One year and counting

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I hope I get some replies because I feel like I’m losing my mind. One year ago I had my right knee replaced. I’ve seen the surgeon for a yearly check up. He tells me X-rays are beautiful and knee looks and feels perfect. GP looks at it, says the same.  I have made arrangements to have left knee done in October since it is bone on bone and really hurting me. Am I crazy or what. Right knee still hurts. It is stiff and hurts me. It’s hard to walk on it. It hurts every morning. I still have to take a pain killer. Some say it’s because of the left knee some say it just takes time. The pain is right in the knee itself. Any ideas? Also I went on a site called bone smart and they said after awhile you don’t have to do the PT every day so I stopped, Dr said you should do it forever. VERY confused

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  • Posted

    Did you talk to the surgeon about your pain? After a year mine was pretty much pain free. It doesn't seem right to me and I would discuss it with the surgeon as a first choice. If that's not possible, another knee replacement specialist.

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  • Posted

    I'm over a year out RTKR and I notice when I stop exercising the pain in my knee returns. Me exercise routine has changed from PT days but always has stretching. Believe me I'm not a gym rat but hate the pain from my knees more than exercising so I try to get to the gym 3x a week. Well worth it. Good luck to you

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  • Posted

    I'm in the same boat as you. It will be a year this September and I feel like I'm worse now then before the surgery. More pain, but a different kind of pain and the swelling is crazy! You can see my swollen knee through my jeans. The worst part is that my surgeon says the implant looks good. I even went for a second opinion and he said all looks good and to just give it more time. My question is why does it feel worse then before the surgery. I feel for you, I really do and I hope you get some answers and some relief. Honestly, if it were me, I wouldn't go through getting the other knee done. At least not until your right knee is feeling better.

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    • Posted

      Hi, I honestly thought about putting it off but the pain in the knee comes on and it’s unbearable. Dr says X-rays are worse than last year and it is putting unnecessary pressure on new knee. I’ll tell you I’m sorry I ever did right knee but now I feel I have to do left knee to get relief. I have tried everything for pain already. It is past all that, the surgery is the only way. Maybe it is because I stopped the exercise, who knows. I just know I’m miserable. Like I said surgeon says new one is fine. I’m going to try exercising again. I’m going to ask Chico some questions. I feel he is the exercising guru. Thanks for writing back.
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    • Posted

      I wish you the best of luck and yes Chico gives great advice. The issue I have with exercising is that I might have Ehlers Danlos Syndrome which effects all of your connective tissue and joints. Regular stretching is off limits and so is yoga. I actually tore my Achilles tendon during a very easy yoga session. I always wondered why I hurt more after my pt sessions and now I know why. I wish I had known about this before getting my surgery. This limits my recovery and I have no clue how to make it better.
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  • Posted

    OK...there may be a few things going on here.  I'm 2 1/2 years post op and have read well over 4,000 posts on the Forum, so let me take a shot at this (I live in Texas...they shoot everything down here...).

    I'm not a big believer in having #2 done until #1 is fully healed because after the op, you literally "don't have a leg to stand on."  That's not a great situation to be in.  I know it's bone on bone and it hurts.  See what you and your doc can do to put off #2 a bit...even 3 more months.  Cortisone, Synvisc, topical Voltaren Gel...anything to give you some relief.  My #2 is also bone-on-bone, has been for years, but the warm Texas climate has literally saved me from getting #2 done...and I'm 70.

     

    If that cannot be put off, then you need to rehab #1 as fast as you can.  That means rebuilding the muscle strength in the #1 leg...especially quads, glutes and core.  The program is here...

    https://patient.info/forums/discuss/post-tkr-exercising-565527

    If you need to do more ROM work, here's stuff for home...

    https://patient.info/forums/discuss/tkr-rom-work-at-home-620053

    If the muscles aren't rebuilt, all the pressure is being put on the new knee.  This causes more pain...

    https://patient.info/forums/discuss/other-pain-after-a-tkr-641040

    Some residual stiffness is absolutely normal, even 18 months post-op.  Long-time TKR veterans will tell you that stiffness will ALWAYS return if you don't keep the knee active.  This is a life-long recovery.  You have to keep moving.  Try the Voltaren Gel (RX in the US, generic diclofenac elsewhere).  Use it in the morning, during the day and especially at bedtime.  Have your pharmacist check for any interactions (very rare).  This is a great anti-inflammatory and pain reliever.  Works in 15 minutes...

