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Debilitating pain 6 months after knee replacement
My husband had knee replacement surgery six months ago. The knee is still swollen, hard, and very warm. He still has chronic pain. He's at a constant 3-4 level most of the time, with episodes that shoot the pain up to 9 -10 range every day -- every damned day! -- that bring him to tears. And this is a man who's had broken bones, suffered concussion, and had a total hip replacement and was back on the golf course in six weeks. He's had every blood test you can think of to rule out infection. He's been X-rayed and scanned to rule out anything else. And we're told everything with the new joint looks fine, so keep doing what you're doing and it will get better. He does PT. He elevates, He ices. He does deep breathing. We've been to a pain management specialist who's fiddled with his meds and done laser therapy. And nothing works to bring the pain down. it's not getting better. Any ideas or recommendations?
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Has he tried PT in a warm water pool? It should reduce the weight bearing aspect but help with strength and flexibility.
6 months post tkr and sudden pain in new knee
Greetings @teak. Welcome to connect where we learn from each other. I am sorry that you are experiencing pain after your TKR. However, that is not unusual for many of us. First of all......a TKR is a pretty massive surgery involving connective tissue, bones, cartilage, and muscles. And.......6 months is not that long when you think about it. My first TKR 10 years ago took about a year and still comes back to haunt me off and on.
My other TKR was a Mako Robotic last year and I tried to be a good patient who does all of the pre and post-surgery exercises as requested by my surgeon. I had a much better recovery with this surgery and at this point don't even know that anything was done to that knee. The difference was just me and having more desire to be a good patient so that I would benefit.
A couple of questions........did you use ice and elevation after surgery? For how long? Are you inclined to overuse your knee at this point? Sports.....gardening.......dancing......sometimes we can get a little carried away and then have to pay the price.
Do you have any swelling in your leg below the knee? Do you know if you have developed some scar tissue? And my final question......have you discussed this sudden pain with your surgeon or even your PT?
Let me know what you are dealing with and let's see if we can get a better analysis.
May you be safe, protected and free of inner and outer harm.
Chris
Hey @teak, I add my welcome to Chris'. We have members talking about the exact problem you are having, so I moved your post to this discussion: Debilitating pain 6 months after knee replacement - https://connect.mayoclinic.org/discussion/chronicdebilitating-pain-after-knee-replacement/?pg=8#chv4-comment-stream-header because I wanted you to be able to relate to many of the members here. I encourage you to read through them. I am interested in your answers to the questions Chris asked you.
You might also be interested in this Mayo Clinic Q and A: Pain after knee replacement surgery: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-pain-after-knee-replacement-surgery/
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2 ReactionsThis advice is going to be too late for some people. For those considering TKR, here is what I suggest (especially if you're over 60 and haven't stayed in good physical shape).
Join a gym and hire a personal trainer. Explain to the trainer that you are going to have a TKR and would like to get in shape for it. If the trainer is good (the good ones have degrees in kinesiology) he or she will show you exercises to strengthen the quads and the hamstring muscles, as well as the core group and upper body.
Why core and upper body for a knee? You'll need to be in good shape before the surgery so you can handle the post-surgery therapy - simple things like sitting down and standing up, using the bathroom, walking, etc. Your recovery will go faster if you're in shape and stay in shape - total body.
Finally, immediately after the surgery, they should have you taking a short walk, and starting PT. They will first work on range of motion, ideally to get the knee to 120 degrees flexion and 0 degrees extension. Then they will start work on strengthening the quad and hamstring (the quad muscle is usually cut partially during surgery to move the kneecap).
Finally, find a surgeon who uses the Stryker/Mako robotic assistant. Best of luck. Don't rush. Get in shape. Find a good Dr - someone in their late 30s to rely 40s. Follow all instructions!
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5 ReactionsVery helpful. I have gone to 3 Doctors for evaluation. One uses Stryker method. The other Doctors who don’t use the Stryker/Mako robotic assistant say the surgery is just as good without the robotic assistant. i felt why not use the best.
At this point I hesitate to have surgery. I don’t have pain in everyday walking. But right knee bows out and is making my walking off and gives me pain in foot. And I cannot go up steps without
I am worried i will have more pain after surgery as many people do.
If there is no pressing need for surgery, I would personally delay. But seek advice from professionals. Surgery can be traumatic and pain and physio afterwards debilitating for months. And surgery can go wrong - after partial knee replacement 18 months ago I am in more pain than before. Building muscles to counter the bowing would be a path to follow now I suspect.
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1 ReactionI'm not so sure the majority of people have pain after a TKR. I'm glad I didn't come upon this forum before my surgeries! The people who are satisfied don't go out of their way to post.
Ultimately it's up to you. I was happy with the results of the surgeon and the Stryker process. FWIW, the PT told me that patients who had the TKR using Stryker recovered faster. I'm a good example of that. I'm very satisfied and all pre-surgery pain is gone.
Best of luck as you make your decision. I suggest more research before you make a decision.
Joe
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1 ReactionI have had several hip replacement surgeries, and a host of smaller orthopedic surgeries to deal with arthritis pain and damage. The best advice I ever got from 2 surgeons was "You will know when it is time to do surgery. When the pain gets bad enough, or the joint gets bad enough, to seriously affect your quality of life day-to-day, it is time."
As for robotic or traditional - robotic! I'm sure several people here can weigh in. My friend had one of each - the Stryker/Mako knee is superior to the other - perfect fit because it was made from the image of her own joint, more precisely placed so healing was quicker & easier. They corrected a serious bow in the leg - on the traditional TKR, the doc said he was only comfortable fixing it partway. I think Chris (@artscaping) can tell you about how they are different, too.
So my question - is it affecting your day-to-day quality of life at this point? Or preventing you from doing what you want to do?
Sue
Hi, @heyjoe415
I definitely agree with you on doing pre-hab therapy and getting into the best shape possible prior to a knee replacement. When I spoke to my surgeon about that he asked what I was doing so far and I told him I did a lot of pool jogging and riding my recumbent bike. He actually felt those two things were the best for pre-hab! The other bit of advice I have is to really stick with the PT after surgery, following up by doing the exercises at home a lot. I don't think I did that enough and neither knee reached quite to 120 degrees which seems to be the magic number.
I have heard good things about Stryker but I do believe there are other options that are equally as good but not robotic. I got a Conformis knee from Dr. Wolfgang Fitz, one of the developers of that knee. There are Xrays or MRIs, I forget which, done prior to surgery so a custom-made knee can be produced that will mimic your natural knee. That was my second TKR and it was much more successful than my first. I was not as knowledgeable when I had the first TKR so I just went to a surgeon and had him use whatever knee he used. I discovered afterward that the knee he used was one that had been around for quite a while and I still do have some discomfort in that knee after exercising a lot.
Dr. Fitz's nurse has told me I can have a minor outpatient surgery that would improve my flex but I really do not want to have to go through rehab again so I have not bothered. I can live with my knees as they are.
JK