Knee replacement with post traumatic osteoarthritis

Hi, @rtbadleg - welcome to Mayo Clinic Connect. The extreme pain sounds very hard to contend with, especially being responsible for your farm and associated work.

I'd like you to meet @johnbishop @contentandwell @debbraw @connie1559 @ellerbracke, who may have some perspective from their own experiences with looking toward a knee replacement.

Did the cortisone shot you received help with your pain at all, @rtbadleg? What has your doctor suggested for immobilizing the knee and/or keeping the pain controlled enough so you can do your farm work till surgery, if you have to wait for three more months?

No the shot did not help at all and it’s been a week. I have drugs for pain and gabepentin for nerves as I have a very big skin graft on the left leg. I can use pain drugs but only when I work outside as they make me itch to beat the band even with antihistamines. To work outside without pain the joint can not move. Uneven ground is difficult. They want me to keep it moving so muscles but I can’t when I work outside. Sleep is hard since when I move it can really be sharp 10 pain.i see surgeon again on March 28.

Hi, @rtbadleg. I just had a total right knee replacement on 1/21/19, due to post-traumatic osteoarthritis. Like you, I had a cortisone injection 3 months prior to my surgery. I had one in July, 2018, and another in November of 2018. After years of getting relief from injections, the last two did nothing, plus I started having a reaction to the shots. After wasting years postponing the surgery, it was time for a TKR.

I had to wait 3 months and by then I had basically been without relief from injections for about 9 months. During those 3 months I tried several “non prescription” braces. I used an Ace brand with Velcro straps most often. It was a less than perfect fix, but better than nothing. I did feel it was very helpful when walking downstairs or downhill.

I also tried various rubs like Aspercreme with Lidocaine, and Icy-Hot. The relief would be minimal and short lived. I even used CBD oil for a time, but got no results.

My doctor prescribed Hydrocodone 5-325 for the last month. It helped, but it didn’t take all the pain away.

I own a business and can mostly work at a desk. I don’t have a farm, but I have horses, a cow and dogs and parrots. I am lucky to have a husband who stepped up and cared for them. I still managed to cook, do laundry and keep a clean house, but I did have to lower my standards a bit.

I wish I could tell you that I found the perfect answer for you as you await your surgery, but I can’t.

I can tell you that the TKR has changed my life for the better, and I improve more and more every day. I had a Valgus Deformity so I got a Zimmer Biomet Persona knee. Even at less than a month post surgery, I am experiencing very little discomfort. Walking feels great for the first time in 14 years!

I hope your wait for the surgery passes quickly. I think you might remind yourself that each passing day gets you closer to your cure. You are going to be amazed at how great it is to have a normal leg again. Good luck to you.

Please visit this group often to talk. There are so many kind and helpful folks here. Be good to yourself every little chance you get. 👍🏻

Thanks for the info I would love to wait till next winter when Farm is very little work as dealing with being unable to do work in the summer is not an option I am afraid. I have horses and they are great. I wish I had no feeling in the knee like I have in the left leg would make this so much easier. When I had surgery on it I was up and at it the next day. It works great.

Hello @rtbadleg, I would like to add my welcome to Connect along with @lisalucier and other members. I have bone on bone along with advanced degenerative arthritis in my right knee. I did have a cortisone shot in the knee last summer and it did help me with the pain until I kneeled down on the concrete driveway to work on drain pipe. I'm meeting with orthopedics on the 27th to hopefully schedule a date in late March or early April for a knee replacement. After the pain came back when I knelt on the concrete the doctor gave me a prescription for a pain creme but it really didn't help much. It's more of an ache than a throbbing or sharp pain but it really bothers me at night when I'm trying to sleep.

I did buy a couple of different styles of knee sleeves that helped a little with the walking. One I liked had a gel cap around the knee cap and seemed to keep it from flexing too much. I got it at a medical store. What has helped me more than anything has been to focus on pre-knee surgery exercises which has given the knee a little more strength. I've been doing them for the past 4 months or so when I started thinking about getting a knee replacement. It has kept my knee somewhat flexible and the pain is not as bad when I bend it a little.

Hope your surgery goes well.

Thank you for your time and insight it’s something I was hoping I would not face till I was very old. My knee has a great deal of scar tissue and the dr that did the injection commented on how hard he had to push. The knee has never been able to bend all the way since the accident. They were just trying to make sure I would walk again. I have done so much more than anyone thought I would. It’s been 12 years since my accident that got me into this mess. I am hoping knee replacement will go well with that fact I have been told this is a one time thing for me as I don’t have enough bone for a second replacement. Screw that goes through rod at top of knee is very close to the joint.

I had TKR May 2016 with great results; obviously it took time to heal along with appropriate ROM etc. I attribute a lot of the good results to the Conformis customized brand of knee replacement. Back to playing competitive tennis now.

How truly wonderful I hope I have that good a result!

@rtbadleg Is there a reason you had cortisone rather than synvisc? When cortisone stopped working for me I started getting synvisc and that helped a great deal. I presume you must still have synovial fluid - synvisc replaces that when a person is “bone on bone”. I always opted for the three weekly shots rather than the one shot. My personal logic was that the gel would spread out better than if it was in one big lump. To me, that just made sense but I have no medical reason to think that, but the shots always did help me a lot.
I have had two TKRs, both L and R. The most recent one, in October 2017, is a Conformis also, like @jeffkirc and I have also had great results.
Regarding your needing to immobilize the knee, is that a doctor recommendation or something you feel would help with the pain? If it’s something you feel would help, maybe you should speak to your doctor of physical therapist. You may find the most relief from exercising it. Yes, it would be painful at first but once you can strengthen those muscles it can make a huge difference. By the time I had my TKR I was in considerably less pain than I had been when I embarked on the journey to have it done. I had to wait a long time, over two years because my platelet count was low due to having NASH cirrhosis. Then after having a liver transplant I had to wait awhile also.
Of course having a rod in your leg really does change everything, that’s not a problem that many people do have. I hope some of the suggestions here can help you, If you do find anything that helps I hope you will tell us about it. You are definitely in a more difficult position than typical.
JK

It is amazing that all of you are open and helpful as I felt so alone in this you guys have made this easier knowing all this information you have shared. I was not given a choice on type of injection did not even know there was anything else. I have had three surgeries on the right leg with the rod to get to the point I could walk again. I was non walking for 5 months. The knee does not hurt if I lock it back and walk stiff legged not letting knee move if I walk normal it will have very sharp pains that will take my breath away. Carrying weight like buckets of water is painful no matter what I do.