Revised PKR to TKR Revision TKR 2nd time Lucky

[lisabl]

@Jockette I don't really know for sure, but in researching I think it might be just partial in general, due to the trauma of surgery the non affected side is just so much more likely to have a major flare up, and due to swelling of surgery may not be identified as a problem (therefore not medicated properly), until damage is done and it's to late to treat non surgically. Therefore patients with RA should have TKR even if 2 of 3 compartments seem healthy, so further deformity is minimised.

OS should therefore be aware of this issue, as many RA patients will at some point need new knees, its not just osteoarthritis that causes the need for prosthetics.

Maybe @Josephine will understand the mechanisms better.

 

[Jockette]

That does explain it well, thanks. How sad for you that your surgeon didn’t pay attention to that and you had to go through this surgery all over again. I would be pretty angry if that happened to me.

In fact, I was angry early in my recovery learning the truth about partials after I had one, rather than before I got one. Before surgery I was under the impression that I was catching my arthritis early and this partial was all I would ever need, and that the recovery wouldn’t be a big deal. Well that didn’t happen!

 

[lisabl]

Week 3 complete

This week has really been a rollercoaster. I felt really good at the beginning of week as sleep was more regular even if I was I the recliner, and staples came out making my knee feel less full of nuts and bolts.....but then the zingers started big time which really wore me down and I became more emotional. Day to day the swelling and general pain have been reducing, and it was great to get back into comfortable leggings and trainers (I am not a skirt person). I am coping ok on my reduced level of medication, but not willing just yet to cut back my night time 30mg dose of codeine as not only does it make it easier to get to sleep, I can now sleep for 3 hours in one go, before waking up for toilet break ... oh except Night 13 where I was wide awake for so long, that last night I went back to sleeping in the bed instead of the recliner). I can now also walk up 14 stairs leg over leg just holding handrail. Indoors I do not need walking stick, outside I use 1 just to let others know I have a problem.

Only slight external swelling now, with little actual pain now the zingers have stopped. Thigh and calf no longer ache, but the skin around the whole of the knee area has become hypersensitive. Week 4 challenge will be my first proper dryside physio session where they will measure knee for first time since I left hospital.

 

[lisabl]

@Jockette I had the same thing from the OS

The chap who did my revision was brilliant however, and I discovered he has recovered from bilateral TKR a couple of years ago, so knew what recovery could be like. This time no mistakes, a rep was in the theatre making sure all components were put in as per manufacturers spec! and as he knew it was going to be a challenging revision he wanted to make sure all possibilities were covered. Also no tramlines as he very neatly made the incision over the old PKR scar.

I have 3 more weeks of healing before I go back and see him for a review.

 

[Josephine]

What is it about that prosthetic, though, that affects people with inflammatory arthritis?

It's not the implant. It's just the opinion that was held back in the days when it was first developed.

 

[tabbykit]

Thanks, @lisabl, seems you are doing great with your recovery and I hope mine will be good too! Just received my Cryocuff, 12 days to go till my revision. What a pity we have to go through these things twice though ...

 

[lisabl]

@tabbykit In the last day or so my motorised lid on the CryoCuff has decided it doesn't like frozen bottled water!! It tolerates 1 bottle in the bucket but when I put two it starts making vibration noises from the air valve! So looks like I will have to get up in the night to replace ice to keep it cold ... I dont want sleep at 2am anyway....sleep is for wimps (wimper).

 

[lisabl]

Three and a half weeks post op, and just finished my 1st dryside physiotherapy session. To calm hubby's nerves regarding the valgus deformity of my leg, when the PT asked if I had any opening questions I led with his query. She measured it and said the OS had placed it exactly the same shape/distance as the other one at 10° valgus, so no worries there, and DH now happy . She compared the two legs and said swelling had gone down well, my patella was surprising mobile (had I been massaging it? -Answer NO), I had lots of strength in my quads and hamstrings, and the wound was healing in an even and clean way (had I massaged scar yet - errr NO).

