Revised PKR to TKR Partial to Revised TKR

[Josephine]

One more I missed:

I then used Tylenol and ibuprofen when needed.

Are you still taking pain meds? and if so, is it still Tylenol and ibuprofen? If so, what dose and how often?

 

[clucas]

@Josephine I take maybe 800mg of ibuprofen 2-3 times a week lately otherwise I take nothing.

 

[clucas]

@Josephine - yes that is high for so long out and that is what I keep trying to tell the doctor and as you can see it has been to no avail!

 

[Josephine]

I've now replied to your information but it's in a a previous post - #20!

 

[clucas]

Sorry for the delay in getting back on here. Since the last comments I have gone in for a bone density scan which the results (I had to get from the medical facility myself) says that I the results are from an infection or a loosening of the joint. I have also been reading more on line and have read several articles on a possible allergy to the metal that was used in my knee.

I got the records from the hospital and my knee has nickel, chromium and cobalt. Now I have never been able to wear "cheap" jewelry and the screw in my foot is titanium.

Has anyone else had an allergy like this?

Trying to get the doctor to listen to me is impossible it seems. I just emailed my case manager and asked to be tested for a metal allergy. The swelling I woke up with Saturday morning showed I no longer had an ankle bone, just a mass of swollen/itchy skin. Am I out of my mind because I sure feel like I am losing it.

 

[Josephine]

says that I the results are from an infection or a loosening of the joint.

They always do. The truth of the matter is that a bone scan will only show a flare at the site which could indicate either of those things. It's not a definitive diagnosis. To delineate between to two, oyu have to have a series of bloods done, infection markers, and probably also some fluid drawn off the knee under local anaesthetic and that also tested for bacterial content. If/when both of those have proven negative, then it's fairly safe to assume that the problem is a loose implant which requires a revision.

 

[clucas]

Original partial on left knee was done on April 6th, 2018 and due to aseptic loosening of the lower joint I had a revision to a total knee on October 29th, 2020. Surprisingly everything was going great with minimal pain up till November 8th. 10 days later and it seems like I have a large area on the outside of the knee that is severely swelled up. The pain is severe and I can hardly bend my knee. At therapy today, while painful as it was, my ROM is still there at 95 deg and 0 straightening. I fell the IT band down the side of my leg is very sore to the touch. Not sure I'f this is the reason my knee hurts so bad or not. Dont go back to the doctor until the 11th. Has anyone else experienced this? This is not my 1st or 2nd time doing this. I had a right tkr on Sept 3rd, 2019 so that makes 3 major surgeries in 3 yrs. Just looking for any advice. Thank you.

 

[Pumpkin]

@clucas,
Welcome back to BoneSmart, sorry to hear you needed a revision of your PKR.

Sounds like something has flared up your IT Band, what did your therapist think was causing the sudden swelling and pain?
If in addition to the swelling your have increased pain, increased warmth, and increased redness, call your surgeon.

Suggest you skip PT until you see your surgeon on the 11th, and let your knee heal.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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 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 a 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 history before providing advice.

 

[clucas]

My PT is amazing and has done all my rehabs. She is not sure what caused this to flare up. Right now she is just working on gentle movement and spent today massaging the area. She will do the same tomorrow and surgeon on Wednesday. I have been on the ice compression machine all day along with the tens unit which helps to redirect the pain in my brain. I slept for a solid hour today which was more than I got all last night and could have slept longer but my partner wanted to make sure I got some sleep tonight. I had a bad time with the painkillers last time and this time was doing really great till this. Now I am alternating with aleve which helps cut alot of the pain as well.

 

[Pumpkin]

@clucas
You'll notice that I have merged your newest thread with your original recovery thread, as it has your history leading to you needing a revision. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Pumpkin]

Glad the Aleve is helping with your pain and you were able to get some sleep today.
Just curious, are you using the same surgeon who did your PKR?

When you see your PT tomorrow they should monitor your knee, and let your surgeon know what is happening.

 

[clucas]

Pumpkin,
No, I am not using the same surgeon who did the partial. The original surgeon, I had to get a lawyer to get out from his care. He was a work comp doctor who I told them I did not want. First time I had to use him I had to have a second hand surgery less than a year later. I am however using the same surgeon, of my choice, who did my my right tkr a year ago. At that time we had to chose the knee that was hurting the worse so hence the right tkr was done first before the revision. Took me over a year to get the courage up for that.

Funny part is I kept telling the original doctor that something was wrong and when they did the revision I asked for the implants back. Was told they could only give them to me if they could get the cement cleaned off.
When I came to after surgery they only gave me the bottom piece of the partial because that was not secured in place.

My PT works very closely with my surgeon. I am lucky on that aspect! Also, thank you for joining my threads!

 

[clucas]

13 day check up yesterday and conversation with the doctors was quite interesting. Surgeon stated that original doctor used some sort of oversized suture on the inside of my knee so along with the loose bottom partial implant it took them extra work to clean up the knee and all the scar tissue. Doctor is ok with my ROM so far. New total knee has the new lower implant going about 4" in to the lower shin bone. Swelling is so so and should go down in time. Worst part of all of this is the severe tightness in the back of the knee and the side of the knee. Wish my bend was more but know it will come. Waiting for Saturday so that I can get with my chiropractor and work on realigning my back, hips and helping to relieve the tension on the IT band.

Has anyone else experienced IT band issues?

Thanks.

 

[Celle]

Has anyone else experienced IT band issues?

Yes, they're quite common.
This article explains:
ITB (ilio-tibial band) issues and treatments

Worst part of all of this is the severe tightness in the back of the knee and the side of the knee.

Are you icing the back and side of your knee as well as the front?
It's still early days and everywhere is still upset and inflamed, causing swelling as well.

 

[clucas]

Celle,
Thank you for the article. Yes, I ice front and back daily along with constant massage around the knee. Today I got to 105 deg only being 2 weeks out so my PT and I were happy. Tomorrow I start laser treatments to help combat the inflammation so hopefully that will give me more relief along with chiropractic adjustments as my gait has changed again.

 

[clucas]

Has anyone used kinseotaping for an inflamed IT band after a TKR?

 

[Pumpkin]

I use kinesio taping for my knee and find it helps. I have not used it specifically for IT band inflammation.
It is easily reversed by simply taking the tape off if you don't like it.
Recommend you give it a chance.

 

[clucas]

Pumpkin, thank you for the insight. I have a massage scheduled for tomorrow to see if that will help with the soreness of the IT band and swelling/stiffness and then trying the taping. Hopefully this helps with the issues. During PT today I hit 111 deg bend and 3 deg from straightening. Will see what tomorrow brings I guess.

 

[clucas]

So I went for a massage today. While apprehensive going in, afterwards was so glad I went. My therapist was stern but gentle in working my entire leg from the hip to the toes. While it was intense when she was massaging the sore area once she quit working that area it felt pretty darn good. I was actually able to get on the stationary bike and ride for a mile. Even tonight I feel pretty good. Scheduled another appt in a week.