Severe Pain after 2nd TKR

Posted by ssbionicknee @ssbionicknee, Sun, Sep 8 1:58pm

I had a right TKR in May of 2018 and it was painful, but tolerable. Physical Therapy seemed to go fairly smoothly. In August of 2019, I had my left TKR and am having a horrible time controlling the pain and Physical therapy is not going near as smoothly. I went to PT last Friday and was in extreme pain afterward. I was up all night. I had sharp pains inside the wound, extreme sensitivity to touch on the inside of my knee, what felt like spasms in the back of the knee and the knee was very sensitive to anything touching it. I had to keep it still and iced all day Saturday in order to get the pain under control. I know I need to do my exercises, but am afraid of triggering the pain again. I have heard that no 2 knee replacements are the same, but this one seems to be really bad. Is this normal? I have to find a happy medium when doing physical therapy. Any thoughts or suggestions?

Hi everyone, to answer your questions; no I am not getting synvisc injections for the "good knee" I'm really afraid to have anyone do anything to the right (good) knee.

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Hi everyone, to answer your questions; no I am not getting synvisc injections nor acupuncture to either knee, my surgeon nor therapist never mentioned acupuncture or injections to me. At this point I am so afraid of letting anyone do anything else to me right until I can get some relief for this left knee. Yes all this was done by the same doctor he said if he does not get the results he is looking for he is going to refer me to another surgeon for a 2nd opinion. Yes I will keep you all informed once I get my results from the test.

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@zakcat

Sounds awful. Was it done by same doctor? Now I'm scared, I'm having my second replacement, left knee, done next week!

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@zakcat i'm not sure who you are replying to, but if you have selected the doctor well then you have no reason to be concerned. Your first TKR finally got better, although it took longer than you anticipated, correct? Since your first knee was good then I am sure your second one will be too.
Although I opted for the Conformis knee because I read that it has an easier recovery since it is made to be the same as your natural knee was, I have pretty much heard that the biggest difference in recovery is in the skill of the surgeon. I think of my recovery as being great and the knee never hurts except occasionally a little twinge when I have overdone exercise.
I hope your second TKR goes well, let us know how you are doing when you are feeling up to corresponding.
JK

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@lynnwade54

Hi everyone, to answer your questions; no I am not getting synvisc injections nor acupuncture to either knee, my surgeon nor therapist never mentioned acupuncture or injections to me. At this point I am so afraid of letting anyone do anything else to me right until I can get some relief for this left knee. Yes all this was done by the same doctor he said if he does not get the results he is looking for he is going to refer me to another surgeon for a 2nd opinion. Yes I will keep you all informed once I get my results from the test.

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@lynnwade54 I am pretty sure that synvisc could not make anything worse and it could really help to have one leg that feels better. If this has not come up with your surgeon you might want to ask him. It honestly did wonders for my knee. The only caveat being that if you do schedule a TKR on that knee at some point you can't have any injections for a certain amount time prior to it. I can't remember if it was 3 months or 6 months. For most people this would not be a problem because their orthopedic surgeon would be the same doctor who you would get shots from, but I go to one doctor for simple things like that, and I went to a different doctor for the TKR, someone who had an impeccable reputation and who used the Conformis knee.
JK

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@zakcat

Sounds awful. Was it done by same doctor? Now I'm scared, I'm having my second replacement, left knee, done next week!

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@zakcat – Don't be scared. I had my 2nd TKR in January of this year and it was a huge success. It's better than my first that was done in 2017. I'm pulling for you. Will you keep us posted? What are you most scared about?

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@debbraw

@zakcat – Don't be scared. I had my 2nd TKR in January of this year and it was a huge success. It's better than my first that was done in 2017. I'm pulling for you. Will you keep us posted? What are you most scared about?

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Doctor said it could go much easier than the first, or be more difficult !

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I spoke with my PT and my doctor. I am taking Lyrica, for nerve pain, along with my pain meds and it has made a huge difference!! The pain is now tolerable. I have even been able to go longer before I need pain meds. The PT has been focusing on the hamstring tendon in the back og my knee. Because the pain is tolerable, he has been able to do more in therapy. Then I come home exhausted. 🙂 Even though I was told each TKR is different, I expected this one to be like the other knee. The front of my nee is still very tender and I believe the nerves are healing slower than they did on the other knee. I am not looking forward to when we have to focus on bending the knee. I am also going to be starting water therapy soon and am hoping to start bending the knee in the water where it will be more comfortable. I can keep you posted on how it goes from here.

