TKR Quads and ROM

[NeedaThneed]

Im afraid I do (but you may not want to read my story as I’m getting a scope to remove it!). But mine is firm and crackly/snappy feeling during simple walking, and pops out when I bend and is clearly getting squished in the joint line below the kneecap.

I think “squishy” is a good sign that it is just swelling and you may want to do some ice, compression, elevation and back off on the stairs until it gets better. Working an inflamed knee is what can lead to that inflammation turning into scar tissue. Unfortunately, it is impossible for me to not re-irritate the area (why I need that tissue removed), and my lump keeps growing.

 

[mendogal]

Has anyone had a swollen lump on the lower front of the knee? It is a"squishy" clearly identified lump, and seems to be causing me most of my pain/swelling feeling when I walk or go down stairs. Thank you.

On my mid June R TKA I have had an area of very discrete swelling in a semicircle curling around the area lateral to my kneecap for some time. It's soft and not warm or inflamed, smaller in the morning and slightly larger by evening. I doesn't respond to ice and elevation.

I have issues that seem related to it: a friction along the lateral (outside) aspect of the kneecap, and my lateral quads experience pain with prolonged sitting.

It's a total mystery to my PT. I suspect a tendon issue. It's preventing me from doing strengthening, though my walking and ROM are great. My appointment with my OS is in 9 days. His PAs seem dismissive of soft tissue issues but I'm hoping to enlist his support in solving this mystery.

Yours could well be a form of bursitis - excess "joint lubricating fluid" getting stuck for some reason. Usually there's an irritation or impingement causing it. Worth checking in with your team especially if icing and elevation, and ceasing or reducing painful activities, don't help it.

 

[Bfan]

Going at the end of the week. Thanks.

 

[Layla]

Happy Three Month Anniversary, Bfan!
Please let us know how your appointment goes. Hopefully you receive answers and obtain relief soon.
@Bfan

 

[Bfan]

Post LTKR on Jan. 3. Doing better. Have a normal gait and can descend stairs most of the time. Just wonder is anyone else experienced groin pain from PT where they have you sit in chair and push knee back with other leg. I think I pulled a muscle weeks ago but not sure. Thank you. I've stopped PT.

 

[Layla]

Thanks for the update, Bfan! Yay for the progress in walking with a normal gait and descending stairs.
I am sorry to read about what may be a pulled muscle. If you haven't already, try icing the area of discomfort and using OTC pain relievers as needed and hopefully it will ease soon.
@Bfan

 

[Bfan]

Almost 4 months post op. Walking fine. Able to ride bike. Still have pain but I've tried to make temporary "friends" with it. I do have a question. When judging ROM... (and I'm hoping more will come just by doing my own exercises and daily routines)... does passive ROM, gentle pushing with assistance from someone else, count the same as making your leg go back on its own? Don't want to be too hung up on it, but I don't know if it's meaningful.

 

[mendogal]

To me the only meaningful ROM is not a number but the functionality, which is all my ortho team ever asked about.

If you want a number, I wouldn't do it after manipulation by anyone, because it may induce swelling, and when you swell later in response any gain they got has gone away. It should simply be a snapshot of where you're at after a bit of warming up - say after a few minutes biking.

It sounds like you're doing well!

Here's a very helpful article on our knees' range of motion.

Something I found especially helpful in it is the degrees of flexion required for the following activities:
- 65° to walk,
- 70° to lift an object from the floor,
- 85° for stair climbing,
- 95° for comfortable sitting and standing
- 105° for tying shoelaces.

 

[benne68]

does passive ROM, gentle pushing with assistance from someone else, count the same as making your leg go back on its own?

No, it doesn't -- and those passive ROM numbers are really misleading in terms of your actual recovery.

Unfortunately, the reason some PTs do it is because they have an incentive to "prove" that their sessions yield results.

I've had both knees done and my surgeon never measured or looked at numbers. He watched me move and asked me how my function was. As mendogal said, it the FUNCTION not the number that counts.

 

[Bfan]

I'm now at 4 months and want to share where I am to see if others are experiencing the same thing. When people ask how I'm doing, the most truthful answer is, much better than where I started, not as far along as I hoped. It seems I'm in a period where one day I think, "Wow, my knee isn't very stiff or sore today. I can finally see where this is going!" A day or two later... stiffness, pain, can't go down stairs etc. I think the illogical trajectory of this recovery messes with the brain. Many ups and downs... the setbacks outnumber the victories. It's sometimes hard to believe this has a happy ending but there's no other choice. When i think back on what I couldn't do one month, two months, three months ago I do realize I am progressing. Surgeons don't help by painting a rosy picture of what this surgery and recovery really is. They should be honest about the pain and duration of recovery. I wouldn't have questioned how I was doing as often if I was honestly told what to expect.

 

[Jockette]

@Bfan I totally agree with you that we should be more informed about this recovery! We would be much more relaxed and accepting. I had a partial, and read that it was a quicker recovery than from a total. Mine was not! I was frustrated my whole first year because it was not what I’d read about and therefore expected.

I copied your post above, out of thread from last year, and added here to your recovery, to keep it as part of your history.

 

[benne68]

"Wow, my knee isn't very stiff or sore today. I can finally see where this is going!" A day or two later... stiffness, pain, can't go down stairs etc. I think the illogical trajectory of this recovery messes with the brain. Many ups and downs... the setbacks outnumber the victories. It's sometimes hard to believe this has a happy ending but there's no other choice

I'm just a couple of weeks ahead of you in recovery and am having the same roller coaster ride! However, since this is my second TKR, I know that there really is a happy ending!

Try to be patient. It does get better; it just takes time.

 

[Maggie M]

I’m a little over 4 months out and I feel exactly like you! Some days are pretty good and I even have the feeling that things are getting back to normal, then I guess I overdo it or something and it starts swelling again. I also wish Drs would be a little more honest about the pain and how long it takes to get well.
My Dr did tell me but I guess it didn’t really register with me!
Anyway, hang in there, we’ll be better soon I hope!
@Bfan