a carpenter, it's like asking them to furnish and decorate your home). But docs don't like to say they don't know, so they tell you (or your PT) what they think, without really knowing. No wonder you have no idea what to think... too many people telling you things that aren't true, but how are you supposed to tell the difference? For better or worse this experience should help you prevent a similar disaster next time, because you will know what to ask the next surgeon, and be able to evaluate his/her answers. I know I will be staying local, because I believe local docs rely on TOTAL patient outcomes (not just technically perfect appliance installation) for their success, and are better versed in what contributes to that. My Boston OS had no idea who/what kind of PT I was getting post-op, but I believe a local practice would have had a clue.

The best advice I got about PT was this: make sure you get a PT who is familiar with and confident in knee rehab protocols who can tailor your rehab to your situation. If your PT relies on the OS for "instructions", guidance or even advice, RUN! In a TKR the OS basically destroys the soft tissues surrounding your knee, but they are not specialists in the rehabilitation of this tissue. End of story. It's all up to the PT (unless you have infection or a failing joint) to help you get back to your (relatively) pain free life. That's a long-winded way of saying you might want to re-evaluate who you are using for PT - they are not all created equal.

I'm not sorry I did my knee, but I'm furious I wasn't better prepared. My timeline, in case it is helpful:
3 months - stopped crying when discussing my pain and situation
4 - 5 months - finally resumed sleeping "normally" (although wake up still involves an audible wince)
6 months - stopped completely "babying" my TKR in PT and started working on strength
7 months - went on vacation, scuba dived, snorkeled, swam (but didn't get to do beach walks)
8 months - started to resume skiing, although walking in boots is awful (as it was before TKR)
10 months - planning to attend a yoga retreat (although achieving "child's pose" may be out of reach)

I would love to hear from anyone who had considerable pain at 8 months (I JUST graduated from a 4 to a 3 on the PT evaluation sheet), who was pain-free at 12 months (or later), because I hope I am not giving you false hope. But my progress has been ongoing, if not steady, and the trend is definitely up, with no plateau in sight. They say it's a 12-month process... I hope they are right!

Sybilla
 
Last edited by a moderator:
Sybilla...Great post! My progress at 16wks is a slow painful one. You encourged me, thanks!
 
If your PT relies on the OS for "instructions", guidance or even advice, RUN! In a TKR the OS basically destroys the soft tissues surrounding your knee, but they are not specialists in the rehabilitation of this tissue. End of story. It's all up to the PT (unless you have infection or a failing joint) to help you get back to your (relatively) pain free life.

I have to jump in to say this is VERY dangerous advice. The PT doesn't know what your knee looked like on the inside or what your complete medical history may have involved. My surgeon has explicit instructions for PTs because many PTs are too aggressive and treat all TKR patients the same. My surgeon was a lifesaver in my TKR recovery because of my history (10 previous knee ops AND arthrofibrosis)---I sought him out because of his view on PT (slow and gentle, not forceful or aggressive). I even sought out my PT for the TKR recovery because I'd had too many overaggressive PTs who treated everyone alike and thought they knew it all. Her philosophy was gentler, but she still pushed a lot of strength training very soon after surgery.

In fact, my surgeon refused to give me more PT visits after 11-12 wks because the PT had warned me we were starting strength training after that Dr.s visit...and he was adamant I wait a few more weeks. He was right, and my recovery may have been slower than some, but it was perfect for ME! In his words, based on my history and complications, I was 3-4 wks behind most TKR patients but would eventually catch up. My PT, though sweet and gentle, did not see things the same way.

So yeah---we shouldn't assume all surgeons are idiots and don't know about proper PT....the same way we shouldn't assume all PTs are mean, aggressive fear-mongerers. It should be a balance--plain and simple.
 
Hi Sybilla

Well, I haven't posted more from a combination of being really busy and disgust. Last week I met a different lady in PT, and she seemed encouraging. She felt that we just needed to find the right combination of PT to help and not hurt.

But yesterday I was back with the usual young lady and she was pushing for this procedure to strengthen my glutes. Laying on my back bringing my heels back to my butt then engaging my abs and glutes while thrusting up and holding it for a few seconds. All that did was PO my lower back!!

She was back to see the thought that I see her next week and if no progress send me back too the doctor which I have zero interest in for the reasons we talked about!!

Today everything is sore between PT yesterday, snow removal from 10" of snow, and snow removal today from a wet 6" of snow!! Thankfully I do have a snow blower, but still sore everywhere!

I am thinking the longterm on this will be just doing my recumbent, stretching, walking the dog and hoping that eventually I feel human again!!

Still throughly disgusted with this entire thing and unless I get to the point that I cannot walk at all, NOBODY is touching my other knee ever!!

I am glad that you have progressed so much! You must have been thrilled to be able to dive and ski!! That is awesome!!

