Total Knee Repair Revision: A Success Story

Hi Joe don’t get me wrong I get frustrated sometimes lol but I don’t stay there …..I am 60 I am very active with my 3 year old granddaughter she keeps me moving …. Thanks Joe

Hello ezas,

No I understand. Just because a good recovery from TKR is possible doesn't mean it will happen. My own three-course recommendation dealing with TKR is:

1) use a PT who knows what you're planning and strengthen your quads and hamstrings and stretching under his or/her guidance BEFORE surgery. Work on this for at least 3 months prior to TKR. If you're in good shape, the time can possible be shortened. Don't do exercises that cause sharp pain. Expect knee bending to be unpleasant, but not sharp-pain inducing. Find a certified therapist who works with TKRs and is knowledgeable about kinesiology.

(Ezas - good for you for staying active with your 3-year old granddaughter. I think that's wonderful and shows what we can do and how quality of life improves when we replace those old, bone-on-none knees with something brand new. It was and is truly life saving for me. I ran 25 or so marathons, but none if the last 23 years. I've just learned to accept it and now find other challenges in the gym. A good trainer will challenge you to grow.

2) immediately after surgery a PT will come by and have you walking the same day as surgery - a short walk with two or three stairs. On subsequent days, you'll have more PT sessions, 2 or 3 a week, 3 to 5 times per day, and homework assignments. Do these faithfully. If you get exhausted and your knee hurts, stop and ice/elevate. I would take a very rare day off when this happened, but never mow than twice, maybe 3 times in the first two months.

3) You've heard it before, ice and elevate your knee above your heart, at least three or more times a day, and always after therapy.

This sounds like a lot, bit it doesn't cause sharp pain, especially the ankle slides and other range of motion exercises. All patients and all knees are different, so be patient.

Don't weigh yourself for at least two months after surgery. Surgery means swelling (water retention) and that adds artificial weight, sometimes up to 10 lbs, maybe more. This gets cut in half in about two weeks, Just wait eight weeks to not get discouraged.

And then going forward, every time you visit your dentist, even for a filling, ask your knee surgeon to fill out an Rx for antibiotics to be taken one hour before dental work. This will help prevent infection in the new joint. I don't think it's as scary as it sounds. Just remember this surgery is very traumatic to the body. The incision will heal, but return to exercise slowly under the guidance of your Dr. and/or PT.

Take narcotics for the first week or so to mange pain. And remember, the pain at the start (about one week) is the worst and then everyday gets a little better. Way better than before the surgery, when the knees continued to break down. After that, use an Rx like Celebrex (I tolerated that well with food), take the pain meds an hour before PT. Get off narcotics asap. A good rule of thumb - if your knee dosen't hurt much or at all when you're still, stop those pills. you can take Tylenol for pain. Celebrex or any NSAID reduces inflammation. And stay away from a lot of sugar. sugar causes inflammation.

Thanks Ezas. You gave me motivation to get all that in one place!

What is your granddaughter's name? You're a lucky guy!

Joe

(Please note, adjust any or all of this for your situation. When in doubt, call your surgeon. No two knees are alike. My right knee took longer to recover than my left knee. Go figure. I wish you all, all the best, and hope you get the same amazing results I did.)

Ezas, I have a totally botched TKR. First my surgeon pinched off the popliteal artery be hind my knee and said the totally numb leg and foot was normal. The foot soon turned purple and cold, he still said normal. My primary is the one who ordered and ABI test and then angiogram that found the blocked artery (but no plaque at least). It was almost 2 months when I had the artery surgery. Foot was pink and warm, but still have some numbness to spots on the bottom of my foot and some of my toes. Then a fractured kneecap (again lack of blood flow to blame). Then I found out he put in too small of a plastic piece between metal parts. That is causing my knee to give out on me.
So long story short...I need to look at a revision to get my leg back to be able to stand on it.
My knee is back to being as big as pain as before TKR in Feb. 2019. Just don't really want to go through it all again if I will be in the same situation again.
I just need to find out if others are happy they did a revision and what results were different from the first go round. (I had my left knee in 2013 and it was a piece of cake! up and going everywhere in 2 weeks with sometimes a cane and was looking forward to the right knee, which ended up being a royal pain in the _ _ _ _.)

