Revision TKR Spacer Replacement

softball mom

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i am 6 months out of TKR and was told yesterday that i need to have my spacer replaced and the scar tissue cleaned up. my surgeon said that recovery is not as bad and there was a risk with a bigger spacer of not having total knee extension. since my kids will be away at school i will have an issue getting to and from PT. how long before you are able to drive on your own. it is my driving leg, of course. How long was it before you can be up and walking. how long is the PT after surgery?
 
Hi and Welcome!

What is the reason for the spacer change?

What is your ROM like?

How much PT have you had?


I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
I had my spacer replaced and scar tissue removed. It was also my driving leg unfortunately. The surgery recovery was about the same as for the tkr - I spent 3 days in the hospital and couldn’t drive for a while (I have forgotten how long it was - probably a few weeks). I didn’t go to pt until I could drive and pt lasted a couple of months. My driving decision was guided by my need to take narcotics - once I could make it through the day without them I was able to drive. It took about 3 months before I was able to do close to normal activities. Have they told you why you need to do this so soon? My knee was unstable and painful before the spacer surgery and it definitely helped but I didn’t have the surgery until 5 years after the tkr. It seems awfully soon to be doing more surgery - you haven’t even healed from the first one. Good luck!
 
Hello
my original surgery date was May 28 2019. i went to PT right away and have been going up until last week when the therapist said that there was nothing more that he could do. i am still unable to go up or down stairs without a lot of pain. my leg feels like it wants to collapse when i am walking. doctor said that there is too much movement in my leg at the knee. i also have RA and they say sometimes the muscles get looser because of that. the good thing is that my range of motion is fantastic. i can get to 135. it seems as if my leg is deteriorating every week instead of getting better. i am just worried about the recovery.
 
thank you Kleo. that time frame helps. i think that it is soon also, but i also feel like something was not right from the beginning. i was unable to drive for about 8 weeks and it was only because no one could take me to a doctors appointment. even if it was too soon, what else are my choices. not going up or down stairs like an adult is not a way to live. quality of life is now what it should be.
 
You are right about not waiting. My knee didn't feel right from the beginning either but it took me a long time to find a doctor that could figure out what was wrong - the original surgeon kept saying there was nothing wrong. It also took me that long before I was ready to do surgery again! I have psoriatic arthritis and they dont know why the tendons stretched. My knee is much more stable now but I still can’t do stairs. I think the replacement surgery was easier but not by much. The surgeons seem to think it’s a breeze but I think they’re speaking for themselves.
 
Hello @softball mom - and :welome:

Please will you tell us the full date of your original knee replacement and which knee it is, so we can make a signature for you? Please also let us know when you have a surgery date for the spacer replacement. Thank you. :flwrysmile:
 
Hello Celle
The original date of my surgery is may28.2019. It was my right knee. I have a spacer date of 12/10/2019 but I am uncertain about if I want to mess up the holidays but have my kids around to help get me to and from pt while they are home from college or to wait until the first week in January to get it done and hope I can drive by last week of January to get to pt. This is my concern. I can’t ask my husband to miss work 3 times a week to take me. What does everyone out there think?
 
Going to formal PT is not as essential as we are led to believe and neither is 3 times a week. You’ve already been through this so you know what to do in regards to PT. Maybe once a week would work and could you ask a friend to take you if you can’t drive yet? Or, you could just do your own PT at home. Our medical professionals need to understand our personal needs. And, we do have the final say about how things will go.

If it was me, and I was physically able to wait, I would enjoy the holidays with my family and friends and wait until after the holidays for the surgery. Unless you have a big deductible to consider.

And I would do my own PT.
 
That's a tough decision. I didn't see you mention your deductible for insurance. If your deductible has been met for this year, that would encourage me to have it done before the end of the year. And of course your out of pocket expenses. Have you topped that out for the year?

Enjoying the holidays with the family is very important - but them being able to help you out is equally important. As for formal out patient PT, I thing every surgeon asks their patients to participate in PT, but you can decided that after the surgery. Or decide to not do out patient PT.

I've certainly not helped you answer your question here. But rather hopefully you can think through everything and come up with a decision that's best for you and your family.
 
thank you eaglemom. my insurance year starts November 1, but fortunately i have met all of my out of pocket and deductible with my RA meds. so insurance is not an issue. i am leaning towards getting it done after xmas if possible.
 
If you can wait, I think it's a good idea. You already know the exercises to do, so you can visit PT infrequently for massage and gait work.
 
I am sorry you are having issues so soon, but at least your surgeon is giving you a good reason for the continued issues you are having.

I had a revision in October and he replaced the femur portion of the TKR and of course, replaced the spacer. I was super surprised to find I didn't have near the pain this time that I had previously. I give a lot of the credit to the spinal and nerve blocks he performed. They made a big difference for me personally. I was off any assistive device the first week. I didn't drive for 4 weeks because I was nervous about movement of the right knee but when I did start, I was thinking I could have done it earlier.

After the first week, the only pain medication I took/take is Tramadol, Celebrex, and Tylenol. They have been enough for me but that is my journey and may not be yours. Especially with your RA, I am sure it is a different cup of tea to dealing with pain. Unfortunately, you won't know until you go through it!

I have performed ALL of my own PT. I did what the PT did previously without the pressure and pain they caused and I have done really well. With you going through your PT so recently, I am sure you know what needs to be done but of course that is your decision to make.

Best of luck to you!!
 

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