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TKR TRKR 10/13/23 - Moving Forward with Many Detours

Got a late start today. Feels good not to rush.

Yesterday turned out differently as it was cold and windy, @Layla and @Jockette. After driving a bit, then parking and taking a few pictures, I abandoned plans and got back into my car with heat. That can wait. I had asked months ago to garner interest, no one replied, so maybe when it's warmer outside.

Thank you for the suggestion @sistersinhim. My knee was a bit stiff and numb on the lateral side where it was cut. Never had gait issues. You mean the recent procedure for scar tissue removal? I'm curious and shall do that tomorrow.

I've not had PT for my back @Jamie and made an appointment for a visit with my surgeon tomorrow afternoon as I'll be in the building. I told him it's to check my gait, which is true, since I hesitate when lifting my right leg. This will give me information for Wednesday's appointment.

Just checked the page you suggested @EalingGran and saw many videos. I'm sure some will help me and thank you for pointing me in that direction.

Despite telling myself not to, I read the radiologist's interpretation of the images and learned some of what is causing the tingling and leg pain. You're right, it may not be from my knee at all:

L3-L4: A circumferential disc bulge is noted. This causes mild narrowing at the origin of the right foramen with contact on the exiting nerve root. There is mild narrowing at the origin of the left foramen with contact on the exiting nerve root. Degenerative facet joint arthritis is seen as is intraosseous lesion in the anterior margin of the L5 vertebra.

Enjoy Sunday. :whistle:
 
Hi, it's been a long day. Good news is I have a job interview for a part-time position that's mostly remote. It's with an educational company, and I'm excited about the possibilities plus working remotely.

Please help me not panic. I have good things coming up and want to feel better. Today I saw my surgeon and asked why I have pain on the lateral side of my knee near my IT band and in my quad. He told me my knee will never be 100%, and I told him many people I know who had knee replacements have no pain and were back to their activities within three to six months. He also checked to make sure it was tracking properly and asked to see me walk. I'm confused about additional pain that I feel when getting out of the car - swing my legs onto the pavement, then get up - and going down steps (have to do this to exit the garage). The MRI said patellar tendonosis, which is different from tendonitis; the lateral/IT band pain is new. I'm sorry if I asked this earlier. It's distracting as getting into and out of the car was not painful. Might the knee pain be from the patellar tendon that was aggravated by the physical therapist? That was at the beginning of January. Thank you.
 
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Time to relax and rest after a long day, dubloosh. I wish you the best with your upcoming job interview!
How exciting.

Your surgeon is right, our prosthetic joint will never match out natural joint. However, it can still be strong, functional and pain free which is normally an improvement over the worn out joint it replaced. The goal shouldn't be perfection, but instead better mobility, less pain and the return to the previously active life we had before the deterioration began.

I am wondering what your surgeon had to say about the pain you described and also wondering about his response to others you know returning to their activities within three to six months post op? Did he have any suggestions for you?

As far as the new pain, if it were me, I'd ice / elevate, take OTC pain meds if necessary and give it some time. Possibly you irritated something unaware and with a little patience...time will take care of it. :thumb:
Wishing you comfort.
@dubloosh
 
This type of lingering discomfort can happen and last longer than you would think. I don’t know that it can always be diagnosed, but I’ll second Layla’s suggestion that time can make things better. There is a reason the “recovery time” for joint replacement is one year. It actually can take that long and sometimes even more for things to settle out in your body. I don’t know if we just kind of get used to the new way our bodies work or things really do improve, but most of the time, these things do normalize. If you need to rely on Tylenol to help with that pain, I suggest you continue with that. Or Celebrex if you can take it.

As for the steps, many people have discomfort with steps for a long time after surgery. You could ask for a round of physical therapy and that might help improve it and maybe some of the other pains you’re having. Most of the time this type of thing is strictly body alignment and soft tissue problems. I doubt that it has anything to do with the surgery itself or the implant.

I know I’ve had to rely on both Tylenol and Celebrex at various times during my joint recoveries. It’s off an on and I can never pinpoint what brings on a bout of pain that eventually goes away.

Good luck on your interview. Try to focus on the positive things you have ahead of you.
 
First, as my surgeon and ortho team have said since my initial preop visit: there are no guarantees. Some of us are functional within 6 months to a year and some are not. Some will be functional but with residual issues. There is simply no way to predict outcomes.

