12 weeks post TKR still swollen and hot and painful

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I had my TKR 12 weeks ago and did well to start with . Last 4 weeks it has been swollen, hot and stiff and painful all the time. BLOOD test showed high inflammation but normal white cell count. Am on my third type of anti-inflammatory which seems to make no difference. Tears of frustration. Am 64 and normally physically fit and well.

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  • Posted

    Frances i can sympathize with you. I am at 12 weeks and my knee is still swollen...in fact its huge. Physio was concerned about the size but my doctor isnt. I asked about anti inflamatory with both my surgeon and GP....both said give it time. i have found exercising helps with the stiffness but when i walk sometimes it feels like bone on bone. I am still icing often and elevating the leg above the heart.

    Hopefully time will help both of us. I'm 74 and lead an active life. i had my first knee done 11 years ago and was dancing at 5 months. My GP tells me its a major op and it takes time.

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    • Posted

      I completely understand both of you. I am 41 and 12 weeks post-op on my tkr. Up until a few weeks ago I was not having any real problems besides stiffness and some still swelling. But it has ramped up very much, way more swelling and my pain has gone through the roof. If I have to get up off the floor I have to go up to one knee and then use something to pull myself up. Getting the pain not just in the knee but same hip and thigh as well. Finally getting appointment to see my surgeon later this week. I wish everyone well and good luck.

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    • Posted

      Hi Jean, i am 12 weeks and still have a lot of stiffness, still on pain killers but reducing them day by day. I would ask your surgeon why it feels like bone on bone ? because you now have a new knee. Mine felt like that before the operation but has subsided. I do hope you find releif soon and can return to dancing. I am back dancing now but taking it very slowly. It is a major op,. and we all heal differently, listen to your body and rest when needs be. Good luck

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  • Posted

    oh please dont be so hard in yourself. try to get as comfortable as you can, rest and keep moving as best you can. THIS will be a memory shortly. Prayers.

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  • Posted

    oh please dont be so hard in yourself. try to get as comfortable as you can, rest and keep moving as best you can. THIS will be a memory shortly. Prayers.

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  • Posted

    I would want a few more answers by then i had little or no swelling and off painkillers , stopped icing at about 8 wks because it had so improved . I didnt take any anti NSAID at all because I'm allergic to them. Must be something causing inflammation . Good luck

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  • Posted

    C Reactive Protein and SED rate (blood tests) will give you the direction to go.

    Any fever? Seepage from the surgical site?

    Find out your numbers.

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  • Posted

    hi I am 17 months post op now and further down the line. swelling and heat was a major problem for me, it didn't matter how much i rested it if it wasn't elevated it used to swell up. I didn't return to work for 5 months because of this and i still had a sharp pain on the outer aspect of my knee which used to shoot down into my calf muscle. i told my surgeon about this pain a year ago but he just had me doing hamstring stretches.

    A year post op i had a routine xray done which shows that the implant has moved and that is why i was getting that pain on the outer side of my knee. i had bloods done which were all normal but a bone scan shows lots of activity in that knee and the report suggested it could be due to infection that has caused the implant to become loose. i asked my new surgeon about the bloods being normal and surely if it was infected it would show up on the results. apparently for joint infections they dont necessarily show up on blood tests. i had the knee aspirated a couple of weeks ago and i find the results out this friday. im really worried to be honest x

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    • Posted

      Hi Snoozy,

      When you say blood tests, that can be a wide range of different tests.

      It's true that when they do an aspiration and run a culture, it can be negative even though there is an infection going on.

      As I told Francis (above) the best blood tests they usually start off with are C-Reactive Protein and SED Rate. Those pick up inflammation. If those are positive and the numbers have increased from when your tests were normal, that can be a better sign of infection than trying to culture the bacteria. If there is an infection, the surgeon will usually go in and clean out the joint.

      If your implant has moved, when he opens up the knee, the Gold Standard (in America) is to take out the implant and put in a spacer and treat you with antibiotics for 4 to 6 months or longer. Then, replace the spacer with the new implant. That would correct your misalignment also.

      You shouldn't have to go through pain for 17 months. My wife had a TKR, after an infection, and she's walking around with almost no pain from day 1. I know not everyone is pain free from day one but it seems to me if your implant has come loose and is misaligned, you'll never be pain free.

      90% of the people in this forum don't do their homework. The Internet is a great source of information to help you decide the best course of treatment and what questions to ask your doctor. Just make sure you are on a trustworthy site.

      Asking people in the forum for advice is fine if you are looking for moral support but I wouldn't trust anyone (including me) for medical advice.

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    • Posted

      The blood tests i had done were to check my inflammatory markers, WCC and CRP were all normal. the aspirate taken from my knee was done in theatre conditions to avoid cross contamination. They put the aspirate in blood culture bottles and i find out on friday the results. What im trying to say is if you think something is wrong insist on an xray to make sure everything is fine. i was just fobbed of by my consultant at my 12 week check up where really he should have taken my pain seriously then and done a repeat xray. He is very apologetic as he missed it x

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    • Posted

      I agree, he shouldn't have missed it.

      Hopefully future tests will give some answers. If there is an infection our doc always hopes the culture will be positive so he knows what antibiotic to use to kill it.

      Let us know how it's going.

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    • Posted

      Well Robert its funny you should say that because i saw my consultant on Friday and hes told me the culture has come back negative. He is still convinced that my implant has come loose due to infection but doesnt want to do anything yet because he doesnt know what to treat it with. Ive been left for another 3 Months and he will repeat bloods, xray and aspitration to give what ever it is time to grow and then hopefully get a positive result. The first thing he said is if the result was positive its easy i just take the implant out and treat the infection. He said even though my inflammatory markers were ok the CRP result was high enough to indicate that a rare infection could be the cause and that hes been caught out before. He wants to make absolutely sure before doing a revision

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    • Posted

      Watch your self closely, Snoozy. Take your temperature often to make sure, if there is an infection, it doesn't spread.

      It's so interesting how these docs differ; my wife's doctor, as soon as her C-Reactive Protein (CRP) went up (after a PKR) got her into the OR within a week and had the partial implant out and a spacer inserted and started her on IV antibiotics for 6 weeks. Couldn't find the bug in her knee but wanted to be on the safe side.

      Left the spacer in for almost a year with no sign of infection then took out the spacer and put the TKR with more IV antibiotics. Two months later, another infection. Opened up her knee and cleaned it out and stitched her back up.

      Now she's on two antibiotics (Vancomycin - IV and Rifampin) and we're waiting to see what's going to happen now.

      If something else happens, I'm going to switch doctors and hospitals.

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