TKR R TKR journey

[Layla]

Hi almostready!

I still have a lot of clicking and snapping in the posterior/lateral area. I asked the surgeon about this. The overall answer was “it’ll get better” which of course I hope is true.

Many members mention clicking, clunking and popping sounds. It is natural to be concerned and wonder if something is wrong. It seems more often than not that noises aren’t indication of a problem. It takes time for the soft tissue surrounding the implant to heal and settle in with the implant and begin working smoothly and over time it will most likely stop.

Here is an article from the BoneSmart Library.

Clicking/clunking knee joint after surgery

Revised March 9, 2021 by Jamie Many patients who undergo knee replacement surgery will describe noises that come from their replaced joint. People commonly mention a clicking or clunking coming from their knee replacement when they walk, and they often worry that something is wrong with their...

bonesmart.org

It sounds like you're doing really well and obviously your surgeon feels the same. Keep up the good work and enjoy a swim in the pool on this long holiday weekend!

 

[mendogal]

You're doing really well at 11 weeks - not even 3 months into a one year recovery!

My L knee is over 18 months old and still clicks like a metronome but is fully functional. I told my surgeon if he was going to install a metronome he might have included a step counter!

 

[almostready?]

Hi everyone! For those of you out there who swim and/or play tennis, when do you go back to breast stroke and some light social doubles tennis?

 

[Layla]

Please do contact your surgeons office on this. A member of your OS's care team should be able to answer these questions for you.

Regarding the breaststroke - a retired BoneSmart colleague offered the following on the breaststroke post TKR -

"My surgeon advised me to avoid the breaststroke kick, as he said it is hard on a replaced knee. I now do breaststroke with a flutter kick. It's unconventional, but it works.

You can use the SEARCH at the top right of the page, if you're curious to read the protocol others followed.
Type in key words such as breaststroke or tennis and all threads where each was mentioned will pop up.

Have a wonderful week, almostready!
@almostready?

 

[almostready?]

Not a lot to report that is different at week 12. My ROM is stable, not changing much - PT says she doesn’t see people get their fullest range until full strength comes back. I think I am tolerating more activity in one day without paying the price. For example, I did a 20 min light Peloton, a 0.75 mile walk with incline/decline, went to the office for a few hours and went out to dinner all in one day. I iced when I could for sure a couple times in there. I was exhausted but didn’t have worse pain or swelling and could sleep. I ended up getting a Game Ready ice machine with a good discount which has been so great. Since I know I need my other knee done and have a 10 yo boy prone to sports injuries, it already feels worth the investment. I am still getting frustrated with the clicking and snapping in the back of my knee. I would like to find a way to psychologically calm down about this. I know it’s been suggested here to start cataloging small wins, and I think that’s a good plan. Thanks for listening!

 

[Layla]

I am still getting frustrated with the clicking and snapping in the back of my knee. I would like to find a way to psychologically calm down about this.

Use the old Scarlett O' Hara train of thought...
"I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow."

You're young, possibly you've never seen Gone With The Wind and are unfamiliar with the character of Scarlett?

Try to put off concerning yourself with the clicking noises because it happens frequently, you're not alone... and it will likely fade as time goes on.
Happy Sunday...hope its a good one!

 

[almostready?]

Yes I’ve been trying something like that. Embarrassed to say I’ve never watched Gone with the Wind I dare say it might be getting better or that I’m noticing it less - either way is ok! Layla - when you are you going to start working as a therapist???

 

[Layla]

That's a funny one...Never!

I hope with the clicking, it's a little of both, it's easing SO you're noticing it less.
Cheers!
@almostready?

 

[Cycle-Path]

Keep up the good work! It will all come together for you really soon. It sounds like you have a great mix of conditioning going. I can't say this with any certainty, but I believe that walking has been highly beneficial for me.

 

[Layla]

Happy Three Month Anniversary!
I hope you're having a good week and I'm wishing you a beautiful weekend!
Thanks for sharing your healing journey with us and supporting others along the way. It is appreciated!
@almostready?

 

[almostready?]

