Total Knee Replacement 8 weeks Post Op

Hi pegs girl, I am new to this forum, but certainly not knew to having a TKR done.

I had Bilateral TKR done approx. 2 years ago, after having put up with walking bone on bone for about 6 years prior to the op. Why wait so long? Because I am a big woman, tall, around 120 kgs, and have a few other genetic health issues that I thought may have put the surgeons off wanting to do such a major op. I knew several people who had had great success with TKR (one at a time in their cases) and I chose a surgeon and went for a consult. He was happy to take me on, as although I'm big, I'm strong and have great stamina.

The Bilateral TKR went very well, and I was home after 5 days in hospital, and continued my recovery with lots of physio exercises, use of ice to reduce swelling, and persistance. Pain was managed by slow release Tramadol. At the 6 week review I was showing great Range of Motion (ROM) and physio was concentrating on strengthening from there on, as the ROM increased weekly. 6 Months review showed everything was on track and I had the x-rays to show things were going well. The patella on the left was in the correct position, the one on the right, just off perfect position, but nothing to worry about....But, at the 12 mth review, something had gone wrong. I was walking on torn ligaments and the right patella had dislocated and was way off to the outer part of the knee. How was I walking? Because I have a very high pain threshold, and to me, I just thought the right leg was taking longer to heal.

The left knee was still perfect. A Patello-Femoral Ligament Repair was scheduled promptly and done in Sept 2013, and that seemed to be going well too, until the 12 week review showed it too had broken down, and the ligament was torn again, and the patella was dislocated, again. It was now too close to Christmas, (I have a business that is total madness over the 'Silly Season' ) and so the second repair was scheduled for mid January. So the repair was done again, but this time not using my own hamstring as the ligament, but an artificial graft instead, which should have been bullet proof, so to speak! However, this time about 3 weeks into recovery my wound became infected, and I was in a straight leg locked brace for several weeks whilst taking antibiotics to kill the infection. No physio beyond flexing the muscles was allowed. Finally, the wound healed, and I was sent to the usual physio who had been dealing with me over the entire knee replacement saga. One of the genetic issues I hinted at earlier is a blood clotting problem which is treated by taking Warfarin, and having regular blood tests to check my INR (clotting time in layman's and after each operation it can take a few weeks to stabilise the INR. At the first session of physio, my INR was too high, which meant I could bleed internally very easily, so I said to him to take things very slowly and carefully. Well, the result was evident the next morning when I nearly passed out with a rush of pain when I stood. When I checked the knee, it was 16cms larger than it had ever been! I had bled into the joint, and had a massive haemotoma.  The surgeon tried to get it aspirated by ultrasound guidance etc, but to no avail, it was too clotted, and the result was, back in the straight leg knee brace for another 4 weeks until mother nature had taken her course and the warfarin etc had lessened the swelling. Then, when I was told to go ahead with physio again? I chose to go to my own physio. It became obvious a few weeks later after that things were not as they should be and x rays showed that the second repair had failed too! It was decided that the first TKR joint would be removed and a totally different one, with metal spikes going into the bones of the upper and lower leg for quite some distance, would be used. It was hoped that when the surgeon got into the knee he would be able to decide whether the ligaments would be reattached, or whether the implant would be one which they call The Hinge, because it doesnt need the ligaments etc to work properly. Fortunately, when he did the op, he used the one with the ligaments, but did comment afterwards that the damaged repair showed the ligaments had stretched. Neither of us could work that out at the time, but since, I realised when looking at the x Ray done when I had the haemotoma, the swelling in the joint at that point clearly shows the patella was forced away from the knee joint by some 5cms!! No wonder the ligaments had stretched! So, I am now 8 weeks post the last op and feeling that this should hopefully be the last time this knee has to be operated on. It feels more stable, it's still painful, but it has had a mighty lot of work done on it. The ROM is 118 and will continue to increase. I'm doing mainly strengthening exercises, for the knee and hip on both sides as the left knee has had to do so much extra work whilst the right has been out of action, but it is actually not quite as strong muscle-wise and fatigues during the exercises more quickly, so I'm trying to balance that. I am still taking painkillers, but have come off the stronger ones. Sitting at a desk is painful after about three quarters of an hour, and swelling occurs. Walking without a stick, limpy because I have to concentrate harder on each step, and my muscle memory to not limp is still feeble! After all, I've been limping for 8 years now!! The other thing I shall have to sort, are the orthotics in my shoes, as I'm now back to my original full height, and having one leg longer than the other, I am noticing that imbalance when standing, as the weight is definitely not evenly spread. I'm currently experimenting with bits of orthotic felt in my left shoe under the orthotic to raise the height so that the left leg feels as long as the right. Once that's sorted it may also help me to improve my gait.

If I had known the drama and pain I have dealt with over the last two years, would I have still been willing to have the Bilateral TKR? Absolutely! I can see the light at the end of the tunnel and feel that the outcome will be well worth it.....

Has anyone else experienced similar problems?

Hi pegs gir I am in my 4 week pluss two days , and thought I wasn't doing well, as is don't know anyone else that has had it done, I can bend my knee so my heel nearly touches my bottom, but I still have swelling and stiffness I also find my knee is very warm towards the other one, it keeps me awake at night , and is stiff in a  morning , but this seems to be the norm  for everyone so reading all these post has made me feel a whole lot better, been to physio twice and back there tomorrow where she said  it may be my last one , I'm back at the hospital 23september so will see what the consultant  says  I had mine done at 11oclock on sat morning and was discharged 10 am on Sunday morning not even 24 hours in hospital xx

 

I am 3 wks post op and am wondering if you had a lot of dicomfort when lying down. I can only sleep on my back at the present time and when I lay down it feels as thougj gravity is pulling my leg down into the mattress, leaving my leg very stiff and achy. I have been discouraged by my whole experience thus far. I am still using a walker to walk, still cant drive because i do not have enough use of my leg to use the pedals correctly. Have found myself getting very emotional, depressed and discouraged. Do you have any words of advice.

Hi everyone I am so glad I found this site I am 4 weeks post op and to be honest with you I could never have prepared myself for this amount of pain I go to physo I have a bend of 90but I carnt strighten it when I go she does get it quite straight but as soon as I get home it goes again I do all the excercise she told me to do and then some but what frightens me is she says if it isn't stright for when I go back to see the consultant I will have to have it manipulated  I push myself that much till I feel sick and in tears has anyone else had problems not being able to straighten there leg ?