Come Springtime however my knee feels I am riding because at this point wait for what?? That is still a solid 3 moths away anyways!! I just refuse to lose anymore riding time because of this nonsense!!

I still regret I did it and doubt I will ever feel differently. The fact that over 3 months out and I am still worse off than before, this is BS!! I have no idea how much time I have left on this rock!! I can't afford to waste 6 months to a year!!

Anyway, I appreciate you all tolerating my bitchin and moaning!! I really only vent about it here, my wife is tired of hearing about it and she has had her own health issues as you know!

I don't honestly see me living much past 70. I am 62 now. Probably won't be able to retire until 67 or so. That doesn't leave allot of time to enjoy retirement, maybe a few years if I am lucky. If I can help it I will not have surgery for anything again!!

Anyhow, keep up the good work!! Enjoy the skiing, definitely have the weather for that now!!

PEACE
DOC
 
So yeah---we shouldn't assume all surgeons are idiots and don't know about proper PT....the same way we shouldn't assume all PTs are mean, aggressive fear-mongerers. It should be a balance--plain and simple

You are absolutely right, there are plenty of ill-informed, overly aggressive PT's who are sure they know everything there is to know about knee rehab (without needing guidance from a doc), and I don't doubt that your surgeon was the saving grace in your recovery because he understood the complexities of your situation. I was oversimplifying and making assumptions, partly because I should have realized that when my (original, at-home) PT asked for the printed handout from the OS, that spelled trouble. And then a well-meaning family member (PT) cautioned me about getting my ROM back "within the window", and when I asked her how long that window was, she said "well the docs tell us it's 8 - 12 weeks". So my personal experience fueled my sweeping generalization, which as you pointed out could be dangerous. Thanks for setting me straight!
 
Quick update. I have found some improvement from not doing any of the PT they wanted me to do. All I am doing is walking the dog and using my recumbent bike with no resistance. Also I have been massaging the knee, felt kinda weird initially but it does seem to help somewhat

Still have more pain then pre surgery, so still trying not to obsess about that. Just makes me so dam angry!! 4 months out and this much pain is an utter failure to me!! My next followup with my surgeon is 12/20. I am going to insist he does some kind of imaging to verify that the implant did not loosen.

Of course the problem with that is I will need to take his word for it even if he does the imaging and to be truthful I have no faith in him at this point!!

I also am concerned that perhaps he did not get the alignment correct. If that is the case and I need surgery to correct this it will certainly not be this guy!!

I need to ask him exactly which implant he installed as well, I have no idea at the moment. I know on the bill the implant itself was $10K. I have no idea if that is high, low or average

Anyway, I am off to bed!

Hope everyone is PAIN FREE!!

PEACE
DOC
 
Pain and discomfort at 4 months is normal. Your knee is only 1/3 of the way through its healing journey. It was about 6+ months before my pain was less than before surgery for certain movements. What was good was I could move my leg while sleeping and it not wake me up like it did before surgery.

It's good news that you are having less pain with the lower activities.
 
I also was no better than before my surgery until the 5 month mark. I knew certain things were better, but the overall pain/discomfort/mobility wasn't better. By 5-6 months, I was CERTAIN I had made the right decision, though things still aren't as great as I'd hoped for. If I could get and keep another 10 degrees of bend, I'd call the surgery a complete miracle. :bored: I'm hoping/praying I see that by my one-year anniversary next May.
 
If I could get and keep another 10 degrees of bend, I'd call the surgery a complete miracle. :bored: I'm hoping/praying I see that by my one-year anniversary next May.
My ROM improved after my one year anniversary and even after my second year anniversary! Yours probably will, too.
 
@Jockette Thanks for the continued hope. It's you and many others here that keep me staying positive. :) I know SOOOO much can change over time, so I'm optimistic. Even if I don't get more bending, I'm still glad I have my new knee. It's all about perspective. :)
 
So I had my followup with my Surgeon yesterday. He did x-rays and said that the implant has not worked loose and that the alignment is fine. He does not have any answer for my pain and still was pushing that I do "Heavy PT" 3 to 4 times a week!! Which I am NOT going to be doing!

At this point as long as the implant is not loose, I figure it is simply going to tale as long as it is going to take to heal!! SO...........

I did find out which implant I have. It is a Zimmer Persona. A quick search was not encouraging, so I wanted to ask you all what opinion you have about this implant. I only did a brief search this morning but I was not thrilled with the results. Hoping that the recalls do not apply to this implant!!

Any information and or opinions appreciated!

THANKS

DOC
 
Ugh! Recalls on knees! Oh, good luck with this. The stories here make it seem like long, slow healing is the way to go, and I believe them.
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011

Members online

Forum statistics

Threads
65,167
Messages
1,596,863
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom