Knee Infection* Still Struggling

[juzzy]

Hello everyone, quick update.
I’m now off the daily IV, leg has been out of the splint for 7days which is a welcome relief.
My bloods are getting to where they should be. I will go back for another test on Wednesday, hopefully giving me 100% all clear in regard to infection.

My questions are: should I get back to icing and elevating, regularly?
I can use 1 stick but prefer 2.
Should I be trying a little harder with exercises? My rectus femoris is still very tight. A consultant said having the towel under and pushing down until I feel some discomfort and then do leg raise. Can anyone help with a suggested exercise regime?
I had my TKR Dec 15, then re opened and had a washout Jan 8. Had no weight bearing for 10days so just need a little advice of best route to take.
Any advice greatly appreciated.
Thanks


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[sistersinhim]

Ice and elevation are great for keeping the pain and swelling down. I certainly wouldn't worry about many exercises yet. I'd start very slowly with just your daily living activities and walking around. I will tag @KarriB would can tell you about her recovery after an infection.

 

[KarriB]

When I came out of the immbolizer after a month my OS didn’t want me doing any aggressive exercise. In fact, he said non-aggressive heel slides and just walking with a bent knee instead of pegleg as I had been forced to do.

I will say I had tight muscles in the back of my calf from not bending, so stretching that by pulling my foot back with a leg lifter or towel helped after a while. I still needed to elevate and ice because my knee still swelled if it was down or if I walked too much.

What did the dr want you to do?

 

[juzzy]

Hi @KarriB, thanks for getting in touch.
The Dr just said to get the muscles around the knee working together. Not to be over aggressive but just to be able to feel like they have a job to do.
Gentle heel slides and leg raises. I have noticed tightness in my calf so will follow up with your advice with that. I’m also just walking with the aid of my sticks, feeling stronger each day. I just need to keep reminding myself to work on an hour by hour, day by day and NOT overdo it. I’m still medicating, icing and elevating.
Thanks


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[KarriB]

You’re right, hour by hour is the way to look at it. When the leg/knee settles down I advise taking a good look at the Activity progression for TKRs. It contains a recommendation for walking through your recovery. I found that walking was the absolute best thing for building the muscles around my TKR. I did all sorts of therapy, including weights at 4-5 months post op, but walking is the only thing that’s helped me build those muscles. But right now just getting the house I started all you need to worry about.

 

[juzzy]

Hello everyone, well it's been a while since I have been on the thread!
Short version: I have had a distal femur osteotomy, partial knee replacement and more recently Dec 15, 2017 a TKR, with an infection after and operated again Jan 9, 2018.
With all this I just haven't noticed any difference, if anything I am in worse pain now than ever before. I would just like to chat to people who have struggled post op. I am 45, have returned back to work and finding this difficult. I am talking with my GP to come up with a plan of action as it is not only affecting me physically but mentally. If you have experienced similar problems I would love to chat.
Thanks

 

[Jockette]

While I haven’t had all the issues you’ve had, I have had a poor outcome with my Patellofemoral partial. It was done March 2017, so it’s been 2 years now.

I’ve had 2 second opinions, the first at 15 months post op, and then the second just before the 2 year mark. My X-ray looks just fine, so no further tests have been offered. They have no answer for my continued discomfort.

Most of the time I’m not in actual pain, but very uncomfortable, and I still have more limitations than I did before surgery. Thankfully, though, if I’m at home sitting with my feet up, my knee feels fine. My discomfort is mostly when I’m weight bearing.

There are times on occasion that I do have actual pain.

I’m a bit fed up with doctors at this point, and I am able to tolerate this discomfort most of the time, so I’m just managing at the moment. I figure eventually something is going to “snap” and then my X-ray won’t look so perfect and they will finally do something. My current bad experience doesn’t make me want to rush to do this over again.

What type of partial did you have?

 

[Celle]

Hello @juzzy,
I'm sorry you're still having problems with your knee.

You'll notice that I have merged your newest thread with your original recovery thread.
For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Celle]

I have had a distal femur osteotomy, partial knee replacement and more recently Dec 15, 2017 a TKR, with an infection after and operated again Jan 9, 2018.

I see that you had a joint washout on January 8, 2017. Did you have further surgery on January 9, 2018, 0r was that a typo? If you did have further surgery, what was done?

