Revision TKR swelling after knee revision surgery

Kimberley

junior member
Joined
Jan 26, 2014
Messages
35
Age
67
Location
Scotland
Country
United Kingdom United Kingdom
Gender
Female
The surgeon I saw last of all suggested that I may have a problem with my hip in that a bit of wear and tear is obvious. I am not sure that the amount of wear would give me the problems I have. They did say it wasn't a lot and that my symptoms are not typical of someone needing a hip replacement.

All the problems with my hips and now my back started a short while after my knee operation and the leg is not straight. I will have a go at sending you a photo of my leg and see what you think. Do I go to 'upload a file' to download a photo?

My physio who works for the same health board has said my leg is not straight and is going outwards at the knee. If she can see the problem then surely they can??? I feel they are trying to find other things wrong so they don't have to admit to the problem with the knee.

If I do have a problem with the hip then so be it but I really don't want that done if it is the knee that is causing the problems. They have suggested I have an injection into the actual hip joint which will anaesthetise the joint and if that works then a hip operation is the right thing. If it doesn't, then they will look at other options.

Do you think I should go down this route first before complaining about my knee? I am so confused as everyone in the team of health professionals I have seen is saying different things. I am going to go and see my GP to tell him I am thinking of complaining and that I want to see someone different who is not connected to these surgeons.
 
Hi Brad

It sounds like you have been through hell and still not resolved yet. My problems have been nowhere near as bad as yours but still debilitating. It's been nearly 4 years since my first replacement and I always knew something wasn't right. The surgeons I went to see, including the one that performed the operation, all said things were ok because the X-rays showed things to be fine. I had physio and injections etc but to no avail and all this time my leg has been crooked. It looks straight on the X-ray but not when I walk.

I finally managed to get a second opinion after being told not to bother as the prognosis would be the same and after he listened to me, watched me walk and then physically examined and moved my affected knee around, came to the conclusion that the implant had failed and was moving on the joint. Oh, great!!! Mind you, I could have kissed him after waiting for so long for my fears to be realised. He said my ligaments would have been working overtime to keep the knee in place as much as possible and that it could have made my opposite hip worse. I do not intend to try and sue as it is the NHS and I don't see the point in taking money from other needy people. He has said that I can have my hip done in October and as soon as I am fit again (8-10 weeks) he will do revision surgery on my knee and put in a stronger implant so my leg is straight. I am concerned about it all because I have a bit of numbness in the outside of my knee still which will never come back and I am scared I may be slightly paralysed in that leg after more surgery but I think I am going ahead with it as I am fed up with the current situation. What do people thing about having this revision surgery? Could I be better or what are the risks involved apart from infection? What do others advise or what did they do?
 
I thought I'd tell your readers of my experiences of both knee replacement and hip replacement as mine were done fairly close together.

I had a left knee replacement just over 4 years ago and never thought it was right from the very beginning. I noticed that my left hip was starting to hurt when I walked. Prior to the operation my hips were fine. I had no pains whatsoever. I thought also that my knee wasn't straight and many people confirmed this to me. When I voiced my concerns to the surgeon he dismissed them and sent me off with a flea in my ear! I approached my GP who at first told me I would have to put up with it and at least I was walking!! He sent me for physiotherapy to strengthen the hip. I did the exercises for quite some time but my hip just got worse and the knee seemed to be getting more crooked with time. In the end I had so much pain in bed with my hip that I couldn't sleep without painkillers so I went to see another surgeon who told me he wouldn't do the knee but he would do my hip. Well, I wasn't very happy with that. I asked for a second opinion and within 5 minutes he told me the knee was unstable and wobbling and that was why it wasn't straight when I stood and walked with pressure on it. He said get the hip done first and then he would do the knee once I had recovered from the hip.

In October 2017 I had the hip done. It wasn't a great experience. I hadn't been told to come off HRT 6 weeks before the operation but was assured that if I took Rivaroxaban everything would be fine so I proceeded. I wish I hadn't. I had what is known as a 'leaky wound' and after a week found that the dressings had burst open and there was a lot of blood and fluid which leaked onto the floor. The community nurses came out and dressed it for 5 days telling me everything looked fine. I was in a lot of discomfort and the wound was constantly wet and soaking through all my dressings and my clothes. After 5 days the head of the community nurses came out and took one look at the wound and phoned the emergency dept of our hospital. I was looked at in A&E but they decided that although there was an infection they would send me home without antibiotics to see if I could fight the infection on my own. They marked where the rash was appearing around the wound and sent me home. The next day I wasn't feeling well so called my GP out who put me on antibiotics orally and said I had a temperature. By the evening the rash had got bigger so I phoned A&E again and they said to come in and see them. They kept me in for a week on intravenous antibiotics until the rash started to go down. I was terrified as I thought I was going to die.

