TKR Still swelling

[MarkTKR]

Hi all,
On Dec 23rd I had my left knee replaced. I was hailed by the physical therapists as the poster child of recovery. 20 days out from surgery and I'm walking on my own, unassisted, no cane, no walker and feeling strong and well. My range of motion was excellent.

On Thursday 01-13 I went to PT. The session was normal and at the end I was asked to lay on a massage table where massage work and some range of motion work was done. She asked me at the end to slide out to the end of the table and dangle my legs off it.

This massage table had an end that could be flipped down. It appears the locking bar was not correctly seated or set. As I slid out to the end the table gave way. As I fell I did the normal thing and put my feet down to catch myself and felt a very loud and painful pop in my new left knee.

After some help to get to my right leg I tried to put some weight on my left and it was extremely painful and buckled. I was wheelchaired to Xray and then my surgeon came in to see me. (The PT is connected to the clinic). Not much could be seen on Xray and palpation was ineffective to to severe swelling.

So an MRI was setup. I did the MRI on Friday at 8:30. I had to wait the entire weekend to hear.

This morning I was notified I've ruptured my quadriceps tendon and it will need a surgical repair. I'm told the recovery is 6 weeks of leg immobilization after which I suspect I pretty much start from ground zero on PT to regain any leg motion and strength.

It really sucks to walk in strong and tall and leave in a wheelchair and face another surgery.

There are legal questions to be answered too. This should not cost me a penny as the equipment was not correctly setup at PT. So in addition to trying to get this fixed there is the legal battles to fight.

Welcome to 2022. So far the year

 

[FourCats]

Welcome to the board. I am so sorry to hear about this terrible incident and that you’ve now a second physical battle to get through, not to mention the legal situation. This board is a safe and supportive place to vent your anger and frustrations. Best of luck and do keep us posted on your progress.

 

[MarkTKR]

Thanks FourCats... We have Three Katz!

Two that are like 12 year and one that is probably 6 or so. Not all getting along at all times but no big fights.

Could not see life without Katz

 

[Jockette]

I’m so sorry you had such an experience at PT. I also came away from PT injured, one week post op, though mine was not as severe as yours.

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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Jaycey]

@MarkTKR What a tragic story - so sorry. Please focus on getting all this corrected and getting you back on track with recovery. Any other "battles" can wait until you are strong again. Wishing you all the best!

 

[CricketHip]

Oh man, that’s a terribly frustrating thing to happen! I am so sorry you have to go through another surgery.
I really do not have words.
Please keep us updated ?

 

[Kdubs]

I was there as well. Torn quad tendon in week 6. Partial tear didn’t require surgery. DId require 6 weeks immobilized and then gradual ROM. LTKR on 8 Sep. Fell on 13 Oct. About to graduate from PT the end of January.
It sucks to go backwards. But you can do this. Hit me up if you have questions.
ONWARD!!

 

[Rubyroo]

@MarkTKR Oh my! I am so sorry to hear what happened to you! I bet it scared the heck out of you & hurt like a dog! Keep your chin up & focus on getting better physically. Please keep us updated.

 

[MarkTKR]

Hi all, well I had the tendon repair surgery last Thursday. So I'm day four into recovery and tonight I'm having a really tough time counting the weeks remaining. I don't have a choice for sure but it is just miserable to have my left leg locked in place.

To make matters worse the cast does not fit well at my foot/ankle so I"m going to go in and see if they can somehow fix that. I regular get a piercing pain which seems to be my skin getting hammered by the gauze/bandage or whatever inside the cast.

This is just probably one of the most difficult things I can imaging going through. I can work some from home but honestly my motivation is low to work. Yet I need to work some. My wife has been amazing. I owe here a lot for all this care. But I just cannot wait for things to be more "normal".

I had planned to do my RKR next December, but I will be honest, I don't think I can go through this for sometime. I realize my tendon tear was abnormal but still even the KR recovery is difficult. We'll see if I can get the courage up.

Anyway I'm ticking away the seconds towards my 6 weeks in this cast. Wish I could skip forward somehow.

 

[Starsfan22]

@MarkTKR , I went through something similar with my revision. My 6 wks on walker during IV antiobiotics was hard but went by quickly because I had replacement and recovery to look forward to. I prayed alot, keep myself busy and took care of myself. That's your main job now, take care of you. Rest, take vitamins, lift weights etc. Good luck!

