Revision TKR Third and final surgery all done

[Jamie]

I'm so thrilled to read your post. This surgeon sounds right on target and you need to try and relax to get through this waiting time. Don't push and worry about anything but just allowing the traumatized tissue to heal. There will be plenty of time later after your revision for getting ROM and strength back.

It definitely sounds like you are in good hands with this doctor. Could I ask which one you chose? I'd like to make a note in my file about how well he has handled your case so far.

 

[SusieShoes]

Allowing traumatized tissue to heal makes sense to me. When I had micro-perforations of the bowel, the surgeon insisted on healing it first for four months (IV antibiotics, rigid diet, CAT scans) before cutting it out. His reason: he'd rather operate on healthy tissue and so would I, because the result would be better, with far less risk of adhesions and bowel narrowing. He was good at what he did. Worked out just fine.

You want the healthiest tissue possible for any surgery. Your surgeon is doing it right. (And maybe a little of the not poaching part.)

Please don't push. Sit back, and trust the doctors.

 

[Josephine]

That's true but the other side of the coin is that the majority of issues are known to resolve around a year out so no-one wants to rush into a revision that might prove to be unwanted.

 

[sistersinhim]

It sounds like your have some really good things happening in your future! What a caring doctor your new one sounds like. Now, be sure to baby that knee until it's fixed!

 

[kayow11]

Just asking any of you out there that are forum advisors or moderators or administrators. Have you heard this before about waiting 4 months at least due to wanting the tissues to heal more to prevent tissue death and infection? I am speaking of time lapse before doing a revision.

 

[kayow11]

Sorry about the last post which I sent before noticing that a couple of you had already answered. Have any of you heard of or seen Valgus like mine (10 degrees off), resolve on its own after many months? Personally, I don't know how it could.

 

[Jamie]

Kayow11.....if the knee was poorly done (as yours appears to be), then it is not likely to improve with time. But there is real truth to wanting the tissues to heal after the surgery trauma to make the best conditions possible for a revision. Please try not to overthink this. You have a good surgeon now and it's important to follow his guidance. He has your best interest at heart. This is all part of why you get an experienced revision surgeon....so he can evaluate what is best for YOU and then do it. I know it's difficult to be patient, but it's important.

 

[kayow11]

I just wonder if I should wait even longer such as 6 months. I sure don't want to do a revision before I am mostly healed and risk more problems. An infection would be a tragedy to me. I have had enough issues to deal with. Even though the new revision specialist has experience, it is impossible for him to know when for sure, would be the best time for me, and when I am truly healed enough.
If I continue to have back, butt, leg and foot problems, then I will be more inclined not to wait in excess of 4-6 months. Does this sound reasonable?

 

[RadioGal]

@kayow11 I don't have any answers for you, but just wanted to say congrats on finding someone to help you. I'm following closely as we have some similar issues - valgus, hip, lower back pain, so I'll be interested to see what happens with you. Best of luck.
BTW, I have an appointment with a revision specialist as well next month

 

[kayow11]

Can anyone out there remember when they felt their quadriceps strength felt back to normal after TKR?

I am 10 weeks out with my 2nd TKR surgery, and 5 months out from my first TKR. Going up stairs still seems very difficult due to weakness, especially with the 10 week old, not really much real pain but extreme effort needed to do it.

I have been at a standstill with my leg swelling situation. Of course this problem prevents me from bending as I should be at this point, and causes a lot of pain and a throbbing ache when I stand or walk more than 10 minutes.

It very much limits my life in numerous ways, including my ability to work at this point.
Today I saw a health care practitioner who had me try a pneumatic compression device called FlexiTouch. I tried it on my 5 month old knee for only 30 min. And my knee circumference decreased by almost one inch and sure felt better for awhile. I am in the process of seeing if I could obtain one for home use daily.

I have already been doing manual lymphatic drainage massage for a couple weeks now, but have not noticed any improvement yet.

Also, today I picked up my first pair of Jobst Elvarex custom thigh high compression stockings on advice from a PT who deals with lymphatic issues. Regular 30-40 compression stockings helped, but not enough.

It is yet to be determined if any of this will help me with my problems, but at least I had/have some things to try to help myself.

I will post any new developments in the future regarding my issues, along with successes or failures in the event that someone else out there who may have similar problems, is also looking for answers.

 

[liam2015]

hi kayow ~ regarding quad strength: i'm 7 months post op and my quad strength is gradually improving. i only had the one LTKR. i have noticed that my non-operated leg has weakened so i do practise going up and down the stairs, sometimes without holding onto handrails. it's coming along slowly. i still have swelling and no longer going to p.t. or doing the recommended exercises; just doing normal everyday activities: walking, hiking, stairs and also elevating at night; no longer icing. you're still just 10 weeks post op on your 2nd knee surgery. i'm sure things will improve in the next few weeks or months. it's great you are experimenting with different therapies and devices to help with the swelling. i will be following to hear if your new compression stockings help.

 

[kayow11]

@Jamie, The revision specialist I saw last week was Kris Breien from Summit orthopedics. I do plan on possibly seeing one more revision specialist next month for another second Opinion.. This is a real big deal to me and I don't want to jump in unless I have thoroughly researched this. If she says the same thing as the former, then I just have to decide what to do or Who to choose. I will try to get a feel for each of them and their knowledge and intentions.

@SusieShoes for your input on surgeries and healing.

@Josephine, with my misalignment, do you think there is any possible chance that that could self correct? I don't see how, but in all your years of experience, have you ever seen it?

