Lingering issues 16 months after TKR

Posted by ellerbracke @ellerbracke, Jan 10, 2020

In spite of very good results from my TKR in September of 2018 - great flex, fully functional - I am still having some problems. The knee moves perfectly re. forward/backward motion, and up/down. However, anything involving some torque, or pulling on it, is not comfortable. For example, if my foot gets snagged on something, like vines in the garden, or a bunch of bedding on the floor while making the bed, it is Ouch! Will be heading to an area with lots of snow soon for vacation, and I can imagine that I won’t be able to walk in snow any higher than perhaps ankle height.....Same with simply standing and bending leg inwards to pull off a sock. Not good, unless I first brace the TKR leg with help of hand against the other leg. And even though I am finally able now to get out of my car (sedan, not SUV) the normal way - left leg out, foot on ground, followed by twisting right leg to join, it is not natural or comfortable yet. Most of the time I still prefer the turn on seat, both legs out together method. Granted, neither of these things are serious or very limiting, but after more than a year I was hoping that the torque ability would have returned to pre-surgery status. Any long-term TKR members have these problems as well, or how did you fix them?

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@ellerbracke I am not aware of having these problems but maybe if I pay more attention I will discover I do! I will try to notice and get back to you if I do or do not. I suspect that discomfort from twisting may be something that is common. If it's not severe you probably just have to learn to live with it. I do know I pretty much get out of the car in a normal way, or did until I fractured my upper femur. Now when I get in the passenger seat I sort of have to lift my L leg to get it in comfortably. I know I get in on the driver side fine though.
Bottom line though, you probably just have to learn to live with it and try to not let it bother you. I envy people who can get back to activities like tennis, skiing, etc. I would love to be able to ski again but now that I have osteoporosis that would be out of the question anyway. I think those people who can do those activities after having one or two TKRs are in the minority.
JK

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@ellerbracke that is so disconcerting - I want to see what others say about their experiences over a year out.

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<p>Reoccurring knee pain 17 years after total knee replacements.</p><p>For the first few years after having both knees replaced, my mobility was great. BUT for the past 10 years, pain has been increasing on both knees. Local Orthopedic Surgeons have viewed X Rays and claim there is nothing wrong. My Pain Management Specialist has tried to "burn" the nerves in that area, with NO improvement.<br />Pain is on the top of the knees, just above the knee cap (join or other parts of the knee do not hurt!). Application of Aspercream (with 4 % Lidocaine) helps, so it appears the source of pain is in the tissue just above the knee cap.</p>

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@manmtn Welcome to Mayo Clinic Connect, a place to give and get support. You had a successful TKR but as time went on have had increasing pain. You are looking to connect with members that have had similar experiences.

You will notice I moved your question to a previous discussion where members like @contentandwell @saeternes have discussed this topic.

Elsewhere in the Joint Replacement group members like @auxiliary @judybearden1 @loriaakre @loriaakre @bluebrass @anncgrl @butter12 @marynajdek are discussing TKR as well.

May I ask if the pain is at all considered neuropathy?

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@erikas

@manmtn Welcome to Mayo Clinic Connect, a place to give and get support. You had a successful TKR but as time went on have had increasing pain. You are looking to connect with members that have had similar experiences.

You will notice I moved your question to a previous discussion where members like @contentandwell @saeternes have discussed this topic.

Elsewhere in the Joint Replacement group members like @auxiliary @judybearden1 @loriaakre @loriaakre @bluebrass @anncgrl @butter12 @marynajdek are discussing TKR as well.

May I ask if the pain is at all considered neuropathy?

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Yes still considered it neuropathy with numb spots some tingling. Can’t go without socks n shoes around the house. Foot gets cold and hurts. My situation is a little different then others. My TKR surgeon pinched off my popliteal artery and told me my numb tingly cold foot with purple toes was normal and give it a year or two. My primary is the one who ordered an ABI test that led to angiogram and the blocked artery. Had another surgery 58 days after TKR to take out clot and return blood flow from my knee down. Went back to TKR surgeon and all he said was “why did you wait so long to get it fixed you could of lost your leg”. I still have cell and tissue damage and will have issues the rest of my life thanks to my TKR surgeon who neglected to listen to me and do anything about my problem.

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@erikas

@manmtn Welcome to Mayo Clinic Connect, a place to give and get support. You had a successful TKR but as time went on have had increasing pain. You are looking to connect with members that have had similar experiences.

You will notice I moved your question to a previous discussion where members like @contentandwell @saeternes have discussed this topic.

