TKR Unexpected leg pain

[Bluebell53]

@CricketHip thank you for your advice on the Manuel Lymphatic Drainage massage, I’m definitely going to call about one tomorrow and then go from there.

 

[Jockette]

I hope you find someone and that it helps

 

[Bluebell53]

@Jockette I appreciate all your advice and help.. I actually went to see my OS today. I told him about the pain behind my knee and and in the side. I asked if it could be my IT band.. he dismissed that and told me right out that I had not been doing my exercises and know scar tissue has formed. I sat there and started to cry when he told me that I would have to wait 9 months for the knee to heal and he would then go in and clean out all the scar tissue and possible replace some of the knee hardware. At this point I’m thinking okay should I even bring up the idea that it could be a bakers cyst behind the knee thats giving me pain. He acted like he was ticked off
at me so I didn’t say another word. He said that there is nothing more he could do until my knee healed. My knee does not bend and straighten out at 14 weeks. This isn’t my first rodeo and I did everything he told me to do, the pain is just too much to bear forcing it to bend. I left his office crying the whole way home thinking I’m going to be stiff and bent for the rest of my life because I’m damned sure he’s not cutting on me again. So tomorrow I’m gonna find another doctor and get a second opinion because I know that this is not scar tissue, I just feel it in my gut.

 

[Jockette]

I am so sorry your surgeon treated you this way! I agree, you are better off without him.

It may be hard to get a second opinion this early in recovery, but I would definitely try. Some surgeons wont see another’s patient until the first year has passed. But we have had members get second opinions before then.

he dismissed that and told me right out that I had not been doing my exercises and know scar tissue has formed.

Exercises don’t fix everything, and doing any that cause pain are counterproductive.

I see you are in WV. I would suggest you consider going to a big city area, for a second opinion. You really want someone who has no association with the surgeon who did your surgery. Bigger areas near a city have more people, so more patients, and surgeons there see more and have more experience with less than perfect outcomes. I would suggest the Baltimore area. Many times surgeons have more than one office and you could find a city surgeon with a location closer to you. I did this with both my second opinions. I live in Delaware, I saw a surgeon in the Baltimore area, and I also went to the Philadelphia area, which I’m actually more familiar with.

None of us want a long ride to a doctor’s office, but sometimes it’s the best way to go. If I ever need a revision, it won’t be done in little Delaware!

Remind me again about your PT experiences, were they good, or too much pushing? If you can’t get a second opinion for a while, I wonder if you called around to some PT offices, smaller, private ones who are not part of a “chain” or connected to a hospital, and described your pain and see if they believe in a gentle approach, maybe do that lymphatic massage, and could use modalities to help you. My impression of modalities is machines, for lack of a better word, like ultrasound, that might help.

Sending big hugs to you,

 

[Pumpkin]

So tomorrow I’m gonna find another doctor and get a second opinion because I know that this is not scar tissue, I just feel it in my gut.

Excellent decision to get a second opinion, just be sure your second opinion has no relationship with your present surgeon, not even golf buddies. A surgeon who has experience with revisions or specialized in complex joint reconstruction will be able to determine what is going on with your knee.

 

[Bluebell53]

@Jockette, @Pumpkin thank you ladies for your nice words it really helps. I’ve already made an appt with another OS and one that I saw previously and who operated on my hand because of carpal tunnel, he too does knees. My in home PT wasn’t bad but rather aggressive. My OS didn’t think I needed outside PT and just told me to do the exercises at home that he gave me. I followed through but just couldn’t get this stiff knee to bend.. the pain was just too bad. The OS that did my surgery is located in Northern Virginia. I choose him because he was referred to me by my GP. I’m currently scheduled for my first PT section on 23 March, I truly hope they can help me.

 

[Jockette]

Remember to keep the PT very gentle, you’ve had a lot of pain for a while. I would ask for modalities and massage, rather than exercises.

I‘m glad you were able to get an appointment with a surgeon you know and like.

IF you should need more surgery on your knee, I would do as pumpkin said, and also get an appointment with a surgeon who does revision and complex joint replacements. (I’m not saying you’ll need a revision) For me, a surgeon who does hand surgery in addition to knee replacements, would be too general for me to consider for my knee. (But I have a lot of issues with my knee so if there’s a next time, I’m going to be very picky.) But, if he does lots of revisions, you could be in good hands.

We wish you the best!

 

[Bluebell53]

@Jockette thank you I will.. btw, I just got my blood test result back. My OS wanted to check my inflammation.

ATTACH]

 

[Pumpkin]

Your inflammation is high, your surgeon and your primary physician will want to look further to figure out what is causing your CRP to be high. Be sure your primary has this information.
Happy you are seeing a surgeon with whom you have had a positive experience.

 

[Bluebell53]

Got a call today from my OS, he wants to drain the fluid out of my knee per the CRP results. Has anyone else had this done? And if so, did it help with your bend?

