Bilateral TKR "There is joint effusion"

[DOUBLE TKR]

@Jockette, bummer on the struggle you are having. When you say something didn't go well, what does that mean?

Have I told all you administrators who have responded to me that I love you? You are the angels on my shoulders (both shoulders) whispering good things to me.

I saw my surgeon two weeks ago. My ROM was still stuck at 75 and he said at the end of September if it didn't improve, we'd have "the talk." I like the guy and he is very respected in his field where I live. I looked him straight in the eye and said, I will not have an MUA. And he admitted that there can be problems with it. I think it was more of an offer than an assumption, and no thanks.

Two PT visits later, and after focusing more on stretching gently at home, I got to 90. That told me tons: that I am recovering, and that recovery isn't a linear progression. And I embrace your observation that I really am in early stages of recovery, although 14 weeks later doesn't FEEL early. And some days are better than others. Both of my knees are still tight right above the knee -- I assume some quadriceps attachment thing? But tightness doesn't hurt, thankfully. It just gets in the way of walking because I have to concentrate to let my knees bend for that.

And I have a couple inches of lumpiness under the top end of my scar on one knee. I have been massaging it and it hurts like heck.

I use Tramadol now only for PT days -- six more visits -- and have found that extra-strength acetaminophen twice a day is satisfying. I don't mind PT because their point of view is that it's my recovery and I control the approach, so I look at it as my stretching time. The woman I work with has been doing this for 18 years and her concern, when my ROM was kind of stuck at 75, is that she has had clients return after stopping PT because their bend hasn't progressed. But, what I wonder is, how many clients who stopped PT "prematurely" did just fine? That's the problem with anecdotal 'evidence.'

Some days I wonder if I will ever really get to 'normal,' and other days I know I will. Sigh. No one said this would be easy. Of course -- of course! -- a woman at PT the other day with a TKR (one knee) stopped her PT a couple visits short of the prescribed time because her ROM was fabulous after less than two months! I really had to push that out of my head and not let it discourage me. And when friends/family say, "you're still icing?" And I say, it takes at least twice as long to recover from a double. So there

Thank you all for your support. I am now hoping that in a couple more months, I will be even better.

 

[Jockette]

@Jockette, bummer on the struggle you are having. When you say something didn't go well, what does that mean?

Well, I had a partial replacement, a Patellofemoral, which basically is just the kneecap replaced. It has never felt good. I’ll be 18 months on the 13th.

I still have discomfort and difficulty going up steps foot over foot, and out and out pain going down steps foot over foot.

I think I developed some type of nerve issue, on the outside of my knee and just down a bit I have an area that is very uncomfortable, and the whole inside of my knee feels like something big and hard swells up inside the second I put pants or capris on.

That’s about it in a nutshell. Understandably I am very disappointed. I never considered I wouldn’t have a successful surgery.

Neither my original surgeon nor my second opinion surgeon will look into my issues because my X-ray looks fine.

 

[HoneyB]

@DOUBLE TKR, I had my RTKR June 4 and I'm also stressing a little (but trying not to stress) about my ROM. I'm having problems with tight quad muscles. My ROM improves greatly with a good massage at physical therapy, but then regresses a few hours later. Today at PT after the conclusion of all my exercises, my ROM was about 0 - 110 (where it's been for several weeks). After a brief quads massage, it was 0 - 116. After a good, long, intense quads massage, it was 0 - 120. However, a few hours later, I'd guess it was about 0 - 105. I know that no two knees are alike, but I can't help comparing it to my LTKR (February 19, 2018). That one was at 0 - 120 at 12 weeks and I was through with physical therapy.

I was on my feet for hours and hours the past couple of weekends at college football games. My knees felt great for walking, standing, etc. It's just maddening to me that I can't get past this tight quad muscle that hinders my flexion on my right knee. My tightness is also just above the knee as you described. My therapist refers to it as the "tear drop" area. I also know what you feel when listening to other patients. A man was at PT with me today who was three weeks post-op and his flexion was already at 120. His extension wasn't great, but his flexion was. I've been the opposite. I had good extension with both knees from the very start.

 

[SusieShoes]

I have a couple inches of lumpiness under the top end of my scar on one knee. I have been massaging it and it hurts like heck.

My OS told me the lumpiness under the top of mine was where sutures had been tied off and they'd dissolve in time. Which mine did. They did hurt when massaged for several months. Not horrible hurt, just kinda hurt. If yours are very painful, ask your surgeon what's going on.

And I say, it takes at least twice as long to recover from a double. So there

Good comeback. People might actually believe it, too! Your recovery probably won't take any longer than a single TKR, but only you need to know that. I had two recoveries with my two knees, done bilaterally: right knee was a champ, one of those 0 -120 at twelve weeks knees, and left knee was a laggard that finally became completely pain-free only after nine to ten months. So... which recovery do I claim?

