Worsening pain six months after TKR

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Edoorley

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Hi, My husband had a TKR on Nov 4th. He is in his 40's and had knee probs since he was a teenager and had his kneecap removed aged 21. His recovery was not good initally, he was not told to elevate the leg post op and the resulting build up of fluid caused such irritation to the nerves that the foot could not flex for the first couple of weeks. However he got past that, worked hard at physio and had a manipulation at about two months. He continues to do the bike, leg lifts, etc, but the pain has been worsening and now its as bad as before the op. He can only walk very short distances and is constantly awake at night with pain. He saw his surgeon yesterday who says the problem is a matter of scar tissue build up and there's not much that can be done. He reccomends continuing to work to break through the scar tissue. The surgeon also said there is an issue with the hamstrings needing to be strengthened. However my husband has been very consistant and has worked very hard on exercising the leg and it has not helped. Has anyone else had this experience or does anyone have any possible solutions. Thank you all, Eithne Doorley
 
Edoorley, so sorry to hear your husband is going through so much with his TKR. It sounds like he had a lot of pre-surgery problems which sometimes can make for a more difficult recovery process. But give him extra hugs for being a champ with the physio workouts he's been doing. That is so important.

However, you didn't mention any pain or anti-inflammant medication that he is on. At this point in his recovery with all that's going on, I would think he should still be on a regular schedule of prescription medication. And icing/elevating....is that going on frequently throughout the day and night? The fact that he is awake at night with pain means that there is not adequate pain management and you need to discuss this immediately with his surgeon. Without proper pain management, it is very difficult to do the things needed to recover from your TKR. I know you say you just saw the surgeon, but you didn't mention any discussion of pain medication. Sometimes surgeons aren't too good at prescribing this type of medication long term. If that's the case, talk to your primary physician or to a pain management specialist. You need to get this under control. I hope he is working with a PT and not trying to do the exercising all on his own.
 
Edoorley,

Well if my surgeon had told me there was nothing left to do, but stay in pain, I would be looking for another doctor.
As Jamie said, pain management seems to be needed first of all. I was referred to a pain management doc shortly after my last surgery and I am still seeing him and it is great. He dramatically changed the level of pain the first day I met him.
Does your husband have a good physical therapist? They are so very essential to recovery.
Let us know
judy
 
I was about to say the same, Judy. Get a second opinion. After all, why didn't your surgeon advise him about elevating his leg! It's such a basic thing but people aren't going to know by instinct!

You didn't mention icing, either. Get some gel packs and put them on the inflamed hamstrings. Also look up "ham string stretches" on Google. Ham string pain can be the very devil!
 
Edoorley-
Welcome to BoneSmart! Jo, Jamie and all the fabulous folks who are part of this group will be here to answer any questions you or your husband ask--they are truly a blessing to eachother and now to you, too. Give your husband a hug and tell him that you both have new friends to help with his recovery.
Blessings,
Irene
 
There are many stories of patient teaching issues in the health care arena today. I hope. Ice and do the PT but know that if it is a big scar tissue issue you can just push throught that so far on your own. Jo has great info on here about scar tissue. I too had surgery in Dec and MUA in February and still have some pain and am still in PT. It is a longer road for some of us than others but just stand in there.

Thinking of you both and hoping that pain eases up.
Nana
 
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