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Revision TKR Wberry knee is up<

Especially (for me) when you haven't taken steps normally in quite a while!
 
I agree with you whole heartedly. If I had known the unloader brace I wore for a year was going to cause this much degeneration, I never would have put it on.


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I wear/wore mine sparingly.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005
 
Well in one week i will be exactly 3 months post op.
I see the OS on Wednesday, and I have one primary issue and one secondary.

Primary is the triple grinds and pop pop that my knee cap does. It has gotten worst and I can literally feel the cap jumping over each movement now. It has become painful after moderate walks. I know I have read of others that say it goes away after the tendons tighten and muscle strengthen. I never thought it would get worst though. The lady that just had hers done says she has no issue like that at all. Now I am worried that I have scar tissue build up or something causing this.

Secondary Issue is the sharp pain to the underside of the knee cap when I do stairs. it has not diminished no matter how much I ice, rest it, massage it or stretch it. It might be related to the primary issue in some way.
Doesn't seem like an IT band issue because of the location.

I have been able to do all my PT regiment easily except the curls and extensions machine. I have been able to do the press machine with little issue as long as the weight is moderate. The other machines i am not doing don't have light enough weight with the base to work for me. The ones they had at my PT could be set to little of nothing and then on up.

I wake up at night around 5AM mostly to go to the bathroom. the knee is a little stiff, but it moves easily when I get up and limbers in about 30 seconds. Swelling is still there, I am icing once a day and massaging the joint off and on all day.

I walk until the triple pop grind causes to much pain around the knee cap. unfortunately I am walking less rather than more as it continues to happen.

If anyone has any idea what is going on with this knee cap issue, I would appreciate the advice.
 
@wberry , I hope your OS is able to get to the bottom of what's going on quickly and that's there's a simple solution. Seems like there's always something else to focus on with these knees.
 
So today I did everything that I know I have found issues with.
1. I do stairs but still with the same sharp pain on the lower area below the knee cap.
2. Still getting a triple bump, click and grind after weight bearing when I bring the operative leg forward as the knee moves from flexing to extension on a walk. I can reproduce it if I hold the leg under the calf and extend the knee straight. I guess because there is no weight on it the amount of bumping is a little less, its more when walking.
Is there anything specific I need to point out to the Doctor or PA. Is there a possibility I have scar tissue build up or a tendon issue involved. I am just wondering if they need to go back in to fix something or remove something.
 
So I went to the appointment today. I met with the PA initially and he manipulated the knee. Kind of gave me the usual exclamation about artificial components versus living components on the knocking issue. But he agreed with me that I should not be having pain under the kneecap after knocking or pain when I do the stair climb.then he had me do x-rays. And later Dr. Hodges came in who is my orthopedic surgeon he also examine the knee and did some moving of it and said similar things about the plastic Ron artificial aspect of the knee. But he felt that the knee is gettinggetting inflamed due to whatever's going on with the motion and the knee. He speculated that we might have some scar tissue buildup around it and we might have to go back in to do some relief around the area remove some scar tissue. But first he wanted to have me do some more PT to continue to work on quads to see if we could get some relief from the pain issue with the new jumping and a sharp pain when I do stairs. You put me in PT for six more weeks with the focus to try to work on an exercise it doesn't cause this pain for many and if after six weeks we still have problems he figures he might have to go and remove the scar tissue or maybe do a release or something like that. I sincerely hope the PT will help and won't have to go back in so I'm going to work at it but I'm a little skeptical because the pain that I'm experiencing now that I wasn't experiencing before.


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Before you leap into more therapy, I suggest you take two weeks and give your knee a break from therapy. Sorry I didn't catch it before now, but your therapist had you doing an exercise that puts a lot of pressure through the kneecap - those flexion and extension machines! And with weights, no less!!! This may be the source of your pain! Normally we advise folks to steer clear of any weight or machines like this for the first 6 months. This, as well as deep squats or any lunges are really hard on your tender new knee!
 
