Revision TKR Wberry knee is up<

[Blendab1]

How's the knee doing? I hope you are having a better go round this time!


Brenda

 

[Braunzie]

wberry- sounds like things are going well based on your last post. So glad to hear it! Happy New Year!

 

[wberry]

Hope everyone had a great holiday season. I was really busy and took time off.

4th month out from Revision Report:
Well we are 4 months out as of yesterday. I am doing really well. There are some issues that seem to be working themselves out. The soreness in the bone area below the bottom plate is getting better, so my initial fears of problems are subsiding. I am assuming it just takes time for the bone and tissue to heal there. The tightness of the joint with the new plat has transitioned into a more comfortable feel. Not necessarily a loosening, but more of a better feeling blend. I have been off PT for a month now and i continue to work on stairs and flexibility. I have increased my walking pace more than the distance. I seem to have better control at the faster pace than i have in the past. The pain in the patella area has reduced significantly. I still have a slight discomfort under the knee cap when i clime stairs. i am hoping that will improve as strength in the join increases and healing around that area progresses. I am being careful not to over do it, because I want complete healing first and foremost. I continue to ice twice a day, the swelling is much much less now, but I fins the ice is great at the end of the day and beginning. Reduces need for any pain medication. I am able to go without anything during the day, and still occasionally use a tramadol at the end of the day. I use to have some pain discomfort under the knee cap when I extended and lift the knee at the same time, that is gone completely. Going down stairs is getting easier, still don't have the strength to completely control the down step, but the stability is better, time should help there. I found is I push down with my foot with my foot in the toe down position it provides a nice exercise for building strength with less weight bearing on my knee. So I do several reps a day of that while I am at work. I think the joint I have is physically larger than my original knee joint in some ways. The size of the joint can be seen. So reducing swelling down to the joint size is as far as we go. Still working on how to get this stiffness when I site for a while out of the knee. This seem to be a common problem with everyone with knees in my condition. I use a tremble and then push up routine to get the joint loose before I stand, that seem to do the trick. Biking every day is a great benefit, keeps things loose and flexible. Squats have been added and are much easier to do now. i am still doing them without weight.

I think that is it. I will add more as I think of it.

 

[Celle]

What a great report!

I'm so glad that things are going better for you this time round.

 

[newlybionic]

That's a great report! I'm happy you are doing so well!

 

[Braunzie]

@wberry - nice report!!! SOOO glad to hear things are going well for you!! For a while I thought my knee replacement must be "bigger" than my original knee, but in the last couple months, the size seems not to be so different. (I just realized this the other day, in fact.) There must have been swelling that wasn't correlated with pain? Wishing you the very best in the New Year! Sounds like you're definitely on the right path!!

 

[kneeper]

 

[Slainte]

Still working on how to get this stiffness when I sit for a while out of the knee. This seem to be a common problem with everyone with knees in my condition. I use a tremble and then push up routine to get the joint loose before I stand, that seem to do the trick.

More info on this, please. I am good as long as I get up every half hour or so, but if I forget and sit at my desk for a couple of hours, I am so stiff when I get up. I want to know about the tremble and push routine!

 

[wberry]

More on Trimble and push. I grasp both knee caps and rock them back and forth side to side for a couple seconds real fast like a Trimble. Then I point my feet down where I am sitting so my heels are off the floor and push down a couple of times, the straighten my legs for a good stretch and stand.


Sent from my iPhone using BoneSmart Forum

 

[PolarBear60]

So happy to hear this is going well for you. Certainly makes the revision worthwhile.

