Revision TKR TKR - Feel like a Failure<

[Celle]

At the six month mark and very discouraged as I had been told by my doctor and other former knee replacement patients that three months was the "end game." Wondering if something is wrong with me. I have great ROM and feel fairly normal when sitting or laying down now but when I stand up to walk the stiffness is overwhelming. I am upset with myself for having this operation - everyone I spoke with was so enthusiastic about their operations. I know everyone is different but don't understand how some people are completely OK by 6-8 weeks. I am worried that I made a decision that will affect me for the rest of my life.

@chrisknee - Your recovery is normal, so please don't feel you're a failure.

Your surgeon has set you up for feeling that way, because he gave you unrealistic expectations. There is no way that three months is the "end game". You've had one of the most major surgeries and no one recovers fast from it. The reality is that recovery from a knee replacement takes at least a full year. Some people take even longer.
It really is a marathon, not a sprint.

I think that many surgeons genuinely don't realise how long recovery can take. They only see you a few times post-op, your knee looks OK to them and they consider their job is done. They have no idea of the day to day grind that is recovery.
Mechanically, your knee joint itself may be recovered (so their job is done) but all your soft tissues are still healing and adjusting and your body's energy is still being sapped by that.

There are very, very few people who are completely OK by 6-8 weeks. They are the exception, not the norm.
The vast majority of us take much, much longer. We struggle and moan, get tired and frustrated, get the blues and have sleepless nights. And how we wish that we could top up our patience from an ATM!

At 6 months, you're only half way through this year-long recovery. There's still plenty of time for your knee to improve. It's still a work in progress, not the finished article, and where you are now is not where you will end up.

Hang in there and remember that

 

[chrisknee]

@Knees4Me - I am hoping that my continuing stiffness is caused by the fact I had two surgeries on the same knee - one in February and a revision in May. The surgeon had to do a lot of "repair work" on the ligaments due to tears caused by an overly aggressive physical therapist after the first surgery. So mine is a little bit of an unusual situation. I totally understand your fear of a second surgery on the same knee having just gone through that.

Visiting this forum has helped me as I too only heard good things about this surgery. Believe me, no one exercised more than me and that actually caused problems. After hearing from folks on this forum to cut back on the PT my pain has definitely improved. It is now more a soreness and the biggest problem remains stiffness. So not exercising did not cause your problems!!

You're right - it wasn't supposed to turn out this way! I am truly hoping you see improvement in the near future and have a good report in January. I know you must be very discouraged having been given such high expectations. This forum is so wonderful in being able to hear and share your experiences with others. I have recommended it to others so they can get a better idea of the true recovery journey!

 

[chrisknee]

Celle - you stated exactly what my husband said about the doctor - mechanically the knee looks fine and that's what they seem to care about. My husband says he cannot tell which knee has been operated on when I walk now - says it is bending normally. I keep thinking I should go back to the doctor because it sure doesn't feel fine to me!
When I fell down the stairs and dislocated my kneecap (which ultimately led to this operation) that was an accident. The decision to have this surgery was mine and it's hard for me to cope with that. Plenty of blues, frustration, etc. I so appreciate this forum and have printed out your reply. Will think "work in progress work in progress" going forward. Thank you.

 

[chrisknee]

Jockette - I too have inner swelling and discomfort when I stand up as you described. I was told at PT that swelling goes away after six months - obviously that is not correct. So many things I was told were not correct! Yes, I will come to the forum more often as it truly is comforting to hear other's experiences. I am glad to hear that I am in the normal range for six months and will consider myself as a "work in progress" per Celle.

 

[Celle]

Another reason why your knee needs to take its time and can't be rushed is because it's had two major surgeries (the PKR and the revision to TKR) one after the other. That's a double whammy, both to your knee and to your entire body. You're a hero, not a failure!

 

[chrisknee]

Thanks Celle!!!!

I see you had a revision to your right knee. Is it a harder recovery with a revision knee replacement than an original knee replacement? My surgeon showed me the revision knee and said the hardware goes up into the bone further. I was wondering if that could be contributing to my stiffness. Thank you.

 

[jaschembra]

...and I sill have some internal swelling at 10 months. It's better, but some of us are more sweller than others.

 

[Celle]

Sometimes it's a harder recovery after a revision, but not always. To a certain extent, I think it depends on what has to be done during the revision. My revision was from a medial compartment PKR to a TKR and actually I found it a little easier than recovering from the original surgery. That was because I waited too long to have the original surgery and my muscles had grown weak and some tendons distorted while I was waiting for surgery.

The longer tibial stem could be contributing to the stiffness, but I couldn't be sure of that.

