Knee Infection* Permanent spacer?

[archie]

Hi all. This is my first post and I am really looking forward to hearing from anyone about their experience with their patellofemoral replacement. I had 2 patellofemoral replacements barely one year apart. First surgery was January 2020 on my left knee, and the second surgery was December 2020 on my right knee. My question is about recovery and getting back to 'normal' activities such as walking up and down stairs, hiking, and standing up from a sitting position without pain. I still experience about a level 4 out of 10 when I have to do this. I am now walking about 1 1/2 km a day, with about a level 2-3 out of 10 pain, and although I am definitely not experiencing the level of pain I had prior to surgery, I am disappointed with the extremely slow pace of my recovery, especially of my first surgery. Anybody have any words of wisdom? I am 64, and although never an athlete, I was always active...swimming, walking for an hour every day, cross country skiing in the winter, biking occasionally etc. etc. This has made me feel old beyond my years and I am truly hoping to become more mobile. I thank you in advance for anything you might be able to share.

 

[Jockette]

I am disappointed with the extremely slow pace of my recovery, especially of my first surgery.

Hi and Welcome!

I also have a Patellofemoral and recovery was definitely not what I was expecting. My first year was very slow, but I did see a fair amount of general improvement in my second year.

I am now 4+ years post op, and while some things have improved even more, some have not, and I am disappointed in my outcome as a whole. I still can’t do stairs, or put any weight onto my knee while it is bent.

If you tell us the exact dates of your surgeries, we’ll make a signature for you.


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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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 to 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 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.

 

[archie]

Thanks so much for your reply. I am sorry to hear your overall outcome isn't what you had hoped for. I realize that I won't be back to my normal self, but was hoping for less discomfort and more mobility than I presently have. My surgery dates were: January 13, 2020 for left knee... December 26, 2020 for right knee.

 

[Jockette]

Thank you for the surgery dates.

I hope you will continue to see improvement in both, it’s still “early” days for your second one.

 

[archie]

Has anyone received a cortisone shot in their knee after surgery, with good results. I just received one about a year and a half post patellofemoral surgery. I am day 5 now and feeling a tremendous improvement in swelling, mobility and pain. Just wondering how long this might last and if it might help improve things in the long run?

 

[Jockette]

I’m glad you’ve seen good results from the cortisone shot, I assume in your left knee? Those shots never worked for me, so I really can’t comment much about them. Other members have had varying results.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

The benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you. You can always bookmark this thread so you can find it easily.

Best wishes on your continuing recovery!

 

[archie]

I had a few shots before my surgeries, and although they provided great pain relief, they only lasted about 10 days. Fingers are crossed that this shot on my left knee, lasts longer since there isn't anymore arthritis to irritate things.

 

[Jockette]

Fingers are crossed that this shot on my left knee, lasts longer since there isn't anymore arthritis to irritate things.

Why did you require this latest shot?

 

[archie]

Shot was for pain and swelling...not horrendous, but enough that chairs, stairs, and walking more than 20 minutes had me at about a level 4 out of 10. It was hoped that the shot would help calm things down and let me stop taking so much Tylenol/Advil and also let me build up quad strength without so much pain. Quad strength improvements will hopefully improve knee function and be easier to achieve without the pain, but it will depend how long this shot lasts. Desperate to achieve as much function as I can because, although very grateful for the surgery and the improvements that I recognize, I am frustrated with my progress.

 

[cantel]

I had PF about 6-7 weeks ago, it is the biggest mistake of my life. The outcome of this surgery is very unpredictable. I suspect my surgeon misplace my implant, great pain on the lateral side.

 

[archie]

So sorry to hear this. I had a lot of pain the first 6-7 weeks but found it manageable if I took my pain meds on schedule. I am 6 months post surgery on my 2nd PF and although not where I want to be, things are MUCH improved compared with before surgery. Did your doctor say things looked OK after reviewing your x-ray? I had x-rays taken at 6 weeks post surgery and everything was where it was supposed to be even though I was still quite sore and using walking sticks to get around. I hope you feel better soon. It's definitely not an easy process. Hang in there.

 

[cantel]

The doctor say it is perfectly placed. From the X ray I feel it placed too far right, as compare to center. I feel the patella maltrack since day 1, it is really painful and tight at the left.

Really helpless, it should not be like this. Any comments on X ray ?

 

[archie]

I have absolutely no medical training so wouldn't dare comment on your x-rays. I can comment on how I felt at 7 weeks, however.

