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PKR Red Rider's 60k mile tune up

RedRider said:
Interesting note: the bandage they used was this elastic edged contraption I was told cost the equivalent of an iPad. Wow! If I knew that, I would've sold it on eBay or Craigslist.:wink:
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I got a copy of the procedure report today. The dressing was called Aquacel. The incision was sealed with Dermabond, which I assume is the glue?
 
TexasTee said:
@RedRider - i have a fit bit, too! And since it sounds like yours is new - I can provide my pre-op data....I average between 20-35m restless at night. Wonder if this will get better or worse when I'm at 6 weeks out? It is often my knee causing me to change positions. Will be interesting to see how the trend changes.
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@TexasTee it'll be great for your recovery. I set my step goals really low so that it's a WARNING if I'm overdoing it. The sleep log just gets depressing sometimes, but it's gradually improving. Speaking of recovery, you're almost up to bat! I'm excited for ya!

Today is my 7 week mark post-op. Work has been going well, although I was really movin' and groovin' this morning. As noted above, I got a copy of the procedure report from my surgery, which I suggest everyone does. It was very informative and talked about some specifics of my surgery that I wasn't aware of. For example the total tourniquet time was 47 minutes. That was pretty fast for a patellofemoral and lateral compartment resurfacing! Also, I got a 9mm spacer which is interesting for no apparent reason whatsoever. I guess I just enjoy the technical stuff.

On Saturday I was rushing out to give the mailman a letter before he left. I unknowingly found myself in a semi-jog towards the mailbox. It wasn't painful, but the experience was surreal; like my body knew what it was doing but my knee didn't. It was such a weird experience!
 
I seem to be riding on a recovery "plateau" lately. It seems like my progress has become stagnant. My ROM is great, but hasn't changed remarkably for a while now.

I'm nearly 2 months out and wondering if I'm entering the "time and patience" phase I've read so much about here on BS. I don't know if I need to work harder or just be patient.

To be honest, I've slacked on my physical therapy, exchanging it for a lot of cycling, walking and work. I've still got a lot of shakes to iron out so I feel a little guilty. I wish I knew exactly what needed to be done, or not done.
 
@RedRider

Plateaus are common no matter whether you are recovering from a PKR or training for something. Things came up over vacation and I never did get up into the high country, but yesterday I discovered something that was a welcome surprise. After my gym workout, I hit the hot tub. I don't do this often and instead usually hit the steam room or dry sauna to relax. The hot pool at my gym is nearly rectangular in shape with one end more narrow than the other. I sat down below the bench on the narrow end of the pool floor and then realized my left knee now bends enough to fit (knees bent, feet on floor).

At two months out from my LTKR, a combination of stupidity (overdid things) and the lingering effects of the RX Levaquin, caused left knee to blow up and I have never regained the ROM I had at 5 weeks (near 120 flex). I got the straightening back within a few months after using an extension board, but until yesterday I thought my flexion was in the 110-115 range. Once I discovered my knee fit in the pool for the first time in 18 months, I did some flexion stretching outside the pool and found that while still short of my right knee, the left is getting close...probably around 120. Other than cycling indoors, I've done nothing to work on my flexion. Seriously nothing.

So, even at nearly 21 months out, I'm getting better. I'm sure by summer you will better than new. Take it easy for now. When the days get long you will be ready to do everything you want.

BTW: Did you catch any fish?
 
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Yes, I'd say time and patience is the thing. Remember you're not even two months out and still have a lot of healing to do. With being back at work, you might even want to decrease your other activity a bit, depending on how the knee feels.
 
Patience, patience, patience! I feel like a kid on Christmas staring at a huge present that I can't unwrap. I guess that's the the way it goes, but doesn't make it any less frustrating.

Still dealing with some patellar grinding past 90 degrees. Again not painful, but there's a specific point of flexion where it starts, then abruptly stops as extension continues. My hypothesis is that the grinding is related to when my patella transitions from the inlaid prosthesis to the natural bone. I wish someone else had an Arthrosurface so I could compare and see if this is the case.
 
Yes patience. In my recovery thread, you mentioned doing a trek through the Bob Marshall Wilderness. I have never been in "The Bob", but like you have it on my list. Depending upon possible legislation in Idaho regarding teacher licensing and pay, I may or may not be free next summer. I haven't been to Montana in years so I'm due.

Back in the early 1980s, I put on the first ultramarathon race (running) in Idaho and did so for 25 years. One guy who came to an adventure run in the Sawtooths was a character named Pat Caffery. A few years earlier (1978, I think), he had written a report that was published in one of the bigger running magazines of a one day traverse of the Bob Marshall Wilderness. With youth and exuberance, Pat crossed the wilderness running and walking for 67 miles and something like 17 hours in a pair of cut-off jeans with only an extra pair of socks and a tube of petroleum jelly in his back pockets in case of blisters. He drank water from streams and ate nothing all day-plus long. He told me near the end of the run he was "burning brain cells". Ever since hearing his story around the campfire in Idaho's Sawtooths after a 54-mile one-day wilderness run, I've wanted to cross "The Bob". However, I'll just be hiking now.

