Revision TKR Complicated RTKR revision 2015, considering LTKR

Randi

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I had my revision RTKR on September 14th. Things went pretty well. As we had thought my original TKR was misaligned in several places with 10% rotation, thus causing the twisted, unstable feeling I had been describing for 3 years . The new prosthesis is one the revionist only uses for complex cases.He also put in 2 rods(?) for extra stability. I was in hospital 6 days, 3 in acute care and 3 in specialized rehab program. I'm impressed by this hospital in general though of course there were some nurses who apparently don't like what they do, but most were great. It is a hospital that only does complex knee and hip surgery . Physiotherapists were really helpful and knowledgeable and got me up and walking quickly but at my pace. My only regret is that I went elsewhere for the original TKR surgery - but what's done is done.

I've had a few medical issues, anemia, low blood pressure , which are adding to my tiredness.I started outpatient Physio yesterday at the same hospital and I really like their methods so all good on that front so far. I am walking a bit around the house, doing gentle exercises twice a day, icing and resting, resting, resting.

I have two questions:
When I took off the bandage yesterday I saw that the skin on one side of my scar is completely bruised, almost dark brown. The other side is slightly pink but otherwise fine.. Sort of looks like someone painted a line between two colours. Wondering if this is common
Also, there is some slight bleeding between two of the stitches every time I bend my knee. Nothing oozing at all. I've covered it with a regular bandage . Do you think I need to do anything else ?

I'm grateful all has gone so well so far. Just curious about these two questions. Any thoughts would be appreciated.

Thanks!
 
Hi @Randi
Welcome to the recovery side again! I'm glad the revision went well.
I wouldn't worry about the uneven bruising. It will all be glorious technicolour for a while.

As for the slight bleeding between the sutures, I'd just cover it with a sterile dressing and either a bandage or strapping. It should gradually ease off.

I'm sure you'll remember these, but I'm going to give you the recommended recovery reading list again:
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist (PT) - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lie down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

Looking forward to hearing about your continued progress.
 
Hi Randi,
I have rods in my bones also from my revision, they reduce the chance of loosening. Glad you are following the Mantras!
 
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Good to know. Anything that prevents this happening again is fine by me !
 
Randi, I am glad you were successful with your revision, finally you can begin to heal with confidence.
 
Thanks Kelly. I'd feel better if my wound would stop bleeding ! Saw an OS and an Advanced Practice nurse who each re-dressed it today but it bled through each time. I'm stopping the blood thinner and starting an antibiotic. Hopefully it will clot soon. Meanwhile I'm elevating even more. Slept most of the day. Not feeling very productive and just a little frustrated because im not even supposed to walk more than necessary until this quiets down. I know this too shall pass but I'd like fewer wrinkles, please !:zzz::zzz::badspidy::badspidy:
 
Good for you for taking it easy right now. This is healing time!!

The bleeding is most likely a result of the blood thinners that are needed to prevent a blood clot in your legs. As you become more active (walking about the house...not exercising or running errands), you'll not need those blood thinners. As long as the home care nurse is checking your incision, you'll be okay even with a little drainage.

That large bruise is probably from blood pooling on that side of your leg. As Celle mentioned, it's very, very common. As long as the bruised area is not enlarging, everything is fine and it will turn lovely colors and then disappear.

It sounds like you are doing just fine. Relax and take good care of yourself.
 
Thank you Jamie. There is no home care nurse involved but I'm lucky that my Physio therapy is at the specialized Orthopedic hospital where I had the surgery so resources are readily available
 
That sounds perfect! I believe you'll find things normalizing fairly soon. Be sure and read those articles Celle left for you. Even if you've read them once, it's good to have a refresher.
 
I think, hope, pray, that the bleeding has finally stopped. Went to Physio last Thursday and they didn't like the bleeding. A huge advantage of having Physio at the same hospital as the surgery is that access to resources is so much easier. So first they called my OS who was away. Then they sent in another OS to have a look. He thought it would stop soon, and put on steri strips , told me to stop the blood thinners and start antibiotics just in case. That didn't work so they called in a nurse practitioner who put on a different type of dressing.Next morning I woke up and my bed looked like a Tarantino movie ! Called the hospital, went to outpatient where the head nurse re dressed the wound again and gave us directions and supplies so we could re dress as necessary over the weekend, with an appointment to come back Monday ( yesterday ) , on the assumption that the bleeding would stop once the effects of the blood thinner were done. So , after a bloody and depressing weekend, went back yesterday . After one peek, the nurse called my surgeon who was in the middle of a case. He came right down, took one peek and knew the problem. He just touched my wound and said there was a subcutaneous tear (?) , then went back to finish his case ( sorry other person..) while I waited in a casting room. The staff were so amazing...brought food for my husband and I, kept checking on us, etc. Finally OS returned and decided to restitch through several layers rather than go back to O.R. , open it up and re-do the whole wound closing. I was very brave (!) watched the whole thing while he explained everything. Anyway, too long a story, but as of 24 hrs later, all seems to be holding . Hooray ! The lesson for me once again is to trust myself. I knew this wasn't just normal pre-op bleeding. I'm grateful for the great and caring care. Now, finally, onward and upward with Physio and exercises .
 
Watched?!? I barely watched when my staples were removed.

What a time you've had of it! Hopefully onward and forward with the healing.
 
@Randi Take it very easy with the physio. Your leg has been through more than most and it needs time to recover from the trauma.
 
@Randi Take it very easy with the physio. Your leg has been through more than most and it needs time to recover from the trauma.

I know. Actually the OS said not to push past 90 with the bending for now. He said I'm doing fine and once the trauma settles I'll get my ROM with little trouble. I bet Josephine will be pleased to hear there are such sensible docs here in Toronto! I have to say so far I am really impressed. I'm just anxious to get moving. Sooo bored and with all the rain we're getting, it's dragging me down. So, if I can stay awake we're going to take a ride and get frozen yogurt tonight.
 
Gosh you are brave, did he do it all with no local pain killer or anything?

I'm just naturally nosey ! And he did use a local but I didn't even feel the needle since that area is still numb. Actually it's the first time I've had stitches while I've been awake so it was really interesting :rotfl:
 
I had a lot of bleeding with my left knee and have had some issues with arthrofibrosis (adhesions---scar tissue) with it. I was reading an article by Frank Noyes and he said that he thought that extra bleeding was sometimes the cause of adhesions. A light went off in my head since I had a lot of bleeding with the left leg.

At any rate--just remember not to stress the knee while it is hot, inflamed and swollen. I was very slow with starting pt on my right knee and it has the better flex of the two.
 
Thanks Kelly. I'm trying to be careful. I'm very lucky but so far I've had very little swelling or inflammation with this knee revision.
 
That is such good news. Of course, i don't mean to scare you, but I wish I had been a little more cautious with my own knee!!! I am so glad that there is not a lot of inflammation---just be aware that if you are doing something that causes swelling and inflammation and swelling, you could back off a little and take more time. I am so glad that the revision is working out for you.
 
Maybe I spoke too soon. Went to Physio yesterday and because I was limited with anything to do with bending I asked for other exercises so I could feel like I was moving forward. And of course I stupidly overdid it. Then my husband wanted to go out for lunch since he has cabin fever and I agreed to appease him. Then had out of country company I really wanted to see. And today I can barely stand up. Sooo frustrating. I feel like I'm back 2 weeks. Oh..and I'm bleeding again, though just a bit. Grrr...
 

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