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@ssbionicknee

I spoke with my PT and my doctor. I am taking Lyrica, for nerve pain, along with my pain meds and it has made a huge difference!! The pain is now tolerable. I have even been able to go longer before I need pain meds. The PT has been focusing on the hamstring tendon in the back og my knee. Because the pain is tolerable, he has been able to do more in therapy. Then I come home exhausted. 🙂 Even though I was told each TKR is different, I expected this one to be like the other knee. The front of my nee is still very tender and I believe the nerves are healing slower than they did on the other knee. I am not looking forward to when we have to focus on bending the knee. I am also going to be starting water therapy soon and am hoping to start bending the knee in the water where it will be more comfortable. I can keep you posted on how it goes from here.

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@ssbionicknee Things are sounding more positive, that’s great. I’m glad that the lyrica is helping. Hopefully as the nerves heal you will be able to discontinue it.

Your physical therapist sounds great, I’m sure the water will help a lot. I tried that once but the therapist was terrible! She would tell me what to do, which wasn’t much, and that would be the last I would see of her! I never went there again. I hope to hear how you are progressing with it.
JK

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@ssbionicknee

I spoke with my PT and my doctor. I am taking Lyrica, for nerve pain, along with my pain meds and it has made a huge difference!! The pain is now tolerable. I have even been able to go longer before I need pain meds. The PT has been focusing on the hamstring tendon in the back og my knee. Because the pain is tolerable, he has been able to do more in therapy. Then I come home exhausted. 🙂 Even though I was told each TKR is different, I expected this one to be like the other knee. The front of my nee is still very tender and I believe the nerves are healing slower than they did on the other knee. I am not looking forward to when we have to focus on bending the knee. I am also going to be starting water therapy soon and am hoping to start bending the knee in the water where it will be more comfortable. I can keep you posted on how it goes from here.

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Good afternoon @ssbionicknee, @contentandwell, I am glad that you are progressing with your recovery from TKR. I was wondering if it might be a worthy idea to look at MFR for the pain episodes and resources you will need when the bending begins. There is a discussion about this approach on Connect: Myofascial Release Therapy (MFR) for treating compression and pain.

There is another worthy idea and that is to involve your friends in the therapy. I was a member of a walking group that tackled 5 day 40-50 mile inn to inn walks around and about. My walking buddies had enough of my knee pain and so locked me in my car and convinced me to just get it done. After the surgery, they were very active in my recovery. Someone showed up every morning to take me to the one grocery store to walk safely up and down the aisles. Another met with the only PT in the village who was also the only attorney we had. He guided them with appropriate exercises and equipment. Do you have an ice machine with a knee adaptation wrap? That was very soothing.

And just for chuckles, our only nurse in the group told me not to bother going off the mountain for stitch removal. She would do it. I got a stitch kit from the surgeon and she proceeded to do her thing. Only afterward did she tell me that she had never removed stitches before. She was a pre-admission nurse who trained paramedics and ER staff. So what did she do….looked it up on the internet.

Be safe and protected from both inner and outer harm today. Chris

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@harley105

Hi – I'm 9 weeks out from my second TKR this year and I'm having pretty severe nerve pain when anything rubs up against the inside of the joint – including clothing, sheets, etc. — it's like burning hot spots on the kneecap and occasional zings of pain down the inside of the calf, coupled with numbness of the inside of the calf. It's wearing me out!! Anyone experienced this? It's numb and it hurts at the same time.

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Hi @harley105 – So sorry to hear about your pain after TKR. I've had two – one a couple of years ago and one in January. You can be totally assured that 9 weeks is still pretty early in the process. I bet you'll see things improving daily or at least weekly for another few months. Meantime, here are a couple of threads that discuss the kind of pain you seem to be having:
https://connect.mayoclinic.org/discussion/burning-after-total-knee-replacement/?pg=2#comment-297081
https://connect.mayoclinic.org/discussion/unable-to-sleep-after-tkr/?utm_campaign=search

Take a look and see what you think. Are you having trouble sleeping? When you say it is wearing you out, is it causing problems with mobility?

