TKR Unknown lump on front of knee'

[Celle]

Forgive me and no offense, but I'm skeptical that your internist (much as you love him) correctly diagnosed a "torn ligament". Wouldn't you want to confirm this with an orthopedic specialist and find out how to proceed?

I'm inclined to agree. It's just as likely to be inflammation, not a tear.

My internist did some tests that my OS at least should have done instead of announcing I need to have a MUA and in the same breath tell me I'm high risk for it. The only way to really be certain what is going on is to have an MRI. I'll give it a week doing what my dr said to do and if it's not showing some improvements, I'll have him suggest a different OS for me to see. I've read that sometimes doctors see what they are expecting to see and it takes a fresh pair of eyes.

I think you need to give it much longer than a week. Nothing happens fast with this recovery.
In addition, you might find it's very difficult to get another surgeon to see you so soon after your TKR. Many of them refuse to take on another surgeon's patients until about a year after the surgery.

Just had a meltdown. I'm physically and emotionally exhausted and just worry too much. I thought by six weeks I'd be whisking my grandson back to Atlanta. Now there's this other issue with the ligament/tendon whatever it is. I feel like a yo yo sometimes- first my knee is stiff then it's not stiff, then it's stiff again. I'm just having one big pity party!

I'm sorry you had a meltdown, but be reassured that it's perfectly normal to do that. All the ups and downs around your knee are normal, too.

It seems that you weren't told before your surgery that this recovery takes a long time. Expecting to be anywhere close to back to normal by 6 weeks is impossibly optimistic - but surgeons often omit to tell you that, which leaves you ill=prepared and frustrated.
A knee replacement is major, major surgery and you don't bounce back quickly. Instead, recovery is at a snail's pace. It takes a full year, sometimes even longer, before all your soft tissues - muscles, tendons, ligaments - are fully recovered. In terms of a race, it's a marathon, not a sprint.
This article may help:
Life in the slow lane

 

[Jackieray]

Thanks for your support, @Celle. I met more with his assistants than I ever did him. I saw him one time in his office before the surgery, once before and after he operated and for about 3 minutes at my six week checkup. In fact, it was my internist who referred me to him. My OS told me to call his PA when I decided whether or not to have the MUA. I called her and told her what my internist said and she said she would tell the doctor. Since both of these doctors are colleagues, I thought they might talk. I'm planning on calling my internist to see if he will call my ortho. He was the one who actually brought my ortho to the Tristar Centennial group so I know he has a lot of respect for him. He wouldn't just casually make a different diagnosis. I really don't mind going back to see him because I don't think it's anything he did during the surgery. I think when he looked at my leg at six weeks, he expected to see swelling so didn't take a closer look. When I went to talk to my internist really about whether or not to have the MUA, he saw something else. He said rest, elevate, ice, antiinflammatories but I don't know what to do about exercising my knee because from what I've read recovery from an injured ligament is the opposite of recovery from a tkr- it's immobilized a lot of the time and takes about as long to recover from.
I don't want lose the use of my leg. When I walk I find myself not wanting to bend the knee for fear of stressing the ligament further so I lock it. I don't know if that's good or not. Grrrr!

 

[Celle]

Please stop stressing!
Rest, ice and elevation are the appropriate treatment for both a TKR recovery and a mildly torn ligament. The treatment is not the opposite.
Resting your leg won't interfere one little bit with recovering your knee. You won't lose any of the ROM you already have.

Recovering from both takes time and you have nothing to lose by waiting. There is no need to rush to do anything.

I'm going to ask @Josephine , to see if she can reassure you.

 

[Jackieray]

Thanks so much, Celle! See I didn't know that. I thought one you kept still and the other you moved. I'm so glad I found this site. Knowing how I stress now, imagine if I was out here swimming alone!

 

[Jackieray]

I think I'm going to put down by ipad for awhile and stop googling stuff. I have my new game and I started the James Herriot books again, the Yorkshire vet, whose stories make me feel so good! Thanks a million, Celle, for saying exactly what I needed to hear!

 

[Josephine]

He said rest, elevate, ice, anti-inflammatories but I don't know what to do about exercising my knee because from what I've read recovery from an injured ligament is the opposite of recovery from a TKR- it's immobilized a lot of the time and takes about as long to recover from.

Well, you've got a big difference here. What you've been reading about is either a TKR or an injured ligament. It's different when you have both together. You have to prioritize here and the ligament comes first.

 

[Jackieray]

Thank you, Josephine. So no exercising the knee. Just normal walking. Once the swelling goes down in the joint, I'm sure it will be alright. It's funny because everywhere I ice my skin feels slightly cool but that one spot and it always stays warm.

 

[newlybionic]

That warm spot shows an area of inflammation or continuing swelling. I've had the same thing in my knee. I had to make sure that there was enough ice at that spot at all times

 

[smarttoys]

I also have a spot on my knee that's warmer than other areas and it's the lower lateral side of the knee cap. It's probably where the OS released my LCL to balance the ligaments. I usually try to ice that spot more. I look at it as progress. Earlier in my recovery my whole knee was fairly warm, now it's mainly just in one area.

