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Inflammation under/over the kneecap after TKR
I would love to hear from anyone else who has had their legs straightened (knock knees corrected) during TKR.
I had both knees replaced in 2024, right in August and left in November, so I am 1 year+ out. For the first 6 weeks after each surgery, I was doing well then, I developed pain around the kneecap area. I can walk on flat surfaces pretty well but stairs and getting up and down from chairs is pretty painful. My range of motion is good.
My surgeon explained that my kneecaps were out of place from being knock kneed and the kneecaps were moved to the correct position during my surgeries. He said that the pain was from inflammation of the muscles or ligaments that pass under (?) the kneecap and it would take time for it to work out and that the more I use them, the faster the inflammation would go away. I am looking for anyone's experience or advice that can help me get through this.
Some additional information. I was discharged from PT at the end of February. I would like to go back but haven't had enough time to go regularly. My husband now needs full time care and I am constantly driving him to doctor appointments or for tests. We are pursuing every avenue to get him better but it takes up so much of my time. I haven't even been able to get out of the house by myself for a nice walk. I suspect that if I had been able to continue PT, things might be better.
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One more piece of information. My surgeon said in many of these cases they will shave the kneecap to allow more room for the ligaments but mine are so thin, he does not want to do that.
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3 ReactionsDo you know what type of alignment correction was done? The traditional view was "mechanical alignment" which essentially drew a straight line down the leg. More recently that has been rejected as very few people actually have that type of alignment.
Now surgeons are using one of three types of alignments: kinematic, inverse kinematic and functional. I was severely valgus (knock kneed) on my surgical leg and my surgeon did a functional alignment. Now my alignment on both legs seems the same.
As part of my TKR my surgeon did a patelloplasty.
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3 Reactions@steveinarizona
You should have received, or have access to, your surgeon's surgery report. I have mine and it is an interesting document.
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3 ReactionsYou sound a lot like me.
TKR on left 11-months ago. Sill have pain on stairs; mostly going down, some up. Tough to rise out of a chair. The lower the chair the more difficult.
I was supposed to get both 'knock knee' and splayed foot alignment (via an MRI to create a corrected implant). None of that happened. In fact the splayed foot is worse than pre-TKR.
I've picked out a new doc who does revisions at an excellent hospital. But I'm waiting for the one-year anniversary to first consult the original surgeon's partner. I wait to just cross the 'T's" to make my case for revision.
I'll closely watch to see if anybody offers some good advice or resources for either of both of us.
Good luck and God Speed on getting better and taking care of your husband (we have that in common too).
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3 Reactions@grandpun
Just make sure that the Revision surgeon is excellent. It is my belief that there are many hip/knee surgeons in the country but few that I would trust with my body. Now add revisions and the list grows shorter. Not all hip/knee surgeons do revisions and, again, not all revision surgeons are ones I would trust with my body.
My incredible surgeon, e.g., spends about 20% of his surgery time on revisions (both hip and knee). Read all the reviews, check out her robot and you might find some more of her reviews there (I would NOT go to a revision surgeon who did not use a robot).
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3 Reactions@steveinarizona
I'm looking for one that uses the MAKO system and at an excellent hospital.
THanks
I have been extremely fortunate to get in house PT before my knee surgery.
Also, see which exercise programs online will help you.
@grandpun
Just a few thoughts. Most such procedures are done in an outpatient facility although many are attached to hospitals. I would try very hard not, in general, to go to the hospital that my surgeon uses (the outpatient center). When I questioned the choice of hospital I was told that I would only deal with my surgeon and his people and the plan was for me to go home immediately after (which I did). On the other hand, an excellent hospital may not have excellent staff in a particular health condition. I would focus more on the surgeon selection and not worry about the hospital.
The MAKO system is excellent but so are some of the competing systems such as CORI and ROSA. I do believe that to do a truly excellent job these days a surgeon should be using a robot assistant. But any of the top three robotic systems would work fine. Rather than focusing on MAKO I would focus on the surgeon and then make sure that he is using one of these robot assistants.
Thanks for the info, insights, and leads.
I looked at all 3 and all 3 are good systems. It seems the vary in surgeon/machine interface set ups as well as their targeted application.
CORI is the only one featuring revision applications. And its real-time metrics and progress guidance seems well suited to revisions. This is very appealing to me for rTKA (revision).
ROSA seems to be very specific to 'first time' TKA use. It seems to use a similar for surgeon interface as CORI.
MAKO also seems appealing though the site didn't address revisions. The way it handles its digital measurements though seems very effective and accurate. The other systems rely on the surgeon to estimate (!) thickness of cartilage and amount (in mm's) of wear & displacement.
So I see two 'winners' in my search for effective revision: CORI and MAKO.
My search will continue to add an excellent surgeon to the mix.
Thanks again