@liam2015,
Thanks for your input on quad strengthening and encouragement in my leg swelling problem. I just have so much going on physically to deal with It seems, and still lots more yet to come. I dislike being the center of all this drama.
My five-month-old knee also weekened after I had the second surgery. It's still hasn't recovered. I will just keep working on my strengthening and stairs ability as I am able. Also, trying to keep a positive attitude about another surgery.

 

[Clipless]

Following TKR it took approximately two years (yes, two years!) for my quads to feel completely "back to normal". Your mileage may vary.

 

[Josephine]

An infection would be a tragedy to me.

An infection would be a tragedy to anybody!

Can anyone out there remember when they felt their quadriceps strength felt back to normal after TKR?

That's what I call one of those 'how long is a piece of string' questions! Everybody's different.

Going up stairs still seems very difficult

Not at all unusual for 10 weeks out. With my first knee, it was 4 months before I got my operative leg doing stairs 'normally'!

with my misalignment, do you think there is any possible chance that that could self correct? I don't see how, but in all your years of experience, have you ever seen it?

No. Sorry but no. It's mechanical thing.

 

[rubyyarn]

I noticed the same thing, the older knee regressing to hurt almost as much as the newer knee. I do believe that kneebling rivalry is a thing!

 

[kayow11]

@Clipless, thanks for sharing your quad story. Now I know that my knees aren't out of line and I will just keep working on it. Hopefully it won't take more than a year but we will see. Even though I work them regularly, it seems like weeks go by and it still feels very weak like I can't trust them on the stairs. The newest one especially doesn't like to respond to my strengthening efforts it seems.

@rubyyarn, I know we aren't imagining it. Those knees seem like rivals but yet they're both babies. The old knee is acting like a spoiled brat in my opinion. It's five months old and still acting up and regressing at times.
I see you did both of your knees three months apart just this past summer and fall also. Would love to know how you are doing with your bending and swelling. I am way behind. Still swelling in both knees and the five month old knee is still at 100° or less.

@Josephine, Thanks for your response. I need to hear that my misalignment is a mechanical problem. That is what I always thought anyway even the day after surgery.
I just can hardly wrap my head around another surgery at this time. But yet, I can't wait six months or more probably because my foot, knee and upper thigh/hip pain, along with my back and buttock/piriformis pain sometimes.
All the pain symptoms occur with weight bearing on a twisted and crooked knee. I think these secondary symptoms are what will force me into surgery sooner rather than later.

 

[rubyyarn]

Hiya, @kayow11!

I never had much trouble with bending/swelling. Maybe because I iced 24/7 from the beginning, maybe because I avoided a lot of strenous activity, I dunno... But the energy drain is murder, even at 8 weeks out for Knee #2. And I have juuust enough swelling to make both knees hurt if I overdo it the least bit.

It's a journey, for sure...

 

[kayow11]

Three days ago I got my Flexitouch pneumatic compression machine. It was prescribed for me by my vein doctor. I have used it three days now. instructions are to do one leg per day. I don't know how long it will take to have any lasting results or impact on my overall leg swelling.
I am also using custom compression stockings now and they seem to help me with standing and walking tolerance better than the old compression stockings, since they are much tighter and hold my leg tissue/swelling in better.

Over time and consistent use of these two new things, I hope to have more relief in my leg swelling and tolerance for standing and walking.
In five days I see my original surgeon again. He will decide, along with me, if there is any way I can return to work even at a limited capacity. My short-term disability comes December 17.
When I look at the job description and how I still feel, I think, as Josephine said, my chances are remote. I still don't have good balance and I feel I am a trip hazard. That won't work in my job. Plus, I only have rolling stools at work. I need stable chairs with handles to push off from when I stand up.
I have been off six months now and need another couple months I think to recover, but my company won't allow that to keep My position. I really should have gotten one leg per year so I had time to recover. Both of them three months apart has really put me down, and it is a struggle to return to normal.
Plus, I am pretty sure I'll be having a revision in February or around there to fix the crooked knee that is still causing trouble.
My life has suddenly changed to possibly not working anymore, and facing another surgery and the uncertainty of all of that.
Also, I am concerned about recovering fully from all of this anyway. I feel my swelling and by overall Lymphatic system in my legs has become angry and giving me trouble.
The whole healing process has been so slow and I often wonder if it is ever going to get back to normal. Hopefully in a few months I will see some light in that area.

 

[Celle]

The old knee is acting like a spoiled brat in my opinion. It's five months old and still acting up and regressing at times.

Your "old" knee is really still only a young child, in terms of this year-long recovery. It had to take on being the "good" knee so early in its own recovery. In those circumstances, I'd act like a spoiled brat, too.
It still needs care and attention. It's telling you "Don't forget about me!"

Also, I am concerned about recovering fully from all of this anyway. I feel my swelling and by overall Lymphatic system in my legs has become angry and giving me trouble.
The whole healing process has been so slow and I often wonder if it is ever going to get back to normal. Hopefully in a few months I will see some light in that area.

You will recover from all this, given time. I know it's hard, but try to look on all this as a temporary bump in the road.

You're probably sick of hearing it, but recovery does take a long time and yours has been a bit more complicated than most. However, time is on your side and it's wonderful what the body can get over, as long as you allow it to take that time.

You sound as if you could do with a hug, so here you are -

 

[Jockette]

Hugs from me, too.

I’m so sorry your replacement has gone this direction and that your job is in jeopardy. Maybe when you really are fully recovered they will have an opening and hire you back.