Revision TKR Scared about surgery

[Celle]

At least the walking is keeping your muscles in good tone. That will help after your surgery.

 

[DEL2021Feb-17]

Yesterday took a break from walking due to the walk on Tuesday so here I am on Thursday all I did was walk a half a mile and the knee feels like garbage!! I can feel the fluid in the knee ( not pleasant ) getting up from sitting an exercise in OUCH!! whats even worse 56 days to go. My gut feeling its not going to get any easier between now and date of surgery.

 

[Peaches0000]

Just wanted to say that I am thinking about you and wishing there was someway to make the pain more bearable. Life really isn’t fair and I have had to take a break from Facebook, everyone is having a jolly good life ( at least on their site- LOL)
and my life totally sux for the past 3 years and I don‘t begrudge other people’s happiness, but it’s better for my mental health not to engage right now In social media. I like this site because we can be honest and real. Hang in there, miracles do happen and your next surgery could very well be the golden one that actually works for you.

 

[DEL2021Feb-17]

Today started out better and was able to do my normal walk approx. 2 miles. While not exactly a normal pace for most ( slower ) by the time I was done knee was done as well. Had to do some work at Mother's house only issue had to go upstairs. She wanted a new toilet seat put on and of course what she bought did not work with current set up and then found out had wrong tools so after going up and down 3x knee is shot. Knee pain absolutely stinks!!!!!!!!!!!!!!!!!!!!!

 

[Celle]

I have moved this post and my response from our PM corresoondence.

Suggestion or at least your thoughts on this? We all agree walking is good ( not speed walking just plain old walking not trying to set records ) so here is my dilemma whether its a half a mile or 2-3 miles the outcome is the same BLAH!! If you do nothing that is just as bad as over doing it so what would you suggest?? Putting it frankly this pain sucks and this coming Friday I will be seeing my pain Dr. The 5mg Butran patch has done nothing so that has to change, the 5mg Oxycodone helps but the effect only last a couple of hours. Besides ice and the diclofenac cream which I use thru out the day I was wondering if you can at least suggest another pain patch or pain pill that gives longer relief?? I figure when I see the Dr. on Friday I can at least ask. Figured I would ask since its possible you are a moderator you have answered and suggested many things to different people so maybe you may have an idea for something I have not thought of that I can at least ask the Dr. You know this whole thing stinks here I am 60yrs old knee is shot the pain stinks been thru 19 surgeries too many another on the way. Been to PT God knows how many times taken many different types of pain meds over the years some better than others to say I am frustrated is putting it mildly. This sounds morbid I have thought of getting the knee amputated but what then?? How many stories have you heard of people dealing with phantom pain there is no way I am going that route. Sometimes I wish I was back in my 20's reason being did not need pain meds if I was in pain ( and no I do not do anything illegal that was then!! ) smoke a joint or do some bong hits then I was good to go. The worst I do now is drink a beer once in awhile. Sorry for the rant hope your having a good day??

I'm a nurse, not a doctor or a pharmacist, and I don't know enough about the interactions or effects of the various pain medications to be able to advise you about pain relief.

The things we recommend on BoneSmart are the things that anyone with experience knows work for most people - such as elevation and icing. Sometimes a warm wheat bag can be comforting, but then it does also tend to increase swelling if you put it on the actual joint. It's good for muscle pain, though.

You shouldn't even think of amputation. It's a major step and it's only done as a last resort.

My son had his right leg amputated above the knee in order to save his life. His leg was damaged in an accident and the poisons from his dying leg sent him into kidney failure.
He's made a good recovery, but the amputation itself presents problems every single day.

Also, an acquaintance of mine had her leg amputated because of chronic pain. Her leg is gone, but she still has the pain.

I hope your doctor can suggest something else to help with your pain, and that carries you through until your surgery on December 31st.

 

[Celle]

A couple of other things, suggested by Jamie:
1. Since your knee is upset and probably inflamed internally, it would be a good idea to stop further irritating it by walking so far each day. You don't want to go into surgery with that knee already inflamed. Some rest, ice and elevation may help it to settle down and be less inflamed before your surgery date. That just might make your recovery a little easier.

2. Most of the pain medications lose their effectiveness after four hours. Maybe your doctor could replace one of them with a long-acting alternative?
In your situation, there seems to be a good case for trying treatment with medical marijuana. Since it is legal in your state, have you considered that?

