Revision TKR Would like advice please, I think knee has moved

[busylizzie]

@Pumpkln, thanks I won't know until the New Year what is in store for my leg. I just hope they can improve its function.

 

[Nana moon 27]

Merry Christmas @busylizzie x x x x

 

[busylizzie]

Merry Christmas @Nana moon 27, I am still awake

 

[Nana moon 27]

Hi @busylizzie

Yes and me. I haven't posted this in my thread but oh my, I'm well and truly in the ODIC. I literally haven't stopped since this morning, cleaning, wrapping presents, had to nip out with hubby to get a few things locally. Back home wrapping. I fell sleep sitting up half way through wrapping, this afternoon. It was a struggle to do it.

My best friend rang. This was totally unexpected but she's doing well and said she had a card and a pressie for me and she'd be over in 15 mins. Well I nearly died cos I'd not bought anything this year as I didn't think she was going to be well enough to go out and about she's had (unusually for her, depression. Luckily I'd a spare present upstairs. I had found a really pretty card, so at top speed I wrapped the pressie and wrote the card x x x it was lovely to see her and we hugged and looked at each other. She said to me slow down you're doing to much, you look so tired, then tonight mom told me off because my TKR is twice it's normal size!!! She noticed through my jeans! I complimented my best friend on her three stone weight loss. I can't remember whether she is doing lighter life or Cambridge. It's one of them. She looks fantastic.

How are you tonight? X x x x

Love Ann x x x

 

[busylizzie]

@Nana moon 27, it sounds as if it is a good job you are going to your daughters today for your Christmas meal. You sound like you are really in the ODIC. I'm glad you saw your friend.

I am up and down at the moment with my problems. My digestive issues haven't settled down and I'm trying not to aggravate them. Only taking the bare minimum drugs. I'm glad we are having a quiet day tomorrow and avoiding the rich food. I think it is possibly my gallbladder among other things that is causing me problems. My leg is the same as usual! Still not long now until I see the specialist. Trying to stay positive.

I've washed all the bedding today as I've an incline the Grandchildren will be wanting a sleepover when they return and possibly Mum and Dad. I've done nothing else except listen to carols.

On a more positive note enjoy yourself today

 

[Nana moon 27]

I'm so grateful my daughter has invited us for dinner. I'm so wiped out physically. Both daughters are coming over in the morning x x that's just reminded me I'd better get some bacon out x xx

I've ended up having to abandon the cleaning until later. I'm sure once I've slept I'll be fine. The meds don't seem to have done much tonight xxx

Have a lovely day and I'll catch you later x x x x

Love Ann x x x

 

[busylizzie]

@kamarx , welcome to the forum, I hope you don't mind me contacting you. I have just read your post on the pre op side. You mentioned you have bowed legs and pain on the outside of your ankles. Does the pain feel like a sprained ankle and has it given you plantar fasciitis? How bad are your legs bowed if you don't mind me asking? The latest knee surgery has left me the same and it looks like I've got mal alignment/rotation of my left leg. I have had CT scans done and I'm waiting for the results. I am unable to put my foot flat to the floor naturally when walking and all my weight goes on the outside edge of it.

 

[kamarx]

hi busylizzie, no I don't mind you asking. Im not sure how much they are bowed but I know theyre not straight I can see that they kinda look like ( ). not as curved but like that. Yes I guess a severely sprained ankle is exactly what it feels like and yes bottoms of my feet have gotten pretty painful as well. I think its due to walking like Frankenstein! for lack of better term. I just was wondering if my knees could have caused this more than likely did.

 

[Legin]

Hiya lizzbizz. Had my crimbles day today with girls today
Brill time. I hv played table football table tennis and won the chase soooo leg amd foot tad large but do i care noooooooooo hope your day was grand

 

[busylizzie]

Christmas day my knee was hurting more than usual and I noticed a clicking on the lateral side of the knee. This got worse and on Boxing day I noticed a double clicking, first one quiet followed by a louder one when flexing my knee. It is where the fixed hinge circlip would be. This has continued and my knee is warm there and I have lost quiet a lot of ROM. But the strange thing is that I can now put my foot flat on the floor and my leg looks straight the first time since June this year. My knee is an oversized custom SMILES fixed hinge made totally out of titanium. It is one piece once in place so I can't understand this. I still have a very small patella.

Here is a picture of a similar knee, the one in the picture is a cobalt chrome one.

I have marked on the diagram where I can feel the clicking. My muscle on the inner back thigh also hurts as does directly behind my knee crease. Also the lateral side of the long tibial
stem.

I had a CT scan earlier this month, but my leg and foot were out at an angle then. From what I'd researched it looked like I'd got external tibia torsion. I don't get the results until the 9 January when I see the foot/ankle specialist.

I am going to try and get in touch with my knee specialist's secretary tomorrow if she is in work but everything closes for Christmas/New Year here

@Josephine any input would be appreciated please

 

[Josephine]

It is one piece once in place

It'll always be four separate pieces, my dear. Femoral component, tibial component, axle and circlip. But they are pretty firmly fitted together so it's unlikely to be anything to do with the implant.