Sorry about all that went wrong lori. I suggest you find a surgeon who specializes in revision TKR surgery. Yes they do exist. And I would probably only use a surgeon who has done revisions. Interview some surgeons, look at recommendations and evaluations. I have not had the need for a revision, but this is what I'd do.

Get better and all the best,

Joe

I am so sorry to hear …I know how frustrating when surgery does not go as planned …it is even harder because you know the pain and all the hard work that comes with this surgery…. But fortunately you had a replacement that went well so you know how well it can go also…. I was like you dreading the pain but always knew I was going to do the revision once The new surgeon told me knee was too big and would help to do the revision …. He said there were no guarantee but was confident he could help me ….My revision was like I said one year later …. Best thing I ever did I was pain free when I awoke after surgery which first time had pain from Time I woke up …. But I also knew a lot more on how to care for knee replacement … I put in place my myofascial therapist for any swelling which worked amazing had no swelling this time round …. Pt i had surgery on a Thursday started pt on Tuesday…..I am so happy I did the revision has been life changing for me …… good luck to you in whatever you chose to do if you want to chat about any of it or have any questions don’t hesitate to ask …..

Hi Lori I replied to you I don’t know what happened to the text so I will try again …. So sorry to hear what you are going through…..I know it is tough to decide to go through that pain all over again it was difficult for me also until I found out my knee was too big …than I just had to mentally prepare myself I knew I was going to do the revision after I met with new surgeon…,he explained what was wrong with my knee and how and with what he would fix it he explained he used mako robotics that it is more accurate system ….. he was confident he could help me …. Fortunately I knew how to prepare for knee replacement I had my surgery on Thursday I was at pt on the following Tuesday than the following Thursday I was at myofascial release for edema I went three times a week for edema was just half hour session I had no swelling after this surgery even doing pt…. I did that the first month than dropped to twice a week for edema …. You know what relief you can get with a good knee replacement…..for me best thing I could have done last year flexion at 65 before revision surgery now I am over 100 …. The moment I woke up from surgery I knew it was going to be different I did not have pain ….. so all I can say Lori for me I found good revision surgeon , put everything in place pt, mfr therapist….. prayed a lot …. I did not want to go on the way I was ….. so Lori good luck to you whatever you choose to do…if you need to chat or have any other questions don’t hesitate to ask ….for me revision was life changing in the best way

Thanks for letting me know how your the outcome on your revision. I’ve really been thinking about getting mine redone. The knee pain is almost as back as before the TKR. It is affecting my walk and is affecting my hip because I limp so bad because of the bad knee. Just a circle knee hip then my numbness in my foot acts up more. Thanks for letting me know about your outcome n thoughts. Lori

After walking with limp so long I also affected my hip has affected my gait also ….. after few months working with mfr and a good chiropractor my gait is just about there…. I have pain in my hip that goes down to my knee but now it only happens when I over due it …. Like I walked to much on Saturday I aggravated my hip wow takes me back …. But the great thing is I don’t have to live in that pain anymore …. My team I work with help me through it ….. I hope you can get some great dr’s and mfr on your team ,it will truly make all the difference

Great work ezas. you took the hard road but IMO the right road.

And it's good to know revisions can be done with a lot of success (and hard work).

In an earlier post you made an excellent point. The pt after surgery hurts, but gets better each day. That can't be said when one is bone on bone. It just gets worse. Anyway, good for you!

Keep up the great work.

Joe

Thank you for giving me confidence about my revision in a few weeks. Due to congenital hip dysplasia I had a THR in my 30’s which I still have at 76 ! Since then other hip and both knees replaced. Have struggled with last TKR since surgery some years ago , had MUA which helped in short term and one arthroscopy to remove scar tissue. Helped in short term but now back to 75 flexion. So now will bite the bullet so fingers crossed. My surgeon in Melbourne,Australia provides pre and post op program supervised by specialised physio.
Susan