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Knee replacement. Advice needed!

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cantaccept posted 9/15/2020 18:35 PM

Try to keep this brief. Had total knee replacement in February. I am still hurting. I am wishing that I never did this, I was in less pain before surgery.

Finished physical therapy. Have good extension and flexion. It hurts to do eother though. It hurts to walk. It wakes me up at 3am. It swells if I stand for more than 10 minutes. Always swollen but gets worse. Stairs are still a problem. I can go up but painfully. I can go down hanging on and really painful.

Had a cortisone shot 3 weeks ago, it helped but has already worn off.

New weird thing...my knee cap feels loose.
If I tap it, which happened when I was massaging, I don't normally tap my kneecap, I can hear it hitting something, loudly enough that SO could hear while next to me. I can feel it hitting something. The whole area is just tender.

So much for being brief. I did call doc but next available appointment is November 24.

Anyone go through this? Is this normal? I am trying so hard. Do my exercises, ride the stationary, ice and elevate and heat too. Just tired of pain. If it is normal then I'll just deal with it and try to remain patient. Tush, I hope you read this!

thebighurt posted 9/15/2020 20:03 PM

No experience or advice, Can, just offering that I'm so sorry you still have no relief after undergoing surgery that should have made things better for you and doing everything right. It sure seems you shouldn't be hearing anything from it. Something seems wrong there... the appliance, it's installation (the doctor?). That's a long time to wait to be seen when something is so painful. ((((()))))

hcsv posted 9/15/2020 20:30 PM

It sounds like you may be a candidate for a revision. The knee cap or "button" can be moving incorrectly or has loosened. It can cause pain, swelling or stiffness.

minusone posted 9/15/2020 20:53 PM

Call the doctors office and demand to speak to the Doctor. You need a call back. You should not be in such pain and have to wait that long for an appointment. Most times the office staff is trained to screen calls and if you are not “pushy” for lack of a better word, they won’t take you seriously about the pain issue.

And your post, scares the hell out of me. I just found out that I need a knee replacement. Lots of pain, couldn’t do steps at all and had to sleep downstairs (with no shower) for three nights until I got my first cortisone shot....sorry for the t/j.

However I needed to speak to my cardiologist because of heart issues and the rescheduling of some tests. i called there and who ever answered the phone asked question after question WHY i needed to speak to the doctor. It was very annoying and I told her that after 15 years with this doctor and this is my first request for a direct call with him.... I was still in pain and not very nice.

I hope you get answers soon and i wish you the very best.

Take care and stay safe!!!

Adlham posted 9/15/2020 21:12 PM

I recommend that you request the doctor's nurse or PA call you regarding a medical question.

Explain your symptoms and request they order an x-ray. Knee replacement stuff I don't know as well anymore but that doesn't sound right to me.

You could go around them and go to an urgent care that has imaging capabilities or even to the ER, but I would consider those only if you can't get them to order x-rays.

Based on some people I know, you shouldn't be in this much pain.

And from personal experience with hardware failure and some less than stellar surgeons, keep at them.

Frankly, you should still be having routine follow ups but covid has made that really difficult.

I have been fighting my neurosurgeon for 3 months now and finally got it through that I cannot travel across the state & risk my family's health.

I hope it all goes well.

eta: we need a TushNurse signal!

[This message edited by Adlham at 9:13 PM, September 15th (Tuesday)]

thatbpguy posted 9/15/2020 21:41 PM

I'm 11 months out. Only 100 degrees bend. Swelling, pain, popping.... Far more knee replacements are like ours than you may know.

Now, my suggestion. A website called Bone Smart has been a huge help to me. Lots of doctors, nurses, pt's... GREAT advice. Just get on the message board for knee replacements and make a post. You'll get sound advice,

cantaccept posted 9/16/2020 05:40 AM

Yay! I slept until 6am and only woke up once. Followed my son's suggestion and slept in the recliner. I feel like I have a functioning brain this morning!

