TKR Ten weeks later . . .<<'

[Cratchit]

It is a bit tricky at the moment but I have to say that today feels a bit better and the pain below my knee and in the calf is not as sharp as it was. I`m hoping that whatever it was that caused it has jogged on.

I think I could probably manage very well outside with just a stick so may have to buy one.

Two things I read today which I recall being told in hospital was that a) post traumatic osteoarthritis often results in increasing swelling post TKR and b) that younger TKR patients seem to experience more pain. So maybe I`m not doing so badly after all?

 

[Cratchit]

Improvement didn`t last very long. Knee now swollen again with the pain in the calf and below kneecap making an appearance again. Even the ITB is joining in.

As an aside, does anyone have varicose veins on the operated leg? Are they more painful since surgery?

 

[baclectic]

I had a hip replacement and strange veins have cropped up on my operated leg.


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[Cratchit]

Thanks baclectic. These have been here for years but are more prominent since surgery. Just wondered if anyone else had experienced a worsening of existing varicose veins since their op?

 

[Celle]

I guess it's possible. Elevation should help those varicose veins, as well.

 

[Cratchit]

My knee at 13 weeks.

 

[Celle]

It's healing well. Is it still a bit swollen?

 

[Spex10]

Its looking good. Do you massage it with Bio oil or similar?

 

[Cratchit]

@Spex10 I`ve just been using E45 on it to try and keep it a bit more flexible and therefore less stingy. Failed in that objective. Part of me has felt that the emollient was preventing the wound from `hardening` as the scar seems more sensitive afterwards. Funnily enough, I have just been reading through ACDCJen`s thread (horrors!) and someone on there, think it was Shelia, said the same thing about wound care and that her OS had advised her not to use anything in order to rough the wound off as they tend to do better, or something like that anyway. So that`s what I`m going to try as it kind of resonates with me.

@Celle The wound is well united but quite hypertrophic and very sensitive at the proximal end. The knee is still swollen and this varies from mild to moderate and anywhere in between. There is often a lot of heat in it when it`s swollen though this doesn`t concern me as I accept it as part of the process. The photo was taken after I`d elevated all evening. I could elevate all day long but as soon as I stand the swelling and tightness recur. I still have pain in it, at least as much as pre-op, particularly over the tibia as well as allsorts of soft tissue pain and intermittent ITB discomfort. At 13 weeks out it disappoints me that I should still have pain, still be unable to walk any distance without using an aid, still be unable to fully weight bear when rising from standing. I also have pain in my hips, particularly the (L) which can waken me at night, back and (L) calf. I am still on variable amounts of pain meds.

All that said, I am aware (from what I`ve read) that much healing is still taking place, especially at cellular level, also that post-traumatic OA can result in a longer period of swelling/tightness and that the younger the age of the person having a TKR the more painful it can be, presumably because of tighter muscles, tissues etc. This kind of mitigates (a little) the disappointment I feel to still be at this stage.

One other little bit I am aware of is an area which would be at the bottom of the photo and in line with the incision but not related to the wound. I can feel a roundness deep within the tissues and over the distal femur, almost as though I can feel the edge of the prosthesis underneath the layer of fat and muscle. It isn`t uncomfortable or painful and it isn`t mobile. It really does feel as though I can feel the prosthesis. I`m sure I`ll be told not to be stupid and that it`s impossible to feel any part of the implant!

I feel bad for moaning. I`ve read through others` stories and the terrible time some folk have and I feel guilty for talking about any of this because apart from the pain and mobility issues, my recovery has been quite straight forward. It`s such a lonely process though. Unless someone has been through this procedure they cannot understand all the myriad elements to it and seem to think I should be over it by now. But I`m not over it. Furthermore I`m yet to have my `orthopaedic moment`. I seem to have so many questions yet so few answers

 

[Celle]

Moan away! We understand.
It is disappointing that you still feel so much pain. I'd be moaning, too.

I don't know why you're still so uncomfortable, but it will ease off gradually. When do you see your surgeon again?

I wonder if @Josephine can suggest anything that might help?

 

[Cratchit]

@Celle Thank you so much

I don`t see my surgeon until 27th Feb but I may try to bring the appointment forward if I`m still not happy. It`s probably all par for the course I suppose. I was reading elsewhere that some people at my stage rarely think about their TKR knee; I think about it every time I move because where it is and how it is, is my first consideration, even if I`m just changing my position when seated.

Just been offered a great incentive for improvement - a perfect little `been there, done that` pony! Aaargh!

 

[Josephine]

Part of me has felt that the emollient was preventing the wound from `hardening` as the scar seems more sensitive afterwards.

Of course it will - that's what an emollient cream does!

her OS had advised her not to use anything in order to rough the wound off as they tend to do better

Quite so - so do I! These wounds never had any massage or creams on them

3 months THR

TKR at 5 months

healing is still taking place, especially at cellular level

People keep using that phrase - I've no idea what it means, have you? Healing is healing in my book.

I can feel a roundness deep within the tissues and over the distal femur, almost as though I can feel the edge of the prosthesis. I`m sure I`ll be told not to be stupid and that it`s impossible to feel any part of the implant!

Well, I'd not go so far as to call you stupid but it is true that it would be impossible to feel your implants at that point! It's more likely a deep stitch that's had one too many throws on the knot!

I seem to have so many questions yet so few answers

Ask away, my dear - that's what we are here for!

