Knee Infection* Third time's the charm, I hope

[jboles]

@maryo52 I noticed a few posts back you mentioned that your knee was left in a valgus state after your first TKR. My right TKR is approximately 10 degrees valgus. I’m in the process of getting second opinions and looking at a possible revision. What were your symptoms? Did you have tendon and ligament pain? Before TKR I had knee pain, now the pain is different, was it that way with you? It’s good to hear about your good recovery and to hear that your leg is now straight.

 

[maryo52]

@jboles I had a recurrent effusion (excess joint fluid) which causes stiffness, and I had valgus of 7 degrees which increased over time. I wore a rigid brace all my waking hours. The sensation of the brace masked the stiffness and provided a bit of force opposing that inward bend. The path report on the material they took from my old knee replacement showed plastic particles embedded in bone. That's polyethylene debris, and I wonder if the excess valgus resulted in excessive wear on the polyethylene spacer. It sure looks that way. The mistake I made was choosing a local surgeon who I had heard positive things about. This revision was performed by a top doc who's rather full of himself but my nearly painless recovery has been proof I made the right choice. If I had any idea it would be this easy, I'd have done it sooner. I just assumed another surgery would bring the same amount of misery.

 

[maryo52]

I have a CPM machine coming to the house. My knee feels very stiff. It did in 2010/11. The difference this time is much much less pain. The CPM allows me to gently and slowly move it with minimal inflammation. I'm glad I requested an order for this, and had called around before the surgery to see who had one. Today I was at 2 weeks and met some friends for lunch. I rode in the car, plus sat in the restaurant, with my leg down, so of course there's more swelling. But it was great to be "normal." Plus ice & elevate for the rest of the day!! Every day since surgery has been good.

 

[sistersinhim]

Wow, all I could do at 2 weeks was to walk very slowly in my yard. You are doing fantastic!

 

[jboles]

@maryo52 thank you for your response. I have a second opinion appointment set for April with a doctor at Duke Hospital. They wouldn’t even make the appointment until I was past the one year mark. I also have my 1 year appointment with my original surgeon in 3 weeks. He did a great job on my left knee, but not so much on the right... he does a lot of revisions but I don’t know if I want to even consider letting him try again. I’m hope your stiffness gets better. You’re doing so well for

 

[maryo52]

Living in this small community for 40 years means I have history with just about everyone I deal with. Start with the home health nurse who took out my stitches. We used to work together, and we worked together taking the stitches out. I grabbed the suture ends with the forceps so he could focus on finding where to cut. My outpatient PT went to school with my son. She's the daughter of a lobsterman, went off and got a PhD in physical therapy, came back and set up a private practice. Boy it felt good to just have her hands on my knee and not get pushed. I topped off the morning with a short easy walk in the woods. Two weeks and two days out and actually having a fun recovery. That's what an expert surgeon can do for you

Speaking of which, in an earlier post I described how just before I went into OR, the surgeon had a meltdown, saying he wasn't going to do the surgery because I was "the most difficult patient" he'd had in years (I spent a full 20 minutes being utterly flabbergasted). Yesterday his office called to move my followup appointment and say that he was leaving the practice at Massachusetts General Hospital where's he's been since 2000. He behaved way beyond inappropriately with me, but on the other hand, the incident makes a colorful story. So glad I had the surgery despite that.

 

[Cementless]

@maryo52, are you referring to the OS that just did your recent surgery? I'm speechless.

 

[maryo52]

@Cementless I was speechless as well. It'll be interesting to see him in February. I certainly won't give him anything to get weird over.

Today more progress, 20 minute walk with my dog. The same dog we farmed out during my 2010/11 recovery. I was doing so badly at that time that we kind of forgot about him.

 

[maryo52]

Yesterday I over did a stretch, and then today drove for the first time. I could drive fine, but the knee didn't like it one bit. Each individual ligament advised me of its discontent! I had PT scheduled and went despite trepidation, she focused on other muscles and manual therapy. I guess I had to overdo it once as a reminder. Not fun.

 

[Jockette]

I am so encouraged by how well this recovery is going for you!

 

[maryo52]

@Josephine I had asked you earlier about absorbable stitches. I was curious what might happen. Yesterday I developed new pain, not one pain but several small areas of pain -- mostly medially and inferior to the kneecap. Could this be the inflammatory activity where absorbable sutures went in?

 

[Josephine]

Can you show me where?

 

[maryo52]

Mostly RF2/D (medially), RF2/E (medially), RF2 E (right over tibia), RF2 C (above knee), plus all squares at the D level in back. As I said, little focused areas all over! And new. I'm not worried in the least, just curious. There are other sensations as well which I don't think I noticed with the original TKR because I had so much pain then. It's more entertaining than anything.

 

[Josephine]

Similar to this?

It's possible that you're irritated soft tissues in the areas of the Pes Anserine which is a group of muscles on the medial aspect of the thigh as depicted in the first image.

 

[PegGar16]

Hi @maryo52. I hope you don't mind me asking but where in Maine are you? I grew up doing summers at Sebago Lake and skiing at Sugarloaf

 

[maryo52]

@PegGar16 Most people know where Bar Harbor is. Our island is about 20 miles as the eagle flies from Bar Harbor, a little more south and west. Little Deer Isle. Just love it here.

 

[sistersinhim]

Our island

Are you having any problems with the water freezing around you and not being about to get supplies? With your knee so new, you can't do a lot of traveling, I'm sure.

 

[maryo52]

My island has a bridge to it. Anyhow, the waterways are not frozen as of yet. Usually they don't freeze. I'm pretty much staying put, enjoying snuggling in my "nest" (reading material, ice machine, food, computer, lap blanket).

 

[sistersinhim]

Oh, of course you have a bridge! Blame it on my lack of sleep. Your water must be tidal, so it's always moving. That'll keep it from freezing. But, then again, look at those waterfalls that have frozen!

Staying in is a good place to be. I'm doing the same thing. I'm not used to temps in the teens!

 

[maryo52]

Every milestone in ROM warrants a celebration! I've been out of my immobilizer for 2 weeks, started at 80 degrees and today I'm at 100 degrees!! You just cannot imagine the relief I'm feeling after my trials and tribulations with arthrofibrosis back in 2010. This kind of recovery makes keeping a good attitude easy. My husband "abandoned" me for the day, and it's bitter cold outside, but I couldn't be happier.