TKR Still swelling

[MarkTKR]

Hi all,

I posted my left TKR followed by Patellar tendon rupture and repair in this forum some time back. It's been a long tough recovery. I'm at the point now where I'm almost exactly 7 months post Patellar tendon surgery.

I spent almost 7 weeks in a straight leg case, followed by about 3 more in a very limited movement brace. I attended quite a months of therapy to regain motion of the knee. I started once the cast/brace were off with about 30 degrees ROM and after approximately 3 months of PT and working at home got to 128.

It took a long time to feel confident walking on uneven surfaces but that has mostly returned. It has also taken a long time to get stairs back but I can now handle. up and down, albeit slowly.

My post today is to talk and ask about swelling. About a month and half ago I was not swelling very much and it was wonderful. I would have occasional days where I would swell some but it was manageable. I thought that maybe I was through that phase.

But in the last 2-3 weeks I've noticed that swelling has returned and I'm not sure why. I will admit that I have not been as good at continuing my PT exercises in the last month so that could be a contributor. I also unfortunately gained a little weight due to a very busy work schedule and not exercising like I should.

I'm puzzled why I went from minimal swelling back to fairly significant swelling. Maybe just exercise or some other change.

When I come home from work (desk job with some walking around) my leg is huge. It's kind of depressing. I'm now back to wearing a compression sock on that leg and when I go to bed at night I put my legs up, very high, for as long as I can manage. I sometimes fall asleep that way and wake up kind of stiff from the strange position.

I guess I'm just interested in what others have seen with swelling. I sort of figured that at 7-8 months I should not be seeing so much.

And I guess it could be some other body interaction however I just had a full physical and bloodwork looked good.

So what have others experienced? Part of my curiosity is that during therapy I have seen fairly fresh/new TKR patients with virtually no swelling and here I am 8 months out with a leg twice the size of the other it feels.

I don't have pain with the new knee or tendon repair. I have pretty good strength. I'm back to playing golf. so I'm just curious on the swelling. If there is one thing I wish that would go away it is that.

Mark

 

[Jaycey]

@MarkTKR

You will notice that I merged your newest post 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.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

I spent almost 7 weeks in a straight leg case, followed by about 3 more in a very limited movement brace.

Based on what you posted you really are not 7 months out. You spent 10 weeks with limited mobility. Then I assume you pushed fairly hard to go from 30 degrees to 128 degrees. Healing from TKR takes one year or longer. Realistically you are not even half way there.

Question: how much icing did you do and how much icing do you do currently. Ice will directly address this swelling. Several sessions per day for 45-60 minutes will really help.

 

[ski_bum]

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

I was told they could not do a MRI because of the metal parts.

 

[sistersinhim]

also unfortunately gained a little weight due to a very busy work schedule and not exercising like I should.

Your weight gain is also putting more stress on your knee. Are you icing while you are at work? Your last surgery was just in May, just 3 months ago. Your knee has been through the wringer these last 8 months. Not just the tkr, but also that rupture and then the wire removal. It hasn't had a chance to heal. Baby it with ice and elevating as much as you can. That includes whenever you are sitting or laying down. That is how I kept my swelling under control.

When I had my patella removed, the doctor shortened my patella tendon and I was in a straight-leg brace for 8 weeks. My bend also came back fine, but I did it without exercises, just daily activities. I still have my wire in there. When I had my tkr the doc said that it was way too embedded to remove it, that it would cause too much trauma. I don't even know it's there until I see my xrays!

 

[MarkTKR]

Hi All,

Thanks for merging this. Was not sure of the policy but it make sense.

I did in fact have an MRI. They did not have an issue with the replacement knee and frankly it is the only way to see damage to tissue such as a tendon.

As I stated, I did not really have swelling problems a month ago so I have not been icing. I guess I need to start that again and have some ice packs at work. Good advice.

My 3 month ago wire remove surgery was extremely minor. The incision was <1 inch so he could reach in and pull out the wire. The cut was very superficial as the wire was already poking at the skin. I personally would not count that surgery as inducing swelling but then again what the hell do I know about any of this.

I will say that things changed a lot when my wire was removed. I mean yes the cut was very superficial but with that wire being removed the quad muscle had new things to do and learn. I was a little surprised how much the wire was doing. So yes, maybe that does contribute to the stress/swelling.

I feel that TKR and Patellar tendon repair, even considering the thousands and thousands that have been done is a discovery process for the patient because as this forum often says, we are all different and heal at different rates.

My weight gain is 6 pounds and yes I know it increases stress. I'm going to push hard to get that back off and lose even more. But yes it could certainly add to the stress.

I guess the reason for my post on swelling is I grow weary of it. I'm sure all of you have grown weary at some point in time of your injuries and it is just a fact that it takes time.

I'll shut up now, get on with my x exercise, weight loss, icing and elevation. Thanks all!

 

[ski_bum]

I wish I had waited for the first knee to be healed or satisfactory before I did the second knee.
Or done both knees together so it was only one year of pain, sleepless nights etc. or waited more than one year to see results of first surgery.
I was talked into the second knee as it was the best knee and was supposed to be easier.
Good Luck with your recovery.

 

[shr]

I guess the reason for my post on swelling is I grow weary of it. I'm sure all of you have grown weary at some point in time of your injuries and it is just a fact that it takes time.

Yes indeed! One of the functions of this site is to provide a place for venting our frustrations.

 

[MarkTKR]

Hi all,

Ok, it's now one year since my last knee op to repair the Patella tendon.

I still have massive swelling below the knee on a daily basis. It is 100% regular. I get up and there is no swelling. By bed time my lower left leg is like a puffed up balloon.

I ride my stationary bike, I do walk around at work, I am not as active as I would like due to winter but it just seems to me that my swelling problem is excessive.

I have a co-worker that had his right knee replaced about 6 months ago. While he has a few issues he has virtually zero swelling. I have also seen fresh new, two-three week out from surgery people that have zero swelling.

So I am going to go and see the surgeon. My MD friend is telling me to seek a vascular surgeon. I'm also going to be engaging legal council because this Patella tendon injury happened on the facility equipment and in their care. If I need more surgery to repair some vascular issue it will need to be covered I think.

I do elevate every night but it's very hard for me to do this during the day at work.

Anyway, just frustrated this is still an issue even a year later.

 

[Jockette]

Anyway, just frustrated this is still an issue even a year later.

I understand long term issues, though mine are not as bad as yours. I hope you can find the right doctor and a solution. I’m sorry you’ve been through so much after having such a great start.

 

[sistersinhim]

I think it's a good idea for you to go to a vascular surgeon. You should not be swelling this much. For you to be going through this through no fault of your own is disheartening. I pray you that find complete success in your searches. We are here for you. Please let us know how things go.