TKR YYZ Back To YYC!

13 month update;

Continuing with diclofenac gel and 2000mg acetaminophen each day. Gel needs to be massaged on surface for 10mins 3x daily. Seems to help as i missed a day or so on a weekend and noticed increased pain.

Walking has improved. Can complete a purposeful 20 minute stretch every other day before inflammation and knee "seizes up"and un bendable. The quality of walking also improved. Focusing on walking and keeping a tall posture with shoulders back, lively arm swing and extending heel to toe stride.... limping is not so prominent. Extension is at 5 degrees so probably explains the limp. This is the limit of activity for that day as inflammation and pain are too much at the moment.

Stairs going up greatly improved can do my split set of steps to upstairs with improved form. Going down can do 8 steps with control and good form twice a day. Latest flexion is measured at 100 degrees.

Wondering if folks this far along still do bending exercises? I continue doing flexing exercises once a week to get more range. Primarily sitting on a chair with my feet planted and moving my hips forward. Try to relax muscles and get more flexion. Knee at its end range is like a brick wall and won't move an inch! Not sure what's up at this point, lol.

Standing still limited. Can brush teeth and do the Waterpik rinse twice but find inflammation setting in towards the last minute. Kitchen chores similar can stand 7 minutes then I need a break and sit.

Majority of pain is in the medial side with joint line inflammation. Average pain is 5/10. Knee continues to be warm to the touch. Went to surgical consultant for one year follow up. Pleased that progress is being made albeit at a snail's pace. He will accelerate the next follow up to at 18 months instead of usual 24 months.

Hoping to be in a position to return to work in six weeks...working in construction with lots of walking so to be continued.
 
Majority of pain is in the medial side with joint line inflammation. Average pain is 5/10.
I’m sorry to read you still have such pain at this point.

I had a rough, slow first year, but I did have a lot of improvement in my second year, as my whole leg continued to relax and heal.
Hoping to be in a position to return to work in six weeks...working in construction with lots of walking so to be continued.
It will be interesting to see how well things go when you go back to work. Be careful there and rest, ice and elevate at home if the pain increases. Best wishes for work!
 
Update
Found a YT channel that focuses on walking optimization utilizing the core among other things.
I’m noticing on my walks that I have a hard heel strike and working on smoothing my stride. I’ve also been noticing issues with my other knee and want to minimize additional pain, damage etc. It definitely seems to be helping with my stride and just need to try and unlock my knee on ground contact. I really am noticing others gait as well which is serving as a great reminder. Best walk to date yesterday 25 minutes!

Hoping for some suggestions on another issue I am experiencing. I’m having trouble doing seated leg extensions in particular completing the last 10 degrees to get the leg fully straightened. Need to use my other foot to prop the leg fully straight. My routine thus far has been seated extensions progressing with a band along with numerous other exercises which I still do 2x week. Has anyone else experienced this and make recommendation to address?
 
I’m having trouble doing seated leg extensions in particular completing the last 10 degrees to get the leg fully straightened.
Can you get full extension with the leg extended on the floor or bed?
I found the best exercise to improve extension was sitting on the floor and putting a soft pilates ball under my knee- then pushing down into it ( just using my muscles- no hands/force).
How is your medial joint line pain?
Is it improving at all?
I still have some similar pain on stairs- although I think mine is improving.
It is now 1-2 out of 10 rather than 2-3 out of ten. I am continuing to try to strengthen my medial quads which I think is helping.
 
I’m having trouble doing seated leg extensions in particular completing the last 10 degrees to get the leg fully straightened. Need to use my other foot to prop the leg fully straight.
Is this something you need to do in your normal life? If not, why worry about it right now? As your knee heals all these things will come back naturally. Your knee is only 1 month old and you should be concentrating on healing right now, not leg lifting. This could anger your already inflamed knee, causing more pain and swelling. It's best at your early stage to just gently walk around. That is natural PT and helps us all to improve naturally.
 
@EalingGran

The medial quads are the way to go for strengthening. Glad to hear the stairs are improving for you. My stairs are getting easier each week. I've got a set of 5 stairs to my garage and now able to do those a few times a day at super slow speed....it does flare a bit but feels ok by days end.

Also medial and joint line pain hasn't got worse and that includes yesterday...I did 10,000 steps through the day and things were not too bad this am!!

As far as my extension...yes no problem getting extension on the floor or bed. I've been doing knee pushdown but with rolled up towels...I'll give it a go this week with a pilates ball instead.
 
57 weeks into recovery

Did two 9 minute walks today with 30 minute rest in between...without knee seizing up just some pain and inflammation!

Got my 9" pilates ball...working on knee straightening/strengthening. Pushing down on ball with knee and also trying to straighten on ball. Will post back with results.
 
Got my 9" pilates ball...working on knee straightening/strengthening. Pushing down on ball with knee and also trying to straighten on ball. Will post back with results
The ball is also good for putting between your thighs and doing inner thigh squeezes. Not quite sure how these inner thigh muscles fit in with knee rehab but my pilates teacher is keen on me doing a few of these to balance out the quads and glutes work.
Also if you put the ball on a firm cushion ( bolster or I use a meditation cushion) you can do slightly higher partial supported leg lifts. Then turn the foot out at full extension to engage the medial quad ( vastus). This is important to improve medial/ MCL pain. It does seem to be working for me.
 
@EalingGran Thanks for the info. My kinesiologist has me doing inner/outer thigh squeezes. I can definitely feel those muscles working! I will look into those other movements to see where it can fit. My PT has over 30 exercises for me so I'm ready to swap some out!
 