I was reading elsewhere that some people at my stage rarely think about their TKR knee

At only 13 weeks? I very much doubt it! Either that or wherever you read it, the author probably knew very little about TKR! It was almost 6 months before I reached that stage with either knee!

It`s such a lonely process though.

You know this is something I make a point of telling surgeons when I go to medical conferences and want to handout posters for them to put in their waiting rooms. I've spoken to many UK surgeons and also some US ones and when I say "you're probably unaware that having a hip or knee replacement is a very lonely business because you never get the chance to meet with others who have been in the same situation". Without exception they have all stopped and thought about it and then said something like "You know, I've never really thought about it like that" and happily taken a poster! And it's true - they don't think about it. Ever. Hence BoneSmart!

 

[little red canoe]

My OS said no cream was needed. Of course you can't see the scar anyway. I mentioned that it was sensitive if I knelt on a pillow.. Actually it was the PA that suggested no cream. and to wear sunblock if in shorts. Also use a massager.. I am .. I don't know if the massager has any effect yet but it feels good. Trying to desensitize the scar not make more baby soft skin prone to burning.

I don't think of my TKR constantly at 14 weeks , more and more often I forget.. Its about sixty forty now, forgetting to not forgetting. Stairs and kneeling make me think.... and off the low sofa and the low upstairs toilet.

You will get there.. I forget now what the early days were like.. had to read my thread to review!

 

[Cratchit]

Well, I'd not go so far as to call you stupid

No, indeed - you stopped just short! It is not beyond the realms of possibility that there is some localised reaction going on and it is this that l am feeling. But l am feeling something. I was advised by the TVN to use the emollient as a remedy for the dry, tight skin surrounding the incision as this was contributing to the stinging sensation of the scar itself. Trial and error.

Yes, this is a lonely process so you will be aware, also, of the accompanying vulnerability and sensitivity that goes with this time. Sensitivity is the gift l give to our little ones and families but applied to myself it hurts me. I advocate well for others, so not for myself. I ask questions in a bid to understand and therefore attain some level of control and hope that this stage is not forever, that it will get better.

So l waken to another morning of swollen, tight knee and a scar that stings with every touch and a limb on which l cannot yet fully weight bear without pain and yes l want to cry but l won't because there are others to consider and l won't spoil their day so l'll keep this to myself and keep on carrying on. And yes, it is lonely.

@little red canoe Thank you. I'm not so many days behind you so hopefully, soon, l'll get to the point where l'm not constantly aware of this knee. It is so easy to forget the early days - l have!

 

[baclectic]

@Cratchit I appreciated what you shared: "some level of control and hope that this stage is not forever, that it will get better."

I,too, struggle with those feelings. Had a meltdown yesterday. Very unlike me.
But today is a new day. Perhaps I can be hopeful today and live only in Today and stay out of the (undetermined)) future.
Hope today is a good one for you. Barbara


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[Cratchit]

Barbara, thank you so much for your kind and wise reply; much appreciated Yes, today is another day and perhaps by the end of it I`ll be jogging that dog around the block. I doubt it though - it`s raining!

It`s a rocky road this road to recovery. I hope for you, too, that today is a better day than yesterday. Perhaps by the end of it we`ll both be singing

 

[Spex10]

Oh @cratchet I'm so sorry to hear that you're feeling so bad. Maybe you should try to see your surgeon sooner? You're not stupid and you're used to thinking in medical terms. I bet you express yourself well to the Dr. You're still suffering in a way you didn't expect. We're all 'survivors' of this type of surgery and, true enough, its a lonely business. The family must be pretty bored with me and my knee and I don't think I'm the only one. This too shall pass but its taking a heck of a time to do it especially in your case.

 

[Cratchit]

Aw, @Spex10 - thank you for underdtanding End of Feb is too long to wait to see the consultant so I will try and bring the appointment forward. I just want the reassurance that nothing is amiss, that sometimes this is just how it is. You`re very right, this isn`t what I expected. I didn`t know what to expect but it wasn`t this, so far on. There was so much damage done to my leg when I broke it that perhaps I should have expected a longer recovery time. Perhaps I`ve been naïve.

I think my family are pretty bored with my knee too! There are only so many ways we can push our plight before they start switching off and I`m beginning to see the looks already!

I am heartened and encouraged by your progress since the MUA though! That has cheered me!

 

[Cratchit]

So, I had an appointment with a physio today, arranged through work. My ROM at 14 weeks post TKR isn`t as good as it was before Christmas. Flexion was initially around 90 but got to 110 at the end of the session. Extension was 10. I have muscle weakness on the quad and the swelling I could feel at the bottom of the femur is probably a knot of muscles. The IT band is tight as is the tibialis anterior, a big muscle that runs down the front of the shin. So I have quad exercises and massage to do and a bit more time on the bike.

In regards to the pain and swelling, this is likely to increase a little initially but as I build up power in the quads, this will support the knee which in turn will result in a reduction in the swelling. The wound is still very sensitive and apparently to reduce this I have to massage it gently at first and increase the pressure gradually to reduce the keloid.

I`m a little disappointed but there you go. I`m obviously not one of those who can increase ROM just through ADL, I need some targeted exercises. She did think aqua aerobics would be a good idea as I could do as little or as much as I was comfortable with. It would serve a double objective of getting me out of the house too. Just wish I had a beach ready body to take to the pool with!

 

[Spex10]

Sounds positive @Cratchit. What the physio said could explain a lot about the specific pain you've been experiencing. Somehow understanding the mechanics of it all helps!