TKR Really fed up

[Sadperson]

Yes Roy, I guess I am my own worse enemy! I think it took a while longer than most to get it right and I am paying the price. Elevation is my reward after a tough day at work and ice is heaven! Given that my op is after exam dates, i can afford to rest more after this than i could before. It certainly is more of an arduous task than any rugby match.

In passing, I went back to my old rugby club, (premiership) and went to the training ground and showed my knee to a top physio. He sucked his teeth, tutted and said 'i'm not touching that!' how is that for motivation?

 

[Josephine]

This sounds like I am whinging

No you're not - you're just being honest. It is a bummer. Besides which, 'whinging' is encouraged on this forum as it's probably the only place where you can really vent and get it all off your chest!

 

[Roy Gardiner]

... I am to have another op! I won't get my leg straight again but the doc is going to give it another go. ... I am to have an epidural, then the rugby team (physio) will come in and jump on it for a 4 day hospital stay. If it does not work ... big decision... revision.

I don't understand this. Caveat: I have no medical qualifications, so perhaps there's no reason why I should understand, and I hesitate to raise a question for this reason.

So am I correct in saying they are proposing not to open you up, but another MUA? Fair enough. Thereafter the BoneSmart mantra will apply and lots of lazing around will be appropriate.

But number 1; then revision if that doesn't work? I thought that revision is only if the joint itself fails or has been installed so badly that recovery is impossible, neither of which seem to be indicated here.

But number 2; you're only a short way out of your first MUA and you say yourself have been overdoing things. Wouldn't waiting awhile be another approach? You say you won't get your leg straight again, but then if it's swollen to twice the size it should be then you wouldn't anyway until that swelling has gone down.

You are no doubt big and strong, and you've said you have tight calves due to all that rugby and other exercise. It strikes me, then, that it might well take you a long time to stretch the tendons to get your leg straight, and that (as you've also said) your body might resist more than a normal person's.





Now I've stuck my nose in here where it doesn't belong, I invite Josephine and Orthodoc kindly to cut it off if I'm talking nonsense again.

Thank you to all for help and advice. Really needed the advice and thank you all for the continued support. I hope I can pay it back.

This place is great isn't it? I got huge help, which can never be paid back IMO -- but it can be paid forward by offering experience, help and advice on here to those following.

 

[Sadperson]

Thanks again Roy. I have to confess that I don't understand all of the issues. There is no question in my mind that the TKR is working and working well. The evidence is a lack of pain and discomfort. I was equally as shocked when the doc said revision. I should have said 'revise what?' but it did not cross my mind atvthat moment. I sincerely hope the MUE (epidural?) goes well.

I am equally as grateful to all who contribute. I have learned more from this forum than I had before the op.

 

[Josephine]

I think another MUA is very much called for. It sounds to me like you have an adhesion somewhere, probably behind your quads tendon. You can see that spot in this xray pinpointed by the blue arrows

Sometimes, when all else fails and the patient it still having problems, the only answer is a revision. I've heard this many a time at conferences, surgeons freely admitting they had no idea why their patient(s) had pain or limited ROM so they did a revision and it seemed to do the trick. Sometimes there are things that defy definition and logic. Everything looks fine but it obviously isn't. Oddly, there are plenty of instances where a revision appears to resolve the problem.

 

[Sadperson]

Dear all, MUA again tomorrow but with an epidural instead.

 

[1ELISEA]

All the best to you tomorrow!!
Sending good thoughts your way!

 

[Sadperson]

Good afternoon. Just back from hospital and MUA with epidural. Surgeon got 110. CPM machine got 110 as well. I got 95 Through physio using calipers. Interesting point ... the CPM machine was saying 110 in reality it had gone as far as it had and my leg muscle bulk stopped the machine from progressing but was still registering the higher number. I know this as physio measured me on the machine! Goes to show you cannot trust machines! I am not questionning my surgeon. The man is a genius to get me this far! Physios are brilliant. I had hoped for 110 but i guess it is going to be more hard work!