I have no doubt that your knee will resolve any issues that prevent you from hiking and cycling to your heart's content. Knowledge about the Arthrosurface inlay and related functioning does seem a bit hard to come by. When do you see your OS again?
 
RedRider said:
I seem to be riding on a recovery "plateau" lately. It seems like my progress has become stagnant. My ROM is great, but hasn't changed remarkably for a while now.

I'm nearly 2 months out and wondering if I'm entering the "time and patience" phase I've read so much about here on BS. I don't know if I need to work harder or just be patient.
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Plateaus are quite common and also equally frustrating---we tend to focus on improvement, but for some reason, our body needs some time to itself during this period and it does nothing.

As for the "time and patience" factor, yes---this is what it is all about---it is not about working harder, as you will then most likely cause your knee to swell more, slowing down your recovery. It is not about working harder during these time periods, it is having the courage to understand that you do not need to do anything differently---just ride it out and remember that the plateau will end and your recovery will continue upwards.

By working hard, you will not only increase swelling, but you will also most likely slow down the recovery
 
Remember that recovery is not linear---it is not a constant upward movement---it looks more like this:
[Bonesmart.org] Red Rider's 60k mile tune up
 
Thanks @referee54 I'll keep that in mind next time my patience dwindles. Here's to a recovery that looks more like this:
[Bonesmart.org] Red Rider's 60k mile tune up



trailspud said:
... Pat crossed the wilderness running and walking for 67 miles and something like 17 hours in a pair of cut-off jeans with only an extra pair of socks and a tube of petroleum jelly in his back pockets in case of blisters.
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That's wild stuff! We were in MT a few years back when they were running "Le Grizz". We were staying in Whitefish at the time and it was the talk of the town. Would have loved to go out and watch it but we had some hiking to do. Beartooth is another wilderness on the bucket list, such an amazing area!
 
That's wild stuff! We were in MT a few years back when they were running "Le Grizz". We were staying in Whitefish at the time and it was the talk of the town. Would have loved to go out and watch it but we had some hiking to do. Beartooth is another wilderness on the bucket list, such an amazing area![/QUOTE]

@RedRider ...that guy Pat who ran across the Bob Marshall was the race director for the Le Grizz 50 for 33 years. I guess he retired in the past year or so. I left the ultra running community some time back, but it was a cast of characters in the 70s-90s.
 
Your are doing excellant . Keep it up. You really are doing the rights things by just working ,biking and walking. No need for crazy exercises unless you are me . Im approaching a year very soon and i feel great. 20 younger atleast,sometimes. Its a dream come true and the best gift ever. You already unwrapped it ,just be patient. C YA , Iceman
 
@RedRider

Definitely no pom-poms or short skirts, but getting enough leg muscle mass back to possibly rock a pair of 1980s running shorts :)
 
Without getting my hopes up, I think I'm starting to see some escalation from the recovery plateau I've been riding on. A few indicators:
1) Extension stretch (the one where I gently push my leg straight) has become easier and less uncomfortable
2) I forget to take my pain meds (a good and bad thing I guess).
3) I'm taking my best foot forward (that is, using my recovery knee more and more for steps, descents, etc.)

My knee is still noticeably swollen though, which I think is contributing to a majority of my symptoms. I can't imagine it's based on overexertion because there's been a baseline of swelling this whole time. How long will it be swollen though? I'm nearly 9 weeks out, although I've heard that the swelling lingers around from months.

Oh, and I hopped on a horse for the first time last weekend. We rode for a couple of hours out in the desert (Anza Borrego). My knee felt okay on the ride, although it was quite stiff when I stepped of the saddle. Yeow!
 
9 weeks is still very early...expect swelling for some time to come. It sounds like you are going steady, but not too excessive. It's good that you are getting extension back as that is helpful for pain (less) and hiking. Slow and steady.
 
At 3 months out I still have some stupid-looking swelling above my knee on the lateral side. But where it used to be very firm at least it's soft now. Horseback riding in Anza Borrego sounds wonderful. I'm overdue for an AB trip- the wildflowers could be great this year.
 
Okay, just want to make sure swelling is still common at my stage. Another question: acetaminophen vs naproxen (or other NSAIDS), anyone have better experience with one or another? I've been on Naproxen for years now and it works somewhat okay. Recently I substituted 1000mg of Tylenol 2x/day. Maybe it's just psycho-semantic but I've noticed quite an improvement. Just curious about other people's experiences with this.

Clipless said:
Horseback riding in Anza Borrego sounds wonderful. I'm overdue for an AB trip- the wildflowers could be great this year.
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The mountain biking is even better @Clipless ! Lots of singletrack and plenty of "loop" opportunities. I'm still not ready for the carbon-fiber horse yet but soon enough...
 
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