Revision TKR Tibia fracture after TKR

[Layla]

Instead, it’s a new day, a new year and I look forward to it all.

That's a great attitude! You have been through a lot and I am sorry for that, these past months had to be difficult, but thankfully things are going well this time around and I pray you experience complete and perfect healing in the New Year. Thanks for sharing your journey with us!

 

[Jamie]

I completely agree with you, @BoningUp. Things can happen even with the best surgeons. It does sound like you did research before having the surgery and sometimes even that isn’t enough. Surgeons are human, after all, and having a problem after a joint replacement doesn’t necessarily mean that there is something wrong with the doctor. Searching out experience is so important when a revision is needed, though. I’m just happy that you’re finally seeing some good times ahead for you and your knee. You are wise to look forward and not try to analyze what may have happened. All the best to you as you recover in this brand new year.

 

[BoningUp]

@Layla Thank you for listening to me, for supporting me and for advising me on this journey. I owe you and this forum a debt of gratitude.

 

[BoningUp]

@Jamie Yes! Hope is everything. Thank you for your wise words and encouragement!

 

[Layla]

Hello and Happy 2024 and Happy One Month Anniversary!
It's been a month since the revision surgery and I hope it's been a good month.
Hopefully you're healing well and feeling stronger week by week.
We'd love to hear from you one day if you are the time.
Wishing you only the best!
@BoningUp

 

[BoningUp]

Hi @Layla! Happy, healthy New Year! Thank you for checking in. I think I’m doing ok. I say think because I still have daily pain that gets worse at night. I’m walking ok. I have a limp though that I hope PT will help alleviate. The revision leg is def longer than the nonsurgical leg. This puts a lot of strain on my already bad back and hips.
Because of this I’m can’t say I’m entirely thrilled with the outcome thus far, but it’s perhaps too early to tell. I don’t have even a quarter as much pain this time around as I had every day since the first surgery. So that’s a big win.
I’m being extremely careful. I can walk without an assistive device since Day 1, tbh.
It took me more than 6 weeks to go from a walker to a cane the first time around. It’s just a completely different experience. I think I’ve lost some of my confidence. I’m not sure that’s the right word for how I feel. I’ve become very cautious and afraid of things I hadn’t been afraid of before. Hard to explain. I hope I get my mojo, for lack of a better word, back soon.
Thank you for asking. If I complained a lot in this response, forgive me. I don’t know what to expect during this recovery. I know everyone is different and every surgery is different, so I’m just taking it one day at a time.

 

[Jamie]

I’m glad to hear your recovery is going pretty well so far. It’s normal to have pain in these early months of recovery, but just be sure you’re taking something for it if it is more than just mild discomfort. Two extra strength Tylenol can do wonders if taken on a regular schedule (providing you are able to take Tylenol).

I am concerned about your limping, though. This is not good and it’s something your therapist should have talked with you about. Any time you cannot walk with a good strong stride and are instead limping or hopping when you walk, you need to use a walking aid. Walking with a limp is not walking and doing this since Day 1 is at the heart of what you’re experiencing. Limping puts your body off balance and alignment suffers. This is likely causing your hips to tilt and then you feel as though you have a leg length problem. Or another reason for this problem is when you’ve had one TKR and your other knee is in bad shape as well. Limping, as you’ve found out, is very bad for your back and hips as well. Ask your therapist for some gait analysis and do use either a walker or cane until you have that smooth stride back when walking.

 

[BoningUp]

Thank you, @Jamie. Your response is very helpful. I am very concerned about the limp myself. It feels like the surgical leg is uncomfortably longer the other one. My PT said he can’t take accurate measurements yet because of the swelling and lack of range of motion.
I responded that when the leg is at it full length with no swelling, it might be even longer! This doesn’t make me happy. I know that the surgical leg was slightly longer after the first surgery. I read that it might be even longer after a revision. Ugh! And, ye, the other knee needs to be done too. It’s the same degree of bone on bone arthritis as the surgical knee.
In fact, I chose that knee ( right) to be operated on first. I canceled that surgery out of fear and when I booked it a second time, I asked the first surgeon if I could switch knees because I had a meniscus tear on the left knee. He said it wouldn’t matter because both knees are equally bad. That’s how I ended up doing the left knee first. Both the original surgeon and the revision surgeon said it’s possible that having had one knee done could improve the other knee enough to not have surgery.
If that’s the case, I don’t want to be uneven. I did a very unscientific measure, standing on one leg at a time, pencil skimming my head to mark the wall, like one does with a little kid to chart their growth, and the difference was about 1 1/3 inches. I looked that up and it’s A LOT!!! Unscientific, I reiterate, but now I’m so scared of everything and seem to be looking on the dark side of things, the discrepancy, albeit, likely inaccurate, depresses me. I will work with my PT on my gait. Limping is not walking. Wow! That hit me in a way I hadn’t considered. I doubt, from the pain I have in the no surgical knee, that I will get away without having it replaced. If so, I hope that fixes the discrepancy in length. But I am SO SCARED to do this again!!! More kvetching and word vomit. Sorry. And thank you again for your comment. It is very helpful and gives me a lot to think about and act on.