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@harley105

Hi – I'm 9 weeks out from my second TKR this year and I'm having pretty severe nerve pain when anything rubs up against the inside of the joint – including clothing, sheets, etc. — it's like burning hot spots on the kneecap and occasional zings of pain down the inside of the calf, coupled with numbness of the inside of the calf. It's wearing me out!! Anyone experienced this? It's numb and it hurts at the same time.

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@harley105 This topic of nerve pain is currently being discussed on “severe pain after 2nd TKR. @ssbionicknee is having the same problem and is being helped by lyrica.
You may want to check out that discussion.
https://connect.mayoclinic.org/discussion/severe-pain-after-2nd-tkr/?pg=2#comment-329679
JK

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Hi – I'm 9 weeks out from my second TKR this year and I'm having pretty severe nerve pain when anything rubs up against the inside of the joint – including clothing, sheets, etc. — it's like burning hot spots on the kneecap and occasional zings of pain down the inside of the calf, coupled with numbness of the inside of the calf. It's wearing me out!! Anyone experienced this? It's numb and it hurts at the same time.

Liked by ssbionicknee

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Hi @harley105 you may have noticed I moved your post to this existing discussion referenced by @contentandwell that discussion severe pain after a second TKR so that you can discuss this with others who have similar experience. Simply click VIEW & REPLY in your email notification to get to your post.

I'd like to thank @contentandwell and @debbraw for responding to your post and sharing resources. I'd also like to tag @ssbionicknee as they may be able to offer you support.

Back to you @harley105 have you been giving any guidance by your doctor? Has anything helped decrease the pain?

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Hi! @harley105. I have just had my second TKR and what you are describing is very similar to what I felt with the first TKR. I had my right TKR in May of 2018 and it took about a year for the pain and zinging to ease up. In October or 2018 I had to have major shoulder surgery as well, which meant I had to rely more on my knees to get in and out of bed. That was a bit uncomfortable. At 9 weeks you are still early in the process of healing. Have you tried loose fitting athletic pants. At home I tend to wear shorts because they are more comfortable. The pain you are describing will subside eventually. I have a small area on my right knee that is still numb and that may be permanent. It no longer bothers me. Kneeling, I am not sure will ever be the same. I got a small yoga pad, which is shaped like a small square. it cushions my right knee when I have to kneel down to get something out of the cabinet or get down on the floor. I hope the zinging pains ease up soon. I am now recovering from my second TKR on my left knee and have been in a lot of pain from the nerves. The doctor prescribed Lyrica for me, which has helped me to get through my therapy and to make the pain tolerable. You may want to ask your doctor if that is an option until the nerve pain eases up a bit. I hope that you feel better soon. One thing I can honestly say is that even though a TKR is painful, the stability that I have in my knee now has been worth it. The reason I had to have shoulder surgery was because of a fall when my knee gave out. I wish you well! Keep us updated.

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@contentandwell

@ssbionicknee Things are sounding more positive, that’s great. I’m glad that the lyrica is helping. Hopefully as the nerves heal you will be able to discontinue it.

Your physical therapist sounds great, I’m sure the water will help a lot. I tried that once but the therapist was terrible! She would tell me what to do, which wasn’t much, and that would be the last I would see of her! I never went there again. I hope to hear how you are progressing with it.
JK

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@contentandwell My goal is to get to the point where I no longer need the Lyrica or pain meds. I wasn't thrilled about taking the Lyrica, but for now it is the only way I can get the range of motion back in m knee. It has also allowed me to cut way back on pain meds. I have to admit my therapist is awesome!! In the past few years, I have fallen apart and have needed therapy. I have been seeing the same PT for about 2 and a half years now. I trust him when he is working on my knee. I know that if I get to the point of agony he will stop and try something new. At one point he did tell me that therapy did not have to be agonizing, that there were many other options to try. The water therapist has been great, as well. There are 2 patients with the therapist and her assistant. I get one on one attention the entire time I am there. I am sorry you had a bad experience.

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