Help with pain after 3 months of TKR

Posted by fran102 @fran102, Mar 8, 2023

It has been 3 months since I had TKR and still have terrible pain behind my knee. I finally got my ROM up to 115 and can bend my knee when walking although I still have to use a walker. I’m going to get a second opinion because my surgeon has been totally unhelpful. Does anyone have any recommendations on coping with the pain and is this normal? I feel so frustrated and scared I might be this way for the rest of my life. It’s pretty much nonstop pain. I go to PT 3x a week for 2 hour sessions and they have helped me with ROM and knee strengthening but have so far to go. They are trying to get me a Dynasplint. Has anyone ever used one and does it help? Thank you so much for any advice you can give me. I’m so depressed! I had no idea it would be like this.

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@ezas123

Not every case is the same… for me I was where you were at 4-6 months pain 60-65 rom my dr said it was my inability to go through the pain , than it was my hip, headaches you name it my dr blamed…. I went for second opinion the knee original surgeon put in was too big …. That is why I could not bend beyond 60-65 even after manipulation….which made worse ….. I had revision within a year happy to say rom like 115 still a work in progress lol ….I went for graston technique yesterday today back of my knee feels great… I continue to do things as I go like graston , mfr , also continue exercising… good luck to you

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Good morning I ended up going to the Cleveland clinic for my second opinion they said everything from x-rays to CT scan look perfect. My doctor actually used the same implant that this doctor at Cleveland clinic uses. He said it is just nerve pain so it all takes time. of course they don’t tell you how long because everyone is different. I just hope that time will heal and I will not be in the percentage of people that are not happy with their total knee replacement. Thanks for your input. It’s always nice to read what people have to say on this website. 🌹

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@jlf2

I’m 14 months out of TKR and take Gabapentin was all ready on it for chronic pain condition and it took a while for it to help me I take 600mg 2x daily am /pm but I still have days when my knee hurts pretty badly I have nerve in it my knee around my knee cap and when the pressure changes when it’s going to storm out hurts in the winter because of the cold my knee also pops some times but I was told the piping sometimes is normal I think my knee will always hurt sometimes because it fake I still sleep with it propped up on a pillow sometimes it help but when I had my knee replaced I could not walk on it at all I couldn’t bear any weight on it at all
And now I can walk but it dose get better it just takes time be patient and hang in there don’t let physical therapy Trish you for what your not ready for I let them and it caused more pain and could do damage to to knee
Good luck have a great day

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I am 4 months out of my TKR, (this is my second one) I too have been told I have IT Band syndrome. Definitely not post op pain!! Now; my knee is freezing at night when bent. I have to literally roll off of my side, slowly push my knee down. My surgeon believes it may be scar tissue now that is getting hung up under my knee cap. The pain at night remains bad when I have to straighten out the knee. I did have 120-degree bend, and -8 degree extension. So now the plan is to go back in for a scope and gently manipulation to try and relieve the pain and freezing. New diagnosis is Encapsulitis. We will see.

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Oh wow so more surgery on it
That concerns me because I have days where I have extreme pain and it’s really stiff so much is the I have to straighten out so I can walk on it and my knee cap hurt at night along with the back of my knee but they take x-rays every time l go see them

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@brescher

Went for 2nd opinion. Not IT BAND !!
All X-rays and CT scan are good!! No swelling….no redness. But very painful surrounding knee. Diagnosed as nerve pain.
Hopefully will go away… prescribed GABAPENTIN!! 17 weeks out from TKR.
Has anyone had this??
Brescher

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Yes I have with left knee and now right knee pain in arch and ankle also ball of knee radiating to the inside of my knee. My surgery was 2/23/2023 but my surgeon even broke a bone in process of doing the surgery. This Wednesday 4/5/2023 saw nurse practitioner and she prescribed Calcitonin SalnonNasal once a day for bone pain

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@heyjoe415

Getting down on the floor and then up is difficult. It's hard to kneel after a TKR. Mine went flawlessly but getting up off the floor is challenging. Small price to pay considering how much pain I was in before TKR.

So when you do have to get on the floor, and hopefully that's rare, have an object nearby that you can use to push yourself up. I hope this helps.

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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

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@heyjoe415

Getting down on the floor and then up is difficult. It's hard to kneel after a TKR. Mine went flawlessly but getting up off the floor is challenging. Small price to pay considering how much pain I was in before TKR.

So when you do have to get on the floor, and hopefully that's rare, have an object nearby that you can use to push yourself up. I hope this helps.

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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.

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@mrnomad

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.

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I really admire your tenacity and am truly sorry to hear about your TKR results. Is this something that could be fixed in the hands of a better surgeon? It's just unacceptable to feel worse after this surgery. All the best to you. You are a courageous person.

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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.

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fran,
When you mentioned pain behind your knee it reminded me of my experience after a TKR. I had terrible pain behind my knee after my knee replacement and I saw 2 knee and 1 spine orthopedists to try to find out why I was in so much pain. I was not going to give up so 17 months later I went to an orthopedic clinic in a different healthcare system. The first procedure they did was an ultrasound and immediately they identified that I had an extra bone that sometimes becomes a problem for people who have had a TKR. It is called a fabella bone. Not everyone has this bone. The pain is behind your knee on the outside area. I had surgery to have this bone removed and the pain went away. I am so glad that I didn't give up.

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@msmom

Yes gabapentin can help. Also massage the areas, the more the better. Yes, it will hurt while doing it but it will help. Rub different textures over and over the areas to desensitize it. Good luck.
I too am 3 months out and mine bothers me mostly at night. I finally asked for pain meds to help sleep at night. Then all of a sudden it seems to be getting better. Pray that yours goes that way also.

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Thanks for your input. I too have trouble sleeping at night. I’m now only taking one 5mg at bedtime. What did the doctor give you for sleep?

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