TKR revision- 11 weeks postop

So it has been 11 weeks since my total knee replacement.  I am trying to stay positive, but this has been more downs than ups.  Physical therapy had been slow.  I really thought since I have done this twice before this would be so much easier.

Quick recap:  Same knee had a partial which had to be converted to a total due to a stress fracture.  All was great with the total and PT went smoothly however about 7 months in I started noticing some issues. Bone scan showed loosening of the prosthesis so about a year after the first TKR I had to have a second one.  In 2 years my poor right knee has had 3 major surgeries 😦

Back to the present, physical therapy and using the CPM machine I couldn’t get past 90 degrees and this was after it was warmed up and at the end of PT. This was very frustrating as I was working on it hard.  I wasn’t too worried at first because I knew longer stems were put in the top and bottom and my orthopedic surgeon told me he tightened up a lot of the ligaments and such. Three weeks stuck at 90 degrees flexion was enough for him….time for a manipulation under anesthesia.  This was done 2 weeks ago.  The report stated they got a firm end point at about 80 degrees…in reality it was probably 90 since that was what I was getting at PT and I am sure they didn’t measure the same way.  At that point, “firm” pressure was applied (thank goodness I was knocked out!!!!)  and they could feel/ hear the scar tissue breaking.  When completed the measurement was 125 degrees.

I went to physical therapy the same day…a couple hours after the procedure.  The doc said he injected numbing medicine but, WOW it still hurt.  My knee was very swollen so they couldn’t get it to do too much but was easily at 95 degrees with all the swelling and with no warming it up.  Okay I will take that.  2 weeks later, I am still slightly swollen and the best we have gotten is 108 degrees with a lot of outside help.  Typically it has been 98- 104 degrees.  I was told not to fret yet but I am getting nervous and frustrated.  Next week, I am signed up for the pool physical therapy for 3 visits so hopefully that will help. I am praying that my two regular physical therapy appointments this week show more progress.

So for now I will continue icing and elevating and taking the anti-inflammatory to get the swelling down.  Thank goodness my husband doesn’t mind hurting me…lol…and it helpful when trying to apply pressure to get more from it.

Something new that I have experienced with physical therapy is taping and cupping.  I admit I was skeptical at first but both techniques have helped.  The taping was done to help reduce the swelling and I could see the difference.

What is the Kinesio Taping Method?

The other technique were have been using is cupping.  The first time I heard of cupping was with the Olympic athletes.  When the therapist asked if she could try it I said sure at this point we can try anything.  We used the cupping multiple times with success.  It definitely helped with the swelling and pain.  We also used it to relax some of the muscles and it was amazing on a knot I had it my calf.  We used both fixed and moving therapy.

http://www.mindbodygreen.com/0-16791/3-reasons-everyone-should-try-cupping.html

 

Update:  PT today (1/17)…111 degrees and 113 with someone applying a little pressure!  Progress!!!!

 

8 weeks Post-Op TKR

Well, I had hoped to continue my positive improvement but this last week has been a tough one.  My friends and family have to keep telling me that it has only been 2 months. I am just a little impatient.  I have to be reminded that I had a revision from a partial to a total knee, along with a stress fracture.  The problem is, between the 2 knees, I have had minimum 10….yes 1-0; TEN…..surgeries.  Everything from simple meniscus and debridement to lateral releases and patella realignment.  I keep thinking I should be all better or at least on a continual improvement path as in others.

 

Recovery can be easy or it can have many ups and downs.  I am fully aware, as I have been through the easy, the long and the bumpy roads.

Since, there is no brace and my incision is looking great I just want to feel better!!  Nope- a TKR can take a year.

 

So, what is happening 8 weeks out?

My knee has been really hot and sore.  I don’t think sore covers it actually.  Painful.  I have been taking Advil and recently my docor said I can try this topical pain ointment called Pennsaid,  It is so painful- if I had pain killers I wouldn’t hesitate.  Trust me that is saying something as I don’t take pain meds when I am supposed to.