 

[Rubyroo]

@MarkTKR I’m sure you must be feeling overwhelmed with the weeks in front of you. I have been fortunate to have a spouse that really helped me with everything during both of my TKR recovery’s & for that I am grateful as you are. I enjoyed listening to audiobooks during my recovery’s. Our public library has a free app and there are a lot of books to choose from. I couldn’t quite concentrate well enough to read at the beginning and it was nice to have someone tell me a story. One day at a time my friend & keep your chin up. Reading other folks recovery journeys on here and posting yourself is helpful too. Sending good vibes.

 

[Vida]

@MarkTKR I was so sorry to read your story. It’s doubly depressing when things go wrong through no fault of our own. While my own experience was nowhere near as painful as yours, I can certainly share your frustration. I experienced a six week delay following my hip replacement when my surgeon fractured my trochanter. Nothing to do but rest and go with the flow. I also had a painful setback after early physio following my recent tkr requiring almost three weeks of inactivity. More ‘jail’ time on top of your recovery really does seem interminable, especially as you had been doing so well. But there’s light at the end of the tunnel. Given your obvious commitment you will soon catch up and be comfortably moving around again. I share your feelings of guilt about requiring extra caregiving. But our spouses know we would do the same for them in a heartbeat. Wishing you a strong recovery.

 

[sistersinhim]

Anyway I'm ticking away the seconds towards my 6 weeks in this cast. Wish I could skip forward somehow.

What an awful thing to happen to you when you were doing so well.

I had both kneecaps removed in the early 90s which required shortening the patella tendons and immobilization for 6 weeks on each knee. I can relate to what you are going through. It's no fun, but it does get better as time goes on. After removing the casts the knee was stiff but slowly regained its bend without any formal PT. Don't worry a bit about yours, it will come back naturally. We are here to help you through this the best we can.

 

[Tegbennett]

I feel so bad for you. I'm at week 6 post op and get good days and bad ones. The frustration you must feel at being back at square one must be overwhelming. I guess the only good thing is that you did so well before, so I hope once you heal you will be strong enough to get back to where you were. I hope you find things to occupy yourself during this time. One of the plus sides I have found is that I gave slowed down and taken more time to appreciate things. Like just cooking dinner or on bad days supervising my son to make the meal. My sister and my son have been a huge help. Please keep sharing your progress and your frustrating days too. Its good to get advice and reassurance from everyone here.

 

[MarkTKR]

Thank you all for the replies. I am now 13 days out of the cast. Perhaps my doctor is being ultra conservative or he is concerned about my age: 65 or maybe that this happened on the TKR knee.

Anyway I spent 6 weeks in casts. I went through 3 casts. The first one after surgery was a clamshell that just didn't work well. So they came out and put on a full thigh through ankle solid cast. I spent two weeks in that one then they had to remove the staples, so it came off. They created another full cast which I lived with until it came off 13 days ago.

My leg was a flakey scaly mess. And the back of my heel hurt like hell. Any pressure on it and it would just start like on pins and needles. So all those weeks of laying on it must have made the skin super sensitive. My wife and the doc checked and there is no cut, just skin.

So now I am in a brace that is locked straight. It has actually about 10 degrees of flex just due to slop. But for the most part I cannot bend. I am putting about 50# on my left leg and walking with a crutch so I am much more mobile than I was with the cast.

Sleeping is a chore. Some nights I sleep like a baby, other nights like last night I could barely sleep at all. About every 10 minutes a "ping" or "spike" would occur in my left or my right leg and wake me up. Some were so painful I jump. Hard to sleep when that happens and that is with a bunch of tylenol. I may have to ask for an evening pain killer to help out.

I start PT again on Monday. Last night in the shower I tried a very gentle test bend of my leg with out the brace on. It's going to be a painful PT as I could only bend about 15 degrees before I felt serious tightness. So I expect PT will be a struggle. I have four weeks of 3x a week PT scheduled where the main focus will be range of motion. I will probably be left to regain strength on my own. Not sure.

My left leg/foot still swells badly by the end of the day. Its uncomfortable and it drives me crazy. I had hoped swelling would start to diminish some as I'm more than 55 days out from surgery but its still there.

For me, this journey, TKR followed by the Patella tendon repair, has been a struggle. Each day I look forward to feeling more normal and I get down when I don't see improvement.

So here is to just slugging through each and every day.

 

[Vida]

Mark you are so strong. I don’t doubt you will come through it but what an awful additional challenge. Is there any way your surgeon would prescribe something stronger for night time? I plucked up courage to call mine and ask for some tramadol as they work well for me. I was nervous about it because most people at my stage are only on Tylenol. I explained that the pain was preventing sleep and got no argument, is there anything that would work for you? After all you have been through I can’t imagine anyone being unsympathetic,

 

[Jamie]

I agree that you shouldn't be shy to ask either your surgeon or your GP for something to help with your pain and sleeping.