 

[sistersinhim]

how many clients who stopped PT "prematurely" did just fine? That's the problem with anecdotal 'evidence.'

Add to that question, what about a great number of us that never did a bit of formal PT and recovered splendidly! I'm just one of many that after 11 knee surgeries didn't do PT. I'm doing just fine. Your knee and body knows what it needs to do to recover. We just need to use it just like God intended it to be used!

 

[Celle]

But, what I wonder is, how many clients who stopped PT "prematurely" did just fine? That's the problem with anecdotal 'evidence.'

I can tell you that here on BoneSmart we have had many, many people who weren't making progress while doing lots of PT, but improved greatly after stopping PT and concentrating on rest, ice and elevation, while just letting their activities of daily living be their exercise.

I have had three knee replacements, one PKR and two TKRs. I did minimal PT for my first two recoveries, and no formal PT at all for the last TKR. I Just let my activities of daily living be my PT.
I have had excellent results every time.

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, he recommends we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

 

[DOUBLE TKR]

I still hear the Bonesmart angel sitting on my shoulder whispering that it takes a long time to totally heal from knee replacement surgery -- and longer if you had both knees replaced at the same time!

My surgery was 6/4/2018. I am just over 13 months out and I am doing pretty darn well. I don't know what my bend angle measurement is, but I can walk comfortably (that is so nice!), go up and down stairs with just a smidge of resistance (especially my right knee), although I do use the railing, and I can get up from nearly any kind of chair or stool. How I remember the pain I felt the first time I drove, the time I couldn't get up off a couch without help. One hilarious time I was at a family party and sat on a deep and low couch and I knew I was in trouble. I tried to push up but couldn't quite do it, so two daughters-in-law tried to help me, which was futile and I slowly slid to the floor. They were aghast, but I saw the funny in it. I was fine -- put a pillow under my knees and pushed myself up.

I am comfortable on uneven ground and can kneel with a pillow. Not my favorite thing to do, but I can manage.

The orthopedic surgeon I saw for my one-year post op visit and x-rays (my surgeon retired since my surgery) said everything looked good. I have some effusion on my right knee, which comes and goes. He said it was normal and nothing to worry about. Is that true?

I was taking arthritis Tylenol (my surgeon's physician assistant recommended it and said to stick with the brand name) regularly until about 4 weeks ago when I realized I just didn't need it all the time anymore.

I found that my hips hurt a lot for quite a while -- perhaps the realignment from knock kneed to straight? That discomfort is receding, but not entirely gone, especially related to the movements related to getting into a car. Not sure what that is all about.

I am very grateful that I have knees that work. I am a little concerned about the tightness/effusion in my right knee as I can't ride a bike yet because of it. And I really want to ride a bike!

As ever, thank you BoneSmart, for the priceless service you provide to people going through the trauma of a joint replacement. Your counsel that the "bend" would come much on its own as the healing progressed helped me not allow any PT to be aggressive (I went twice a week for 14 weeks). Little by little, sometimes a step back, I have come to a good place with my two new knees.

 

[Celle]

Hi again, @DOUBLE TKR
You'll notice that I have merged your newest thread 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.

So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Celle]

The orthopedic surgeon I saw for my one-year post op visit and x-rays (my surgeon retired since my surgery) said everything looked good. I have some effusion on my right knee, which comes and goes. He said it was normal and nothing to worry about. Is that true?

I am very grateful that I have knees that work. I am a little concerned about the tightness/effusion in my right knee as I can't ride a bike yet because of it. And I really want to ride a bike!

I think you can trust your new surgeon and believe that your knee will continue to improve as time passes.
Even though we do tell people that complete recovery takes a full year, sometimes it does take longer and some people have found that it can take as long as two years.

Continue to rest your knee and not to over-exert it, and look for gradual improvement.

However, if it should get worse and doesn't improve with rest and elevation, then go back to the surgeon.

 

[DOUBLE TKR]

This was the result of x-rays of both my knees in June 2019, which was one year after bi-lat TKR. It is now two years out and my right knee effusion is always present. It does not inhibit ROM or activity. I haven't had my ROM measured in over a year, but I can ride a bike, do some squats, and have no problems getting around, so I'm pleased with that. This effusion feels like a constant bit of pressure. No pain. Is this just an irritation I need to learn to ignore? It gets worse with exercise, but not to the point of pain. I want to hear from this community to see if I should even approach my new surgeon (the surgeon who did the surgery has retired) to see if there are any remedies I should pursue.

 

[Pumpkin]

@DOUBLE TKR
You'll notice that I have merged your newest thread 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.

So 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'll 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.

 

[Pumpkin]

My left knee revision still swells a little with activity, no pain.
Mention it at your next visit with your new OS. If it get warm, red, and painful call your OS.

 

[DOUBLE TKR]

Pupkin, I can't remember how to find my thread. It's been a while since I posted and I looked all over the place. How do I add my own thread?

 

[Jockette]

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