I did call doc's office yesterday and left a message for the physicians assistant. Probably have to call a couple more times before I get a call back. Since covid their office has been terrible in responding.

Minusone, don't let my experience and apparently BP's also, scare you. Just about everyone I have met that has had this is thrilled. One thing though, 6 week recovery is not average! My surgeon said I would be back to work! Almost a blessing that I got laid off, never would have been able to be on my feet for 9 hours, even after seven months.

BP, so sorry to hear that you're in the same situation. This is so much harder than I ever anticipated! The pain is making me so tired. I am on Bonesmart. I am not doing well navigating the site. I posted but it didn't update. Could be the lack of sleep. I will try again. Is your surgeon saying your recovery is on track? Just wish the info before surgery was more accurate. The sales pitch I got from my surgeon makes me so angry. I now call him the used car salesman at home.

ChewedMeUp posted 9/16/2020 08:09 AM

My mom (75) had hers done back in February as well. When covid hit, she wasn't doing her exercises on her own as much, nor getting as much PT because they spaced appointments more. She had some other issues, but in the last few months, she's seen dramatic improvement finally, and is back to working a retail job, on her feet for about 10 hours a week. It sounds to me like you need to see your doc because something has gone awry.

thatbpguy posted 9/16/2020 09:47 AM

My surgeon wanted to do a surgery about 3 mos out to enhance range of motion (cannot recall the name of the procedure, but they out you out and twist the knee around, breaking up scar tissue) but the procedure is only about 40-60% successful, ungodly painful, and often makes matters worse. I refused. That said, if there are other issues with the tkr hardware, then you get back and see your surgeon.

cantaccept posted 9/16/2020 12:14 PM

My surgeon wanted to do the same procedure. It's called manipulation under anesthesia. I refused also and had PT really push to improve bend. I am now at 118 but it is not pain free. I also cannot tolerate anti inflamatories. They make me so very sick. Would be nice to be able to reduce swelling but can only use ice and elevation.

WhatsRight posted 9/16/2020 15:39 PM

I had my knee done in 2015.

I am a rehab rockstar, so I did pretty good with the flexion and extension. But I continued to have lots of swelling and pain. It goes on for what seems like forever, then at some point… Months down the road… You notice that it is getting better. That you might not of even been aware of it, but all of a sudden you think,“Wow, I went up those steps pretty easily!“

It was just this summer that I caught myself running. Now I don’t mean “running“ running. I mean walking fast enough then occasionally both my feet are off the ground at the same time. At any rate, it was a first for me since my replacement.

It sounds like you definitely need to have your knee looked at, but I just wanted to give hope that after the Agonizing, irritating chronic pain that doesn’t seem to wanna go away… At some point it just does. And that if I had it to do over again, I would most definitely do the surgery again.

Good luck to you! And don’t let up on those doctors… You need to demand to be seen.

tushnurse posted 9/18/2020 13:27 PM

Hi ortho queen responding. I did not read any responses.
I dont care if this guy is rated number 1 or the ki g of joints. This is NOT normal. Honestly it sounds like you have scar tissue that needs breaking up.
Its time to get a second opinion.
Knees should and do hurt pretty bad for the first 2-4 weeks. After that it should slowly improve and by 6 mos be great.
There are newer techniques where pts are great and off all pain meds by the 2 week follow up.
Keeping swelling down is key warly on to getting good range and no pain but if that is slowed or you have tremendous swelling or a pissy immune system you absolutely can develop scarring in the new joint space that leads to limited movement and pain. This is usually fixed by a procedure under anesthesia.

tushnurse posted 9/18/2020 13:30 PM

Just read responses. The manipulation is needed and it does work extremely well IF YOU get back to therapy and are religious about your exercises. Even if it hurts.

1lifeoflies posted 9/19/2020 00:12 AM

I had a knee replacement in 2012, the physical therapy hurt like hell but you have to do it. The physical therapist makes all of the difference, mine pushed hard. I learned to take the full dose of pain meds about an hour before she arrived, otherwise I didn't need them so much.

