Revision TKR Third and final surgery all done

[kayow11]

Thanks @sistersinhim, for your input.
That is my main plan, mostly ADLs, listening to my knee, and paying attention to how it responds also. I have a better plan now for this knee, and hopefully I will achieve better ROM eventually.
That is one of my biggest concerns, since 90 some degrees of flexion does limit function, and causes pain with many activities.
@liam2015, reminded me to keep moving, and that was good since I can be an all, or closer to none, kind of person if I can't achieve my goals or sense some irritation.
I did keep my PT eval appt today, and the PT was actually real helpful in helping me to keep things in perspective. I can still do things, just limit them, including PT.
I do feel more hopeful and have a plan, with all of the helpful advice from several of you. It seems that postop symptoms along with Oxycodone can confuse and scramble clear thinking.

 

[SusieShoes]

Post-op and on meds is a recipe for confused thinking. It helps to have supportive others to help keep things in perspective.

Your plan is a good one! Listen to your knee. It will want to move; movement is good for knees. Just what it likes and take things slowly. I’m glad your PT is helpful for those s.

 

[kayow11]

I posted something similar to this on another person's site just to give her some additional information of something that has helped me. But I will mention it here also.

Both of my physicians mentioned that this can be helpful too, wearing an ace wrap, approximately 6inches wide, wrapping diagonally, and not too tightly wrapped, starting just below the knee, and moving upward a few inches above the knee, has been very helpful in adding a little more compression to the swelled knee joint. It definitely has decreased my knee pain by decreasing swelling and helped me to feel much better.

If my knee starts to ache more after this, I know I have wrapped it too tightly and then just loosen it some. I also have worn knee hi Ted stockings for the first 2-3 weeks, and then after that wear a thigh high compression stocking instead, to also add to this compression and decrease overall leg swelling. That also has helped a lot.

Maybe someone else will find this information helpful for them to try.

 

[kayow11]

@Jamie, I still feel grateful about the info you gave me regarding revision specialists. I did choose Kris Breien from Summit orthopedics and so far I feel pretty darn good. Much less pain than after the other two surgeries, practically no bruising, and much less swelling, and my leg is straight !!!! I still am convinced the Hemovac helped immensely, too.
I feel hopeful and as if I am on the other side of misery and uncertainty, and not looking forward to doom and gloom these days. I feel my life can actually go on now.
My biggest concern though is range of motion which is only about 75° but it is only 13 days postop. My 10-month-old knee isn't quite 100° yet either so this is a problem. But it still could come as that swelling goes down to. I sure hope so because it's limiting functionally.
I am feeling thankful, and thank you all for your prayers for my surgery and healing.

 

[mlwreader]

Hi @kayow11 I had a not very happy outcome using an ace bandage for a different reason (not to keep down swelling) - my stitches were oozing, and my doctor's nurse told me to apply bandaids and then wrap with an ace bandage to prevent the stitches from breaking open when I was out and about. The ace bandage cause an incredible allergic reaction - I developed such an itchy rash I could not believe it. I have very sensitive skin apparently and you can read about my stitch journey on my thread, but just wanted to mention that early on stitches can be very sensitive for some folks.

 

[Jockette]

As much as wrapping the knee, tubigrip and compression stockings has helped others, I never wanted anything wrapped around my knee this early in recovery. I still don’t at a year. But that’s just me, we are all different.

As my uncle likes to say, that’s why there’s chocolate and vanilla!

 

[kneeper]

Sounds like you're doing well. You asked about exercises a while back. I mostly did a few heel slides each day (spread out over the day) but not as many as they had on the PT sheet. Maybe 5 at a time in 2-3 "sessions" kind of casually over the day. Walking around the house a little bit to start, then graduating to outside for short increments.

 

[kayow11]

I posted something similar to this on another person's site just to give her some additional information of something that has helped me. But I will mention it here also.

Both of my physicians mentioned that this can be helpful too, wearing an ace wrap, approximately 6inches wide, wrapping diagonally, and not too tightly wrapped, starting just below the knee, and moving upward a few inches above the knee, has been very helpful in adding a little more compression to the swelled knee joint. It definitely has decreased my knee pain by decreasing swelling and helped me to feel much better.

If my knee starts to ache more after this, I know I have wrapped it too tightly and then just loosen it some. I also have worn knee hi Ted stockings for the first 2-3 weeks, and then after that wear a thigh high compression stocking instead, to also add to this compression and decrease overall leg swelling. That also has helped a lot.

I did not have stitches with any of my knee surgeries, I assume a type of glue or Dermabond. Also, I am used to wearing compression stockings since have been wearing them for several years likely due to some lymphatic issues. The compression feels so good to me, but with staples or an oozing incision, I can see how it would cause more problems.

Maybe someone else will find this information helpful for them.