Second, whatever happened with the patellar tendon in January can easily take three months to heal. I reiterate what you've heard above: you MUST allow daily periods of rest, ice, elevation - and patience - so this acute problem doesn't become chronic.

Third, sharing my lateral knee experience.

My R TKR has left me with chronic pain at the lateral lower thigh - the outer quad and a bit of the ITB - that my very smart problem solving PT couldn't figure out.
My ortho says it's scar tissue.

It hurts when the knee is flexed too long, as in sitting, and at the end of the day if cumulatively I have sat too long, despite having very good, functional range of motion. It also hurts with the repetitive circling of an exercise bike.

As my recovery approached one year I started serious strength training, as my post op R leg was lagging far behind my L. Oddly there is no pain while I'm on the machines, and that area seems to loosen up afterwards (reinforcing my agreement with my ortho that in my case it's scar tissue).

We're in this for the long run.
 
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Thank you @Layla and @Jamie and @mendogal. I appreciate your support and input and read every reply. While @EalingGran's suggestion for Pilates is a great idea, it would be too painful at this point. The last time I had IT band pain my hip needed replacing. The right hip is good so I'll rule that out.

I'm icing and elevating and came home later than planned. My surgeon couldn't give me an answer. Based upon my visit today, I'm not having any more cortisone injections into my left knee as I intend to keep that knee. No more joint surgery for me. He seemed baffled by my question. I understand there are no guarantees yet I didn't expect pain would return after feeling mostly stiffness.

Not sure what this new pain is from and probably best that I not focus on it as you've advised. Hopefully, this job interview will turn into a job to take my mind off it.

Last year @Jamie asked me about the underside of my patella. It's a button that's attached; this is why I asked him to check how my knee is tracking. I think you're right about soft tissue as it's only been three months since the second procedure; I read earlier posts and realized my knee was stiff two months ago, too. Tylenol is helping; I'm trying to cut back on Advil.

I'm sorry you have pain @mendogal and appreciate you sharing your experience. Scar tissue may be the issue for me, too, though my surgeon said nothing @Layla. I have a high chair here, and when I'm sitting I swing my legs. I've also followed suggestions to use the rocking chair and to put plastic bags under my feet.

My primary care physician put in an order for PT; the wait is at least four weeks so I'll keep moving until they call me. I believe you're right @Jamie about soft tissue and healing.

Thank you again for your suggestions and for reminding me it takes time and to be patient.
 
Good morning. Yesterday the weather was unusually mild, in the high 40s, and something interesting happened. My knee was less stiff, less painful, and more flexible than it had been in months. I'm happy and thinking maybe it turned a corner. That's the answer: move to a warm climate. :SUNsmile: Today it's somewhat the same; a good reason to look forward to warm weather.

Last year I bought coconut oil to try with cooking and with salad dressings yet didn't care for the taste so I put it into the refrigerator. It solidified. When I took it out for a day it melted. Maybe it's the same with scar tissue; it needs to heat up to become pliable and be molded.

Tomorrow I see the spine surgeon and am hopeful he'll have answers and solutions.

Hope everyone enjoys the day!
 
Love that you're feeling better yesterday and today, dubloosh! I hope you have a wonderful day and I wish you the best with your appointment tomorrow.
Have a good one! :SUNsmile:
@dubloosh
 
dubloosh said:
Last year I bought coconut oil to try with cooking and with salad dressings yet didn't care for the taste so I put it into the refrigerator. It solidified. When I took it out for a day it melted. Maybe it's the same with scar tissue; it needs to heat up to become pliable and be molded.
Click to expand...

:heehee: Nice thought….but, no….that’s not how scar tissue works. But you are right that warmer weather can sometimes bring on improvements in a knee’s function. So, hopefully as the weather warms up more going into summer, your knee will loosen as well.
 
Oops @Jamie, I'm wrong. One good day is a positive sign. Today it's damp, cooler and rainy, and my knee is not having it. However, because of yesterday, and stiffness without pain, I feel more positive it will continue to heal.
 
Hi dubloosh, Happy Thursday!
It's true that you can feel weather changes in your joint.

t's especially true for patients with arthritic joints who have not had a joint replacement, but also the case even after you have a new prosthetic in place.