Thanks so much Layla! I appreciate you!
13 week update:

-ROM hovers at 130-133 which seems completely fine and better than pre-surgery for the last few years. I use a heating pad and an icy hot-like CBD cream every morning for 20 min and then do my flex/ext stretches. I might do this forever as it feels very built in to my morning routine with the NYT games app and coffee .

-Strength: I am regularly able to do and slowly increase weights on quad extension, leg press and hamstring curl machines without aggravating the knee. It’s really nice to see the weight I can tolerate increase. Also doing the ankle weight and band exercises from PT.

-Cardio/other: walking downhill is getting easier, sticking with 10-20 min on stationary bike many days with some increased resistance.

-Work/social: I had to do some coverage work for a colleague this week which turned my normal part time schedule into a 40 hour week and had two evening social events. It was too much for me, and I was really down yesterday just wanting to feel I was could do whatever I want. It’ll come, but it was a bummer moment.

-Clicking: grrrr. I think it’s improving overall with a lot of fluctuation. Also easy for me to get down about this. Trying to stay with the long view.

All of my appointments feel like a part time job in themselves: acupuncture, PT, body work, etc.

Hubby and I are going away this weekend to Carmel for our wedding anniversary - first time away since the surgery. I’m packing the ice machine and the extra pillows, medicines, creams, heating pad etc. Pretty romantic!! Haha. We’re going to a hot tub/cold plunge place called Refuge on Sat morning. Should be fun. I’ll prob be walking on uneven, hilly streets and the beach a bit, so will be cautious.

Thanks for the support here!

 

[sansabosa]

Hi everyone!
I’m logging back on after almost eight years. I am five weeks post R TKR (June 12, 2024). I am youngish person (50yo) who did not win the genetic lottery in terms of my bones and joints (grateful for other strengths). I had L THR in 2011 (posterior) and R THR in 2016 (anterior) after a late discovery of hip dysplasia (bone or bone at first X-ray, age 36).

In addition to needing a TKR (and the other one will follow, hopefully with a break of at least a couple years), my doctor discovered a tumor at the distal femur that the team decided they needed to deal with. I was lucky to find a great coordinated team at Stanford such that the oncologist went first and then ortho went second all in the same surgery. For the tumor, they went into the bone, scooped out the abnormal area, treated it with some kind of cryolaser to clear the margins and filled it with medical cement. Pathology came back as “atypical cartilaginous tumor of bone” - no further treatment needed.

As far as the replacement, my doctor thought he “might get away with” a patellar femoral partial replacement only. We agreed that if he got in there, he could do a total if indicated. So when I woke up, I heard I got a total and that it was an “easy decision” once he saw inside despite the fact that I had good joint space in the other compartments on MRI.

Let me pause and say that this has been a nine month journey of finding the right diagnosis from the best team for the job and then receiving the most comprehensive surgery that it turns out I really needed. I am grateful for where I landed and don’t think I could’ve gotten here without some really challenging persistence and advocacy on my own behalf which is quite sad as it relates to our health care system. I saw five different doctors in five different systems to get to this place with the privilege of having PPO insurance and being a health care provider myself. Rant!!

So now at five weeks, I am posting to say I have all the frustrations.
-stress about range of motion
-challenges with energy and starting to work
-ODIC
-post op blues and daily tears
-PT set backs
-impatience and comparison

I think in reality I am doing okay, but each daily is groundhog’s day of “I’m okay” to “I’m screwed.” And like others, I HAD NO IDEA!!!

-ROM: +3 to 120
-Swelling every afternoon/evening even with no activity
-Tylenol, Advil, gabapentin at night
-walking slowly with a lot of focus on gait, no assistance
-working sedentary, did 10-12 hours this week
-icing and elevating a lot

Thanks a lot for listening.

You are not alone!!!
I had my L THR at the age of 35
R-THR at 50 yrs
L-THR revision at 55
L-partial KR at 61
Right knee in the upcoming years…?
I am 62 and grateful though some days are painful and with limitations. Have gait because of the left hip. Knee was more difficult in terms of healing compared to hip.
Take care

 

[mendogal]

@almostready?
I wonder why, when you're doing incredibly well, the clicking is distressing? It's100% normal.
My very happy 20 month old is still a metronome. My less happy 15 month old isn't.

