PKR PKR Part Deux: now I’ve got a matching set!<

[MCC]

Hello all! I’m excited to say that I finally busted off my plateau and in the last week have ditched all walking aids and gotten up to 84 degrees of flexion. I’m also off pain meds aside from a Tylenol before bed to help me sleep (still lots of adjusting during the night, but works better than it was 2 weeks ago). Obviously it’s still a work in progress, but so much improvement sure is encouraging after feeling stuck for so long.

It does get better! Weeks 4-6 were a real bummer for me, but I’m seeing some light at the end of the tunnel and dreaming up hikes I’ll be doing next year.

Hope you’re all having a great day!

 

[MCC]

Hi all, I think I’m having recurrent patellar subluxation. Anybody have experience with that post PFA?

 

[SusieShoes]

I don’t know enough about this condition to be of much help, @MCC but maybe @Josephine can advise you.

Your post earlier this morning sounded so positive! Has something new happened?

 

[MCC]

Hi @SusieShoes! Things are still going well, but for the past 10 days or so I’ve had an intermittent snapping/clunking sound. I initially thought it was just due to swelling and stiff soft tissue as my PAC suggested, but today I’ve definitely had some mild patellar subluxation. It never happens when I’m doing exercises and really engaging the muscles, but happens when I’m not paying as much attention.

I talked to my doc’s office and they said some of that can be normal at this stage because muscles are so weak and imbalanced (especially given how bad my luxation and muscular imbalance was to begin with), but my OS will get back to me this weekend if I need to go in. It’s thankfully not painful, and it’s probably only a 5-10 times/day mild subluxation vs the 20-30 time/day moderate to severe subluxation + complete luxations I was experiencing pre-op, but I was just curious if that’s common or not. The dread hyper mobility causing recurrence of the luxation worries me but we’ll see. I know it’s a possibility, but I’m still hopeful and feeling so much better overall!

 

[Josephine]

Okay, doesn't look as if I'm needed much here after all.

 

[MCC]

Hi @Josephine! Actually I do have a different, non-related question for you: I took out a rook (high cartilage piercing) earring for my MRI, surgery, and recovery, so it’s been out for 3 months now. I’d like to re-introduce the earring, but it may have closed partially. If it is, I’ll need to essentially re-pierce it. Do I need antibiotics for that like I would for teeth cleaning? Or is it just entirely not recommended?

Thanks!

 

[Josephine]

You mean one like this?

Well, assuming the piercer has good hygienic practice and conditions and sterile tools, there should be no more need for antibiotics than going to the dentist. But if it does have to be re-pierced , I I'd leave it another few weeks yet.

But I'd say there would be mo more risk vis a vis your knee than any dental procedure.

 

[MCC]

Thanks @joesphine! I’ll give it another few weeks if it needs repiercing. My knee wasn’t quite up to walking 8 blocks to the piercist today. I spent 60 minutes picking blueberries on Sunday and while it felt great to be out doing something, it was a bit much for the ol’ knee. I’ve got 10lbs of berries to snack on here at the house while I ice though. And the knee did let me get up to make a delicious cobbler last night, so I can’t complain.

The picture you posted is actually a helix piercing, which I used to have. Here’s the rook:

 

[MCC]

Hi all,

I'm curious, when should walking get easier? I'm now off all walking aids and can do pretty much most light housework type stuff (though I still haven't hit 90 degrees flexion...though I got to 84 at PT last week. 90 is so close I can taste it!), but I can only be up for about 45 minutes at a go before my knee is feeling angry. I can only walk about 2-3 blocks before the soft tissues in my knee get painful, and I am starting to become concerned that my patellar subluxations are more than could be considered within the realm of normal. I had one today that actually felt painful on the medial aspect of my knee. I know stretching those already angry soft tissues with further patellar instability (I've always had a very tender medial retinaculum because of all the lateral luxations) is not ideal.

I guess I just need a little reminder to be patient and some encouragement. I'm really, really hoping these subluxations don't mean the procedure failed to correct the maltracking. And there's no retropatellar pain, so at least there's that! I know things don't always go to plan and that's fine. It's all manageable, but I'm feeling a bit down today!

 

[Jockette]

I had a Patellofemoral, too. You are still only about 2 months post op and your limitations sound par for the course, I had those issues as well, but I didn’t have the osteotomy. I did have a lateral release.

This is a year long recovery, hang in there.

 

[MCC]

Thanks @Jockette! Sometimes I get caught up reading how much other folks are doing two months out and it’s frustrating. I know I shouldn’t compare, but it’s not easy! And I keep dreaming of the hikes, and yoga, biking, and dancing I’ll be doing when I’m healed which is a double-edged sword. Haha I think my surgeon thought I might be further along by now too, though I don’t think this combo of procedures is a common one. Do you have any kneecap instability?

