TKR Patella Clunk

[Softtail]

Can’t speak to the calf pain or fever, but I can attest to the gentile break in period that everyone advises for at least the first 3 to 4 weeks with onlygentile stretching and bending exercises which you can find on bonesmart. I am an old jock, who took a more aggressive approach , from around 4 weeks out, and it worked pretty well for me , but at no time was the therapist, like Navy’s , calling the shots. He would ask me after every exercise if it was painful , and going forward was based on that. Take it easy on that new knee, like everyone says especially till swelling reduces significantly, and elevate that leg pretty much constantly while sitting and lying down. The ice is a great pain reducer as well , so use it often.

 

[Scouseman]

Thanks guys,
My pain meds are as they were, with the addition of Tramadol that my GP prescribed for me some weeks ago and I shied away from taking - up until now!

50mg 4 times a day. Should this be a sufficient dose?

 

[helenium]

Hi @Scouseman
I was still on the strong stuff (oxycodone) 6 days out from my TKR. It was a few weeks before I was able to drop to a combination of tramadol and paracetamol. I took 100mg tramadol with 1,000mg paracetamol 4 times a day. This seems to be in line with Josephine's recommendation for you on Monday (#38):

Codeine is not adequate for a knee, not by a long shot. And certainly not just 30mg. That's almost the dose for a headache! I suggest you contact your GP and tell him that the codeine isn't 'doing it' for you and can you have something else (then suggest) perhaps like Tramadol (as you've heard it is better for knees). If he agrees, he should prescribe you 50-100mg every 6hrs which you can take with the paracetamol.

If you find a lower dose keeps you comfortable then great, but I know it wouldn't have worked for me. Almost goes without saying, needs to be accompanied by loads and loads of rest, icing and elevation!
Hope you have a comfortable day.

 

[SusieShoes]

I too had a low-grade fever during the first week of recovery. It’s not uncommon and unlikely to be because of infection. My knees were also swollen and hot. Your body is weathering some major disruptions and it’s pulling out all the stops, but things will settle down.

 

[Scouseman]

Good Morning everyone,
I think that I turned a corner yesterday afternoon, in developing a technique that allowed me to walk around my living room on my crutches.

Previously, getting to an upright position resulted in chronic calf pain and I had to return to a sitting position with my leg elevated.

Yesterday afternoon, for whatever reason (maybe an indication of some healing taking place in the calf), I was able to stand erect, albeit it with some degree of pain.

I spent a couple of minutes ‘stretching off’ my calf before proceeding to gently weight bear on my crutches around the living room. This was major progress for me, both means physically.

This is now a regular pattern of rehab for me. Before weight bearing, I need to engage in a stretching off of my calf.

In all of my ore Surgery reading and preparations, no reference was ever made to the potential challenges that my calf would present.

As previously mentioned, I do have Post Thrombotic Syndrome, due to my four previous DVT’s in this calf. However, a stringent care plan was created by my Consultant Haematologist, followed to the letter by my Orthopaedic Surgeon. The same plan was adhered to for my surgery in July, when metalwork was removed from my knee, with no issues at all with my calf post surgery.

I have to factor in the fact that I had approaching 2 hours with a Tourniquet applied during my procedure. Has this aggravated my PTS? Will this settle down?

Knee pain is bearable with some evidence of a reduction in the swelling. I just feel extremely frustrated by the complications presented by my calf. A week post surgery, there is no evidence of any significant improvement.

I return the the Hospital tomorrow morning for my first PT session. I will discuss with them.

 

[sistersinhim]

Wonderful that you found a way to relieve that aggravating calf pain! That's what this recovery is all about. Us finding the best way for us. It's an individual thing. That's why we always say that no two knees are alike, even on the same person!

 

[Jaycey]

A week post surgery, there is no evidence of any significant improvement.

Are you taking the new pain meds now?

 

[Scouseman]

Not taking any new pain meds.

I had reason to call the Hospital earlier this afternoon to request an assessment of my surgical wound.

The changing of my dressing due to a significant blood discharge immediately post surgery resulted in a closed dressing that completely covered the wound.

This afternoon, I noticed that a red rash had appeared at the extent of the clear adhesive part of the dressing. My temperature was 37.6.

So, my wound will be assessed for infection at the Hospital tomorrow morning, when I attend for my first PT appointment.

I will report back the outcome.

 

[sistersinhim]

I pray that you have a good visit tomorrow and there's no infection.

 

[Scouseman]

Thank you so much!

 

[Celle]

This afternoon, I noticed that a red rash had appeared at the extent of the clear adhesive part of the dressing. My temperature was 37.6.

So, my wound will be assessed for infection at the Hospital tomorrow morning, when I attend for my first PT appointment.

I don't think i's likely that you have an infection.

It's more likely that the rash is because of an allergy to the adhesive in the dressing.

Best wishes for you appointment. Do let us know how you get on.

 

[Scouseman]

Hi Celle,
I hope that you are right! Temperature of 37.9 this evening is a worrying development though.

Will report back to the Forum tomorrow!

 

[Jaycey]

Excessive pain can give you a fever.

Did you miss this post? You might try starting the new meds you were given. I don't like taking meds either but if needs must - all very temporary.

 

[Scouseman]

Hi Jacey,
I must be missing something.......

I am taking all of the meds provided to me upon my discharge from Hospital. I have also introduced Tramadol, which I have taken intermittently and with caution.

Whilst such meds do ease my knee pain, they are having absolutely no impact on my dreadful calf pain! I would not at all be surprised if I did have a DVT, despite the initial scan being negative for this!

Will hopefully be better informed tomorrow!

 

[Jaycey]

@Scouseman Hope your appointment went well! Please update when you can.

 

[Scouseman]

Dear All,
It was confirmed that I have a clot in the juncture of a superficial and deep vein in my leg! High risk of it moving to deep vein and travelling to lungs.
A scan indicated the location of the clot.

My Consultant Haematologist was contacted and she advised the surgical team of a major change to my care plan. Stomach injections for next two weeks, another scan of the leg next week and a review of my Apixaban dosage.

Frustratingly, my new knee is absolutely brilliant! No issues with this at all!

This is just a frustrating setback and nothing to do with my new knee, thankfully! Just my body’s response to major traumatic surgery!

 

[Celle]

I'm sorry to hear you have another clot. This will resolve, given time and the treatment ordered.
Hang in there - things are going to get better.

 

[Jaycey]

@Scouseman I was worried it was a clot. Not being able to treat it with any pain meds was ominous. Glad you are now on a treatment plan. As Celle says - things will get better. Please keep us updated. Fingers crossed this will ease quickly!

 

[Scouseman]

Celle, Jaycey,
Thank you so much! Your advice and support is invaluable to me!
It is rather frustrating, given that my new knee appears to be in great shape!
Things will indeed get better and I will certainly keep you posted!

 

[NavyGunns]

@Scouseman, prayers heading your way that all will be resolved now that you have confirmation of a clot. Glad it’s not your knee and that it is behaving during recovery.