TKR Turtle still hoping to cross the finish line

[maryo52]

I have walked one or two 5ks myself. A former acquaintance responded to my knee troubles years ago by telling me that his jogging made knees stronger and I should do the same (I let him live, but it was close).

@Coachie So glad you are doing well. I think the snorkeling with fins was perhaps more beneficial than swimming. Anyhow, we woke up to the sky spitting sleet. If we had gotten what you got, I probably would've stayed in bed all day!! There's a hint of sun out there now, and it's kind of mild. But I guess we're due for further punishment soon.

 

[maryo52]

Yesterday I climbed the mountain (only 1,000 ft of altitude) that I have climbed several times a year since 1977 when I moved to this area. In fact, my profile photo shows a selfie (thanks to SLR camera timer placed on a boulder) from 1976 after I'd picked about 2 gallons of wild Maine blueberries. (I thought it was great that a person could just descend on Blue Hill Mountain and pick their fill of blueberries, but turns out I was an idiot and it was a commercial field!)

Well yesterday I had a fall. Over the years I've probably had a dozen on that mountain. All were due to wet ground or hidden ice. Typically what happens is one foot slides suddenly down, my other leg bends over my foot, and all my weight falls on my bent leg. Always, it's my right knee (now a TKR) that gets hyperflexed. Yesterday it was again the right, and it didn't hyperflex but once at maximum bend kind of turned inward. No damage, and I figure I underwent a slight manipulation.

When I do these climbs, I notice the absence of good proprioreception that goes with bad knees, which, due to excess laxity in my TKR, I still have. So as I pick carefully along the rocky trail, my mind still wanders back to my youth when I would do these hikes like a gazelle (such as in sandals and a skirt). The good ol' days!

 

[71Beetle]

Hi @maryo52,
I have not seen you on the threads so just wanted to check in to see how you are doing.
Hope you are having a great summer!

 

[maryo52]

Nice of you to check in with me @71Beetle. It gets busy in our state of Maine in the summer. So I haven't been on the net much. Though 'knees' are in my thoughts every day. Lately I have noticed the proprioception in that knee has improved (or perhaps I'm imaging that), allowing me to scramble through woods and over rocky terrain more confidently.

And what about you Beetle? Howz your recovery going?

 

[skigirl]

@maryo52 My OS told me that wearing a neoprene sleeve increases the proprioception--so I think that is due to your brace!

 

[maryo52]

@skigirl. That's interesting . . . I like your ortho! But I've had the brace two and a half years now and only recently have I had a decently confident level of negotiating uneven surfaces.

 

[71Beetle]

Hi @maryo52 - what is proprioception? It is good that you are able to manage uneven terrain. Is it part of your job to do so or do you go hiking to keep fit?

 

[maryo52]

I stay fit enjoying the outdoors. I'm not a big anything, just an all around small scale explorer. So we go out on our sailboard overnights, which involves walking the dog on islands . . . kayaking . . . things like that. Proprioception is what allows us to not move like robots. There are nerve endings in muscle and joints that guide our movements, and the strength of our movements. So not much is needed walking on a flat surface, but a lot is needed to negotiate the rocky shoreline of an island. Here's an example:

 

[71Beetle]

Wow that is quite the terrain to manage. It looks amazing though!
Take care!


Sent from my iPad using BoneSmart Forum

 

[maryo52]

I guess you're never too old to be a baby. I've had my share of challenges with this knee. Never pain, just permanent stiffness which I've learned to live with. A few days ago I noticed the usual effusion was more so, and the outside of my knee hurt a little. Since then I have been icing and not doing anything strenuous, and I am getting random painful twinges, mostly in the back of the knee. In these 3+ years I have had no twinges. I called my ortho's office just to see how long I'd need to wait to get an appt. and since it was only a week, I'm going to take a wait and see approach knowing I can get in soon if need be. Any thoughts? @Josephine

 

[WaterBaby]

Hi, Mary. Gee, you have my sympathy re the knee pain. I think it's good that you are going to see the MD in a week or so.

I also have been dealing with quite limited ROM - less than 90 degree flexion, stiffness as well as pain in my left knee that is now 3½yrs post original TKR (which was a botched job - see my older posts) and 3yrs post the TKR revision. I was to the point of accepting that this was just how it was going to be for the rest of my life (sigh). The revisionist surgeon diagnosed me post-op with severe arthrofibrosis and said that, because of this, I was not a candidate for ANY further surgery on that knee, and was not a candidate for any future joint replacement surgery. As a person with RA, this was especially bad news.

Last month, due to a generalized flare of the RA, I was put on a 3 week course of prednisone - 30mg/day to start with then tapering down 20 mg/wk, and 10 mg/wk the third week. By the 10th day, I had NO pain in that knee, I could walk better and longer, and there was no swelling or heat in the joint. It was amazing! My symptoms have, for the most part, come back after finishing the prednisone a few weeks ago.