 

[wberry]

Catch Up Report:
Wow, didn't know it has been that long since I posted so I need to give an update.
Looks like I am a little more than 5 months out from my revision. So how am I doing?
I am off all meds, which is really good. My last appointment was a couple of weeks ago.
My primary complaint was the pushing pressure under the knee cap when I climb stairs or
sometimes when I straiten the leg in seated position. The Dr. felt it was more of the lower bone pushing up when pressure was on it from other than, a straight standing position. It is like a weird push behind the knee.
It is not like a sharp pain, more like a shove and a high pressure under the knee cap. The doctor felt
that once I strengthen the issue will get better. Knowing that everyone's healing being different, I asked
around. No one had similar instance I talked too. What I have noticed it is less pressure and pushing
early on, but get more significant throughout the day. I have pushed and tried to hold the knee cap to see if the pressure and minor pain helps and it has not. I continue to exercise and hope more strength will help.
I had some swelling a couple of weeks ago, I used ice and also a vibration unit with heat in the areas I knew scar tissue might exist. It had helped and the swelling has lessened a lot.

last two weeks I have had a significant amount of tightness of the muscles and tendons on the back of the knee. so it was really tight making it difficult and painful the straighten. Again I used ice, heat and anti-inflammatory.
I am not sure if this is what I have read as an IT band issue. if I can get past that I will continue to move forward.
The doctor continue to remind me I am only 5 months out. Any comments appreciated.

 

[skigirl]

It does not really sound like an IT band problem: here is the library article

ITB (ilio-tibial band) issues and treatments

Sometimes when scar tissue develops behind the knee it prevents extension of the knee. What does your PT thinK?

 

[Jamie]

I would say it's a factor of you still being just 5 months out. With both my knees, I had tightness and odd feelings for the better part of a year. Just don't push too hard with your exercise. Slow and steady is better than hot and heavy. Your knee has been through a lot and it takes significant time for things to settle and ultimately improve. It could even be a couple of years for the improvements I know you're looking for. I'm glad the pain is gone, though. That's truly the important thing.

 

[jfiori54]

Wow, I have not visited this site for a long time. Sorry to hear you are still dealing some issues, but the less pain & off the meds is a good thing. I used to use a paint roller with the 2-3" roller pad on it to massage the tightness that I felt behind my knee & on the outer side. It helped me very much. In fact I need to start doing it again because I feel a little stiffness because I have not been very good about exercise. I am anxious to get back into the swimming pool because that is what helped me the most. I was fortunate to not have complications such as you have had, but if you can do any kind of water exercise I would go for it if you can. I hope things continue to improve for you. One foot in front of the other; it takes time.

 

[Josephine]

last two weeks I have had a significant amount of tightness of the muscles and tendons on the back of the knee. so it was really tight making it difficult and painful the straighten.

Well, wberry - fancy seeing you again!

Can you tell me the exact site of your pain using this chart?
Please note the instructions in the smaller image

I'd also like to ask you some questions if you don't mind (you don't have to if you don't want) and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery! ) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. are you using any pain medications for this - if so, much are you taking (in mg please) and how often?

3.are you icing your knee - if so, how often and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. Are you still going to PT - or doing exercises at home? If so, what kind exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

 

[wberry]

I will try to answer these in relation to the two primary issues:
Issue A - the tightness of the muscle or tendon behind the knee
Issue B- the push presser and moderate pain behind the knee cap and below.

About issue A - this issue has subsided since my last post, icing the back and using heat seems to have done the trick. I am also stretching that area more often. Only thing I can figure is my increased activity on the stairs to try to help issue "B" may have over strained things. The tight binding muscle or tendon was on the back of the knee at D-E/RB1. It kept me from getting full extension and flexion when it flared up. it was very tight and hurt to bend it.

About issue B - it still persist. I am trying to keep doing stairs in hopes of pushing though it. I have noticed a few things, I can cause the same push pain behind the knee when sitting and I straighten lifting the foot off the ground. There is a lump area above the knee on the thigh muscle, if I press it, the push is less and the pain also. Like putting compression on something. The area I push is in B/RF2 area on the thigh above knee. The pressure push under the knee cap is in the area of D/RF2. I mentioned this below, but above the knee is a rise area of muscle or scare tissue, not sure which. if I push and hold that area down when I lift the leg the pressure is a lot less behind the knee cap. That the area of B/RF2 I push on. If I stand and bend the leg and press down like I am taking a step, I get the same push behind the knee cap, but if I hold that spot, I can feel it shift and tighten If I hold it tight enough the press behind the knee cap is lessened. This last part I recently discovered and had not had a chance to tell the doctor about. I generally thought I had a piece of scar tissue of soft lump or nogel under the knee cap that was moving and causing the pressure, know I am not sure.