Once home I started doing my exercises and was walking with two sticks for the 6 weeks stipulated. I found my leg was weak and although I went down to one stick or none in the kitchen I had to support myself on the kitchen worktop to move around. When I went back to see the surgeon for my check up he did no xray as he was busy but he found I couldn't walk without a bad limp and I couldn't even stand on the leg for a second. I was told to go home and do exercises for my abductor muscles. I was getting concerned knowing I could be called in at any time for my knee replacement revision surgery. My muscles around my hip were so weak that I couldn't do a side lift lying down. I had to concentrate on standing exercises only where you move the leg out to the side and back. I could manage those and did them until one day I found I could just about lift my leg lying on the floor. This was about 3 months after the actual operation. I couldn't understand why I was so weak as I had always kept myself fit before this and wasn't overweight at all.

Anyway, I was just making progress when I was called in for my knee operation. That went well but I was severely anaemic and had to have 3 units of blood, I was very sick on the painkillers given me and the anti sickness tablets didn't work at all. All in all I was feeling really ill in the hospital and then I had a fit of some kind. Not nice as I was holding a sick bowl at the time which ended up all over me and the bed!! I was taken for a chest scan and head scan. The head scan came back clear but they discovered I had an old blood clot in my lung from the hip surgery. I recalled having really bad pains in my chest one night which woke me up and I nearly called an ambulance thinking I was having a heart attack. As this was in the February and my hip operation had been in the previous October I never connected the two and just thought I had had severe heartburn. I was told I couldn't drive for 6 months and sent home with 10mg rivarobaxan for a month. I had nearly finished the blood thinners and thinking everything was fine when I had another bad attack of chest pains and ended up in hospital again. I was told I had had another blood clot passing through and they asked me what I was taking for it. I told them 10mg of Rivarobaxan and the doctor looked shocked and said that as they knew I had a blood clot already I should have been sent out with 20mg for six months. I am now on these and can say I have had no more attacks but have another 5 months to go. What with the hot flushes because of coming off the HRT and the inconvenience of not driving life hasn't been great.

However, I can say to everyone that you have to keep on with the exercises given to you even though they are boring and take up a lot of time during the day because now I can walk without a stick and without limping!! It has taken a total of 8 months and I know my recovery wasn't normal but I have got there. Yes, I still get a bit of pain in the hip but I think that is because I overdo the walking and the exercises. When I get pain I just don't do my physiotherapy for a day and have a rest. I am getting stronger but it has taken a lot of hard work and I never thought I would make it.

My knee is straight now and the swelling after 12 weeks has nearly gone. I have some permanent discolouration of the skin around the wound but other than that I am really pleased as the knee is stronger too. It might seem a long haul and like me some of you will have doubts that you will get there but be patient. It all works out in the end. I was determined I wasn't going to walk with a stick on a permanent basis. I didn't want to look old and frail and that gave me the strength to keep on and keep the faith. I hope this helps some who are struggling.
 
Hi Eaglemom. I had a revision on my knee after 4 years of hell and nobody listening to me that my knee felt unstable and wasn't straight. Eventually I had revision surgery and that was 12 weeks ago. They found the new knee had been screwed in to the tibia at a crooked angle and on one side of the femur it wasn't shaved enough and too much on the other side. I have found my recovery to be much better this time around. I didn't do too much in the first 3 weeks. Just got up had a shower and made cups of tea etc and put ready meals into the microwave sitting down while waiting. I would say that at 6 weeks I took no painkillers at all and I did my exercises to the best of my ability. I didn't worry about the bend at all. I did the heel slides but never pushed anything. I certainly never did anything that hurt me. My bend is getting better all the time just doing normal things now. In fact, I did a 7 mile walk the other day using a stick for my hip but nothing for my knee and it was fine. No pain or extra swelling at all so I am pleased. Just take one day at a time and it will come and hopefully, like me, you will find a big improvement.
 
Can anyone tell me how long the swelling in the knee takes to go down please? I am 14 weeks out from revision surgery. My knee is strong and I am living a normal life now doing everything I did before. I can walk long distances without my knee hurting and without a stick for support. However, there is still a bit of swelling on the inside of the knee area and just above the knee cap going towards the thigh area. How long will this take to go or will it never go now? My knee looks quite a bit larger than the other and not very attractive. I won't wear shorts yet. Any advice and should I still be icing it? Thank you for your time and best wishes to everyone.
 