Sometimes you can get an infection in the replaced joint, has this been checked out.

cantaccept posted 9/19/2020 15:32 PM

Hello Ortho Queen! Thank you for replying. I value your experience greatly.

This has been a rough road. Finally got started with PT in March (in home PT was a flake). 3 visits and PT tested positive for covid. I was lucky, didn't get it but had to give up PT until June. Massage was wonderful, PT can get me to 128 with some gentle pushing, I can do it with a strap, 118 just on my own, no help. Swelling is much better, it was awful. It does swell almost immediately when standing, things like cooking. I go to Home Depot and it seems it swells as soon as I walk in the door and I am useless for the rest of the day, pain and swelling.

I wasn't ready for mua at the time. Had just gotten started with PT. Saw PA and she said I was fine, mua not needed. This was after I fell and crawled across the yard trying to escape yellow jackets. Guess I'm not ready to run! Gave me cortisone, xrays, all was good.

The pain that wakes me is concerning. Lack of sleep is a bitch.

Would you still consider mua? Have an appointment on Oct. 3rd with surgeon (finally). Seems once surgery is done he is too busy. A wee bit arrogant. Bringing a list this time. He says I am not patient enough. Gave me a healing time of 6 weeks, 7 months now. I have been too patient. This covid did make things difficult. I also had the nerve burning pain, then spit out about 4 stitches. Learned to remove them myself (I was better than doc).

Sorry so long! It's just been hard. I am sick of myself! I am tired of sister (nurse) telling me that no one takes this long, that I must not be exercising, that I'm wearing the wrong shoes, not walking enough, walking too much, you get it. I am trying!

tushnurse posted 9/20/2020 15:31 PM

Would you still consider mua? Have an appointment on Oct. 3rd with surgeon (finally). Seems once surgery is done he is too busy. A wee bit arrogant

You just described every Ortho surgeon ever. Lol.
Seriously they have things set up so that all they do are pre-op visits and surgery. They tend not to enjoy talking to people. They just want to do the hands on work. Plus they never want to hear of a less than stellar outcome. Honestly I would encourage you to see a different ortho. Yes an MUA can still be an option followed by PT again. You missed an essential period of therapy by not having it after surgery. Best outcomes are the patients that skip home care and go directly to Outpatient PT within the first week.
My dad had to have an MUA after his last knee. He went from the OR to the therapy center next door the same day. He felt 100 times better and got off his pain meds in 2 days after it. Ask about oral steroids after too. That decreases the bodies inflammatory response and allows it to heal without scaring. That makes a huge difference and if you have to have the other side done have an aggressive plan in place so it won't happen on that side.

Foley05 posted 9/21/2020 13:07 PM

My wife has seen six different orthopods, for different issues. None of them meets the description just given. If yours does, find a new one.

cantaccept posted 10/20/2020 15:19 PM

I am not happy. Saw surgeon 2 weeks ago. Sent me for blood work, came back normal, very slightly elevated white blood cell count. He said it was fine. He did aspirated fluid to send for testing to confirm. That hurt!!!! He is suggesting replacing the spacer because I have a lot 9f side to side looseness. He thinks this could be causing the pain. I am so upset. The thought of another surgery and recovery is just terrifying. It has been such a nightmare. This was such a mistake! I was better before this surgery. Hope Tush reads this! I need a calm, factual perspective.

tushnurse posted 10/21/2020 11:39 AM

ALWAYS ALWAYS ALWAYS get a second opinion if you don't think things are right, or sound not quite right.

Changing a spacer would not be as big as a TKA, but it is another real invasive surgery.
Find another Ortho, and get a second opinion. Your first surgeon won't care, and it is important to get another perspective.

cantaccept posted 10/21/2020 12:17 PM

Thank you Tush! I was thinking that I should but doubting myself.

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