I was still VERY sore; napping every day because trouble sleeping at night; taking 2 Extra strength Tylenol at least 2 times a day; sometimes taking a hydromorphone if pain was bad; incredible difficulty getting out of a chair or off a toilet seat (even with a raised seat); had to haul myself up stairs using railing; couldn't stand to make a meal for more than about 15 or 20 minutes before the pain made me sit down; walked with a cane or 2 walking sticks around the house; and just began to go to the store for short (20 min) shopping trips after which I would come home and ice while others brought groceries in and put them away.

If I had a 20 minute shop or walk that would be about it for me for the day, other than some stretches on the bed and a few simple physio exercises. It HURT!

But, every day I noticed small improvements and that kept me going. Maybe I didn't take Tylenol twice on a day, or I actually slept for 4 hours straight. I just kept looking for little improvements.

Now 6 months out, I am in much less pain than before the surgery, and although I still have more healing and strengthening to do, know that things will continue to improve for up to a year and even more improvements as quad strength improves.

Patience isn't my strong suit, but it is something I have to daily remind myself of. This just simply isn't a fast recovery. All the best.

 

[Ginger1210]

Hi archi i am in my eighth week of recovery from Right Medial P.K.R. and i am still struggling with pain and stiffness just below my knee cap but not under it. But you are right i do see small improvements week on week. I have returned to work part time and light duties but this has been hard I am still taking pain medication which helps. On the plus side i am walking around 2500 steps a day which is around a mile. I thought i would be further on by now but i will have to be patient. When get frustrated i keep telling myself, to be kind to myself and rest ice and elevate.

 

[archie]

We SO want to get back to normal as quickly as we can and this has caused frustration with my 'slow' progress on my part. That's why I am trying to look for daily tiny improvements instead of counting the weeks post surgery. OK, I still count the weeks ;) but am trying to shift my focus. Concentrating on what IS improving and just having faith things will continue moving in the right direction. Bottom line for me is whether or not I achieve anymore improvements, I am still better than before the surgery. A few generations ago, I would have been in a wheelchair! So, lots to be grateful for. Stay positive and I wish you great success with your recovery. BTW, at 8 weeks out I wasn't doing anywhere near the steps you are doing! Amazing!

 

[archie]

Has anyone experienced lateral shin pain and ankle pain a year or more after patellofemoral surgery? I’ve had both knees done about a year apart, and have shin pain on one leg and ankle pain on the other making walking difficult. Physio not helping much and I am not sure if the cause. Painful and frustrating.

 

[archie]

I am now 1 year post surgery for my right leg and 2 years post surgery for my left leg. I feel like I am losing ground. I have, at times, debilitating pain in the tendons/muscles on the lateral side of my left knee. It comes and goes, but can stab fiercely and cause me to yell out. Weight bearing is very hard (almost impossible) during an episode of pain but after the pain subsides, ( generally in about 30 seconds) I can cautiously step out. Going for long daily walks is almost impossible. I would say I am walking about 1/5 of the distance I was in September 2021, even though I did have the occasional stabbing pain episode even then. Steps around the house aren’t too bad, but any longer than 2 hours on my feet gardening/housecleaning/cooking/ laundry etc and I am in pain about level 6. I then, sit and ice my knees.
I have changed physios due to my lack of progress, and now after almost 4 months with the new physio, I am still in the same boat.
I was curious if this is a common complaint and what people have done to improve things. I see my physio once a week for an hour, do my exercises every other day, and also have a one hour leg massage by a registered massage therapist.
I feel let down by my surgeon. Not at all where I thought I’d be.

 

[Sara61]

@archie So sorry you are still having issues with your knees so long after recovery, the stabbing pain sounds like Zingers, these I still get on my knee that was operated on in 2019, healing of the nerves is still ongoing. However your level of pain doesn't sound good at all, would you not think of getting a second opinion from a completely different doctor, one that isn't familiar with you, a new set of eyes to give their expert opinion and see why you are still having this level of discomfort.

 

[DEL2022Jan-23]

@archie I have to agree with Sara61 , it really does sound like nerve pain, extremely sharp and sudden pain that comes and goes quickly- it can be very debilitating. Can you go to your GP and discuss this issue with them or possibly go to a different OS for a second opinion?
I am currently suffering with nerve pain just over 3 months after LTKR, in my case it is causing buckling, increased all round in pain levels and of course those zingers. I got a lot more help from my GP than from my OS and was prescribed medication to help with this.

 

[Jockette]

I think a second opinion is a very good idea. Zingers are one thing, not being able to walk well due to pain is another. I also have a Patellofemoral. It’s been 4 years and I’m not happy with it at all. I will admit, though, 2 second opinions have not found a cause for my discomfort, so I am just making the best of it.

Also, since PT isn’t helping, maybe consider stopping that. Sometimes the more PT we do, the more we maintain upset tissues. Maybe yours need to time to calm down.