Hello @Kimberley - and :welome:

Please will you tell us the dates of your knee replacements, so we can make a signature for you? Thank you.:flwrysmile:

Why did you need to have a revisions?

It's normal for you knee to still be swollen, especially as you are apparently back to doing everything you did before surgery. The swelling will gradually go away, but it is dependent on how much activity you do. Elevating and icing your knee will still help with that swelling.

Remember that complete recovery takes as long as a full year, so you are really only a short way into this long recovery.

Here is some post-op reading for you - lots of useful articles here.
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
5. Here is a week-by-week guide for Activity progression for TKRs


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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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 a 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 history before providing advice.
 
Kimberley,
I've read back through some of your posts in other people's threads and I have gathered some sort of history about your knee and hip replacements.

It would have been easier for you and us if you had started a thread of your own, so that all your problems were documented in one place.

Please will you continue to post your progress in this thread now. It's your very own recovery thread and we will be able to advise you here, without disrupting other threads.
Thank you. :flwrysmile:
 
Hi Celle

I had my first knee replacement 4 years and 5 months ago. It never felt right. It took me a long time to recover from it and I always felt I wasn't walking properly and everyone told me that my leg wasn't straight anymore. I also developed problems with my opposite hip shortly afterwards and I have been told it may have been caused by the knee being out of line so to speak. I persevered with exercises to strengthen the hip because it became painful especially when trying to sleep and I was having to take painkillers to get to sleep. Eventually I had to have a hip replacement and after getting a second opinion on my knee I was told the knee wasn't stable. When they did the revision surgery on my knee in March of this year they found the first implant had been screwed in crooked into the tibia and the top part that goes into the femur had not been shaved enough on one side and too much on the other side.

I hope this helps. My knee is fine now and recovery this time has been so much easier. It's just a bit of swelling that concerns me but I hope it will go down in time. My hip gives me problems in that I limped really badly after the operation. At 8 weeks I couldn't stand on it for even a second and I limped all the time. I have worked really hard on the abductors and now find I can stand for long periods of time on the leg and don't limp but do find it easier if I put a 5mm heel lift in my shoes. I am getting stronger all the time but have to be careful as they think I have inflammation on the Trochear?? I think that is right. I take it easy and don't over do it as my hip will ache. I hope this clears up as I get stronger in time. It's been 8 months since the operation and a long old slog but I feel I am improving. I hope this helps.
 
they found the first implant had been screwed in crooked into the tibia and the top part that goes into the femur had not been shaved enough on one side and too much on the other side.
Didn’t any of this show on an X-ray?

My partial, a Patellofemoral, has never felt right but both the original surgeon and and second opinion don’t see a problem on the X-ray, “so there is no problem. “
 
I had two xrays and both times I was told they were within an acceptable margin. That means many things to many people. All I know is when we went on holiday with friends we hadn't see for a long time they were both shocked at how my leg was while walking. The surgeon that did the revision only had to bend my leg from side to side to decide it was not stable. I don't think the NHS would have performed this operation on a whim and if it weren't necessary. It has been totally better for me this time around and my whole leg feels much stronger. I always walk with a straight leg now and that is very important to me.

Cementless. That is shocking and quite obvious that it is wrong. How do these surgeons get away with it? I hope you have managed to get another surgeon to correct this?
 
Last edited by a moderator:
@Kimberley , thank you for you previous history, but we need dates of your surgeries, especially the revision.
I found the date of your THR for a post you mad in the Hip Replacement Recovery Area.
 
My first replacement was in November 2013 and the revision surgery was 20th March 2018.
 
Thank you for the surgery dates, Kimberley. It does make a difference to the advice we give you.
 
@Kimberley
I have moved the X-Rays that Cementless posted in your recovery thread and the responses to them into his own recovery thread, here:
https://bonesmart.org/forum/threads/i-have-been-told-i-can-live-with-a-loose-knee-implant.48377/

Here on BoneSmart, each person has her/his own recovery thread, in which the main topic of conversion should be about her/his knee. It's OK to post in other people's threads, as long as you talk about their knee and not about your own, unless you think that something you have done might help them.

Posting pictures and talking about your own knee in someone else's thread takes the emphasis off their recovery and hijacks (or derails) their recovery thread.
Forum etiquette: being polite when posting
 

BoneSmart #1 Best Blog

Staff online

Members online

Forum statistics

Threads
65,180
Messages
1,597,061
BoneSmarties
39,364
Latest member
All2Gd88
Recent bookmarks
0

Latest posts

Back
Top Bottom