Swelling and stiffness, 3 years after total knee replacement

Posted by bengalady @bengalady, Oct 9, 2019

I had knee replacement 3 years ago. It is worse than previous knee pain, and getting worse as more time goes by. My surgeon (in another state) says everything normal based on X-ray. Ortho doc here says the same, and said I’m having pain and he referred me to pain clinic for possible nerve block. I want to know WHY am I having pain, although I didn’t call it pain. ROM is 100. They can’t see everything on X-ray. I want an MRI. Want to go for second opinion. Should I tell new doc I’m there for second opinion, I don’t think that’s necessary……I think that would cause some bias, ie they would just say same thing.
Has this happened to anyone ? Thoughts ?
TIA

My question is this, was your blood test an allergy test for metals and bone cement?
I have many contact allergies and when ortho felt I was ready for first knee replacement I insisted on an allergy test for all components. He warned me this blood test would be $600 and Medicare would not pay. I accepted that had the test and learned I was allergic to 6 metals and yet not the bone cement. He said titanium contains elements of other metals. The ceramic coated knee replacement he recommended is now having a recall, so now accept my fate is sealed and must learn to live with difficulty and pain. getting up yet walking on level ground no issue. So sorry for your problems and frustration over not understanding why.

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Consider having testing for allergy to the components of the knee. Dr. Karin Pacheco at National Jewish in Denver, Colorado does this testing and she may know of someone close to you who offers this testing.

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@mnitchke

I had TKR (R) July 2018 and I still have swelling and stiffness after nearly 2 years post-op. X-Rays, Ultra sound, Blood tests, nerve blocks etc etc. and the pain (only during certain movements) is always present. Developed a rash at my knee but Dr.'s say it's not a reaction to the knee (materials). I disagree. I have swelling from the knee joint line right down to the ankle. And the more I stand, walk, do stairs, etc. the more I pay for that in tiredness, stiffness, pain(lateral side) to the point that I feel that exercise worsens my condition. And that's what happened after the TKR too. My TKR knee is 1" larger in circum. than the L side. Likewise the R leg is larger due to Edema down to the ankle. I know I have a lot of 'Scar Tissue' and that probably is the main reason I have stiffness, etc. I've had Arthroscopy surgery to remove scar tissue, & do a manual manip. of the knee but 3 weeks after it was back to where it was before. I need a 'Sherlock Holmes' to figure out what to do. My life sucks now due to reduced activity. When I try & pick up an object off the floor, I look like a Giraffe. I can't kneel down. I'm protective all the time of my knee. And now my L knee needs attention. But that won't happen or I'd be in a wheelchair.

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@mnitchke Your symptoms do not sound like typical after-effects to me. Certain things are pretty common, like not being able to really kneel. Kneeling is painful for many people unless they put a cushion under the knee, and if you don't have good flex it's very difficult to really kneel without toppling over. I have that problem. My flex hovers around 120. The only other thing that I can't do really is exercise where I have to get down on the floor and back up again quickly, as in yoga and pilates.
I have had two TKRs. My R one used to bother me when I overdid exercise but ever since I had a fall last summer and had a minimal hip fracture on my L hip, the L one bothers me more than the R one.
I have never heard of a significant difference in circumference.
I think you definitely need to get another opinion from an excellent surgeon.
If you do need at some point to have another TKR, please be assured that every TKR is different, even if a person has bilateral TKRs, the two knees can have different problems afterward, they are two separate surgeries despite being done at the same time. My second TKR was with a Conformis custom-made knee and it has worked out very well. Many people have great success also with Makoplasty surgery which uses a Stryker knee.
If you do find an excellent orthopedist to get a second opinion from I would really appreciate hearing the outcome.
JK

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I also had a knee replacement almost 4 years ago. I still have swelling and pain and my motion is at 95. I had a mri and went for a second opinion they said all was normal and based all the problems on scar tissue. I would like to know how to break through this scar tissue and get more motion. If you receive any info on this please pass it on.

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@eeppeerr88

I also had a knee replacement almost 4 years ago. I still have swelling and pain and my motion is at 95. I had a mri and went for a second opinion they said all was normal and based all the problems on scar tissue. I would like to know how to break through this scar tissue and get more motion. If you receive any info on this please pass it on.

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I had to have a knee manipulation to bend my knee I was at 105, now I'm at 115. They knock you out & bend the knee manually. I'm surprised the dr had suggested that to you. Good luck!

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@eeppeerr88

I also had a knee replacement almost 4 years ago. I still have swelling and pain and my motion is at 95. I had a mri and went for a second opinion they said all was normal and based all the problems on scar tissue. I would like to know how to break through this scar tissue and get more motion. If you receive any info on this please pass it on.

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Hi, @eeppeerr88 Welcome to Connect. As you have seen, there are many of us who have had TKRs. I have come to realize how fortunate I have been to not have the problems that many do have.
My orthopedist told me he could do lysis on my knee to improve my flex if I wanted that, but I decided to just live with the @120 flex that I have. As @barrett727 mentioned, they also do manipulations to improve flex. Has your doctor not mentioned any possible solution to improve it?
It seems odd to me that you still have swelling too. Regarding pain, I think we all have different thresholds that are tolerable so it's impossible to know if the pain you feel simply may not be felt as strongly by others.
JK

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I am current 9 months post op after having a partial knee converted to a total knee I have had a issue with my bend and pain sense day one. Currently I can straighten my knee to 1 degree but my bend is only 95 once I attempt to pass 95 degrees the pain is unreal I can walk around with little to no pain but at night when sleeping on my side if feels like someone is trying to brake my knee in half side to side. I have a follow up with my doctor on may 15 2020 to see if this is getting better. I feel it is getting worse and starting to get stiffer I don't notice any fluid or swelling knee looks deformed compare to my other knee but I wouldn't expect it to look the same has any one had these symptoms. I am 47 years old and was hoping for a better out come.

