Help with pain after 3 months of TKR

I had my therapist teach me before I stopped TKR rehab how to get up off the floor if I fell and he had me practice it with him so I am able to get from ground safely to upright position I have used several times not from falling but working in garden or on floor cleaning and it works

I have a solution for getting off the floor and while it's a not a quick solution, it definitely worked for me. Once I accepted that the TKR knee was never going to live up to my expectations, that it was never going to function like before and w/o pain, I learned to live w my new limitations. The days of climbing under a car restoration project or working on the brakes of an airplane would never be the same. With arthritis, I could still get into tight spaces but the pain and inflexibility of the TKR to bend properly meant a lifestyle adjustment was necessary. First, I compensate for the TKR inadequacy by building up the muscles in my hands, arms and legs. I go to the gym 3-4x per week and my regime is many pushups, curls, and lower leg exercises to build the calf muscles to compensate for the failure of my TKR knee. With good music and a great headset, it's a pleasure, not a task. After a few months I am proud to say it worked. I balance better using calf muscles and have not fallen in 10 months. Using two hands and one remaining arthritic but functional leg, I get up from the floor and couch. I recently climbed 4 flights of stairs, non stop, using the balls of my feet and other muscles rather than place the entire burden on my defective TKR knee. The second measure was to lose weight. Asking my arthritic (but functional knee) and my stronger arms to lift me off the ground was easier when my weight decreased. Third, my wonderful wife of 53 years offers to hand me tools when I am under a vehicle and that way I can avoid so many ups and downs.

My decision to TKR was a hideous mistake but I can' undo it. It took months before my rage settled down, but once I accepted my plight, the next step was problem solving. I refuse to become a couch potato, too many Honey Doos that need my attention, and waiting for some doctor in an 11 minute consult to solve this problem isn't going to happen. Is the TKR painful during and after exercise? Yes. Does it feel numb & hot and become inflexible after a short walk? Yes. Do I cringe with pain when I climb onto the torso twist machine? Absolutely YES, but all of that is less painful than accepting a sedentary and boring life.

Hi. I’m having mine on May 11th and if you’re anything like me you’re reading everything you can get your hands on. Please try to see how much the success outweighs the failure, something I really had to focus on because I’m scared to death! I’ve spoken to many that have had it done, this includes family members, friends and many acquaintances that have had it done along with their family members. This really helped me look forward to having it done and getting rid of this pain that keeps me so restricted. Keep the positive outcomes in mind, such as I’ve learned to do. My best to your husband ❤️
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Thanks for your kind words. Yes, I had two "second opinions". The prothesis was installed properly but the procedure varies amongst docs (I learned subsequently). I also had an MUA, MRI, an arthro surgery to remove scar tissue, am awaiting a tenex procedure to fix a tendon, tons of pt, taping, and a Genicular Nerve Block. My informal survey suggests those that are happy w the TKR (assuming the correct prothesis was installed) include thinner people with upper body strength. I have one friend who got hooked on Oxy and had to detox. Mayo's website speaks to "the saphenous nerve" and to shift it during surgery to avoid issues, but my surgeon didn't do that. In my non medical opinion, that might have mitigated months of nerve ending pain but I can't attest to that given I am an under informed patient, not an md.

To prep for the Genicular Nerve Block, Step 1 was an exploratory process. In my case, the doc stuck 4 long needles into the knee nerves that were giving me so much electric shock pain. At times the electric shocks traveled along the shin bone, into the ankle, and it would go on for hours making restful sleep a fond memory. The needles inject pain deadener which lasts 90 min. If no pain for 90 min, the doc concludes he hit the target nerves. Step 2 is done 3 weeks later and he performs a Radio Frequency Ablation which is similar to the procedure used in a heart. Step 1 worked for me, I was pain free for 90 min for the first time in months. It felt so good my wife and I danced to "good old" rock and roll. But when the 90 min respite ended, nerve pain returned but not as pronounced as before so I never went ahead with Step 2, the ablation.

