2+ years post TKR tendonitis or ?

Posted by cecilsmichie @cecilsmichie, Mar 7, 2023

I'm 66, had right TKR July 2020, left TKR December 2020 for osteoarthritis. Both surgeries went well as did rehab. Both knees bend well. The problem I have is a tight burning feeling around the knees, one or both, ( that I would compare with tendonitis ) that occurs after some activities : taking lots of stairs, shoveling snow, walking up and down hills. I have a series of stretches that I do. I have taken ibuprofen on occasion. I have never had swelling or sharp pain. Over time it resolves but then it comes back again. My knee implants are bi-cruciate retaining, so I have all my ligaments. I wonder if they ( ligaments ) are still adjusting ? Reluctant to see a surgeon and mine has since retired. My main physical activities are cycling, walking/hiking. I would like to increase my cycling and hiking but this discomfort happens frequently enough that I feel stuck in place. Any suggestions would be appreciated.

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Hi, I am 65 and had a TKR in November 30, 2022…. I am now suffering from a very very tight feeling on outside of knee and then around the entire knee. IT BAND…
I have done 3 months of PT…. Now trying dry needling…. Hopefully get some relief from this pain …. I will keep you all informed as I move forward!

REPLY

Hi @cecilsmichie, I would like to add my welcome to Connect along with @brescher. @janicemmccarthy mentioned tendonitis like pain in an older discussion and may have some suggestions or thoughts if she is still following Connect. Here's an article that mentions PT for similar symptoms:

— Successful Nonoperative Treatment of Persistently Painful Knees Following Total Knee Arthroplasty—A Case Series: https://www.practicalpainmanagement.com/treatments/interventional/successful-nonoperative-treatment-persistently-painful-knees-following.

Since you mentioned that the symptoms seem to occur after some different activities, I wonder if it's just a matter of too much activity? Have you discussed the symptoms with your doctor or care team?

REPLY
@johnbishop

Hi @cecilsmichie, I would like to add my welcome to Connect along with @brescher. @janicemmccarthy mentioned tendonitis like pain in an older discussion and may have some suggestions or thoughts if she is still following Connect. Here's an article that mentions PT for similar symptoms:

— Successful Nonoperative Treatment of Persistently Painful Knees Following Total Knee Arthroplasty—A Case Series: https://www.practicalpainmanagement.com/treatments/interventional/successful-nonoperative-treatment-persistently-painful-knees-following.

Since you mentioned that the symptoms seem to occur after some different activities, I wonder if it's just a matter of too much activity? Have you discussed the symptoms with your doctor or care team?

Jump to this post

Thanks for connecting with me…. I am actually going to my Dr. tomorrow…. I also feel all this PT that they have me doing is way over the top…. My leg is strong and motion in both directions is great. I never had a problem with that…
I will keep you informed on this chat!! I am laying low today…. No exercising…. I also few it was to much!!
Thanks again !!
Brescher…

REPLY

No More PT…. Could have been over worked…. According to Doctor…. Possibly irritated lower leg tendon….
Still trying dry needling a couple more times in a new area…
Staying hopeful as my knee itself is no pain and excellent motion!!

REPLY
@brescher

Thanks for connecting with me…. I am actually going to my Dr. tomorrow…. I also feel all this PT that they have me doing is way over the top…. My leg is strong and motion in both directions is great. I never had a problem with that…
I will keep you informed on this chat!! I am laying low today…. No exercising…. I also few it was to much!!
Thanks again !!
Brescher…