 

[DEL2021Feb-17]

Here is a question maybe someone can help me with?
As you are aware I have had 6 total knee and 1 revision. Now here is what scares me prior to the revision last Dec. my surgeon said if they have to replace the entire prosthetic it is more involved and a longer surgery. His reasoning since I have had so many replacements the implant is larger/longer then a typical knee replacement. The other concern relates to bone loss there can only be but so much left considering what the knee has been thru? So while the last revision was no big deal just replaced the plastic on the tibia side this one could very well be?? If there is no other reason for me to be scared this is the main one that's driving me nuts!! What do you think???

 

[Jockette]

Just wanted to say that I am thinking about you and wishing there was someway to make the pain more bearable. Life really isn’t fair and I have had to take a break from Facebook, everyone is having a jolly good life ( at least on their site- LOL)
and my life totally sux for the past 3 years and I don‘t begrudge other people’s happiness, but it’s better for my mental health not to engage right now In social media. I like this site because we can be honest and real. Hang in there, miracles do happen and your next surgery could very well be the golden one that actually works for you.

I’m so sorry you’ve had so much trouble with this knee. I agree with Peaches0000 and I think she speaks for all of us, I couldn’t have said it any better.

 

[Celle]

Hi again,

Yes, if your knee replacement is going to be revised to a hinged knee, then the existing hardware will have to be removed, because the femoral and tibial components of the hinged knee won't fit the existing components.

That doesn't necessarily mean that you will have to lose an appreciable amount of bone. It may just be a matter of doing some slight shaping, to fit the new hardware. The longer stem on the hinged knee will go further down inside your tibia, but you shouldn't lose anything from the outside of your tibia to accommodate that.

If your surgeon is experienced at doing knee revisions - and I hope that he is - removing the present prosthesis shouldn't present a problem but, as he says, doing that will make it a longer surgery than just replacing a plastic spacer.

As for your recovery, it will be more like your recoveries from the total knee replacements. That is, a bit harder than your last recovery, but not necessarily worse than some of your previous ones.

Back in 2011, I had to have a revision from a Partial Knee Replacement (PKR) to a TKR. That meant removing all the existing hardware, then the shaping the lateral compartment of my knee to accommodate the larger hardware.

I expected my recovery to be harder than my previous recovery but, actually, it was a little easier. I knew better how to handle recovery and I was more willing to let my knee heal on it own schedule. You know that too, and I'm sure it's going to help you.

 

[DEL2021Feb-17]

I may have wrote it wrong the last revision last Dec. was easy less then an hour!! Prior to the surgeon doing the surgery they thought the entire implant had to come out which was going to be more involved then a normal TKR. Not that I have been lucky with the knee once the surgery was underway it was a fairly simple fix. ( referring to surgery last Dec. )
Thank you for your response Celle!! This next surgery itself big deal asleep thru the whole thing so however long it takes no biggie. My concern is recovery and really the only real difference is the time it takes. My best guess based on my history it is going to take the better part of next year.
The knee will never be perfect it will never be pain free but based on talking to surgeon asking questions there should be some improvement. The way I see it any improvement no matter how big or how small is still an improvement.

 

[DEL2021Feb-17]

A couple of other things, suggested by Jamie:
1. Since your knee is upset and probably inflamed internally, it would be a good idea to stop further irritating it by walking so far each day. You don't want to go into surgery with that knee already inflamed. Some rest, ice and elevation may help it to settle down and be less inflamed before your surgery date. That just might make your recovery a little easier.

I agree but also disagree the reason being in my case whether its a short walk 15minute or a long walk 60minute the result is still the same, it hurts. The biggest difference is how bad neither one feels great and yes the longer the walk the worse it feels later but in my case " Murphy's Law " there are times a short walk is just as bad as a long walk. There is no magic wand and all I am trying to do is improve the strength so hopefully when surgery gets here recovery maybe a little easier??

 

[Celle]

[QUOTE"]
I agree but also disagree the reason being in my case whether its a short walk 15minute or a long walk 60minute the result is still the same, it hurts.
[/QUOTE]
It doesn't matter. Either way the walk hurts your knee.

That means you're making your knee more upset, which is not a good thing before surgery.

You won't lose much muscle strength or tone if you stop walking between now and your surgery and you will gain the benefit of having a knee that isn't already inflamed.

How many times do we tell people this?
If it hurts, at the time or later - don't do it.