    Your doc is right about keeping the knee active and you must do the muscle rebuild to walk correctly, regain your balance and do stairs normally again.  Once you have your strength back, a lot of that knee pain will go away...the muscles will be handling the job.  THEN you can get #2 done.  If you can't put that off, get as strong as you can NOW!!!

    You already know that this is all very individual and that you can't compare yourself to anyone else's recovery.  You must do the best you can FOR YOU!!! 

    "Never give up!  Never surrender!" - Tim Allen, Galaxy Quest

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    • Posted

      Hi

      Thanks for replying. You say DON’T do same routine every day. I read all your other posts on exercising and am very confused. I am 71 and at least 50 pounds overweight. Just tell me what to do each morning and I will do it. I have no access to gym. So it has to be simple that I can do right here. Surgery is getting closer, Oct 29th. I live in Florida so walking out there is a kill between the rain and heat. Do you think you can just tell me what to do right here in the house. Any suggestions will be greatly appreciated 

      Hope you’re doing well. Thanks

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    • Posted

      When you start the exercise program, all your stretching and cycling warmups can be done every day.  So can a SLOW walk on a treadmill to keep increasing your steps.  That's also cardio and it can be a daily thing.  Once you start on the no-weight reps for your endurance, those also can be done daily but only for a little while  Once you start adding weight, everything changes.

      Trainers will tell you NEVER to exercise the same muscle group two days in a row.  Why?  The exercise breaks down the muscle tissue and releases lactic acid into your body.  That's why you hydrate a lot after a gym session...to flush the lactic acid.  If you don't, you'll hurt.  Simple fact.  The day off lets the muscle rebuild stronger...that's the way the body works.

      So...  If you start the gym routine with weight for your legs, you do it EVERY OTHER DAY.  On the off days, you can still do cardio, biking, stretching and, if you are at a gym, work on your upper body.  Then resume the leg work the following day.  Or take the alternate day off.

      This is all from my daughter Kate who is a graduate nutritionist from Rutgers University and a personal trainer for 18 years.  She is certified by the American College of Sports Medicine (2-year program) plus has 16 certifications from the American Council on Exercise in many disciplines (spinning, kick boxing, aquatic aerobics, etc.).  Kid's a total pro on this stuff.

      The trick is to make it a routine...NO EXCUSES!!!  You will get there...

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    • Posted

      Chico, this is not a reply to the above, but have been meaning to get back on here. 

      Of all your studies and knowledge, have you ever known of anyone that may have had something possibly go wrong during surgery of a left TKR and develop neuropathy?  My husband is this 1 in 100 person that would have something occur after almost any type of medical procedure. 

      He is 14 mo post op and his ankle pain began 3 weeks after the surgery. Every doc says no, but after biopsy of nerve removed from ankle, the report leads to a possibility. He is being seen by numerous doctors at Mayo here in Jax.  It sometimes seems they find something more after every test. Crazy. 

      This condition has robbed him of ever walking without some assistance for life. He is retired 52 yr police and it pains me daily to watch him go through such agony. 

      What are your thoughts?

      Stephanie 

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    • Posted

      Having a nerve damaged during a TKR is always a risk...but very rare to the level you describe.  Everyone feels numbness at the incision site which will never go away plus decreasing nerve issues, especially when kneeling on hard surfaces.  That may decrease over a long period of time or never fully resolve.  All of that seems to be normal as reported by many people.

      However, developing neuropathy due to the surgery itself...I have not heard of anyone report that.  Yes, short term issues with calf, ankles and feet post-op as the nerves heal and imbalances in walking can cause stress on other body parts have been reported (just like the onset of sciatica)...but this is temporary and resolves by the end of year one.