 

[kayow11]

I had my first post-op with my surgeons PA today. Day 17!

Overall I feel I am doing fairly well. Got another refill on my Oxycodone. PA said they are not concerned with addiction problems until 8-10 weeks in. I am so thankful I don't have to fight with them regarding pain meds.

Told him I am getting more hip pain, deep inside, the last few days. He explained what they had to do during the revision, with the pounding, etc. and feels it should improve at the 4-6 week point.

Of course he mentioned a few times how important it is to work on my bend since it is probably 75-80 degrees at most. I am somewhat concerned about that also since neither knee has gotten to 100 yet. Have some of you been in the same boat at this point with ROM?

I also showed him my 10 month old knee that is still stiff, and squishy from edema. He wants the surgeon to look at it in 4 weeks when I see him.
The PA said I am walking around on 2 flat tires. That is a good analogy. That knee has not changed or improved in many months.
I don't want to start worrying about that knee now, but it has been an issue all along. I just pray it starts showing some improvement since the other leg is straight and putting less strain on it.

 

[SusieShoes]

Your report sounds very postive overall. Of course you’d like to see more flexion, but it’s still early days and you have every reason to believe that will improve. At two weeks it’s usual to have less flexion than even right after surgery.

The flat tires analogy made me laugh. It is rather on target!

 

[kayow11]

@SusieShoes, yes it does seem like more swelling and stiffness sets in for at least 2-3 weeks after surgery, limiting flexion.

But, have you seen here that some have had flexion of just less than 100 degrees at 10 months out, along with continued swelling, and still improve a lot more I.e. Up to 120 degrees in the following 6 months?

 

[Celle]

Of course he mentioned a few times how important it is to work on my bend since it is probably 75-80 degrees at most. I am somewhat concerned about that also since neither knee has gotten to 100 yet. Have some of you been in the same boat at this point with ROM?

75-80 degrees at only 17 days post-op isn't a worry - it's a great ROM for so early.
Most surgeons don't expect 90 degrees until about 6 weeks, so you're well on the way towards that.

You have plenty of time to achieve ROM. There's no need to rush, because ROM can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

There are plenty of people who had a slow ROM development and who ended up with good results. her are a couple of examples:
This is from bertschb.

I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.​

And this one is from Campervan:
As you can see, her flexion continued to improve for a long time.

"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "
​

By the way, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[kayow11]

@Celle, Thanks for sending those examples of other bone smarties.
I am not so concerned about my newest knee which I do think is coming along decent. But my first knee that is 10 months old is still less than 100°.
It Still has swelling and has pockets of squishyness, and the PA remarked today as I posted earlier, that he thought this was not normal.
Even the examples you posted, are way better than mine have ever been. My ROM and swelling has not changed in 6 months.
So that is a concern for me, but my focus now is the new knee. Maybe my first one will start improving now that it is under less strain. I will give it some time, and then assess.

 

[jboles]

My left knee was 6 months old when I had my right knee done. Lefty was to the point in recovery that I hardly ever thought about it any longer, but after taking the brunt of the work during the first month of recovery on the right knee, it has let me know that it needs a little TLC occasionally. Maybe that will be the case with you, once both knees are able to do their fair share, maybe they will both start to get better. At least, that's my hope.

 

[kayow11]

@jboles, that is my hope and prayer, that now with both knees "recovering", that the bending part of my rehab will finally improve.
I know others here have felt their bending was slow, and then kept increasing, but mine has never gotten to a decent point ever, and has really lagged way behind in general, right from the start. When I have compared their posted ROM and slow but deliberate progression, I wished I could have had ROM even close to theirs.

I am happy thus far though with how much less pain this last knee (revision) has been. I really think I may be able to get off the drugs sooner than the other 2 times.

I have iced the oldest knee 10 month old, elevated it, ace wrapped it, nothing so far has changed its condition. I do believe it could bend closer to normal if not for the swelling.
Time will tell. I am just so happy I have a good surgeon who was able to undo, and redo a mistake, with great success. At least I have trust in him, to take good care of me with my 2 "bionic" knees.

