Revision TKR TKR 8 months later<

[Celle]

I'm glad to hear that the revision has gone well.
If your wife is feeling exhausted after her PT sessions, they are probably too long. It might be kinder to her new knee if the therapists cut back a bit.
You see, it's not exercising that gets the knee its ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. The ROM is there right from the start, just waiting for all that to happen so it can show itself.
Here's an article worth considering: BoneSmart philosophy for sensible post op therapy

And here is some additional reading for you and your wife-
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist (PT) - to do it to you. exercise only gently
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lie down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

So that we can see it at the bottom of every post you make, and thus advise you appropriately, please will you alter the Signature, to add your wife's revision surgery and its date in full? Write the name of the month, so there’s no confusion.
Hover over your username, top right of the page, and select Signature from the drop-down box. Enter your surgery details and then save. This article also explains how to do it:
How to create a signature
If you can’t do it, please let us know, so that we can do it for you. Thank you.

Best wishes to both of you.

 

[Josephine]

Oh gosh - it's so positive when the patient reports less pain from from the get-go! I feel this will be a really good turning point for her. However, I agree with Celle. She is doing too much PT and should cut back a lot ! I know (suspect) that they are all panicking about adhesions but I've never known that to really be a problem just because it's a revision. What is much more likely if they work her too hard is that there will be excessive swelling that will block the ROM and which they will then blame on adhesions!

 

[LTKR4Xmas]

Great uodate!! I pray the problem has been solved!

 

[larryo]

Update 2!
Sorry for the delay in reporting back. I wanted to make sure there were no more surprises.
As I stated earlier, my wife had revision TKR on 17 Jan 2017.
After a couple of interim visits to the PA and finally, this week, the 10 week visit with the surgeon, she has the "all clear" to do anything (with moderation).
The details behind all this are:

• They finally admitted that they waited longer than they should have to do the revision surgery
• They claim that the reason the first device failed was because my Wife has "loose Ligaments" (which she does in fact have)
  
• The device they put in this time is a Vangard Biomet SSK knee revision system (from what I understand this device has a stem in both the Tibia and the Femur whereas the original device only had a stem in the Tibia. But this understanding came from reading the manufacturer's data online, not from a Dr's explanation)
• Recovery and PT went well.
• About 5 weeks into recovery, she noticed a localized swelling, almost looking like a pimple just above the kneecap. After a week, she contacted the PA and was asked to come into the office. They put antibiotic cream and a band aid on the area. A week later, nothing had changed and the swelling had become very painful to the touch. We went back to the PA and she decided to make a small incision on top of the swelling. She then proceeded to use tweezers to pull an inch long object from the incision. Turns out it was a piece of suture. The type of suture used inside the leg that was supposed to have dissolved by the body. The PA said she had never seen this before.
• After that we have not experienced any more problems.

My wife is now using a cane around the house and only uses the walker if we go out and have a large distance to walk.

Thanks for all the advice we received fro this group.
I expect within the next year or so she will have the left knee done.
Regards
Larry

 

[sistersinhim]

It sounds like your wife is doing really well. Thank you for the update. BoneSmart is the best place to be for a joint recovery!

 

[speccybecky]

That happened to me. I had a spot with a tiny white pus drop which eventually went to a small hole which everyone agreed was 'clean' and when they had a deeper look it was a knot of stitch. Nurse removed it and it healed nicely with no more problems

 

[sistersinhim]

Internal stitches not dissolving and moving upward are not that uncommon. Normally, they don't cause any long term problems and can easily be pulled out. I am glad both of you had no problems with yours.

 

[newlybionic]

I'm very happy to hear her revision has gone so well. I had a revision 8 months post op on my left knee and I did very well with it too.

 

[Josephine]

She then proceeded to use tweezers to pull an inch long object from the incision. Turns out it was a piece of suture. The type of suture used inside the leg that was supposed to have dissolved by the body. The PA said she had never seen this before.

I don't believe her! I've seen it happen scores of times! It's very very common. You can read this which has been in the Forum Library since 2009!
Closing surgical wounds: how is it done?

 

[larryo]

Hello all, I apologize for not posting earlier, but it has slipped my mind until now (I seem to forget more and more as I age )
It’s been a year since my wife had her knee revision surgery. This time the surgery was more successful than the original, but after a year, she still has pain and swelling in the knee and shin areas.
She went to the Surgeon’s office for the one year checkup and he says the joint is stable and she has a good range of motion. We asked if a pain or steroid shot in the area would help and he said no. In other words, in his mind, he’s done.
Her pain is around the kneecap and just below the joint. It’s painful when she walks and painful when she presses a finger on the affected areas. The swelling is not severe, but noticeable when you compare it with the knee that hasn’t had surgery.
The Dr. can’t ( or won’t) explain why she still has the pain that she has.
She can walk around the house without the cane, but if we go anywhere that requires significant walking, she has to use her walker or her electric scooter.
I guess my question is, is this common or out of the ordinary?
How long should it be before the pain and swelling goes away and/ or should we seek advice from a different Doctor?
Thanks for any comments.

 

[sistersinhim]

I am not painfree either. I also, have pain below the joint in the upper tibia. If I'm in a crowd, I still use a cane. I think your wife's previous surgeries, if any, would have a lot to do with pain now. If your wife's not happy, she can always go for a second opinion.