Revised PKR to TKR KSCAgent99's Knee Replacement Journey

[Kscagent99]

Hi! I had a partial knee replacement (medial and patella femoral) on June 28, 2020. After about 2 weeks, I was walking without assistance then one night I woke in severe pain. I later found out this was nerve pain and my doc started me on Gabapentin. I’m still on it. My knee and front/outside leg are numb. That’s not the problem. The problem is that I still have severe weight bearing bone pain on the medial side. I also have some edema. The pain is so bad that even crossing my legs while in a sitting position hurts. Due to COVID, my therapy has mostly been virtual, but I’ve been in therapy a lot and I know the drill. I did over-do it post surgery because we were selling our house, so I’ve been on ladders, packing, and painting the house. My therapist said I haven’t allowed the bone to heal. I’m a busy person... I can’t just sit around. What constitutes doing too much? Can I stand to clean house, cook, etc? What do I need to do to get this to heal? I hurt worse now than I did before surgery. I go back to doc for my 6 month follow up in a month.

 

[Kscagent99]

I bruised significantly. Range of bruising was from top of inner thigh down to my foot.

 

[Roy Gardiner]

to BoneSmart

I can’t just sit around. What constitutes doing too much?

anything that hurts or causes swelling.

Can I stand to clean house, cook, etc?

It is important to let the body heal, so if you can put it off, do so. Please, a dirty house won't kill you.

What do I need to do to get this to heal?

Rest, Ice, Elevate (see below)

I hurt worse now than I did before surgery.

You've been overdoing things, slow down please.

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 Care In Hospital​

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.

 

[Kscagent99]

Thanks Roy! I’m not sure I would have had this done if I had known the amount of down time during this busy period of my life. Basically, any weight bearing activity hurts pretty bad. I almost think I should use crutches for awhile. I’ve gotten my cane back out to try to offload some weight. We’ll see if that helps.
Wondering if anyone has used red light laser therapy. I purchased one to use at home.

 

[Jaycey]

Try a cane or crutch temporarily to take the weight off your knee. Obviously your surgeon set unrealistic expectations for this recovery. Climbing ladders, packing and lifting and painting is just not something a new knee needs. I would back off as much activity as you can. Ice, elevate and take pain meds if you have them. Time to let that knee heal!

 

[Kscagent99]

Thanks Jaycey! My cane has a broken rubber bottom but will get to the store tomorrow to get the tip replaced and then I plan on using it. My crutches are in storage :-(.
I know I did too much (long story - had to get house sold). I do think the doctor should have been more cautious than “weight bearing as tolerated” (it felt great for awhile!). From what I read on here so far, they fell into the category of getting the ROM and that’s it. I’m retiring next week and I’ve moved so now it’s time to really pamper the knee.

 

[Jaycey]

I’m retiring next week and I’ve moved so now it’s time to really pamper the knee.

Good plan. You can turn this around and get back on track. Read the articles Roy left for you. Focus on healing. Plenty of time for strength training and building ROM once you get this pain flare under control.

 

[sistersinhim]

Many are led to believe that a partial is an easier and quicker recovery, but that's just not so. We have found here that the recovery is basically the same for a partial and a full replacement. Your main job now is to heal and that's all. As your knee heals you'll be able to do more things without pain. If you do something and later on your knee hurts, your knee is not ready for that activity yet. Listen to it and you'll have an easier time in this recovery.

 

[Kscagent99]

Thank you all!! This has given me the hope I need! Reading articles now!

 

[Kscagent99]

Well, my 6 month appointment was yesterday and didn't go well. The xrays show dense bone forming around the prosthetic and the doc indicates that it is caused by too much pressure on the prosthetic (he said my bones otherwise look good in general and my bone density test that I had about 1.5 years ago showed no signs of bone issues). I'm also still in a significant amount of weight-bearing and certain movement pain. He said the only way to fix is a revision to a full knee replacement.

1) Can admins change the name of my recovery thread to "KSCAgent99's Knee Replacment Journey"?
2) Although totally surprised by another surgery, I'm very at peace with it. The pain I deal with everyday is horrid and weight bearing on my left leg is not pleasant at all. Any suggestions for this second surgery?

 

[Kscagent99]

My 6 month post op was yesterday and I'm still in significant pain post PKR last June (2020). Xrays indicate that the bone is not forming correctly around the prosthetic and there is too much stress on the PKR (medial) area. I'm being scheduled for a revision to a TKR. I'm not happy that this is happening, but I'm also very unhappy and in pain from the PKR. Anyone else experience a TKR within a year of a PKR? Any suggestions or words of encouragement?

 

[Kscagent99]

I'm getting scheduled for my 2nd surgery w/in 7 months (on same knee) soon and my living conditions have changed drastically. I just retired (early... at 56) and we sold our house and moved to the woods in our old RV until we can buy our dream retirement house. The RV doesn't have anyplace to cook except for a small microwave (I do have a small fridge/freezer combo). We have built a "kitchen" in an old trailer but I have to walk to it... probably about 30-40 steps. Stairs are involved (3-4 steps at a time). We really are living in "camping" type conditions. My mom and dad will be around for a week or two after surgery but they are in their 80's and I don't want to impose on them too much or for too long (although they love it!). My hubby works long hours but will be here in the evenings. I'm trying to think of preps I can do prior to surgery to make life a bit easier. I'll be reading thru this thread to get ideas (I meal prepped the first time and it helped immensely), but if anyone has been thru this in a crazy living situation and has some ideas, throw them at me! Greatly appreciated!!!!

P.S. - I live way out in the woods. I doubt traveling nurses will service this area, but we'll see!

 

[Jaycey]

@Kscagent99 I changed your thread title for you. I also merged your latest thread with this one. 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.

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 will 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.

 

[Jockette]

Getting a total is a good idea. But I would get at least one more opinion, if not two. Personally, I’d want a different doctor to do a revision to a total. I would be questioning why your doctor didn’t do a total in the first place, since 2 out of 3 of your knee compartments needed to be replaced. You want someone who has done a lot of revisions, so that they have lots of experience. More experience gives you a better chance for a good outcome.

 

[Kscagent99]

Thank you!!!

 

[Kscagent99]

Thank you for your reply. The reason my surgeon did a partial is because of my young age (56) and activity level. He wanted to do the least amount of correction needed. My lateral side is fine and my knee stability is excellent. I have thought of a second opinion but this doc is rated and known as a very experienced and top notch doctor. He specializes in this type of surgery and is by no means a rookie. His credentials are excellent and he comes highly recommended. I am looking at other surgeons in other communities and have yet to find someone with a better reputation.

 

[Jockette]

I’m glad you found a doctor that you have confidence in.

Not all doctors believe in doing less because of your age. We have many members here in their forties with TKRs and even some in their 30s.

I had a Patellofemoral partial, also, and my knee is worse now than before the replacement. I did not research my surgeon, I assumed he knew what he was doing. I later found out he doesn’t do very many partials. It was a very hard lesson to learn, as I am still struggling with the consequences, and it will be 4 years in March. I’ve had 2 second opinions that offered me no help. My trust level at this point is a bit low, and I’m managing well enough, so for now, that’s good enough for me.

 

[Kscagent99]

Jockette, I am sorry you are having a tough time. That stinks. I did a lot of research before getting surgery and my best friend is an Athletic Trainer who helped me with the research. I’m traveling 3 hours to get to my doc.

 

[Kscagent99]

Well, here we go! At the hospital now and getting ready for my TKR (revision). I had a partial in this knee last June and it didn’t heal properly.

 

[Carmencita]

Wishing you a successful op and good recovery