 

[kayow11]

Hello Bonesmart friends!
I have been posting on another persons site and trying to encourage her since she is just about nine days fresher than me, and having many varied issues. It feels good to be able to help others when I have been at this for so long myself, and still going through it. The distraction is good for me.
As I said on her site, I am very sick of this convalescing for the past 10 months. Three surgeries in that amount of time is crazy! But I had to get that crooked leg fixed. I am thankful that so far things are going OK. Plan to start weaning off the oxycodone next week. I am 4 1/2 weeks out now. Have been having back issues too, which really complicates my condition. So my poor new knee is taking a backseat and not liking it.
My range of motion in flexion is continually poor. It seems to stay about the same right now, 70-80 degrees. Of course it's still swollen inside so that hopefully is the main reason.
I will be seeing my surgeon in less than two weeks now. So far have only seen the PA. I know he won't like that I haven't been doing regular PT, and I may get the reminder of the scar tissue lecture, and how I need to get my range in the first two months or I likely won't get anymore after that. I am going once every two weeks, so have only been there twice and will go next week one time.
Whenever I go, I feel flared up for a couple days at least. I know I don't have to go at all and may completely quit at some point. But the icing and elevating at home doesn't seem to change the condition of my knee and it's limited motion.
The weather is finally starting to get nicer in Minnesota here, so hope to get out and see the sun and enjoy being on my deck and getting some fresh air.
Currently I am walking 15 minutes every day with my cane, and doing some household chores, and cooking and some other standing stuff. I hope it's not too much because I feel I can do it, but maybe it is overkill and that is why I'm not bending better.
I don't like to wish my life away, but I am waiting till fall when this last knee is six months old. I sure hope to feel a lot better than I do now, physically and mentally.
I don't have the stress of work or finances so I feel very blessed and fortunate because of that alone.
If I could, I would really be working my body and legs to get better faster, but I have tried that route somewhat, and it always back fires on me and shows me who is boss. I pay for it for many days. So I am stuck going at the pace of a snail and resenting it.
I have also gained 10 pounds during this time too. Not good for my body, but I just need to stop shoveling so much in. Not really much overweight but any extra isn't good for anything.
Just thought I would give a personal update. My faith in the Lord has helped my mind to feel Less despondent about my situation.
Any thoughts would be appreciated.

 

[Celle]

You have been through a lot in the past year and I understand how tired you must be of this recovery time. It's an ordeal for everyone, but you've had more to contend with than most people.

All I can say - and I realise you're sick of hearing it - is be as patient as you can and let time do its healing work. Easy to say, but hard to do, I know!

Your last TKR is still very new and you're still in the "angry tissue" stage. I hope it settles down again soon and that your back soon stops hurting as well.

70-80 degrees of flexion at 4+ weeks isn't too bad. There's plenty of time for improvement.
If you can, try not to discuss PT with your surgeon. Don't mention it unless he does, and try to ignore any lectures about the window of opportunity. You know it doesn't exist, and ROM can continue to improve for a year, or even longer.
What's important is that you are listening to your knee and doing what it tells you feels right for it.

Hang in there -

 

[Jockette]

You are coming along very well! The wise thing to do is to accept the knee’s dictation for how it’s recovery goes, and you are doing just that!

I’ve read your posts of encouragement and commiseration to others and I am so impressed with what you say. You have come so far since your first replacement. You have had a difficult time with your recoveries but you are using that in a wonderful way to encourage others, as well as accept this third recovery in its own right. Bravo to you!

You also have a disappointing job/recovery experience so you have good insights on advice about that.

Best wishes as you continue to recover and reach out to others to help them through their recovery.

 

[kayow11]

@Celle, @Jockette, you two lovely people, along with some others, have been such an encouragement to me! I love to hear the facts, for others to share their stories, and yet to show patience, especially when having to repeat things.

I won't bring up PT when I see my OS, but I know he will. I am so thankful I don't have to "obey" what someone else deems as a requirement to be entitled to this or that. I also know how my knee reacts to most activity, and forcing it to bend just flares it up for days. Also I seem to need reminding about my ROM that majorly lags behind, and to not let that lack rule my thoughts.

I am happy that I'm at a point where I can share, and hopefully inform/encourage others with their problems, since I have had so many of my own.

As an example, yesterday I went out to do a little shopping with my spouse, using my cane, sitting to rest at every opportunity, did walk at home 15 min., and probably was on my feet more than usual, didn't ice and elevate much, and it felt not too bad.
But last night when trying to sleep, I could tell it was a bit more aggravated, especially when I tried to lay on my side with a super soft pillow between my knees for a position change, and it was just aching too much. I realized it was from yesterday's activities, which were just too much this early, even though I could do them. My knees are notorious for this!
Now today I have to back off and rest/ice more to recover. I do get so frustrated!

I am a very goal oriented person, who normally gets a lot done in a day, lives by my organized lists, and gets a lot of joy from accomplishing tasks. I have had to give in, and resign myself to very minor achievements.

But I do feel somewhat relieved in that I feel I can look forward, instead of looking uphill. My leg is STRAIGHT, I have much less other symptoms from misalignment, the work/disability situation is resolved, and now just to focus on healing, so I can get back to normal life.

 

[Jockette]

Since you are a list person, write resting on your to-do list so you can cross it off, that might make you feel more accomplished.

Because resting is an accomplishment, it’s giving your knee time to recoup from an activity allowing it to heal without over stressing it. It is NOT “doing nothing. “