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery! ) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness
Answer: ISSUE A - level 4-5 when it is tight on the back of the knee, but I have good news, it subsided after sever days of icing and heat treatments. I am thinking I may have strain them trying to get more stair work in. ISSUE B - when the press happens it is a pushing pain in one spot, then increases based on the amount of pressure the activity requires, Stairs have the strongest push, straitening the leg sitting the lightest.

2. are you using any pain medications for this - if so, much are you taking (in mg please) and how often?
Answer: Both A and B - Sometimes a tramadol at night. During the day not much, aspirin if it get irritating,

3.are you icing your knee - if so, how often and for how long?
Answer: Both A and B - call me the ice man, twice a day at lest 40-60 min each, when tightness behind knee started I went to 40 on front and forty on back where tight muscles was.

4. are you elevating your leg, how often and for how long?
Answer: no, has been a while since I elevated

5. What is your ROM - that's flexion (bend) and extension (straightness)
Answer: Bend is 130, extension is 0 once issue A subsided again,

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
Answer: General hours work, yard work, mow, haul logs, walk, climb latter. I have also done three conferences with walking. Non of these seemed to result in issue A flaring up. I also walk a few times a day and try to do several flights of stairs a day up and down.


7. Are you still going to PT - or doing exercises at home? If so, what kind exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

Answer: Yes,
Heel slides x15 reps at least 3 times a day
Straight leg raise x30 reps at least 4 times a day
Steps x10reps on each flight at least 3 times a day
I planned to start back at the gym because I have been off the bike for a while.

 

[wberry]

Ever had the saying a good thing doesn't last. Well I am sitting down in a meeting, when I go to stand after about 40 min, then tight back of the knee came back. So I immediately went and found a wall and spent 5 minutes stretching the back of the quads and calf. Relief.

 

[Josephine]

Heel slides x15 reps at least 3 times a day
Straight leg raise x30 reps at least 4 times a day
Steps x10reps on each flight at least 3 times a day
I planned to start back at the gym because I have been off the bike for a while.

I'm curious why you are still doing these exercises at 5 months out? By all means go back to the gym but don't go mad with it. But please do stop all those heel slides, SLRs and steps. You really don't need them, especially when you're back at work and out and about. That would be the best remedy for your problems.

found a wall and spent 5 minutes stretching the back of the quads and calf. Relief.

That's perfect! I also suggest you go see a good chiropractor as it sounds like you just have tight hamstrings and similar things which a chiro will see to with great alacrity!

 

[wberry]

Okay, so the changes lasted for a week or two. The pain behind the knee seems more like tight tendons than anything else. Wouldn't be so bad if it was gone after a night's sleep and just increased through the day but the tendons in the back of the knee hurt in the morning when I wake up. When I sit for a while they get tighter and I have to try to stretch to get the knees moving again. I am trying the sliding in a chair on wheels to strengthen the calf muscles and tendons up more. Anyone else had this issue and can recommend a solution. I am still icing, but have now added icing the back where the calf and lower quad are and the tendon.

The knee cap issue still persist. I was really hoping it was just scar tissue and would work it out over time. It is always the same spot under the knee cap, only when I climb steps or push up on that leg. It is less and only slight if I do a knee straighten. What ever it is, it's under the knee cap. Can anyone tell me if this is gonna work out and it simply soft tissue?

I went on a cruise, which was fun, but added a few pounds of weight - could that be contributing? Back on my diet again. Everything I have read my back of knee is either Baker's cyst or hamstring tendon injury. The under knee cap is likely some kind of anterior knee issue or patella type issue. It is not the issue I had before that was fixed with the revision and new spacer. When I climb stairs or go down there there is an isolated high pressure that is around 5-7 on the pain scale and increases with the amount of pressure the stair climb or decent is.

I am not scheduled to see my surgeon until October. I mentioned these issues to him and he seemed to think the pain under the knee cap when I step was soft tissue and would work out. Well noting had changed in several months.

@Josephine and @Jamie Wondering what I should do.

 

[wberry]

I cut way back on stairs like you recommended by the way.