Post-op TKR: "Patella" pain?

Posted by daner54 @daner54, Wed, Aug 7 9:55am

Is it normal to start having “patella” pain at 5 weeks? (they did a facetectomy and neurectomy as cartilage “looked good”) how does one know if they need a MUA? I also had arthoscopic surgery on posterior 2016 and interior 11/2019 now total knee June 27,2019. So many questions! Thanks, Dana

Hi @daner54. Welcome to Connect! Glad you found this Group. I've had two TKRs – one in early 2017 and the other in January of this year. If I understand you correctly, you had no pain/little pain for the first month then at 5 weeks started having "patella" pain. Is that correct? I feel like 5 weeks is still very early in the process. I imagine you are still doing physical therapy. In my experience, when I worked extra hard at PT, I often had a lot more discomfort. Do you feel like the pain could have resulted from over exertion or other PT issues? Are you still icing on a regular basis? And finally, are you still taking pain meds and if so, does the pain persist in spite of the meds?

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@debbraw

Hi @daner54. Welcome to Connect! Glad you found this Group. I've had two TKRs – one in early 2017 and the other in January of this year. If I understand you correctly, you had no pain/little pain for the first month then at 5 weeks started having "patella" pain. Is that correct? I feel like 5 weeks is still very early in the process. I imagine you are still doing physical therapy. In my experience, when I worked extra hard at PT, I often had a lot more discomfort. Do you feel like the pain could have resulted from over exertion or other PT issues? Are you still icing on a regular basis? And finally, are you still taking pain meds and if so, does the pain persist in spite of the meds?

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Hi Debbra, I take 800mg ibuprofen 2 times a day. I may have pushed it too much, I do PT at home . I have been in 2 times to PT but mainly for advice on the snapping behind my knee as well. It’s good to hear it is early on… I read it take 10-12 weeks for bone, tendons and muscle to fully heal so more patience. I am still icing as well. So do they to do PT even if sore from previous day or as tolerated ? I know when I have to do my Right knee I will be much wiser! Thank you

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@daner54

Hi Debbra, I take 800mg ibuprofen 2 times a day. I may have pushed it too much, I do PT at home . I have been in 2 times to PT but mainly for advice on the snapping behind my knee as well. It’s good to hear it is early on… I read it take 10-12 weeks for bone, tendons and muscle to fully heal so more patience. I am still icing as well. So do they to do PT even if sore from previous day or as tolerated ? I know when I have to do my Right knee I will be much wiser! Thank you

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@daner54 How often do you have PT? I only went two times a week, a half hour each time. My ortho gave strict instructions too, NO PAINFUL PT.
I am sure that as @debbraw suggested, the PT is causing the increased pain. I think every doctor has their own requirements for that.
JK

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@contentandwell

@daner54 How often do you have PT? I only went two times a week, a half hour each time. My ortho gave strict instructions too, NO PAINFUL PT.
I am sure that as @debbraw suggested, the PT is causing the increased pain. I think every doctor has their own requirements for that.
JK

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I have gone to PT 2 times in 6 weeks. They don’t push it at Mayo if we can do it at home. I live on a hill and walk, I must have over worked things and made it angry. I need to remind myself we all heal at a different pace. Slow steady steps .

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@daner54

I have gone to PT 2 times in 6 weeks. They don’t push it at Mayo if we can do it at home. I live on a hill and walk, I must have over worked things and made it angry. I need to remind myself we all heal at a different pace. Slow steady steps .

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@daner54 My doctor doesn’t push it either, but if you want it he will prescribe it.

It does sound like you need to cut back a bit. The other thing my doctor likes is the recumbent bike. Knowing I have one he told me to do it for five consecutive days and then to take two days off for recovery. If you are doing your walking daily your leg probably doesn’t have enough time to recover.
JK

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I virtually lived in my PT office; in fact, my first 10 days were in a rehab hospital. If possible, I HIGHLY recommend it. Once discharged, I was in PT 3 times a week. I was 6 solid weeks out from surgery before I felt like I could take on the world. One knee didn't heal right and I had to go back in twice, the last time they had to leave it open to heal from the inside-out. THAT was a long year; surgery in early January, my knee finally closed fully in late October. Despite this, the knee functionality was still back to what I would consider "normal" within 5 to 7 weeks post-op.

I've known several who did home PT who had much less success in their recovery; you just don't have access to the equipment and the knowledge of a professional at home when you need it. I can't imagine doing this on your own at your home. Your mileage may vary…

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I agree.. it’s interesting that the facility does not have a better program for post op.. they showed me 3 exercises and told me to walk… I do have a mini recumbent bike I do quite often and stretches, steps..I feel like a “wimp” if I go in.. Ha. I’m grateful to have found this connection. Thanks I guess I should have been more assertive…

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This is such a good illustration of the difference in ortho surgeon's recommendations for PT. Mine had me in physical therapy before my first knee replacement just so I could learn the exercises, then on both knees he wrote orders for a physical therapist to come to my house three times a week until I could drive. That lasted about 3 weeks. Then, I went to outpatient PT until my 12 week milestone the first time. The second time, I was doing great at 8 weeks so I was able to stop there. Personally, I'm with @randythehack – I believe the PT contributed a tremendous amount to my recovery. Part of it was just having a "coach" to keep me going and tell me when I was pushing myself too hard and when I needed to stretch a little. I know some doctors are not big on PT, some physical therapists are very aggressive, and some are gentle. It's confusing. But in your case, it does sound as if you might be pushing your recovering knee a little too hard for 5 weeks. Could you try an experiment, rest this weekend, then let us know if the patella pain goes away?

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@debbraw

This is such a good illustration of the difference in ortho surgeon's recommendations for PT. Mine had me in physical therapy before my first knee replacement just so I could learn the exercises, then on both knees he wrote orders for a physical therapist to come to my house three times a week until I could drive. That lasted about 3 weeks. Then, I went to outpatient PT until my 12 week milestone the first time. The second time, I was doing great at 8 weeks so I was able to stop there. Personally, I'm with @randythehack – I believe the PT contributed a tremendous amount to my recovery. Part of it was just having a "coach" to keep me going and tell me when I was pushing myself too hard and when I needed to stretch a little. I know some doctors are not big on PT, some physical therapists are very aggressive, and some are gentle. It's confusing. But in your case, it does sound as if you might be pushing your recovering knee a little too hard for 5 weeks. Could you try an experiment, rest this weekend, then let us know if the patella pain goes away?

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@debbraw. My at home PT was great. If you are on Medicare that is a benefit. I did better PT with him than when I went to outpatient PT. I hated giving him up but you can only have in-house as long as you are house bound and I was getting cabin fever.
It sounds as if you had a really excellent therapist.

The one I had in house had worked with patients of my doctor before and knew his success rate so was happy to abide by his directions. The outpatient one was at a loss for what to do for gentle PT so I stopped going to him in about 4 weeks. I had been to him two times before for other things and thought he was excellent, but not with the latest.
JK

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