Have you been back to your surgeon since your last surgery? If so, what did he/she say or do? Have you had the same surgeon all along, or did a different surgeon take over? If you're still with the same surgeon, a second opinion would be a good idea. You'll need one who has no connection, either professional or social, with your current surgeon, so that he/she can form an independent opinion.

I'm going to ask @Josephine , our Nurse Director, to advise you. She has many years of experience in orthopaedics.

 

[Josephine]

should I get back to icing and elevating, regularly?

Absolutely if you still have any degree of swelling and pain

I can use 1 stick but prefer 2.

Until you are 100% comfortable with one, use two

Should I be trying a little harder with exercises? My rectus femoris is still very tight. A consultant said having the towel under and pushing down until I feel some discomfort and then do leg raise.

Absolutely not!

Can anyone help with a suggested exercise regime?

Before I suggest anything more, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[juzzy]

Hi @Celle after my washout I was seen by a member of the original surgeons team on four separate occasions and two others, one time each. I also had an MRI scan to assess soft tissue damage. After the MRI the original surgeon told me there is absolutely nothing more they can do! To get off the diclofenic pain relief and learn to manage what I do.

As I am only 45 with a young family this is easier said than done. Since off pain relief I realise how little I can do. I am not in agonising pain, just very uncomfortable. If I knew it was going to be like this I would never have opted for any of the surgeries.

The lack of after care has been appalling and the original surgeon has washed his hands of me and basically told me to get on with it. Luckily I have a good gp who is helping and a great support network at home.

Work is becoming very challenging to say the least. I am a PE teacher at a Prep School so finding this very challenging.

I will take your advice to my go about a second opinion but too be honest I’m tired of doctors, scans, surgeries and feeling deflated. I just want to feel comfortable but don’t want to get hooked on pain relief(again).

Thanks

 

[Josephine]

Oh gosh, I'll bet you are fed up with all that! Not at all surprising.

To get off the diclofenic pain relief

However, I am very pleased you have stopped taking Diclofenac as it is not a 'nice' drug. Read these
Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

I would rather suggest you try using Tylenol at the rate of 1,000mg 3-4 times a day and at 6hrly intervals.

I a aware that the FDA has ruled that 3,000mg acetaminophen is a safe maximum but that would be assuming that the patient is taking another medication that also contained it and thereby inadvertently take an overdose. Assuming that this is not the case, the maximum safe dosage per 24hrs 4,000mgs.

 

[Celle]

Short version: I have had a distal femur osteotomy, partial knee replacement and more recently Dec 15, 2017 a TKR, with an infection after and operated again Jan 9, 2018.

I see that you had a joint washout on January 8, 2017. Did you have further surgery on January 9, 2018, 0r was that a typo? If you did have further surgery, what was done?

Hi @Celle after my washout I was seen by a member of the original surgeons team on four separate occasions and two others, one time each. I also had an MRI scan to assess soft tissue damage. After the MRI the original surgeon told me there is absolutely nothing more they can do! To get off the diclofenic pain relief and learn to manage what I do.

@juzzy - Thank you for that, but you still haven't answered my question.

You wrote that you had "further surgery on January 9, 2018". Previously, you said that you had a joint washout "on January 8, 2017". Did you have the joint washout in January 2018, but you wrote January 2017 by mistake?

 

[juzzy]

@Celle , Hi that was a typo. Washout was 2018.

 

[Celle]

Thank you. I've changed the date in your signature.

 

[Jolease]

Hi @juzzy
I just read your thread and can certainly sympathize. Although I didn’t get a knee infection I’ve gone through 3 surgeries in a very short time. I just turned 50 and it has been a nightmare for me. I’m 6 months post op from 3rd surgery and still suffer daily.

If I to had known would never have had the initial surgery and kept the arthritis pain. I’m currently waiting to see a pain management specialist ( not sure what they will do) but am willing to try anything. I know they say it’s a year healing but most days it feels as though I’m going backwards when things should be getting better! Some days are better than others, but never without pain or discomfort.

I have different pains in different areas of the knee, a lot depends on what I’m doing. Like walking down stairs all on outer side of knee. I get medial pain and pain in back of knee and calf. Can’t walk more than around the grocery store or short distances. I’m beyond discouraged and simply fed up and trying not to sink into a depression. I was so active before all of this and when I try to do a bit more I suffer for a few days after .

I just wanted you to know you are not alone in this. I hope you are doing better since your last post!! If you are ,I’d love to hear as it would give me some hope!!