She the measured extension at 5° (just managed to fit a couple of fingers flat under knee) and flexion 98° (lets call it 95 so improvemnt looks greater next time).

Finally she said she wouldn't normally get someone on stationary bike on their first assessment session but she was intrigued as to what I could do, did not do full rotation, but foot was about 11+1 oclock rocking back and forth so nearly there.

I admitted I had not done the long list of exercises they had given me to do on discharge, I just did one of each every couple of days to check I could do them (no sets of reps for me). She said I was obviously listening to my own body and whatever I was doing was working for me, so carry on.

Now laying down with leg elevated and about to nap.

 

[Benay]

Happy to see you're doing so well!

 

[RAD]

Sounds like you’re doing great!!

 

[lisabl]

Looks like I am back on the recliner tonight. The only way I seem to be able to get some solid sleep is with the cryocuff. The iced water seems to hit body temp after 2-3 hrs and if I am sleeping upstairs in my bed, by the time I have navigated the stairs, got fresh ice and got back to bed, I am wide awake and it takes at least an hr to get back to sleep. In the recliner it does not seem as necessary to have ice cold water in machine to sleep, and when I change.the frozen bottle over its sorted in 5 mins and I can get back to sleep.

Swelling may have gone down on the outside of knee, but on inside it is still very stiff and uncomfortable.

I have also noticed as swelling is going down the knee is getting more 'clunky' - anyone else noticed this?

 

[TimeBuster]

I have, especially getting in and out of the my truck.

On my last appointment when I brought it up to my OS she explained it to me like this.

It’s not unusual for your artificial knee to make some popping and clicking sounds when it’s in motion. This is normal, and you should not be alarmed unless of course it's followed by pain or swelling.

Most noises are the result of the metal and plastic components rubbing against each other. Because the components are not connected but rather held in place by the body's own muscles and connective tissues, the noises will often settle as the tissues grow around them.

Generally speaking, as your artificial knee get stronger you should expect noises to diminish over time, not increase.

I have noticed since my swelling has significantly decreased I get more of the clicking sounds. I'm hopeful as my muscles around the knee get stronger the clicking sound will subside.

 

[Jockette]

Here’s an article about the clicking:
https://bonesmart.org/forum/threads/clicking-clunking-knee-joint-after-surgery.13534/

 

[lisabl]

@tabbykit I have solved the buzzing vibration on the motorised lid of the cryocuff... there are 4 screws (with a tiny 5 point electrical head) which needed tightening. They hold the whole motor/vacuum pump in place.

 

[eaglemom]

With the vibration fixed you should be able to rest, at least lets hope so. BTY thinking to look at the lid and the screws was brilliant. Way to go.

 

[lisabl]

Week 4 complete

Joined EDIC this week
DH went on a hike on Saturday, and I felt so jealous that I walked to bus stop, bussed to shopping mall, did some shopping, long coffee break and journey home to ice and rest. Sunday rested and Monday I could not get comfortable in any position sitting or laying down at all during the day. Think I might have still been in ODIC although I spent all morning sitting ( with leg raised and iced) at church (Alpha course), and lunch with friend at my house. No nap as not tired in afternoon just very uncomfortable.

 

[Jockette]

Things will settle down. You’re allowed an occasional visit to the ODIC. That was a lot of activity for 4 weeks.

Did you enjoy yourself, or was it an overrated experience?

 

[lisabl]

@Jockette I thoroughly enjoyed myself, and even coffee mean I could people watch instead of being stuck at home.

 

[Jockette]

Well then it was worth it.

I could not have done an outing like that at 4 weeks.

 

[sistersinhim]

I couldn't have done that much either. My first outing was SS and church and that wore me out. The next day we went to Walmart and I drove the electric cart. Being down like that, my knee blew up! It was a couple of weeks before I tried that again.