 

[Jackieray]

@smarttoys
Is that area swollen and discolored? Like darker maybe slightly bruised? That's exactly where this spot is on me but it has caused huge swelling in the joint and area that's just above it is swollen but it's above the knee cap. Do you have that too?

 

[smarttoys]

Early in my recovery I had a good amount of swelling and pitting edema on the outside of my knee. The pitting edema was gone by around 6 weeks. I still have a little soft swelling and extra warmth in the LCL area and I expect it to be there for a while. I also get a very noticeable increase in swelling above my knee cap right where the quads meet the knee cap when I'm too active and on my feet for too long. That seems like a popular spot for fluid and swelling to accumulate for me. My increased swelling in that area goes away pretty fast when I elevate and ice. No discoloration anywhere other than redness when I'm a little too active and have increased heat and swelling. That also goes away when I ice and elevate.

 

[Jackieray]

Thanks for your comments, John. Mine sounds very similar so I'm pretty sure it's my LCL. My doctor said the type of pressure the PT put on my knee while I was doing wall heel slides could definitely cause a sprain or tear in that ligament. I hoping and praying it's just a sprain. It started small and I noticed a little red line then a bigger bump, then stiffness in the joint all on the side of that swelling. I've been icing and elevating since my surgery but it has not gotten any smaller. Doctor wanted me elevating knee above heart and that's no easy task. Lol! But they continued bending my knee to get that rom. Had me using a strap, on and on. The more they did, the stiffer it got and I wasn't getting anywhere. After staying off my knee and icing, etc. the swelling going down a little but returns if im up to long. From what Josephine and Celle told me and other's stories I've read, it's just going to take time.

 

[Celle]

So no exercising the knee. Just normal walking.

That will do the job just fine. actually, just a little bit of walking around the house is all that is needed to heal and recover your knee as well.
I did no PT at all for my last TKR - I just walked around a little bit, and now and then, when I was sitting at the table, I would try to tuck my foot back under the chair (my mini-version of heel slides). My knee healed well. I can get it perfectly straight and I estimate that my bend is somewhere just over 125 - all with no pain or effort.

 

[Jackieray]

After reading others stories on this site especially @KarriB who had her knee immobilized for a month, I'm just not going to worry anymore. And I read Josephine's article "tight band across the front of knee". That's exactly where the stiffness is in my knee. I've been through some difficult times in my life with back surgeries, chronic back pain, my grandson's accident, and God has been right there for me. He's not going anywhere now!

 

[karol723]

How thoughtful of your grandson ! I can identify with how you feel .Some days my emotions are all over the place. Knowing it's normal to feel this way at this point helps a little. I try not to stay in "poor me" mode for too long. Hope that ligament/tendon problem doesn't take too long to heal. I have one tiny spot on my incision that doesn't look as healed up as the rest. It's so easy to over-worry about everything, I guess cause we can't do much but sit around with our leg up, icepack on knee and pain meds. We need to keep looking forward to Spring ! Then we'll be able to enjoy going for walks again and not feel like life is passing us by. Hang in there, it'll get better.

 

[Jackieray]

Thanks, Karol. I have two 17 year old grandsons that I took care of all the time when they were babies and are very close to them. If you have read my thread, one is two years in a wheelchair due to a wrestling accident. My other grandson, Nathan, said the second time he cried over his cousin, Hunter, was when Hunter asked him to lift him to standing and hold him up. He said he stood there holding him and just sobbed. Of course that made me cry. My daughter said when they went to Disney World a couple of weeks ago, Nathan worried over Hunter all the time, putting his arms around him on the first roller coaster ride until he saw he wasn't going to fly out. Lol! Disney has changed their policy on the disabled to having to wait in line because so many people were faking being paralyzed. Cheez, people never cease to amaze me. Hunter has been so brave and has never complained much. I remind myself that if he can accept his situation with courage and grace, what is a few weeks (months?) on the sofa for me! This is my view most of the time. I

 

[Jackieray]

@smarttoys
Hi John, I'm posting two pictures of my knees. One when I first noticed something different on my knee toward the end of Dec. and the second from today. Did yours look similar?
First noticed small red spot to the left of my knee in mid photo


Next is from today

There is also a wrinkle that leads to a bruisey, puffy spot. Both are hard to get to go down

 

[smarttoys]

No, my swelling doesn't look quite like that. My area of swelling is fairly close to the same location but maybe a little lower and further to the outside of the knee and is only pronounced when I bend my knee. It's hard to tell from your photos but the lump looks pretty close to where the LCL would be released from the tibia. I'm assuming you had a lateral release with your surgery. Hopefully that area will calm down soon with some more rest, ice, and elevation. When I say soon, I mean weeks from now. After all, it is a long recovery.

Sent from my SM-G800R4 using Tapatalk

 

[sistersinhim]

Jackieray, that looks awful. I would certainly be concerned. Was that big blue thing in your photo an ice wrap? If so, where did you get it? That looks like something I'd like to get.

 

[Clipless]

Looks fine to me... but I'm used to looking at my own lumpy, bumpy knees!