 

[DEL2021Feb-17]

It doesn't matter. Either way the walk hurts your knee.

That means you're making your knee more upset, which is not a good thing before surgery.

You won't lose much muscle strength or tone if you stop walking between now and your surgery and you will gain the benefit of having a knee that isn't already inflamed.

How many times do we tell people this?
If it hurts, at the time or later - don't do it.

Hate to admit it when I am wrong but if the knee is going to feel like it does today everytime I go for a walk then its time to stop. Today is no fun!! Hopefully Saturday when I start PT the therapist will have some ideas that will help and not hurt.

 

[Celle]

I don't think you have anything to lose if you stop the walking now.

I hope the PT therapist has some helpful ideas as well, but do be sure you don't do or allow anything that causes your knee to hurt.
I'd be inclined to stick to upper-body exercises, so as to be sure not to irritate your knee any further.

By the way, I've been wondering if you've had the same surgeon all along for your knee, or if you've consulted others for second opinions

 

[DEL2021Feb-17]

I have had a few different surgeons at the start of the knee saga and as far as TKR's I have had 6 all of whom have or had ( if they retired ) excellent reputations. The surgeon that did the 6th TKR was low key but he was very well known within medical community his specialty was treat cancer patients with orthopedic problems due to tumors etc. I found out he had co authored a paper with another prominent surgeon in the Washington DC area.
My current surgeon was trained under him a younger guy but very good at what he does. If this means anything considering the problems I have had I do as much research as I can when looking for a surgeon. Just because they are qualified does not mean they are right for your particular need.
Some are legends in their own minds luckily with the exception of 2 Dr.s ( the first one I had a problem with repairing a torn meniscus and the second was when I had 3rd TKR ).

 

[DEL2021Feb-17]

I am having a crummy day emphasis on CRUMMY!! Yes I walked yesterday and wouldn't you know I felt like rubbish for the rest of the day?? So here we are today against better judgement did a short walk 10-15 minutes max. then transplanted a few bushes in backyard nothing big yard work lasted 20 minutes by the way I feel now you would think someone hit me knee with a sledgehammer repeatedly. I have iced several times took a pain pill and boy does this just flat out stink!! None of this makes any sense there are so many that have had replacements and once they have recovered never had any more issues not me!! Sorry but this is bugging the heck out of me. Hope no one ever goes thru this.

 

[Pumpkin]

you would think someone hit me knee with a sledgehammer repeatedly.

I agree, looking at your past surgeries, your knee has been hit with a sledge hammer or equilivant every time you had a knee surgery.
You may want to take it easier between now and you surgery in December, so you don't irritate your knee.
I know you are frustrated and it is unfair that you have had such challenges with your knee while others go on to getting their life back.

 

[Celle]

None of this makes any sense there are so many that have had replacements and once they have recovered never had any more issues not me!! Sorry but this is bugging the heck out of me.

No, it isn't fair and there's no logical reason why you've had such bad luck, but do try not to dwell on it, or compare yourself to others.

What's done is done, and it can't be undone. And letting it bug the heck out of you is only making you feel worse.

Your upcoming surgery with the hinged knee could be the surgery that finally fixes your knee.
Try to focus on that.

I know that's easy to say but hard to do, but there is still hope for your knee.

 

[DEL2021Feb-17]

I really appreciate the kind words THANK YOU!! Its great you have optimism in regards to the next surgery but your not me my version for a successful outcome would be 2 to 3 years following a one year recovery time frame. There is always going to be some degree of pain no matter how you look at it. Not trying to put anyone down and yes when I had my first replacement I was worried but compared to everything that has taken place from the 1st total to # 7 coming up ( not counting last revision was not a total ) its pretty trivial. What gets me even more most after a year or less they will have forgotten how it hurt and are enjoying life again with a good knee, not me!! Yes I am driving myself nuts but given the history it could be my right. Everyday for me has some degree of pain a really good day last May June I was at 4 now a good day close to a 6 today is a solid 7 yes it could be worse. Just want to feel better hopefully tomorrow will be better.

 

[Spacedust]

Hoping the best for you, NFenske. It's definitely been a rough time for you far more than most, and you have every right to rant, rave and vent. I won't tell you it could be worse; you already know that. Nor will I feed you platitudes; those probably stopped being terribly meaningful about, oh, 15 surgeries ago, I imagine. But I *will* continue to hope for better days for you.