TKR Patella Clunk

[sistersinhim]

The wound is healing very nicely (thanks to liberal massaging with Bio Oil

Nothing should be place near the wound until it's completely healed. It would be easy to introduce bacteria.

one issue that I would appreciate reassurance with is the regular episodes of significant swelling of the knee post any venturing outdoors on my walking stick.

Oh yes, this is completely normal and will occur for months. As you heal, you'll be able to do a little more every few weeks with less swelling. It's a common sense thing. If you do it and it swells afterwards, then it's inflaming the knee and it's not healed enough to do that much. Back off and let it heal some more.

 

[Mollymax]

@Scouseman I have just read through your thread as I am 12 days post op and for the last week have had calf pain which is getting worse. Pain killers not helping. I see that you were the same. I saw nurse today who said to go back if it doesn't ease. Tonight it is agony. Reading your posts I think if I can get through Christmas day I will go to A&E on 26th if I am still in this amount of pain as you persevered knowing something was wrong. I am on rivaroxaban so that should be helping.
Thank goodness for this forum as it is a great help when you are worried about something

 

[Celle]

@Mollymax - don't wait until the 26th. Go to A&E now. Your calf pain seems to be getting worse, not better, and you need to do something about it.

If it turns out to be a DVT, you will need treatment as soon as possible. If it's not, you will be reassured earlier - and hopefully get some more effective pain relief.

 

[Scouseman]

Mollymax, with apologies for my delay in responding. Although Rivaroxaban should, in theory, provide you with a degree of protection, the nature of TKR is such that this protection is not infallible! I am proof of that! I hope that you managed to have your symptoms assessed and that all is well?

A little update of my own:
It is approaching 8 weeks post surgery. My clotting episode apart, I have been extremely pleased with my new knee and making good progress with my Physiotherapy. I am hoping to be able to drive at some point this week.

However, I thought that such progress might be too good to be true and I do hope that someone further on with this journey might be in a position to advise accordingly with regard to the following two issues:

Firstly, the ‘clunking’ in my knee has become more prominent and is activated by any movement of my knee. The Physiotherapist felt this during her manipulation of my leg during our recent Physiotherapy session. Whilst not painful, I would hate to think that this sensation might be a lifelong burden to deal with.

Secondly, my sleep was disturbed last night with acute pain affecting the inside area of

 

[Scouseman]

Sorry! Inadvertently pressed respond! Continued:

Affecting the medial aspect of my new knee. This is a new pain experience for me that required a dose of Tramadol to assist and to help me sleep.

This ‘new pain’ has continued throughout today and has me a tad worried. I have not been engaged in any activity out of the ordinary, over and above my personal rehab regime.

My GP has indicated that I should be fit to return to work (I am a Teacher) at the end of January, which will be twelve weeks post surgery.

Should I be concerned about the ‘clunking’ and recent pain developments?

Just when I thought that everything was going ever so well!!

 

[Celle]

Firstly, the ‘clunking’ in my knee has become more prominent and is activated by any movement of my knee. The Physiotherapist felt this during her manipulation of my leg during our recent Physiotherapy session. Whilst not painful, I would hate to think that this sensation might be a lifelong burden to deal with.

That knee clunking is normal, as long as it doesn't hurt:
Clicking/clunking knee joint after surgery

There's not a lot of logic to it. Some knees do it and some don't. My right knee made clunking noises for about 3 years post-op, and then gradually stopped.
My left nee has never made noises.

Affecting the medial aspect of my new knee. This is a new pain experience for me that required a dose of Tramadol to assist and to help me sleep.

This ‘new pain’ has continued throughout today and has me a tad worried. I have not been engaged in any activity out of the ordinary, over and above my personal rehab regime.

It's still early in this year-long recovery and not unusual to still get pain in various places.
Give your knee some extra rest, ice and elevation, and see if the pain settles down.

 

[Scouseman]

Thanks Celle!
Could do without the ‘clunking’ but certainly preferable to a joint diseased with osteoarthritis!

Glad to receive your opinion that pain is normal and to be expected really!

Best wishes!

 

[Scouseman]

Hi guys!
It is now ten weeks post my TKR and I see my surgeon next Monday for the first time since my surgery.

The past ten days have witnessed a couple of things that I welcome your opinion on.

Firstly, the ‘clunking!’ For every movement of my new knee, from small everyday movements to deliberate flexion and extension, I experience clunking. It is significant and I feel like ‘Robocop!’No associated pain and it has been reported on this Forum that the clunking without pain is normal. However, the thought of a life of clunking is not one that I look forward to!