Jump to this post

I have gradually come to realize that repetitive motion exercise activities such as bike riding, stairs, walking & gym exercise machines (all of the things I enjoy in life) exacerbate the pain in my TKR knee. After these exercises the TKR knee swells, gets warm, ROM is limited, and is painful. I'm not a doc but here's what I think is happening. As I flex my TKR knee, it rubs against the scar tissue that's formed (and reformed after arthro surgery) & gets irritated (I euphemistically refer to it as "angry") and the only solution is rest. Drugs and ice do little to reverse the impact of repetitive knee exercises. I refuse to give up my fitness and acquiesce to the pain but I fear continuing to aggravate the knee could cause the tendon to sever. This website discusses the issue.
https://www.practicalpainmanagement.com/treatments/interventional/successful-nonoperative-treatment-persistently-painful-knees-following
Mayo also discusses the issue here.
https://sportsmedicine.mayoclinic.org/condition/kneecap-instability-patellar-tendinitis/
Excerpt: "The pain is often worse with activities such as running, jumping, walking up and down stairs, and squatting, and it can also occur with prolonged sitting."
Given these limitations, how do I remain fit other than swimming? I found that walking upstairs is easier on the knee than downstairs, therefore, I use both handrails when walking downstairs to min the impact each step inflicts on the TKR knee. I continue cardio and strength building exercises. I build those collateral muscles that support knee functions thru targeted gym exercises and minimize the full flex of the knee that "angers it". On my TKR knee, I limit the range of the leg press to "just before" the knee pops. I use the leg press by alternatively pushing (lifting) with my toes and heels (see attached photo). I warm up extensively before my daily power walk and try to plan sedentary activities afterward. I strengthen my arms and hands to forestall falls and also to supplement the inadequacies in my TKR knee. Fortunately, I didn't TKR both knees and am using Hyaluronic acid on the non TKR knee with some success.
IMO, weight management is essential to reduce the load. In addition to focusing on weight loss, instead of unloading car grocery bags two at a time (IE), I carry the bags "one at a time" to min the extra weight on the TKR knee.

I am not suggesting any of this is easy or desirable but the surgery didn't match my expectations, I need to move past the anger/frustration, and my doctor(s) haven't solved the problem(s). I refuse to succumb to the pain, refuse to become sedentary, and am experimenting with "work-arounds" till something better comes along. Hope this helps.

REPLY
@mrnomad

I have gradually come to realize that repetitive motion exercise activities such as bike riding, stairs, walking & gym exercise machines (all of the things I enjoy in life) exacerbate the pain in my TKR knee. After these exercises the TKR knee swells, gets warm, ROM is limited, and is painful. I'm not a doc but here's what I think is happening. As I flex my TKR knee, it rubs against the scar tissue that's formed (and reformed after arthro surgery) & gets irritated (I euphemistically refer to it as "angry") and the only solution is rest. Drugs and ice do little to reverse the impact of repetitive knee exercises. I refuse to give up my fitness and acquiesce to the pain but I fear continuing to aggravate the knee could cause the tendon to sever. This website discusses the issue.
https://www.practicalpainmanagement.com/treatments/interventional/successful-nonoperative-treatment-persistently-painful-knees-following
Mayo also discusses the issue here.
https://sportsmedicine.mayoclinic.org/condition/kneecap-instability-patellar-tendinitis/
Excerpt: "The pain is often worse with activities such as running, jumping, walking up and down stairs, and squatting, and it can also occur with prolonged sitting."
Given these limitations, how do I remain fit other than swimming? I found that walking upstairs is easier on the knee than downstairs, therefore, I use both handrails when walking downstairs to min the impact each step inflicts on the TKR knee. I continue cardio and strength building exercises. I build those collateral muscles that support knee functions thru targeted gym exercises and minimize the full flex of the knee that "angers it". On my TKR knee, I limit the range of the leg press to "just before" the knee pops. I use the leg press by alternatively pushing (lifting) with my toes and heels (see attached photo). I warm up extensively before my daily power walk and try to plan sedentary activities afterward. I strengthen my arms and hands to forestall falls and also to supplement the inadequacies in my TKR knee. Fortunately, I didn't TKR both knees and am using Hyaluronic acid on the non TKR knee with some success.
IMO, weight management is essential to reduce the load. In addition to focusing on weight loss, instead of unloading car grocery bags two at a time (IE), I carry the bags "one at a time" to min the extra weight on the TKR knee.

I am not suggesting any of this is easy or desirable but the surgery didn't match my expectations, I need to move past the anger/frustration, and my doctor(s) haven't solved the problem(s). I refuse to succumb to the pain, refuse to become sedentary, and am experimenting with "work-arounds" till something better comes along. Hope this helps.

Jump to this post

Thanks for your sharing your experience, I will continue to work through this best as I can…. I will check into those articles….
NOT EASY….
Brescher…..

