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TKR spacer replacement

Discussion in 'Knee Replacement Pre-Op Area' started by Hayden, May 27, 2018.

  1. skigirl

    skigirl FORUM ADVISOR Forum Advisor

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    I had a spacer replacement as well but also a Lysis of Adhesions (removal of scar tissue). I left the morning after surgery, had about 4 or 5 days of pain meds, but then a slower recovery since my OS was adament that if you exercises a hot, swollen knee you caused scar tissue to develop. I took it easy for 8 weeks and then began to work on strengthening my knee. By 8 weeks, I was really doing great, just did not stress the knee until after 8 weeks.
     
  2. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    My first knee surgery was a diagnostic arthroscopy prior to having the replacement. I worked with the surgeon so asked him over coffee, how long I'd need to take off and would one week do it. He looked astonished and said "Hardly! You'll probably need more like 6 weeks off". And he was right - I did!
     
  3. Hayden

    Hayden new member
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    It's a work related injury so I'm being told by work I should be back after a week off they will accommodate me. I don't think my doctor will agree my surgery is the 26 post opp check up is the 9th of july
     
  4. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    @Hayden Are you having a spacer replacement, or a revision TKR? I'm confused due to your signature and your original post in the thread.
     
  5. Celle

    Celle FORUM ADVISOR Forum Advisor

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    A spacer replacement is a revision of the original TKR, as the knee has to be opened up again.
    However, recovery should be a bit faster than a total revision of all the hardware - but you won't be fit to go back to work in a week..
     
  6. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    @Celle I had a spacer replacement and it does require opening up the knee again, but it's not technically a revision. That's why I was confused.
     
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  7. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I think we do class them as a revision here on BoneSmart.
     
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  8. Hayden

    Hayden new member
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    My doctor said arthroscopy was not needed and would just make the process take longer but he did class the spacer replacement as a revision. The only problem is hes not sure if there's any damages to the metal components but he said they looked intact in the x-rays. He also said he would have no choice but replace them if he found damage once he opens the knee. He is also going to remove a significant amount of scar tissue
     
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  9. Celle

    Celle FORUM ADVISOR Forum Advisor

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    After my spacer broke, I unavoidably had to wait several weeks for a replacement.
    During that time, without the spacer to protect them, the metal components of the replacement were articulating against each other, even though I was only partially weight-bearing.
    That had caused some damage, resulting in metal fragments being worn off, so I had to have all the replacements hardware removed.

    I'm glad your surgeon has warned you that could be a possibility, @Hayden .
     
  10. Hayden

    Hayden new member
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    I just set up a time for my post opp therapy equipment but got a letter from workmen's comp stating that I do not need a vascutherm cold compression or dvt prophylaxis dme that I am to start immediate weight bearing and return to work
     
  11. Celle

    Celle FORUM ADVISOR Forum Advisor

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    You can still ice your knee without a machine - see this article:
    Ice to control pain and swelling

    You'll probably be given TEDs compression stockings in hospital, to prevent DVTs.

    As for returning to work - you'll need your surgeon's recommendation on that. Since you will have a wound (the surgeon will open up your incision again) when you return to work should be a negotiable matter. There's no reason why you shouldn't start weight-bearing and walking before you leave hospital, but you won't be fit for work at that stage.
     
  12. Cbdynamo

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    Just joined the page because I’m in the same boat, and am very curious how your surgery went. Hoping you did not rush the return to work. That Workman’s Comp suggestion had me worried ..

    Hope it’s all worked out well for you. My new knee 6/2018 has NOT been a ripping success.
    Swollen, painful and replacement spacer has been mentioned.
    Not happy.
    Claudia
     
  13. skigirl

    skigirl FORUM ADVISOR Forum Advisor

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    I had what is called an "Open Lysis of Adhesions and a Spacer Exchange". Basically my knee was opened along the old scar line. The doctor removed extensive scar tissue and put in a slightly larger spacer. I had pain for three or four days and then just the boredom of yet another recovery!!

    My doctor stressed that if I exercised a hot, inflamed knee I would cause more scar tissue to form---especially since I had already had a large amount of scar tissue. So, for the first two weeks, I just stayed home on the couch with my knee elevated and iced. I did a few heel slides and some leg lifts, but that was about it. He told me if I do any activity that increases the swelling, I was to put ice on it immediately until the swelling went down.

    At three weeks, I began formal PT, but my PT agreed with my doctor. His advice, we will go very slowly until 8 or 10 weeks. If the scar tissue reforms, at least we will know that we did everything we could to prevent it.

    If I had limited insurance coverage for PT, I might have waited another week or two to even start it.

    We did only table exercises---leg lifts, clam shells, heel slides for another two weeks--no weight bearing exercise at all. I did ride the bike for 15 min prior to PT. If we did anything that made the knee warm, we stopped and iced it.

    I was so impatient!!! I hated the forced inactivity, but I was determined to give the knee the best chance I could give it. We started light exercise at 8 weeks. step ups---very small lift. bike for 20 min. no squats or serious weight on any machine.

    I am now three years out from that surgery. I have some scar tissue there, but it does not impair my movement like it did prior to surgery. I have pretty good rom---138. Most of all, my knee is much more stable with the bigger spacer. My doctor told me that since the knee was moving a little too much with the first spacer, that alone might have caused some of the scar tissue. Am I glad I did it? Yes.

    The biggest hassle was the slow recovery. The pain was really nothing compared to a TKR.
     
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  14. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Don't worry - we don't have that in the UK!
     
  15. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi, Claudia, Welcome to Bonesmart! I’m sorry you are disappointed with your replacement. Mine isn’t great, either.

    How about starting a thread of your own, on the Recovery forum, so we can get to know you better and offer you some personal guidance. If you need help doing that, post here and we’ll help.
     

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