 

[almostready?]

The clicking is ok - I can get used to the implant making sensations and sounds I thjnk. I was using clicking for ease of wording - the thing that stresses me is actually the snapping that I have too and feels really yucky and occasionally painful. I hope this is also the category of it will go away or I’ll get used to it but it’s harder not to be worried there.

 

[EalingGran]

also said NOT to try to get beyond 130 degrees of flexion to protect the joint. I should’ve asked more about this…is this everyone or just my implant etc…that kind of bummed me out bc I was hoping to get to the same as my better nonsurgical knee someday

I think it does vary with the implant and type of surgery. I have an Oxford fixed lateral PKR and I have 150+ degrees bend- although I was borderline hypermobile pre-op and have 160+ on my good side. The lateral PKRs used to have mobile bearings like the medial PKRs but apparently they were so mobile there was an increased incidence of dislocation. So I think there can be a balancing act between stability and flexibility. I don't sit back in child's pose fully now- as I wouldn't want to risk putting my weight on the fully bent knee.
I have read that there are some extra- mobile implants used on India- where culturally there is a strong wish to fully squat again. I haven't found out though whether these are linked to any increased risk of dislocation though.

 

[EalingGran]

the thing that stresses me is actually the snapping that I have too and feels really yucky and occasionally painful. I

When/ where do you get the snapping? I used to get occasional slightly painful snapping at the back of my knee at full extension- if I walked with a longer stride than usual. I had it for a while and it worried me too. My surgeon said it was popliteus catching on a slight lip on the implant and it would settle as the tissues healed and my muscles strengthened. Thankfully he was right and I haven't felt it for almost a year now.

 

[almostready?]

Glad to hear that - mine is both in the middle of the back of my knee and another place in the back lateral. Sometimes it happens every step I take and sometimes it calms down. Seems better in the morning than the afternoon. My bodyworker is able to get it where it’s tender and says it is prob tendons. My surgeon kinda had an attitude of “it’s soft tissue and not my problem” which was frustrating. I do have hope that it’ll continue to settle.

 

[almostready?]

Hello! Thought I’d write a 15 week update. I’ve been able to do a few things this week that were milestones and made me really happy. The first was taking a two mile walk. It felt so good. A flat fireroad with nice views. The next was walking down our steep hill to town and back with my son to get breakfast. This was a ritual for us on the weekends, and he said “mommy, when can we do that again?” So happy I tried it! I was able to take him to tennis and sit there for 2.5 hours and then still hang out and do things the rest of the day - felt very “normal.” Lastly, and this sent me to ODIC, I did the three mile loop through the hills by our house which was the thing I told myself I was working toward since I could still manage this before surgery. I did it! And also didn’t plan well bc I had to be out and about all day afterwards. I didn’t not sleep well and was sore the next day. I took it easy and iced 5 separate times yesterday. I think I’m back to baseline now. I had a video visit with the oncology team yesterday who basically said goodbye forever, nothing else needed (I had a “tumor” - clump of abnormal cells inside my femur - removed at the same time as the TKR) which was great! Re: my clicking and snapping, I am just trying to assimilate these feelings as best I can. It helps to ask myself “is this really a problem if I’m functioning well?” My knee seems like a part-time job now rather than a full-time job. Still doing my flexion and extension routine every morning and something for strengthening every day. Still icing, elevating, using all the creams, etc. Still getting body work, acupuncture, shock wave. Just wow. Grateful to be able to fit it all in while I am also working!

 

[benne68]

Wonderful update, @almostready?; And great news from the oncologists!

Glad you've recovered from your visit to ODIC bench. It happens to all of us at least once during recovery (some of us -- like me-- require multiple visits to learn our limits ).

So glad you are able to do the weekend breakfast walk with your son again. It really sounds like you are getting back to life!

Wishing you continued progress.

 

[mendogal]

That's outstanding!!!!!
Walking good distances on paved flats and hills was my own number one priority so your post really resonates with me.
It's normal at your stage to have short ODIC visits as we know we are improving but it's impossible to accurately gauge day to day!