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@madjacks

I am current 9 months post op after having a partial knee converted to a total knee I have had a issue with my bend and pain sense day one. Currently I can straighten my knee to 1 degree but my bend is only 95 once I attempt to pass 95 degrees the pain is unreal I can walk around with little to no pain but at night when sleeping on my side if feels like someone is trying to brake my knee in half side to side. I have a follow up with my doctor on may 15 2020 to see if this is getting better. I feel it is getting worse and starting to get stiffer I don't notice any fluid or swelling knee looks deformed compare to my other knee but I wouldn't expect it to look the same has any one had these symptoms. I am 47 years old and was hoping for a better out come.

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Hi @madjacks, welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion where members like @bengalady @eeppeerr88 @cobweb @babette @sfcob and others talk about stiffness and pain that they experienced months after their knee replacement, as well as members who found solutions or did not have prolonged pain or stiffness like @contentandwell @gardeningjunkie and @artscaping.

You may also be interested in reading these discussions:
– scar tissue after knee replacement https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/
– Night Pain: Using a knee wedge after total knee replacement? https://connect.mayoclinic.org/discussion/using-a-knee-wedge-after-total-knee-replacement/
– What can you do to extend the life of your TKR and mobility? https://connect.mayoclinic.org/discussion/what-can-you-do-to-extend-the-life-of-your-tkr-and-mobility/

Jack, have you been able to continue PT and moving the knee during this stay at home period?

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@colleenyoung

Hi @madjacks, welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion where members like @bengalady @eeppeerr88 @cobweb @babette @sfcob and others talk about stiffness and pain that they experienced months after their knee replacement, as well as members who found solutions or did not have prolonged pain or stiffness like @contentandwell @gardeningjunkie and @artscaping.

You may also be interested in reading these discussions:
– scar tissue after knee replacement https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/
– Night Pain: Using a knee wedge after total knee replacement? https://connect.mayoclinic.org/discussion/using-a-knee-wedge-after-total-knee-replacement/
– What can you do to extend the life of your TKR and mobility? https://connect.mayoclinic.org/discussion/what-can-you-do-to-extend-the-life-of-your-tkr-and-mobility/

Jack, have you been able to continue PT and moving the knee during this stay at home period?

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@madjacks As Colleen mentioned, there are those of us too who did not have prolonged pain, and I was fortuante to be part of that group.
I wish I had more to offer to you, but if your orthopedist does not offer any help then I would try a different doctor, one not at the same medical center. I find that when two doctors are at the same medical center they do not contradict each other. Try to find one at a major medical center, preferably a teaching hospital. I live in southern NH and have a lot more confidence in the doctors in Boston than I do in most of the doctors up here. Very simply, they see more so they know more.
There are a couple of different procedures that are done to improve flex, has your doctor suggested that at all?
JK

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@contentandwell

@madjacks As Colleen mentioned, there are those of us too who did not have prolonged pain, and I was fortuante to be part of that group.
I wish I had more to offer to you, but if your orthopedist does not offer any help then I would try a different doctor, one not at the same medical center. I find that when two doctors are at the same medical center they do not contradict each other. Try to find one at a major medical center, preferably a teaching hospital. I live in southern NH and have a lot more confidence in the doctors in Boston than I do in most of the doctors up here. Very simply, they see more so they know more.
There are a couple of different procedures that are done to improve flex, has your doctor suggested that at all?
JK

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As far as flex he has not at the last appointment he said if the pain persists he would want to do a nerve study. I feel it is scar tissue the joint feels good and moves freely in the travel it does have just seems everything around it on the outer portion of joint soft tissue is the problem at night is the worst if I role in my sleep the pain is unreal if I catch myself and tighten my quads the pain is not near as bad

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@madjacks

As far as flex he has not at the last appointment he said if the pain persists he would want to do a nerve study. I feel it is scar tissue the joint feels good and moves freely in the travel it does have just seems everything around it on the outer portion of joint soft tissue is the problem at night is the worst if I role in my sleep the pain is unreal if I catch myself and tighten my quads the pain is not near as bad

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@madjacks if scar tissue is a problem that of course would cause the lower flex too. 95° flex is less than most doctors aspire for. Hopefully the doctor will be able to identify the problem and be able to do something to help you.
I realize that non-essential appointments are on hold, but do you have an appointment scheduled yet?
JK

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Yes have one on May 15 it hasn’t been canceled yet

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I have persistent pain in one of my replacements. It is annoying, but the knee is still functional.

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misery loves company. Five years after my tkr the swelling has never gone down, in fact it goes up when i tried exercising in water. Now i am told it is lose. I do not walk much but bike a lot and ride a golf cart. Pain? Yes, but i know they will want to do another tkr and that was not fun. My second knee i did stem cells 4 years ago and PRP yearly. This has helped me from doing another TKR. In reality i think the PRP has helped the most. Yes, it is expensive. I have noticed some compaies have insurance for this so its up to you to do your homework.

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@pjoyner

I have persistent pain in one of my replacements. It is annoying, but the knee is still functional.

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Hello @pjoyner. Glad to see that your knee is still functional even though annoying. When did you have your knee replaced?

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