It is still swollen which accounts for some of the heat and pain.  Yes, this can be normal. It feels like my bending has decreased again but maybe that is my  imagination. Sleeping is rough again too.  The weight of the blankets on my leg when I try to move puts too much pressure on the knee.  The worst thing though is how painful it is when I am standing/ walking for any amount of time.  A simple trip to the store is tiring and then causes afterpain.  Standing for an hour is about all I can do.   The pain is more in the back of my leg/ knee.  I keep massaging it- hoping maybe it is some ligament/ tendon that is just too tight.

I am hoping that I can get back into physical therapy.  I do my exercises at home but I am hoping the structure and encouragement of PT will assist. I don’t have a bike or pool access at home which I feel would help immensely.

So what is my goal?  This probably should of been mentioned early on in my blog.  Just turning 48 this week I have always been active.  Most people would be happy at the progress thus far, but not I.  Being a mother of a 5 year old and loving sports I need to be able to do physical activities.  I work as a chemist and a bartender, therefore being on my feet for an extended amount of times is common.

It is a long recovery….I can do it…..YOU can do it.  Have Patience and Keep Moving.

 

 

Total Knee Replacement-Surgery

Before I get into the total replacement let me say although my partial didn’t work for me it may for you.  Due to my age, my surgeon gave me the option for a partial or a total in August of 2014.  I choose to do the partial and it was great!  It felt like my own knee and recuperation was fast.

I believe a tumble I took in February 2015 was my downfall.  Ever since then my knee was hurting.  X-rays didn’t show any issues, but my pes anserine bursa was inflamed.  Physical therapy and a topical pain ointment helped to alleviate the bursa but I still had another type of pain.  We opted for arthroscopy to do some debridement and check things out.  It felt okay but still something didn’t feel right.  My surgeon was worried I might have a stress fracture or glue loosening.  Unfortunately, he would have to do a bone scan but bone scans can give a false positive if done less than a year after surgery.

Jump forward to November 2015.  The pain is unbearable and I can’t walk for any type of distance.  A bone scan is ordered.  Not only does it appear that the glue has loosened but I more than likely also have a stress fracture.  Talk about luck!  The only decision at this point is to go ahead with the total knee replacement.

Day of surgery is November 30th.  The hospital is undergoing renovations and family isn’t allowed in pre-op.  Why should I be nervous?  I have had way to many surgeries in my life so this should be a walk in the park.  Nope- I am extremely nervous.

The anesthesiologist comes in and tells me about the nerve block (expected) but then how once I am in the operating room they will do a spinal!  Yeah not happening.  I had three kids without an epidural because I didn’t want a spinal so not doing it now.  Thankfully, he noticed I was not too keen on the idea and let me do general anesthesia.   I have no recollection of the nerve block after they gave the “happy medicine” or being moved from pre-op.

Next thing I know I am waking up in post-op in severe pain.  I have had nerve blocks before and they were great for the pain.  For some reason this time it didn’t seem to work.  I was on morphine and percocets around the clock.  They do get you up right away and make you move around to get that knee working.  I had PT twice a day and had to get out of bed at 5:30 am!  Not good for a non-morning person.  I was released on post day 3.

 

The first picture was post-op day 1 in the hospital.  Didn’t have to much bruising except on that right lateral side.  I also had many spots of bruising on my other leg, upper thigh, and lower abdomen.  Those spots were obviously from the manipulating of the leg during surgery.  I used to be a surgical technician so I know what happens in the OR. It isn’t the most gentle surgery.  The three other photos are a week after surgery.

Physical therapy is going ok and I am good at extension; perfectly straight at 0 degrees.  Flexion on the other hand is a bit tougher and the best I have gotten is 85 degrees.  Still can’t do leg lifts without assistance but I can feel the quad trying to work.  It will come.

Here is the big reveal, the removal of the bandage, 10 days post.

I will update after my appointment on December 15 to see what the surgeon says.  I do remember through my drug induced state that he stated the glue was definitely loose and he couldn’t see a stress fracture but reinforced it anyways as you can’t always see them.

Till next time…..I will keep doing my physical exercises and icing.