The point is, I grossly underestimated the crippling side effects I would experience after TKR. I thought I did my research, read the waivers, but my research proved inadequate. Before I agreed to TKR, I should have experimented with Hyaluronic Acid, PRP, & stem cell but there is no turning back. Cortisone gave me some relief but it was very short term. Weight loss and building muscle have been my most successful answers at mitigating the grief this TKR caused. I look really silly getting up off the ground, I look like a toddler, but I am able to do it and not get hurt. That's better than the alternative.

Just curious, when was yours TKR, and how soon after did they remove scare tissue…
How did they know your pain was caused by scare tissue.
Doctors just tell me it’s nerve pain, Not sure what to believe.
I know I am on this blog quite often, just trying to figure this all out….
Brescher

Brescher, I am not an MD, but have struggled for 10 months to understand what happened after my 6/2022 TKR. I have no idea when the scar tissue began to form but the arthroscopy surgery I had in 12/2022 revealed (and removed) lots of it. Attached is a photo of what the doc found. After arthro, my patellar tendon still clicked & hurt every time I bent the TKR knee. That contributed to my inflammation. My knee would heat up and get very stiff. The arthro surgery revealed that my patellar tendon was badly abraded from normal movement and exercise, to the point where the tendon might rupture (IMO). An ultrasound confirmed the patellar damage. Concerning the relentless nerve pain, I received numbing injections in 9/2022 as part of the Genicular Nerve Ablation procedure. I got "lucky" therein, the numbing injections reduced the nerve pain so I didn't follow thru with the ablation.

I conclude the following and it's important to remind u that I am not an md. Mayo's website discusses "tuck the saphenous" nerve. To a mechanic like me, that means the nerve is "tucked" out of the way during surgery and that's done to reduce subsequent nerve pain which, in my case, radiated down the leg and was most persistent. Radiating, relentless nerve pain prevented sleep. It felt like a bare 110 volt wire touched my leg and the pain radiated down to my ankle.

My saphenous nerve was NOT tucked during surgery.

Some practitioners (I have heard) move the patellar tendon aside to install the prosthesis. My tendon was cut and that lead (IMO) to "severe tendinosis" according to the MRI procedure I demanded. My next step is Myofascial Release injections under the guidance of an ultrasound machine. Hopefully, my tendon will repair itself (heal) after the abrided portion is removed but at my advanced age, it may not heal properly. If MFR with ultrasound and injections doesn't work, I will try "tenex" which means I will need crutches. If that doesn't work I may have to be content with limited function until some other procedure comes along. The single best idea was losing weight so the TKR knee has less of a load.

I apologize for the jargon. It was not my intent to study knee surgery so thoroughly, but with most doc visits reduced to 11 minutes (I am not a Mayo patient), it's difficult to learn very much. Internet research on Mayo & Cleveland were the best way I could find to reduce the pain and increase knee function. If I was able to roll back the clock, I would have found a doc who tucked the saphenous nerve and did not cut the patellar tendon. BEFORE surgery, I would have fully exhausted the alternatives which include Hyaluronic acid (which is helping my other knee), prp and stem cell (there may be others I am not aware of). Cortisone produced very short term relief for me. If TKR produced any problems, I would adamantly insist upon an MRI & an ultrasound to help diagnose what's going on. I would also agree to the numbing portion associated with the Genicular Nerve Block procedure but I'm not an md so I can only speak to my personal experience.

God knows this was a real challenge. Hope I've helped.

Gabapentin can be very helpful for nerve pain. I was taking it before my TKR and went off it however went back on after the TKR because of nerve pain. It will go away in time and the Gabapentin will help. It made me drowsy so I took it all at night. Keep in mind it must be weaned off of when you stop as you can't just stop taking it or there are side effects.

Can you get it on prescription in the uk