 

[Jamie]

I’m glad my comments helped give you some things to consider and discuss with your surgeon. Since you do need surgery in your other knee, it may be best to have that done before long. It frequently happens that a bone on bone knee can cause that leg to be a bit shorter than a normal joint. Once you restore the joint, you could have a better balance between the two.

Don’t hesitate to ask questions if something pops up. We’re here to support you. And try not to worry about this last surgery. You are VERY early in the recovery process and lots can change as you get back to normal with that leg.

 

[Layla]

You aren't complaining, so no worries. You were responding with an honest account of your progress and we appreciate that. Although "more kvetching and word vomit" made me chuckle.

I see you received some useful advice from, Jamie. I feel for you in your apprehension because it's understandable considering all you've been through. Don't hesitate to come here and vent if you feel the need. We're here for support always. I wish you luck working with your PT on gait, please keep us posted on your progress. All the best to you!
@BoningUp

 

[BoningUp]

@Jamie,

Thank you! Yes, I hope that my legs will be more even after TKR of the right knee.

Thank you for all your help and support!

 

[BoningUp]

@Layla,

Glad you got a chuckle from my description of my wordy response. And, thank you for your support and advice! I often try to soldier on, but leaning on people on this site has been extremely helpful, especially in my dark hours when I beat myself up for not progressing as quickly as I think I should. Thank you again for your kind words and support.

 

[eaglemom]

I just had another thought - your shoes. Are you wearing the same shoes you wore prior to the revision? Clearly your gait is different now, but it could be possible that your shoe (s) are playing a role. If you think about it, they have been 'worn' with your gait totally different than it is now. This is just a thought.

Of course also, you are very early on in the healing process. Try to not panic and simply let your body heal. (I know, much easier said than done.)

 

[BoningUp]

@eaglemom Hi! I notice the leg discrepancy in shoes and barefoot. I’m always barefoot in my house. Besides limping, I kinda bop. Up and down and up and down, like a cartoon character walking. My PT suggested I wear a shoe on my right, non surgical leg and go barefoot on my surgical leg. I don’t like that idea because I feel even more unstable. I limp less noticeably when I use the cane. I notice the discrepancy when I’m sitting too. It’s a weird feeling, disconcerting. I think/hope the exercises will alleviate it. My PT says I might have to wear an orthotic in my non surgical leg but that it’s still too early to tell.

Yes! I need to stay calm and allow myself to heal. It is easier said than done. I know you know!

Thank you, as always, for your help and support.

 

[mendogal]

Hang in there!!!!

Hey.... Did you/can you show your PT how you bop? Just in case its a matter of your hips/pelvis skewing so one side is hitched up or - what I did for a while many years ago - instead of using normal muscles to initiate gait (glutes) on one side only I had started firing my low back muscle (quadratus lumborum) - a very ineffective way to walk but it DID give me a noticeable hitch and bop!

 

[sistersinhim]

I was in a cast after breaking my foot/ankle. When I could finally weight-bear, I had to get a lift for my other shoe because the cast made my foot higher which hurt my back and hip. It was the same when I was in the boot for another 4 weeks. The lift really helped me. You might give it a try.

 

[BoningUp]

@mendogal Thank you! I think I walk weird anyway. I blame my back which has been bad since birth. I never bopped before though! I will take your comments with me to my PT tomorrow and have him assess my gait. Thank you again! Have a good night!

 

[BoningUp]

@sistersinhim Oof! I broke my foot a number of years ago and wore a boot for eight weeks. No fun. I will wear an orthotic, for sure, if it will help. I guess I’ll have to get accustomed to wearing shoes at all times, if it comes to that. I hope that PT will help and so will getting my other knee done. Idk. I’m just frustrated. I got my knee done for the obvious reason of bettering my life. I feel somewhat cheated out of that. I know I’m still early in the recovery process. I hope it gets better every day. Thank you for your support and for sharing your story. It def helps!

 

[Jamie]

You are not alone….patience is the most difficult part of recovery for most people. It’s tough, because we’ve been through so much with a bad joint, had major surgery, and just feel things should get better fairly quickly. But it does take time. Remember your body was all aligned and functioning in its own way prior to surgery. Then all at once, your surgeon put your leg in normal alignment as far as the bones go. But, all the soft tissues around your joint and throughout your body can’t react that fast. Even though the surgeon does a lot of balancing with the area immediately around your knee, the whole rest of your body must learn to work with the new joint, stretch or contract to adjust to your new alignment, and generally adapt to the new you. This can take time. Give your body some grace and it will reward you with better function in the end. It’s really a time to listen to any signals your body is giving you that it needs more time and possibly more support from walking aids to get through this “remodeling” phase. Please don’t feel cheated. Be happy that in today’s work of orthopedic medicine it is actually possible to have bad joints replaced so that you can get a normal life back.

 

[BoningUp]

@Jamie If I embroidered, I’d embroider your encouraging and explanatory message on a sampler and hang it in my bedroom. I’m great at giving everyone else grace, just not myself. Time is my enemy. I’m so impatient. Yes, thank goodness joints can be fixed. I have to remember what my body has been through and understand there’s a time element to healing and also that healing is a journey. I do have good days, positive ones, and bad ones too. All are ok. I’m off to PT. Thank you for your encouragement!