REPLY
@johnbishop

Hi @cecilsmichie, I would like to add my welcome to Connect along with @brescher. @janicemmccarthy mentioned tendonitis like pain in an older discussion and may have some suggestions or thoughts if she is still following Connect. Here's an article that mentions PT for similar symptoms:

— Successful Nonoperative Treatment of Persistently Painful Knees Following Total Knee Arthroplasty—A Case Series: https://www.practicalpainmanagement.com/treatments/interventional/successful-nonoperative-treatment-persistently-painful-knees-following.

Since you mentioned that the symptoms seem to occur after some different activities, I wonder if it's just a matter of too much activity? Have you discussed the symptoms with your doctor or care team?

Jump to this post

Thanks for the links to to the articles. I haven't discussed this with my care team yet. I think I have low expectations for orthopedic surgeons ( sorry to say), my impression is that follow up care is not what interests them .

REPLY
@brescher

No More PT…. Could have been over worked…. According to Doctor…. Possibly irritated lower leg tendon….
Still trying dry needling a couple more times in a new area…
Staying hopeful as my knee itself is no pain and excellent motion!!

Jump to this post

Thanks for the suggestion of dry needling.

REPLY
@mrnomad

I have gradually come to realize that repetitive motion exercise activities such as bike riding, stairs, walking & gym exercise machines (all of the things I enjoy in life) exacerbate the pain in my TKR knee. After these exercises the TKR knee swells, gets warm, ROM is limited, and is painful. I'm not a doc but here's what I think is happening. As I flex my TKR knee, it rubs against the scar tissue that's formed (and reformed after arthro surgery) & gets irritated (I euphemistically refer to it as "angry") and the only solution is rest. Drugs and ice do little to reverse the impact of repetitive knee exercises. I refuse to give up my fitness and acquiesce to the pain but I fear continuing to aggravate the knee could cause the tendon to sever. This website discusses the issue.
https://www.practicalpainmanagement.com/treatments/interventional/successful-nonoperative-treatment-persistently-painful-knees-following
Mayo also discusses the issue here.
https://sportsmedicine.mayoclinic.org/condition/kneecap-instability-patellar-tendinitis/
Excerpt: "The pain is often worse with activities such as running, jumping, walking up and down stairs, and squatting, and it can also occur with prolonged sitting."
Given these limitations, how do I remain fit other than swimming? I found that walking upstairs is easier on the knee than downstairs, therefore, I use both handrails when walking downstairs to min the impact each step inflicts on the TKR knee. I continue cardio and strength building exercises. I build those collateral muscles that support knee functions thru targeted gym exercises and minimize the full flex of the knee that "angers it". On my TKR knee, I limit the range of the leg press to "just before" the knee pops. I use the leg press by alternatively pushing (lifting) with my toes and heels (see attached photo). I warm up extensively before my daily power walk and try to plan sedentary activities afterward. I strengthen my arms and hands to forestall falls and also to supplement the inadequacies in my TKR knee. Fortunately, I didn't TKR both knees and am using Hyaluronic acid on the non TKR knee with some success.
IMO, weight management is essential to reduce the load. In addition to focusing on weight loss, instead of unloading car grocery bags two at a time (IE), I carry the bags "one at a time" to min the extra weight on the TKR knee.

I am not suggesting any of this is easy or desirable but the surgery didn't match my expectations, I need to move past the anger/frustration, and my doctor(s) haven't solved the problem(s). I refuse to succumb to the pain, refuse to become sedentary, and am experimenting with "work-arounds" till something better comes along. Hope this helps.

Jump to this post

Mr Nomad, thanks for sharing your experience. Same here with the repetitive motion exacerbating knee discomfort. I too am experimenting with "work-arounds" - not giving up on being active. Wearing a knee sleeve or sometimes KT tape helps take my mind off the discomfort. I have found that carrying anything heavier than 17lbs ( weight of my dachshund ) can cause next day knee discomfort. I don't like having limitations but I am not giving up.

REPLY
@cecilsmichie

Thanks for the links to to the articles. I haven't discussed this with my care team yet. I think I have low expectations for orthopedic surgeons ( sorry to say), my impression is that follow up care is not what interests them .

Jump to this post

I totally agree. I wish I would have realized that prior to TKR!!

REPLY
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