 

[WFD]

I had it done twice, though not because of potential infection. In both cases it helped with the bend, but in proportion to the amount of fluid removed.

 

[Bluebell53]

I went to PT today and she worked my knee hard to the point of my ROM from a 60 to an 80. I have a lot of inflammation which is holding me back. Hopefully next week when I get my knee drained I’ll see better improvement in my ROM. The problem all along was tight quads and hamstrings. It was tough and painful but I told her I was all in for the duration. I have a trip to Venice planned for this summer and I wanna walk straight and without pain.

 

[Jockette]

60 to 80 degrees is a big difference in one session, and the fact that it was tough and painful, is not in your best interest.

I know you are tired of this recovery, but this type of “therapy” is not the way you reduce inflammation, but it’s a sure way to increase it, which will cause more pain and swelling, which could leave you worse off than before you went to PT.

Got a call today from my OS, he wants to drain the fluid out of my knee per the CRP results.

If it was me, I would be extremely careful with any PT until you have this fluid drained and see what they find with it. Now is not the time for painful PT, not that there ever is a good time for painful PT.

 

[Jamie]

Hi, @Bluebell53 ..... I'm not sure I understand what you mean by your therapist "working your knee hard" since you mention later in your post that the therapist believes your problem is tight quads and hamstrings. I'm hoping that your meant your therapist did some deep massage to try and loosen up the tight muscles and not forcible bending on your knee. Can you please explain with more details?

I'm asking because it would be unwise to do aggressive exercises that cause you pain since your knee is already inflamed and your surgeon is concerned about your CRP levels. Usually when a patient has high levels a surgeon take a fluid sample (he may not completely "drain" your knee) to test for the possibility of an infection. The fluid is there because it's your body's way of countering inflammation. It's the surgeon's job to get to the bottom of why the fluid is there and why you might have this higher than normal reading. Just removing fluid isn't a cure, even though it can certainly make you feel better. It will come back if whatever is causing it is not resolved.

 

[Bluebell53]

@Jamie, @ Jockette what I meant is she did a deep tissue massage to loosen everything up. This allowed me to bend to that 80 degrees. She then put the tens unit on and hooked me to an ice machine for 10 mins. I felt so much better when I left there. I don’t have another PT session until after I have my knee drained on Wednesday. Today I’m just relaxing and icing.. In between, I’m just doing my normal heel slides and stretching out my leg.

 

[Jamie]

Thanks for the clarification. If your pain is not lessening with you staying off your knee most of the time, be sure to let your therapist know that. You don't want another deep massage that might make the pain worse until you talk with your surgeon and explain all this to him.

 

[Bluebell53]

I’ve been working so hard with my PT to get this leg to go straight and bend. I’m 17 weeks PO and my extension is measuring at -20 and flexion is still at 75. Last night I had a session with a therapuetic massage therapist. She did a lymphatic drainage massage to help with fluid and cupping to help with scar tissue. Today at PT after getting my measurements I’m starting to feel defeated. I know that this is a year long recovery but at this point into my recovery you would think I would see some improvement. For those of you that have gone through something similar as me, I have to ask.. will this knee ever loosen up so I can walk normal again? After having both hips replaced and both knees done that this knee would just follow suit. I’m so sorry if I seem whiney as there are probably others going through the same even worse than me and I can only send you hugs and pray for you.

 

[lovetocookandsew]

Sometimes our knees have different ideas for recovery than we have. But, in the end, most eventually recover and behave. Your knee may just be taking it's sweet time and will eventually straighten up and fly right. Granted, there are cases when knees don't cooperate, but I'd give it more time and see if it will behave. If not, then a message or call to your surgeon may be in order. But, I also suggest you lighten up on the PT and just give your knee a break for a while. Icing some wouldn't hurt either. I also suggest not measuring your ROM for a while and just work on not overworking that knee. I never had my ROM measured as I didn't want to be stressed out over not reaching some random number; instead my indicators are what I could do that I couldn't before my surgery.

 

[Bluebell53]

@lovetocookandsew, I hear what you’re saying.. I’m actually waiting to get in with another doctor for a second opinion. Even my PT today said she’s worried because there doesn’t seem to be any improvement, so I’m really starting to worry ya know. Trying to stay optimistic but it’s hard. Thank you for your words of encouragement it means a lot.

 

[Jockette]

I’m so sorry this has been such a struggle for you. I know lack of ROM improvement is very discouraging.

But, I also suggest you lighten up on the PT and just give your knee a break for a while. Icing some wouldn't hurt either. I also suggest not measuring your ROM for a while and just work on not overworking that knee.

I agree with lovetocookandsew, sometimes, and maybe even many times, we just have to step back and let our knee just “be” and give it the privilege of sorting itself out. We cannot exercise a knee, that isn’t ready, into submission.

17 weeks is not even halfway healed in a recovery that takes an average of 52 weeks.