      This is from the National Institutes of Health, USA...

      "It is reported that at mean 4 years after TKR 6% of the patients have pain of likely neuropathic origin[9,29]. The use of perioperative pregabalin reduced the incidence of NP at 0%, while placebo pregabalin didn’t seem to reduce NP."

      This was not a direct study but a review of studies published in peer review journals.  I haven't read the whole thing...

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539476/

      ...and I have no idea if any study cited controlled for other causes of neuropathy such as diabetes.  I would suggest some further research on the subject. 

      Too bad you're not in New Jersey.  My cousin Greg has been a doc since the 60's.  He's semi-retired as he now, at a robust 74, practices as a "Patient Advocate" for people with tough cases involving unusual presentations and multiple other involved doctors.  He's kind of like that TV character "House"...but much nicer.  You might look into finding such an older doc to take a completely new view of the case, review the literature and provide some advice.

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  • Posted

    I was going to put a post up today asking where I should be after 7 months post TKR, as the pain still is really bad and at night it's horrendous. After reading these posts I will delay seeing a doctor as it seems normal. It's a very long tiring journey xx

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    • Posted

      Everyone experiences their recovery differently and there is no specific timetable for any single individual.  Any statistics you hear from me or anyone else always apply to the POPULATION of TKR patients...never to one person.  You have to own your recovery and get through it with determination and strength.  Not easy.

      You might try some Voltaren Gel (RX in the US, generic diclofenc elsewhere)...GREAT topical anti-inflammatory and pain reliever.  Use it during the day and especially at bedtime.  Works in 15 minutes.  Check with your pharmacist for interactions (very rare).

      Also, you should be in the middle of your muscle rebuild.  If not, your pain may be the result of your body putting all the stress on the new knee instead of back on the surrounding musculature where it belongs.  This will definitely cause more knee pain.  Gotta rebuild those muscles.

      Click on my name and then "See All Discussions".  The Post-TKR Exercising discussion is in there among the 30 I've posted.

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    • Posted

      I’d say ‘nornal’ Might not be right. People note likely to post if they have a problem so you can get a biased idea of normal from a forum  like this! Common isn’t the same as normal as in all is fine!  GP might be able to review meds and ask him/her refer you to a msk Physio for assessment and possibly some treatment.  
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  • Posted

     I’m not as experienced as some of the people on this group but I would say exercise every day I don’t think the pain never goes away I’m still early days but a friend of mine I was speaking to yesterday is two years down the line and she still has pain on a daily basis  she is also due to have her second Knee replacement done but is thinking about it because of the pain she is in I don’t think we can ever win but we need to stay positive and strong 
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    • Posted

      One possible reason your friend is still having pain could be that she never completed the muscle rebuild for her quads, glutes and core.  This is necessary to take the strain off the knee and put it back on the muscles where it belongs.  Failure to do so keeps all that pressure on the new knee.

      Again, this is just my thoughts on this.  She could have other internal, structural issues that only her ortho can diagnose.  But if the knee is sound and aligned, I'd have her strengthen that leg before she does #2.  Just sayin'...

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    • Posted

      Yes she has not done her exercises as she should but she does go swimming daily she has to use a float and just kick her head as she can only do the breaststroke and been told she must not do that my problem is I too can only do the breaststroke but I’m not  allergic  To the  Clorane  So can’t swim any more 
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    • Posted

      First, the breaststroke is not recommended for at least 6 months by the accounts of many on this Forum.  It puts undue stress on the knee.  Swimming is great; better is to do the rehab exercises in water and then hit the gym...or use $25 exercise bands at home.  Plus, when back and hips are not aligned and the muscle rebuild is not done, other pain can persist...

      https://patient.info/forums/discuss/other-pain-after-a-tkr-641040

      Gotta take that stress off the knee and put it back on the muscles.  Cannot skip the rehab.  It doesn't get better on it's own.  Time, work and patience...

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