Weather changes are predicted by changes in barometric pressure, which is the weight of the air pressing against the earth's surface. These changes can trigger pain and stiffness in the area of the prosthesis. The activity of bone adapting and growing around the metal leads to the sensitivity felt during weather and pressure changes. These sensations normally disappear within one to two years following surgery.

Have a great rest of the day!
@dubloosh
 
You're right @Layla both my grandmas told the weather, they said. It rained earlier, and I'm feeling better. I also learned something new: that the bone adapts and grows around the metal. Thank you.

After this morning's appointment with the spine surgeon I feel protective and do not want him to do any procedure. There's something about him I don't like, maybe because he rushed to set a surgery date - I said nothing about surgery - left the room without saying goodbye, and when I told his nurse I had another question, he stood in the doorway to speak with me.

I'll try a different modality of pain management. Perhaps the warm weather will resolve my back as well or at least the pain near my knee. Yesterday I didn't feel it at all. :happydance:
 
Been a week since I've been here and posted. It's been a long week, feels like a year. The pain on the lateral side of my knee, tingling below my knee, quad and thigh pain are all related to nerves that stem from the lumbar area of my spine. It starts in the morning and continues sporadically during the day. Next week I'm meeting with another surgeon as today it was very painful, maybe because of the weather. I am very scared.

My patella tendon is still sore and taking its time to heal; last time it healed more quickly. Did a lot of running around and proctored an exam Saturday; didn't ice and elevate as much as I had been. Need to pay more attention to doing that.
 
@dubloosh .... if you think a spine procedure may be in your future at all, I strongly recommend that you get multiple opinions before having anything done. At least one of the surgeons should be a neurosurgeon and not an orthopedic guy. While there are great orthos who are spine specialists, the neurosurgeons in my opinion are more likely to be able to successfully deal with difficult nerve issues. I was told this by a trusted GP years ago. It proved true for my husband, my daughter, and two other friends of mine.

I know it's scary to think there is some problem in your spine. But lower back problems are not an uncommon thing with people as they age. Just like knees, left untreated any nerve compression and the pain that accompanies it does not get better on its own and only tends to get worse the longer it goes. These days there are even laproscopic procedures for many of the problems if they are caught early enough.
 
100% agree with Jamie re: neurosurgeon
 
Thank you @Jamie and @mendogal. I agree with you and acted too hastily to contact an ortho spine surgeon. Next week's appointment is with a neurosurgeon. I have more questions now than I did prior to the first visit and want to avoid fusion. Earlier this week I brought my car in for a check-up, and overheard someone talking on the phone about procedures mentioned to me without fusion. I asked him when he ended the call. He said he still had issues yet is 90 percent better and was back to work (desk job) within two weeks. Thnking back, I had two chances to learn the lesson - hip and hand - and didn't realize the extent of the nerve issues. Now I wonder if the pain management doctor could have told me sooner it would become more painful over time. Hopeful about next week's appointment.
 
Sometimes spine problems can be helped with specific physical therapy. But if you have spinal stenosis or a disc problem and there is nerve impingement, it’s more likely that resolution involves some type of procedure. There are things that may be possible without fusion. But the surgeon will be able to tell you what your options are.

I am curious as to why you are so against fusion. For both my husband and daughter, a fusion in the lower back actually gave them relief and didn’t impact their mobility at all. Be sure and discuss your concerns about that with the neurosurgeon.

Since you know you’re dealing with spine issues, you might want to start a thread over in the Other Joints (Spine) area to talk about this part of your joint journey. You’d be more likely to meet some BoneSmarties there who have experienced what you’re going through. Having a separate thread for your back problems will keep the conversation more targeted. But it’s up to you. Since nerve problems are impacting your knee, it’s also okay to leave the discussion here.
 
Thank you for sharing about your family's experience with fusion @Jamie, and for the suggestion to start another thread. My knee still is healing, and the patellar tendon is still tender. Re fusion, I live alone and have no one to help me on a daily basis. One of my neighbors, a friend who lives upstairs, would help if I asked her to take me food shopping; laundry will be a challenge alone if I'm unable to bend. Another neighbor helped during knee surgery and picked up my prescriptions at the pharmacy. I'm also scheduled for temp work and then work in June so I don't know if now is the time or later. Oddly, the pain I felt last night that kept me up late is gone. You're right, I'm mixing two topics and shall focus on my knee here.
 
Well, that’s kind of a good sign that your back pain isn’t constant. I’ll hold good thoughts for you for your next surgeon appointment.
 
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