 

[Mutley]

The CPM machines in my experience are a good 10 odd degrees less than what they register. My surgeon managed to get to 120 during my MUA. I've been hovering around 100-110 ever since. I'm just trying to maintain what I have on a daily basis that way I don't set myself up for any disappointment! Wishing you a speedy recovery from this latest procedure

 

[maryo52]

THe swelling from the MUA can set you back many degrees. Even my arthroscopy set me back 40 degrees for a week.

 

[Sadperson]

I wonder how many people don't know how far out the CPM machines can be! I thought they were 100% accurate. 40 degrees in a week ... That's a lot! I just need to work hard now ... by being smart rather than macho!

 

[Sadperson]

So i am in hospital bed. Catheter in, Epidural in back, drip in left arm, CPM machine going up and down. Nurse comes in and asks me to turn over! Right!

Surgeon got 110, Hospital Physio 95, First post hospital physio 82. Tomorrow second physio. i will be opening a book to bet on what it will be . . . . 82? Surgeon will decide revision 19th July.

 

[bottomshollow]

Oh, Sadperson, that CPM is doing nothing for your flexion. It stands for continuous passive motion. Your muscles are not being used at all during the entire time you're hooked up to it. So there is no real stretching of muscles, tendons, and ligaments. And I bet your knee is swollen, and swollen knees DO NOT bend.

I am just so sorry that you are having to go through all of this---just seems so unfair that you're in that small percentage that does not have a successful outcome. But we're here for you and have your back. So come here to us to vent, whine, cry, holler, cuss (well not really) and we will do our best to make you feel a bit better.

Take care and keep us posted. We care.

 

[Sadperson]

Thanks, I will do. You are right. Knee very swollen. Lots of ice again, pain killers ... Again. Physio will bend and measure it tomorrow. What a conundrum. As i write knee twinges are uncomfortable!

 

[amab]

Oh my! Best of luck in your continued challenge. I have a friend who recently had a revision but it was about 10 years since his initial replacement. I saw him last week and he is doing quite well. Passing that along in case you have to do a revision. Hang in there!

 

[robynhood]

Sorry you had to have MUA. Hoping your recovery goes well and a revision will not be necessary. Take care.

 

[Sadperson]

Can I ask a question? What benefit is a CPM machine? I was under the impression that this gadget would solve all my knee bend problems. BUT if I have swollen knee with pain and it really does not stretch tendons, muscles or ligaments, then have i wasted my time? Having read the article on Wkipedia, i feel a tad frustrated. Reading between the lines, I should have had MUA followed by physio ASAP.

PS i am now a junior (still ignorant) member. Thank you

 

[Mutley]

When I had my MUA my surgeon SPECIFICALLY requested that when I awoke in recovery I should be on a CPM machine. I believe, regardless of any swelling that the machine just keeps the knee moving. ( Someone will correct me if I'm wrong!) However, I didn't awake to a CPM machine, just a huge amount of pain & a pathetic excuse as to why there wasn't a CPM waiting for me. I now think that this is the reason why I'm below what my surgeon achieved while performing the MUA. At the end of the day, the machine is manual so it's not really going to push you to the limit unless you keep your finger on the 'up' button I don't think you've wasted your time as such. I found my physio/CPM sessions quite positive when I managed to increase a few degrees, even if it wasn't quite as many as being measured with a good old fashioned ruler

 

[robynhood]

I think bottomshollow explained in the post above she dosent think the CPM machine does any good as regards keeping the knee moving. Its a passive motion so surely that cant help. Im not sure why they use them at all I think at my hospital they said it would help prevent DVT

 

[SadKnee]

SadPerson, you have been through a lot! I am hoping this does the trick for you as it sounds like you need a break! Hang in there! Keep posting and let us know how it goes! I hope you are icing, elevating and stretching. I don't believe my CPM machine ever helped as much as a good PT or water exercises. It may have just been me as I have read where some people really thought they helped.