 

[Jockette]

I occasionally have some instability, but it’s recent. I don’t think things are going well for my knee. It’s never felt right. I am very disappointed in it at this point.

The section where I think the lateral release was done, has always felt bad, I used to describe it as if someone jammed a hunk of wood into that spot. It’s a little better, but not much.

Of course my X-rays look just fine.

 

[MCC]

Oh that’s terrible! I’m glad my lateral release site feels great, but my PT told me prior to surgery that she sees a lot of people who have residual pain and weakness related to lateral releases. How’s it been going with your gabapentin? Any improvement on that front? Or any talk of revision to TKR?

 

[Jockette]

After 3 weeks of side effects I couldn’t live with I ditched the gabapentin, and no relief of the discomfort that I was taking it for anyway.

No talk of revision because my X-ray looks fine.

Thank you for telling me about those others with lateral releases. Maybe it’s just going to take me a really long time to heal from this. I never dreamed it would take this long. What I read about partials and what my surgeon’s office did and did not say, I expected recovery to be 2-3 months. It wasn’t until I found Bonesmart at 4 weeks post op that I learned recovery could take a year. What a shock.

 

[MCC]

Ugh. I’m sorry @Jockette! It is frustrating how 2-3 months “recovery” estimates seem to mean so little. I think by recovery the surgeons seem to mean being able to walk/hobble without most aids. I wish they’d give us that estimate in addition to a return to normal function date. I was fully hoping I’d be back at spin class by month 4! Maybe that’ll happen, but given that I just hit 90 degrees flex, methinks not! And my left knee probably won’t be excited about that.

My left knee is aching far more than my right tonight and keeping me up. Or really they’re alternating which aches the most every minute or so. Assuming all goes well, I cannot wait for lefty’s turn. Anything to get that deep bony ache to go away for even a bit! The PKR on the right at least took care of that! And my left kneecap is all over the place like it’s drunk and trying to dance. Oy! Chronic pain is trying! Glad to have this forum to connect with folks that know that frustration.

I hope you can find some relief eventually!

 

[SusieShoes]

I think by recovery the surgeons seem to mean being able to walk/hobble without most aids.

You've hit that nail on the head! My OS painted a glowing picture of me being "off the cane" by week six. Which I was. He never mentioned that I would still have pain, brain fog, have to limit my errands and activity still, and be so tired I'd need daily naps. That part of recovery doesn't really register as important to most surgeons, I think; they figure we will handle that part of it.

 

[MCC]

Hi all! Thought I’d give a little almost 10 week update. I saw my OS two days ago, and he is not worried about the patellar subluxation at all. As soon as I can regain some strength in my quads, he thinks it should balance out. The lateral release, Fulkerson, and implant specifics have made lateral luxation nearly impossible (yay!), but I’ve been feeling my patella slip slightly medially and that’s expected. X-rays look perfect and I’m at 96 degrees flexion.

I’m feeling optimistic! I walked about 8 blocks yesterday and it felt fine until block 6, so now I know my limit. In other news, I’m currently on a family trip and tried sitting in the front seat of the car for the 2 hour drive and 1.5 hour ferry and what a disaster! Pain, pain, pain! I’ve been awake all night with knee grumblings. My knee is just NOT a fan of travel at all. Wish me luck for the next 48 hours! I think I’ll pretty much be stuck in the room, but I’m dreading the ride back.

 

[Jockette]

Nice to hear from you, I was actually wondering about you this morning! You must have heard my thoughts!

Good to hear you’re moving in a positive direction, we all know how slow that can be!

I hope you can enjoy this time away with your family and that the ride homes goes better.

 

[SusieShoes]

Please tell me you have your ice packs with you. If not, send someone out to buy some big (really big) bags of frozen peas or corn and use those for icing while you are on your return trip. I did this for about three months. We’d ride to Mr. Shoes’ sister’s house every other weekend, and I always had my ice packs along, not just for in the house but for the drive! My knees always were glad of the ice during the drive. Helped quite a lot.

Knowing your limit is wonderful for enjoying exercise without painful consequences. You can now expand your walks when you think you can go further... and build up to longer strolls.

 

[NavyGunns]

@MCC,
Your knee probably didn’t like being stuck in one position for so long. I made an 8 hr drive at week 9 / 10. Had to stop at least every 2 hours and take a walk. Getting out was a chore due to stiffness, but quickly loosened up. No pain during the drive, but I did get a lecture from my knee that evening .

Maybe on your return trip you can sit in the back seat where you can stretch out.