However, this experience has spurred me to make an apt with the revisionist to ask him what this all means. Perhaps in the 2½yrs since he last saw me he has become aware of some new treatment for my situation. Or perhaps he'll tell me that my synovial tissue has grown back and is staying inflamed due to the RA. I have been on Humira weekly, 20 mg MTX weekly and 300 mg of Celebrex daily which has not helped the pain in that knee in all the time I have been on it but has helped other joints that have flared up. Only the higher dose of Prednisone has made a difference with the TKR knee.

My appt is on Sept. 4th and I will post here any info I get that could be helpful to you. I also feel strongly that my doctor should see the patients that have not had good results over the long term - it may influence how he treats and advises other patients in the future with similar problems. I would bet that they generally operate under the assumption of "no news is good news".

 

[maryo52]

@WaterBaby thanks for your thoughtful post. I think it's interesting that they don't want to operate on your knee again. That's the sign of a conservative ortho. I think these arthrofibrotic knees really are saying, "Leave me alone." Which is why I've chosen not to have it revised unless there is a clear indication . . . although in my case, I suspect the flexion instability is the cause of the arthrofibrosis. But isn't that constant effusion a nuisance? I've had moments where I thought, just give me a few tabs of prednisone, just to get some relief. But then I've had good periods too. No doubt the current issue was caused by me telling people my knee had improved this summer (better proprioception). Do tag me when you post after your Sept. 4th appt. so I know what happened.

 

[kneeper]

Sorry to hear this discouraging update @WaterBaby

 

[Pumpkin]

Mary,
Sorry to hear you are having trouble with your knee, glad you have an appointment next week to get to the bottom of this new development.

No doubt the current issue was caused by me telling people my knee had improved this summer (better proprioception).

I agree, the minute I post that I am making progress, my knee has a .

@WaterBaby, Last year when I was on a Medtrol pack for asthma, my knee had no pain, and felt normal for a few days. I thought Oh, this is what it is supposed to feel like.

Wishing you both the best,

 

[WaterBaby]

Mary, my revisionist said that ANY surgery, even arthroscopic, would trigger the arthrofibrosis...and the results would not be good. It does seem that the knees are saying "leave me alone". However, I am going to revisit this topic again with the MD because my "good" knee is crunching and audibly snapping and causing me increasing pain. I will be asking about treatment options for that knee, as well.
Did you have excruciating pain in the TKR knee post up - that felt like your knee was being entirely gutted? I had that horrible, horrible pain for the first year. When I stopped doing the post-op exercises, and just went about living my life, that pain gradually eased up but the stiffness and limited ROM never improved. The current pain and swelling is more localized in nature. it is definitely coming from the lower portion of the implant, and is worse on the inner side of the knee. It is more or less unchanged over the past 2 yrs. I just have no idea why it is the way it is...I would like it to be better, just like you! And I had no intentions of hijacking your thread, really. I haven't talked to anyone about my situation lately - i guess reading your thread opened the floodgates
Enough said about me! And thanks, kneeper, for the sympathetic words. Hope you are doing well post up with your LTKR!

 

[Dhare63]

Sorry to hear this news Mary. I hope you get answers soon! Like Pumpkin, you give so much to others and it would be nice to see you improve!

Keep us posted,

Dawn

 

[maryo52]

@WaterBaby Misery loves company! I have to tell you that the arthroscopic procedure I had to remove scar tissue was very effective, though it took a while to get the muscles stretching again, but my ROM has been good. I actually didn't make the appt. today because I know from everyone else's experience that most of these things work themselves out in a few days, but the knee got worse over the course of the day.

I am wondering about loosening . . . and if it is, I already have a revisionist ortho in the works from two years ago when I sought second opinions. I can't even begin to entertain the possibility of my life getting turned upside down again.

And yeah, @WaterBaby, I had lots of pain . . . but I think one explanation is the unbending knee gets pushed a lot and the result is lots of pain! My pain levels dropped right off when I stopped the home PT.

 

[maryo52]

Up at 4 am feeling dread. The knee worsened over the course of the day. The only thing that comes to mind is loosening. Which means my whole life will get derailed this Fall. Although my thinking may be premature, it's hard to avoid that train of thought.

I have a friend whose knee loosened after 10 years and she was able to get in with Dr. Freiberg pretty quickly to have it revised (she took a cancelled slot in his OR schedule). If this is loosening, how hard will it be to live with until it's revised? @Josephine

 

[Josephine]

If this is loosening, how hard will it be to live with until it's revised?

My dear Mary - if I knew the answer to that, I'd be a very wise woman! It's like everything else, different for everybody. It depends
1. how loose it is
2. where it is loose
3. how much toggle there is in the loosened implant
4. how much walking and/or weight bearing you do

 

[Pumpkin]

@maryo52 ,
Seeing the revision specialist will let you know what is going on, and then you can go from there.
That night time pain and awakenings are the worst, you are up and worrying and cannot take any action until the morning.
A revision really does turn your life upside down, I can say mine is getting better, and I will do well in the long run. It is just taking such a long time.
In the meantime you can use some sort of assistive device to take the stress off your knee as needed.
Hoping you find answers to your questions soon and can move forward,