Hopefully @Jamie is right and a break will give you some relief. If not, at least you have a partial answer and a plan. Here's hoping the problem will resolve without any extra work on it.

Roxie
 
Well, the pain feels like someone poking a knife under my knee cap. I told the surgeon that.
He wants to see if there is anyway we can do quad work without stressing the knee joint.
I decided to go back to my original PT, who I like much more than the ones i had that had me on the machines.
So I will have to leave work and head home because they are in my home town 25 miles away.
@Jamie I stopped those exercises on the machines about 3 weeks ago and also the squats. Kind of felt like you that might be the problem, so I stopped and did the rest ice routine. The only exercises i kept even close was the steps, but only if they are pain free. This hopping knee cap is not something I think is quite right. Even though I get the lecture about non-biological parts. Why does the lady who is only 4 weeks out not having the hopping knee cap then. Does it have anything to do with me keeping my knee cap and getting a button on the back? I would ignore it, but the clunking and hopping of the knee cap got worst, not better. I feel like I paid good money and shouldn't have this going on with a simple explanation like its artificial. Artificial is not supposed to hurt as a result of the catching, is my feeling. Personally I think the button one the back of my knee cap is getting caught on the knee joint as it moves. Maybe I am totally wrong, maybe I'm frustrated, maybe I need to be patient and let it work itself out.
 
Ahhh.....wise of you to think that might be the problem and give those machines a rest. Since you've stopped them and you still have the pain, I agree with you that the doctors need to step up their game to identify the problem.

Actually, the knee cap is not removed when your joint is replaced. If there is arthritis under the patella, the surgeon will shave it down slightly and place a button to provide a smooth surface for the knee cap to track. Balancing the ligaments can be a bit of a challenge in some cases and maybe this was an issue with your knee. Let me tag @Josephine and see what she has to say.
 
Hmm, maybe that is why he said something about a release of ligaments and also scar tissue removal.
 
So I spent today walking around and tried to ignore my knee catching and grinding sound, but I couldn't. I probably could if it was just a noise, but I can feel it bump across the knee cap in the joint. That's what I was trying to relate to the Doctor. Putting me back on PT, doesn't sound like I got my point across. If it didn't catch as it does it, it would be less irritating. So I have to continue to put up with this for another 6 weeks before he will consider doing anything. I think he is convinced it's my quads. Well I have been working them regularly now for weeks, and instead of improvement, the problem seems to have gotten worst. And I think it is adding to my decreased ability on stairs. @referee54 or @vinny or @Jamie you guys got any recommendations


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Yes, if you believe the therapy is making things worse, get an appointment with your surgeon and tell him that. Please don't continue with something that you feel is counterproductive or harming your knee.
 
Agree with Jamie, WB. Ultimately we have to be our own health advocates because we know our bodies inherently and know when something is off. I would insist that my OS take another look or seek a second opinion from another OS.
 
wberry said:
Artificial is not supposed to hurt as a result of the catching, is my feeling.
Click to expand...
Well artificial doesn't hurt but unfortunately they are only a small part of the knee. Most of it is still soft tissue - ligaments and muscles and so on - and that will hurt!

I wonder if you have something like fat pad impingement (Hoffa's Syndrome)
 
I am not familiar with this syndrome.

For me, the knee went from maybe a little noise and clunking to a lot of noise, club king so excessive I can both feel it and hear it. The triple clucks as the knee cap rides vibrates up my leg. I have not been able to keep up with my walking, because the clunking now results in the muscles behind the knee tightening up. To add to it the sharp pain on the right under the knee cap is not helping when I try to step up on the operative knee.

I see my old PT today after I took two weeks off from all PT and just rested it. Tried a few things this morning and nothing has changed.
How should I explain this to the PT?


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I would tell him just what you told us in your last post. I wouldn't give it a whole 6 weeks either if it clearly isn't helping. Sounds like something is off to me although I'm no expert.

Roxie
 
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