The place you have marked appears to be around the IT band insertion which is a very common place for tendinitis. All you other symptoms appear to support this.

Which makes me ask my infamous questions!

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 ....

I'd be grateful if you would give me two sets of answers: 1. for June-August and 2. for now. And I do need full details - generalisations will not be helpful

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. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee 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. what kind of PT exercises and exercises at home are you doing? How much and how often? (and detailed details would be appreciated, please! **Reps, sets and sessions** and all that)

** If you're not familiar with this, it goes like so:
1 lift of your leg = 1 rep (repetition)
5 reps and then a brief rest = 1 set
5 sets and finishing = 1 session.

 

[busylizzie]

Thanks Josephine.

Q1

After I came out of hospital in June the knee pain was not too bad, maybe a 3/4. Most of my pain was from my foot and ankle which started on the surgery day when the spinal wore off. This was up to 8 at times when I put weight on my leg. I also had sciatica. I have been using 2 crutches since June outside the house and continue to do so, or I use my mobility scooter. I walk very little round the house to minimise the ankle/foot pain.

Now the knee is up to a 7/8 especially on movement. My ankle stopped hurting the last few days. The foot pain continues, but my foot has now twisted back to its correct position. I still have plantar fasciitis. My sciatica pain has also gone since my leg has straightened up.

Q2

I came out of hospital with tramadol and paracetamol. I am unable to tolerate the max dose prescribed due to other medical problems with my digestive system. I took 4 x 50 mg tramadol and 2 x 500mg paracetamol a day. Ice controlled the pain well. In hospital I had IV paracetamol . Also a tunneled epidural of local anaesthetic Bupavacaine, left in place for 8 days. I have a high pain threshold measured in a pain trial at Salford Hospital a few years ago.

At the moment I cannot take any oral pain meds due to a severe flare up of abdominal pain. I have had 4 consultations with GP the last 2 weeks and have to see her again on Tuesday.

Q3

I have a aircast ice cooler and used on and off all day and night a few hours at a time after surgery until the swelling and pain went down.

I have had the cooler on today most of the day, only removing it to mobilise which isn't often.

Q4

Apart from when I mobilise my leg is always elevated and I have been doing this for the last 6+ months. My foot/ ankle is more comfortable elevated.

Q5

After surgery my extension was 0 and my flexion was about 10 due to having spent 6 months in a immobiliser brace. Slowly I gained flexion and at the beginning of this week it was 100.

Now it is between 60/70 and feels to hit a hard stop.

Q6

I do very little. I do not do any cleaning, very little cooking. I prepare the vegetables. I do the washing and leave most of the ironing to hubby. My balance isn't good. I shop using my mobility scooter. My hubby looks after me.

Q7

The only exercise I have ever done is non load bearing gentle knee bending and leg lifts, about ten of these a few times a day. Nothing strenous. With my foot/ankle problem dynamic exercise just caused pain and the physio told me not to do any until the problem was assessed and a solution found. I occasionally sit on my exercise bike and gently push the pedals back and forwards and do a few revolutions.

At the moment no exercise is possible. I am doing the bare minimum weight bearing.

This present clicking/catching started on Christmas day and has got worse since then. I am unaware of anything that I have done to trigger it. It is odd that my leg has straightened up and my foot will now go flat on the floor for the first time since June. They seem related. My ROM as decreased, and the pain is increasing. I can now stand with my ankles, calves and knees touching which I definitely couldn't do before. The spot indicated on the diagram is painful to touch now and warm. It wasn't previous to this. Last night it was 5 degrees C higher there than the rest of my knee. It is a very specific spot. Why would this happen so suddenly?

 

[busylizzie]

I forgot to say the spot feels spongy, I guess from inflammation.

 

[Jamie]

I'll tag @Josephine for you to be sure she sees that you've answered her questions.

 

[busylizzie]

Thanks Jamie

This morning I am sure something is moving, I can feel it more. Also I have hyperextension, I noticed it whilst in the shower. When laying down I can raise my left heel significantly more off the bed than my right one. The polythene insert is supposed to help prevent this. My flexion is still reduced.

 

[Nana moon 27]

@busylizzie please try and ring your OS today. They may be open. Also tag Josephine back in. That does not sound right. What's the pain like? Is there any change there? X

 

[Legin]

I agree with Ann it needs checked

Legin THR Sep 14

 

[busylizzie]

Consultant's secretary is not answering phone, I guess she is still on holiday. The hospital hasn't got an A&E department. Fall back position if it gets worse is to go to A&E at another hospital in the trust or wait until I see the GP tomorrow morning.

 

[Legin]

You could ring NHS 24 Doubt if they.would send dr.but you never know

Legin THR Sep 14

 

[busylizzie]

I also have a pain management appointment next Monday and foot/ankle consultant appointment a week on Thursday.