 

[chrisknee]

Thank you Celle. I hope that a revision surgery can have a successful recovery. Sounds like your revision surgery worked out OK. The surgeon said he gave me a revision knee to improve stability - he felt it was best after the kneecap surgery failed.

FYI to anyone contemplating a knee surgery - only sign surgical authorization papers that indicate the exact procedure to be done. Although my surgeon and I agreed upon a TKR the papers I was given to sign the morning of the surgery had a kneecap replacement as well as a TKR. The surgeon told the nurse and the operating room personnel that we were doing a TKR - I told him not to do the other as I read it had a high failure rate and only wanted to do surgery once. When I work up, he said he felt the kneecap replacement was a better option once he saw the knee. Sure enough, it failed and I was back in surgery in three months. When I went in for the second surgery, I refused to sign the surgical authorization as it listed a kneecap replacement revision as an option. I spoke to the surgeon in the surgical waiting area and made him take that off the authorization. I also made everyone in the area state that they were witnesses and that we were doing a TKR. Who would think this would ever happen but it did. Hoping this might help others learn from my experience.

 

[Jockette]

I remember reading that and I was outraged for you!

I wondered how to avoid that, but didn’t think about reading all through the whole consent form and make them take out anything you refuse to have done. It’s hard to read those forms, they are written in medical and lawyer language. But then I’ve never had surgery where they did something I specifically didn’t want. I will try to remember that.

My surgeon did tell me that once he got inside my knee it would be easy to do a total instead, if the knee was worse than he thought. Believing all the promises of partials I naively hoped that didn’t happen. Now I wish it did.

I’m so sorry you had to go through that. I would have been beyond furious!!!

 

[Josephine]

The longer tibial stem could be contributing to the stiffness, but I couldn't be sure of that.

Not as a rule.

I hope that a revision surgery can have a successful recovery.

Most revisions do!

 

[chrisknee]

Thank you Josephine! I have been worried about the revision and this gives me peace of mind.

 

[Celle]

I wondered how to avoid that, but didn’t think about reading all through the whole consent form and make them take out anything you refuse to have done. It’s hard to read those forms, they are written in medical and lawyer language. But then I’ve never had surgery where they did something I specifically didn’t want. I will try to remember that.

Never sign anything without reading through it all. If you sign before doing that, who knows what you might be giving consent for?
You are also entitled to a thorough verbal explanation of what your surgeon intends to do. That all comes under the definition of "Full and Informed Consent."
CONSENT: what it means and how it can be used

 

[Jockette]

I felt time pressured in the surgeon’s office that day and knew I had to sign it or the surgery wouldn’t happen. I hardly understood the wording. I didn’t know what should or shouldn’t be on the form anyway.

I will be more careful in the future.

 

[Celle]

I hardly understood the wording. I didn’t know what should or shouldn’t be on the form anyway.

And that's why you should be given a full verbal explanation.

 

[chrisknee]

Today I went on the golf course with my husband and friends. Knee is very stiff and sore but it felt wonderful after many months to be out in the beautiful fall weather. I have been so limited in activities and it has really been mentally challenging. I obtained a handicap flag for my golf cart and off we went. I used my walking stick to get to the ball and took a whack as best as I could. Everyone was very encouraging. I still worry if I will continue to improve but remember Celle's words - "I am a work in progress." My golf today wasn't pretty but it represented a significant milestone and, in a way, made me feel more myself than I have for months. Now if I could only ditch the walking stick!!!

 

[SusieShoes]

Well, at least you enjoyed yourself... and you’re one step closer to tossing away that walking stick! The more normal I started to feel, and the more normal I started to live, the more normal my knees started to feel.

 

[Jockette]

Great job on the golf!

I felt like that when I carefully started back to bowling at 12 weeks. I only started bowling in the last 2 years, but I enjoy it. My approach to the line is not like it was before surgery, my balls’s speed is not what it was, nor is my score, but I’m doing it!

 

[chrisknee]

Thanks!!!! I never thought it would feel so good to feel "normal!" Yes, one step closer .... it's been a long haul. I hope to have a walking stick burning ceremony soon!

One of the golfers today is the one who encouraged me to have the TKR operation (and recommended the doctor). She is the one who told me people golf six weeks after surgery and if you have pain after eight weeks something is wrong. I asked her if she was truly OK after 6-8 weeks with no pain or stiffness. She said she didn't remember. So many people on this website have said people don't always remember the real timeline for their recovery. Well, I had my proof today! This person, as well as my doctor, set my expectations way too high. I just keep telling myself "work in progress work in progress."

 

[Celle]

You've come a long way, @chrisknee . It's good to hear that you got out and tried golfing - good for the spirit, as well as for the body!
You still have plenty of time to improve a lot more, too.