Since you are experiencing late-day swelling, you might want to up the time you spend icing and elevating your legs. Make sure you aren't sitting upright (like working at a desk) for large amounts of time during the day. That can increase your swelling.

Also be sure that any PT starts off relatively gentle. No forced bending by either you or the therapist that goes beyond mild discomfort. It's probably going to take a while for things to completely settle. Your knee has been very traumatized. If any of your therapy results in additional pain or swelling afterwards or the next day, let your therapist know that and be sure they scale it back until that doesn't occur.

I'm so sorry you're having to go through all this.

 

[sistersinhim]

I had both of my patella tendons shortened when I had my kneecaps removed. The recovery from those was challenging and slow, but completely successful. The bend was also slow, which I did all on my own. I never took formal PT after any of my 12 knee surgeries. I used commonsense and let my tendons stretch naturally without any pushing. The easiest way I worked on my bend was to get into a very warm tub of water and slide my butt back and forth increasing the bend a tiny bit at a time. This worked well for me.

What I did for PT was to just do my normal duties around the house and yard as I was able to do them without increasing pain and swelling. Of course, icing and elevating were a huge part of my recovery. Until my knees quit swelling I iced and elevated the whole time I was sitting or laying down. As long as you have some fabric between your knee and the ice pack, you can ice as long as you like, even hours at a time! You naturally get up and walk every hour or so and that gives your knee the movements it needs. and I little time away from the ice.

 

[MarkTKR]

Hi all,

Yes I decided to ask this morning for Tramadal which I seem to tolerate much better than any other pain pill.

On the swelling, I do need to be up and about and I still work so I'm trying to phase back into 1/2 days and it is desk work and walking about. So not much I can do except to elevate when I can.

 

[MarkTKR]

I want to say that I wished I'd found this site before I did my TKR but then again, I might not have done it! LOL

The advice here is simply great. While my doctor is world renowned and produced a lot of great info upon discharge, one thing I found very lacking is a list of things I should get to be prepared at home.

I knew I needed a walker - Got that from Amazon

I was not at all prepared for swelling, elevation, assistance with socks, shoes etc. I ended up buying many of these things after the op and suffering some.

On a whim at Walgreens one day I bought a grabber tool. This should be a required item for TKR as it has allowed me to reach and do things that would have not been doable without it.

I really appreciate the post op articles that are here and the people that answer posts like mine really help. A huge thanks to all of you.

The biggest thing that each of you start out with is "each knee is different" and that is so important.

My TKR was fantastic and as I noted above some 20 days post op I was walking totally normally with no walker, crutch or cane. I felt on top of the world and ready for a summer of golf. Then my PT accident happened and here it is two months later and I'm only now beginning to walk on it and have very little ROM.

Since the PT center that caused the accident is covering all costs we rented and had delivered a hospital bed that allows me to elevate the knees and I can prop up my back. It's electric and has been a life saver. I think the cost per month is like $350 for this thing but I don't think I'd be sane without. I figure that $1000 is very little price for the PT center to pay considering I had many legal options. Thus far they've been just fine with virtually all of my requests.

I'm not a problem customer. I don't see mega payouts for this pain and suffering, I just want it made right. I think the center sees this and believes catering to my few requests is way cheaper than a lawyer battle which I would hate.

The one mental thing I am dealing with is that my left knee TKR was fantastic up until the accident and the torn patella tendon. My original plan had been to do the left in December and the right the following year in December. But in all honesty this process with the TKR recovery, followed by the difficult recovery from the tendon repair is really making me wonder if I want to go through right TKR.

It is a balancing act in that I have good insurance now. When I finally switch over to Medicare I'm told it is no where near as good. So that is my wife's motivation for me to get it done. But I've suffered a lot with pain swelling, being cooped up for a very long time that I'm having a really tough time coming to grips with even the right TKR.

While my left TKR went well, I did have pain, swelling, trouble sleeping but I pushed through it until the patella tendon accident. Like you all say, every knee is different and my right knee could go worse than my left and that provides a little terror for me these days.

So I'm going to point friends and family at this website as it has the best info ever on what to expect, what to do etc. So thank you all very much.

I will continue to post in this thread on my recovery and how it goes. Monday is the first PT for recovering ROM so we will see. One thing I have learned is I will not let the PT person push me too hard. I've paid the price for my own stupidity in thinking if I push I get well faster. Not true. You hurt way more is about all I can say.

Hope you all have a great weekend.