Next, I am experiencing significant pain on the medial side of my knee, with a strange sensation of ‘tightening/stiffening’ around the whole of the knee.

I have joined a local Gym and am engaging in exercises to target my quads, hamstrings and to increase my range of movement. Only two days into to this (in combination with my weekly Physiotherapy) so I am hoping to see some improvement.

I am desperate for my TKR to be a success and am doing all that I can to contribute to such success.

Any words of wisdom? What approach would you advise I take with my surgeon next Monday?

Thanks in advance!

 

[Celle]

it has been reported on this Forum that the clunking without pain is normal. However, the thought of a life of clunking is not one that I look forward to!

Don't assume that, just because your knee is clunking now, it will continue to do so for ever.
My right knee clicked and clunked for about 4 years, but the clunking gradually grew less noticeable, until one day I realised it had stopped.

Many people find that the clunking goes away long before mine did.

My knee is fine, 7 years old now, and I'm hardly aware of it because it functions so well

I have joined a local Gym and am engaging in exercises to target my quads, hamstrings and to increase my range of movement. Only two days into to this (in combination with my weekly Physiotherapy) so I am hoping to see some improvement.

I think you're rushing your knee. It's only a couple of weeks past 2 months old. Complete recovery takes a full year.
It may be too soon for doing strengthening exercises at the gym, and that could be the cause of your new pain.
I'm going to ask @Josephine to advise you, but I suggest you back off those gym exercises for at least another month. Allow your knee some more time to heal.

Working hard at exercises isn't necessary for a good recovery. IN fact, doing too much, too soon might slow down the recovery.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[Scouseman]

Thanks Celle!
I guess that I am just too keen! Probably due to the fact that I don’t feel physically strong enough to return to work just yet, so my Doctor has extended my absence from work for a couple of more weeks!

In my defence, the pain came about prior to the Gym sessions. I would appreciate it if @Josephine could also advise.

Best wishes
Nigel

 

[Jaycey]

@Scouseman gym session AND physio? Your new knee will not benefit from all this.

 

[Celle]

I guess that I am just too keen! Probably due to the fact that I don’t feel physically strong enough to return to work just yet, so my Doctor has extended my absence from work for a couple of more weeks!

We usually recommend taking about 12 weeks off work, and then doing a Phased return to work , if possible.
So you really shouldn't be expecting to feel fit enough for work just yet.

 

[Scouseman]

Thank you guys!
You know how much I respect your advice!!

I only have Physiotherapy at the Hospital every two weeks - which I never really felt was enough. I have been supplementing my Physiotherapy with exercises at home.

Would it be OK to continue to use a static bike at the Gym to free up the stiffness and leave other knee work for a month or so?

Reassuring to hear about the time frame for return to work. My Doctor feels the same!

Many thanks for your support!

 

[Josephine]

I would appreciate it if @Josephine could also advise.

I haven't chimed in so far because I am thus far in full agreement with all that has been said!

 

[Scouseman]

Thank you Josephine!

Noted!

 

[Scouseman]

Well, I am 12 weeks post surgery and I return to work tomorrow!

Employer is being very supportive (I am a Teacher) so that is one less worry!

My knee is making very good progress. I feel strong with only occasional bouts of post surgical pain. Clunking appears to be easing but still a regular amount of swelling, which is not really concerning me.

I am to remain on 5mg of Apixaban with the possibility of reducing this to 2.5 mg after blood tests in August (I am on lifelong Anticoagulation due to history of DVT and PE).

The support, advice and encouragement that I have received from this forum has been invaluable.

I will attempt to reduce the size of the many photographs taken of my knee during this amazing journey to share with the forum.

God bless you all!

 

[Scouseman]

First day back to work went well.

However, upon returning home, I was shocked to discover that my knee had literally ‘balooned’ to quite a large size!

I can only assume that not having my leg elevated at any point during the ten hour day is to blame!

Let’s see how the rest of the week goes!

 

[sistersinhim]

can only assume that not having my leg elevated at any point during the ten hour day is to blame!

Oh yeah, I bet that sure did cause all that swelling. Is there no way that you can elevate. If only during your breaks and lunch break time would give you some times to get that poor leg up. These knees want to be elevated for quite a long time in this recovery.

 

[Scouseman]

I think that I have over done it!

Had a pretty full on week after I returned to work and will speak to my employer tomorrow about a phased return to work.

I was too naive and should have taken this route in the first instance!

 

[kneeper]

Yep, back to work and not elevating will do it. I hope you can get a phased return. Sometimes people can get 1/2 days or a day off in the middle of the week.