Elsewhere in the Joint Replacement group members like @auxiliary @judybearden1 @loriaakre @loriaakre @bluebrass @anncgrl @butter12 @marynajdek are discussing TKR as well.

May I ask if the pain is at all considered neuropathy?

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I DO also have peripheral neuropathy (Sp?), which occurred some years before the knee replacements. Knees were good for about 10 years after replacement, but now are progressively getting worse. Local Orthopedic doctors have done X-Rays, Bone Density tests, etc., and can find nothing wrong! Based on my Internet research, I'm now looking at something called "Metallosis".

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@erikas

@manmtn Welcome to Mayo Clinic Connect, a place to give and get support. You had a successful TKR but as time went on have had increasing pain. You are looking to connect with members that have had similar experiences.

You will notice I moved your question to a previous discussion where members like @contentandwell @saeternes have discussed this topic.

Elsewhere in the Joint Replacement group members like @auxiliary @judybearden1 @loriaakre @loriaakre @bluebrass @anncgrl @butter12 @marynajdek are discussing TKR as well.

May I ask if the pain is at all considered neuropathy?

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@erikas @manmtn As I said in my response to ellerbracke a year ago, I never really had that problem. I think though it is probably a common problem that people have to learn to live with. A knee replacement is never the same as a natural knee. With me, it's primarily that I don't have the flex I would like. Doctors aim for 120° but I have heard of a few people who managed to get to about 140°. Mine hovers around 120°. After a lot of exercise, I may feel some mild discomfort but it's not severe enough for me to give it a second thought.
The thing that comes to mind first for what you describe though is a possible allergy to the metal in the replacement. This seems particularly possible since it's both knees. Allergies can happen after never having had them before. It may be possible that is a new allergy. Perhaps you can have an allergy test. Unfortunately if that is the problem I think the only solution is to redo the knees.
JK

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Thanks for your reply. Internet research has indicated that yes, Titanium CAN oxidize and produce "particles" of pain causing materials. It is recommended that I have some fluid removed from the joint area (using a hypodermic needle) and see if it is "dark colored". IF SO, that indicates the Titanium is indeed "flaking off"! Unfortunately, trying to convince MY local orthopedic doctor to do is going to be difficult, he just wants to keep trying different drugs to stop the pain! Alton

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@manmtn

Thanks for your reply. Internet research has indicated that yes, Titanium CAN oxidize and produce "particles" of pain causing materials. It is recommended that I have some fluid removed from the joint area (using a hypodermic needle) and see if it is "dark colored". IF SO, that indicates the Titanium is indeed "flaking off"! Unfortunately, trying to convince MY local orthopedic doctor to do is going to be difficult, he just wants to keep trying different drugs to stop the pain! Alton

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@manmtn I have given up on the local doctors around me, I’ve heard too many tales of woe, and I have a couple myself. I live in southern NH, about 55 miles north of Boston, so I go to Mass General or Brigham and Womens for just about everything beyond my PCP. Is it possible for you to go to a major medical center? If not I think you should at least consider getting a second opinion from a different doctor who is not affiliated with the same hospital as your current orthopedist - that’s important.

It’s just seems way too coincidental to have the problem in both knees unless it is the prosthesis. Your own research indicates that it can be a problem.
JK

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I am 9 weeks out of total tkr I went to dr last week he informed me there was nothing more he could do for me …..I have been struggling with inflammation my therapist tells me I have to back off therapy a few times in the last several weeks……my therapist and I finally came up with a game plan to take slower that recovery was just going to take longer. I also had a manipulation at six weeks went well but inflammation was draw back again…..long story short my last appointment at dr i was in with pa I asked maybe steroids would help with inflammation and maybe if possible try manipulation again if we can get swelling under control … he listened to all my concerns he said be right back dr came in less than a min exam my leg said I was worse than before the manipulation which I don’t believe was true ….. he continued to say there was nothing more he could do for me he said it can still change in next two years than left room.,,,I left there so angry I picked a very good dr but as I went back and checked reviews his success rate very high he had a few problems but the ones with problems had the same problem I am having…. If your recovery is not in his time he wants nothing to do with you …my own fault I read this but I thought I would be one of those ones recovered in 3 weeks what a mistake I made… now I am looking for a dr to get second opinion thankfully my family dr great she prescribed water therapy told me she will do whatever she can to help …. My therapist gave me home exercise I do every 3 hours …I am not going to give up I can’t afford to I am 59 I have active grandchildren would love to get back to work I am happy I drove last week I have gotten some independence back so give up not in my vocabulary….has anyone else had dr like this

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