My PT has over 30 exercises for me so I'm ready to swap some out!
A couple of other uses for the soft pilates ball if you fancy some changes to your routine.
1. Put it between your ankles and squeeze gently during heel lifts/ calf stretches.
2. Pop it behind your lower back during wall slide squats.
 
@EalingGran Thanks I'll want to try those! Most of my exercises are one leg balance type ones so I'm thinking I'm doing too much of those and inflaming the knee.
 
14 month update

Still have my knee dictating my life! Unable to return to work(construction) and difficultly doing any chore for more than 15 minutes. Walking 15 minutes a few times a week but cannot do that amount on a daily basis due to inflammation/pain at the outside of the knee and joint line. Medial pain is recurrant now so that is a bonus as it is not constant. Ongoing work on gait as I'm still locking my knee upon heel strike and it's flaring my left side hip, lower leg. Optimally knee should have slight bend upon heel strike.

Continued issues with stairs both up and down. So sick of exercises, icing and elevation! Followed all the instructions from day 1 and am still facing all of this! ../sorry end rant
 
I’m sorry you are still struggling. I didn’t get the outcome I was expecting, so I understand. It’s very frustrating. :console2:

What exercises are you doing?
 
So sorry you have such ongoing issues.
Do you think you may need an MRI to see what is going on? It does seem to be possible to have some types of MRI post knee replacement.
It must be so hard to have your knee dominating things for so long. I have found six months tough enough.
 
Hi @2chains , from a fellow long time sufferer. Firstly, may I say that my bilaterals have improved quite substantially during the second year. However, at two years out, one in particular was still most unsatisfactory, and I have now embarked upon finding out why. This involves doing the research and going to entirely different surgeons who are experienced in sorting out problem tkrs. I have discovered that my original surgery was flawed, and due to my also having to take two flights to get to the new surgeons, will take a while to resolve.
Based on my experience, I would wait another 6 months, then start investigations, away from your OS.
 
Hi folks! Thanks for lending an ear!

@Jockette I am doing many exercises 2x weekly and have cut back at this point..band exercises include seated leg extension, seated leg contraction, anterior stabilization, side lateral, push outs, clamshells, heel slide. Single leg balance exercises include straight balance, uni pedal stance, one leg romanian dead lift, one leg min squat, proprioception clock, single leg heel raise, single leg stance on foam pad, isometric hip abduction. Other exercises weighted hip abduction, knee extension, sit to stand, wall slides, quad sets, single leg bridge, wall squat with ball, knee flexion.

@EalingGran MRI has not been mentioned but I'll enquire about the waitlist. I think they can change settings on the newer machines to accommodate implants?

@Ghostpipe Another voice speaking to second year improvements. Thank you!
What was and how did you determine there was a flaw in your initial surgery? I don't envy you having to take 2 flights each way to get this sorted. Airports in my area offer assistance to passengers and hope you have this option!
 
This is from @Rain Dancer and her thread! Popliteal issue after TKR. Wanted to post this here for future reference so I can find in it down the road!

@2chains Thanks! Sorry that you are still having issues. The popliteus issue affected a number of things. I could only walk a few steps before I had pain on the outside of the knee (lateral side). The pain was on the upper calf, the crease of the knee, and above the knee, which is where the popliteus is located. I had no pain on the medial side. My gait would get worse the longer I walked.

My flexion was stuck at about 93 degrees. (My flexion now is 115 degrees and continues to improve.) My extension was 0 degrees, but I couldn’t keep the knee flat in bed for longer than a few minutes without placing a pillow under it because of pain on the lateral side.

If I tried to lie on my left side (the surgery side) there was sharp lateral pain as I maneuvered the leg into position. The pain could be relieved by putting a pillow between my knees. I would experience the pain again as I rolled onto my back. I had no pain when lying on my right side.

This could be your issue from your description of the test results. Some people experience pain only when lying on the operated side and have no pain when walking. As mentioned in my earlier posts, this issue was not diagnosed via an x-ray or MRI. I hope that you resolve your issue soon. I am happy to answer any more questions that you may have.
 
15 month update

My GP does not think I have an issue with the Popliteal as my pain is mostly lateral or medial and not behind the knee at the crease. I asked about MRI and was told all it would show was scar tissue, also wait list is 15 months. GP thought my recovery is inhibited due to having diabetes. Bloodwork came back negative for diabetes but did show low vitamin B12....surprised as I eat meat few times a week!

Walking continues to be an issue. I'm locking my knee when my heel strikes the ground...to correct I try and have a soft knee but it is painful on follow through and can only do it for 3 or 4 minutes. Pain has resumed below the knee... I feel it is the location where the lower implant was inserted. Lateral pain just below the fibula bone on the lower leg feels like a burning sensation but just going down a few inches or so not the entire lower leg.

Traded in my walking for groups of tasks. Typically put together a few short tasks ie. clean cat litter, sweep, roundup recycling and perform 30 mins of activity. After that I need a 2 hour break and try similar in afternoon. This seems be going good for the last two weeks.

Did try another walk yesterday and it is noticeably harder to get around. Stiffness and medial pain along with the lateral pain near fibula. I will try and add more walks through the week see how it reacts.

Going down stairs is getting easier. I can do my 2 flights at home, albeit rather stiffly, but still reliant on the handrail for stability.

Life still greatly dictated by my knee and I'm not able to make it back to work yet due to limitations with walking.
 

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