Debilitating pain 6 months after knee replacement

Posted by canls @canls, Apr 21, 2019

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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@ddsack

@tahoerider1 - "Are there lots of good results out there?"

Yes, as Sue said there are thousands of good outcomes which get people back to near normal use of their knees, otherwise doctors would quit doing these surgeries. But there are no 100% guarantees on any surgery, so it's mostly those with problems who post here.

I had my right knee done two years ago, and my left knee done one year ago. Though my knees will never feel the same as real bone, I am happy with the lack of pain and there are no limits to what I can do, other than common sense. I can kneel on a cushion for gardening if I keep most of the weight back off the knee cap itself, which pushes back like the hard metal object it is. I can do light jogging if I need to, but don't feel that is a good use for my artificial joint because of wear and tear. But there are serious runners who run with TKR's, knowing they may need future successive replacements.

Before I had my 2nd knee done, I noticed in photos that I was standing very pigeon toed, and asked my surgeon if there was a way to straighten that leg with the TKR. He said he would, and a bonus result was that I quit having the sciatica pain on my left side, which was likely influenced by the leg twist and side tilt in my gait before surgery. In three weeks, I am scheduled to go in for reverse shoulder replacement with the same surgeon, and I hope that will be as successful as my knees have been.
I think the key to having a good outcome is first, a good surgeon, second, knowledgeable physical therapists, and third, making yourself put in lots of time and effort in doing the all the prescribed rehab exercises even when you are hurting and don't feel like it. The exercises I hated most and was tempted to skip were probably the ones I needed most. Before surgery, I faithfully did the toe flex and knee back tighten exercises they told me to do at home before the TKR, and continued to do them in the hospital bed after surgery, and for weeks at home at night when I was trying to go to sleep. If I did enough repetitions they dissipated some of the unused energy in my legs and I could fall asleep a little better.

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Thanks lots for the info, I'm trying to do as much pre-hab as possible, if this one goes OK, I'm on to number 2 shortly after.

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@tahoerider1

Thanks lots for the info, I'm trying to do as much pre-hab as possible, if this one goes OK, I'm on to number 2 shortly after.

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One word of caution - the surgery itself (without the necessity of rehab) takes quite a bit out of the body. I had my first hip replacement surgeries just 7 weeks apart when I was 54 - my work travel schedule dictated it. Although the hips were healed, my body took almost a year to completely recover and just working full time was tough - travel was awful.
When I had to have them done the second time 5 years later (recalled implants - failing and affecting my health) my surgeon insisted on 3 months between the 2 operations. Then I needed an emergency revision one week after the second operation. Finally, I proceeded to have orthopedic surgery on my hand 3 months later. So 4 surgeries in 6 months - my body rebelled and it took over a year to completely recover strength and energy.
So give your body time to heal and get your energy back before the second TKR
Sue

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Thanks Sue, I was going to wait about 3 months between, trying to get them in before I retire and use my sick time.

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I am sorry he is in pain. I also had bilateral TKA with ongoing pain. I went to National Jewish and ended up being highly allergic to the small amount of nickel in my knees. I had a revision in left knee with nickel free parts but because connective tissue damage still in pain. Trying now to make appt At Mayo

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@karengail

I am sorry he is in pain. I also had bilateral TKA with ongoing pain. I went to National Jewish and ended up being highly allergic to the small amount of nickel in my knees. I had a revision in left knee with nickel free parts but because connective tissue damage still in pain. Trying now to make appt At Mayo

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Hello @karengail. Welcome to Connect. Oh my, oh my.......your experience sounds quite frightful. I am just 7 weeks out of my second TKR. This one has been relatively normal. I work daily on my exercises and have conquered stairs. I am now working on balance and stability to avoid buckling.

I wondered about the metal allergen issues but have mostly plastic in my Mako Robotic replacement plus a bit of titanium. I have great confidence in Mayo and know you will receive the best care available. Would you please share your Mayo experience with me? Knowledge is power and by sharing on Connect, many can benefit from your contribution.

May you be free, safe, and protected from inner and outer harm.
Chris

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Good morning Chris. Thank you for your words of encouragement. I have just started the process to make my initial appointment with Mayo. I am coming from Colorado so will be an adventure. I am so glad you are healing from your recent TKR.

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Sorry to hear that. Chronic pain is wearing on body, mind, and spirit.

My knee replacement is also at 6 month point, yet the pain just increases. Walking is OK, but bending knee to stand up or walk up stairs is excruciating. Latest X-rays cannot locate the issue. Can’t face more surgery at this point.

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@karengail

I am sorry he is in pain. I also had bilateral TKA with ongoing pain. I went to National Jewish and ended up being highly allergic to the small amount of nickel in my knees. I had a revision in left knee with nickel free parts but because connective tissue damage still in pain. Trying now to make appt At Mayo

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Oh no, that sounds terrible. I hope you can get some relief.

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@gardengal33

Sorry to hear that. Chronic pain is wearing on body, mind, and spirit.

My knee replacement is also at 6 month point, yet the pain just increases. Walking is OK, but bending knee to stand up or walk up stairs is excruciating. Latest X-rays cannot locate the issue. Can’t face more surgery at this point.

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Welcome @gardengal33, Sorry to hear you are still having pain with your knee replacment. You mention walking is OK. Does that mean you don't have any pain when walking? Do you still have swelling in the knee?

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@johnbishop

Welcome @gardengal33, Sorry to hear you are still having pain with your knee replacment. You mention walking is OK. Does that mean you don't have any pain when walking? Do you still have swelling in the knee?

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There is no swelling but knee is slightly warm. Up until a few days ago, I could walk with no pain. Now there is a little pain while the knee bending from a seated position keeps increasing in pain intensity. Last week I could walk upstairs with little discomfort but now it hurts. I don’t know what to do next.

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