TKR The Knee Team journey begins!

[SmartChoice]

Did any of you suffer with the HARDENED area between incision and bend of knee? I am growing more concerned this its not due entirely to fluid, I am a bit concerned adhesions are there. I am following mantra, icing significantly, elevating, CPM, exercises....but still FIRM area measuring about 3x4 square. Could alternating some warmth and coolness break down pocket?
Josephine, any suggestions please.

 

[Josephine]

3x4 what? Inches?

What you have is just a hard area of the incisional scar which happens sometimes. This is quite different from adhesions.

Tell me exactly where it is using this chart. Each square needs the number for the row (horizontal) and the column (vertical) to identify it. Also say if it's front or back.

Also describe in what way you think this is incapacitating you.

 

[SmartChoice]

Hi! It's the L1, C area, and top portion of D. Very hard to touch, the rest of knee is doing quite well, very flexible, capacity to complete exercises PT requests. The troublesome pocket deters good bend of knee. Once in CPM it feels much better until I stand and it feels fluid or blood all rushes to that area.
Yes...inches

Have religiously used ice, elevation, and trying to massage it, NO improvement! Thank you...

 

[kneeper]

I don't have any specific response to your question, but one thing to keep in mind is that nothing moves very quickly in your tkr recovery. You are in the infancy of your recovery right now.

 

[SmartChoice]

Thank you for sharing, as a newbie, and wanting to be proactive in avoiding adhesions, it's helpful info.

 

[SmartChoice]

I used a drawstring trashbag today and took a quick shower. No wetness on incision area, and I feel almost human again. ;)

 

[SmartChoice]

A word to the wise, just as BoneSmart has recommended....DO NOT allow physical therapist/assts. to bully you, to try to manipulate you with threats & fears of MUA!!!! I have felt my progress in two weeks is excellent, but PTA kept pushing my leg into VERY uncomfortable positions. I changed PTA, and also saw the OS for his firsthand professional opinion of my post-op progress, he is very pleased where I am considering the swelling I have. My ROM. Is 95, can do 110 on the CPM, using much less pain meds., and walking with a cane. X-rays show all s going very well.
SEE perseverance and motivation pays off! Listen to your instincts, you will know your limitations, and your success, don't let others push you...

 

[SmartChoice]

Hmm, I've been wondering about the specific tight area on outside of knee, and wondering if it could be where the IT band goes there?
I'm still having that specific tightness, when bending knee more to walk correctly, and of course forcing the knee to bend more on heel slides. IT band?? Josephine. referee54

???

 

[referee54]

I've been wondering about the specific tight area on outside of knee, and wondering if it could be where the IT band goes there?

It does sound like it may be your IT band. It could be tight where it attaches down near the knee.

I had IT band issues and used ice cup massage as well as stretching.
the ice cups are easy to make---put water into a dixie cup, freeze it, and then put the ice directly on the painful area. as the ice melts, peel the paper away.

Stretches for the IT Band look like these:

Remember, ultimately, ice is your friend!

 

[SmartChoice]

Thank you!!

 

[SmartChoice]

Tomorrow will be 3 weeks, I replaced a PTA who hurt me repeatedly, I like the replacement, but with last weeks winter storm & she's now not coming due to illness.. I'm wondering if it's ok to go it on my own now? I am doing all the exercises, following mantra, and can now cycle on my recumbent bike. Any of you have experience with when to end home healthcare PT?

 

[referee54]

IF it is an IT Band issue, it could take a while to resolve itself. Where is it exactly located on your leg---at the knee, above the knee, thigh, etc?

 

[Josephine]

Oh I don't know about that! I think what you are describing is simply this "Tight band" feeling across the front of my knee. Perfectly normal and also very long lasting, but which I mean a matter of months.

BUT don't let her push you in heel slides, very counter-productive. It should only be to the point of discomfort and no more. I suggest you go back to post number 17 and read your recovery articles again, specially this one Myth busting: no pain, no gain.

 

[SmartChoice]

Now that the swelling is going down, I can see that my bursa that was there Preop is still there, evidently surgery did not take care of it, and it's to the side of it where the tight band feeling has been.

Good news though, I am finally beginning to feel normal again. I almost slept thru the night, the first time in 28 days! I have a pot of homemade soup simmering. I am trying to do my exercises 2 times daily, and doing lots of walking, concentrating on heel, toe, heel, toe to get my heel/gait normal. The increase in warfarin created two MISERABLE days of continuous leg cramps, so I discontinued, and the cramping is gone.

 

[SmartChoice]

:sleigh:I had my 4 week check-up and OS was very pleased with my progress and my incision healing well. My leg cannot lay straight, but it's only off like 2 or -2, ya'll will know what I'm talking about. My ROM is 105, I had hoped for 110, but I still have some swelling in the knee. I can walk without assistance, but prefer to use a cane. My gait is pretty good as well, but of course, many times it isn't, but again that's to be expected. I begin outpatient PT after Christmas. I was one of the November Nimbles, and looking forward to a great year in 2014.
Wishing y'all Merry Christmas or Happy Holiday.

 

[SmartChoice]

Hi, it's now almost six weeks post-op, I have begun my outpatient PT, everything is going very well, except "that continuous attachment/tearing feeling," I have had since surgery. It remains on the outer side of knee (LTKR) I force myself to bend knee in order to walk with normal gait, heel, toe, heel toe, the gait looks almost normal,
*but can someone PLEASE give me some idea WHY this feeling remains to the degree it does?
*What it may be? @Josephine
It's very frustrating not knowing how to get rid of that nagging Tear feeling!

 

[Josephine]

Principally, it's because you are only 6 weeks post-op! That's very early stages and you're still likely to get pain for a while yet. For me this was the worst part of my recovery when pain was at its worst and my GP actually gave me permission to increase by dose of Tramadol from the usual top dose of 100mgs to 150mgs! I know some places say that everythings back to normal in 6 weeks but that is so very far from the truth it makes me cringe when I read it!

 

[SmartChoice]

Thank you @Josephine. I am using the ibuprofen/Tylenol cocktail for this stage of recovery, elevate/ice, and rest for pain and swelling. I have the normal feeling of the incision healing from inside out and the knee/patella movement rubbing against it, and feel that is normal. The OS said he did the undercutting on the inside side of knee&thats where the drain tube came out, "that side is all fine." It's the opposite side which is so troubling. :(
Again thank you... Wishing you all a Happy, Healthy New Year!

 

[Josephine]

The trouble with statements like that from a surgeon is that he is looking at this from a completely different view point than his patient! It's the same when a dressing is pulled off for the first time revealing a gnarly, blood encrusted wound with heaps of bruising and staples and the surgeon or nurse will say "Oh that looks very good" while the patient recoils in horror at the mess that was once their knee or hip! Different strokes for different folks, as the saying goes!

 

[SmartChoice]

Neither OS or PT are answering my question, I so want a reasonable explanation for!! A person knows their body, recognizes different feelings, different degrees of healing, outside in...inside out.
Do any of you know, what tendon, ligament, muscle on (outside) of knee is affected by allowing your knee to hang over edge of bed at a 90 degree angle?