My PKR Experience

[JOW_103]

I had been having medial OA pain for the last 18 months.  Went through a round of Euflexxa and Synvisc One only to have them provide little to no pain relief.  Finally OS and I agreed a PKR was in order.  Had my surgery on April 1st at Massachusetts General Hospital.

Week 1:  Surgery commenced at 10:15 AM on April 1st.  Opted for spinal and femoral block instead of GA.  Surgery went well and was finished and in recovery about 2.5 hours after the start. 

1st day after surgery hospital PT person visited and had me do some heel slides as well as go for a short walk around the nurses station using crutches.  Pain hasn't been too bad.  Later in the day, PT person came back with CPM machine and had me in the machine for 2 hours at 40 degrees of flexion.

2nd day post op feeling better.  Will be discharged if I pass my PT test which is walking up and down stairs using the crutches.  Passed stair test without any problems.  Back in CPM machine for 1 hour at 60 degrees flexion.  After siging discharge ppers left the hospital for trip home.

3rd day post op visiting nurse came to house to make sure I was doing OK.  Have to inject myself each day with blood thinner to prevent blood clots for next 12 days.  Purchased continuous ice therapy machine to help with swelling.  Machine doing it's work and swelling is going down a bit.  Walking with the aid of crutches.

Day 4.  In home PT came today.  Had me do heel slides, quad set with leg raises and knee bend.  Got knee bend to 80 degrees and extension to -6

Week 2:  Continue to use ice therapy machine at night to help with pain and swelling.  Have vicodin as pain med but only taking at night.  Have PT three times this week.  Making good progress with flexion.  Knee bend as gone from 90, to 95 and then 102 degrees the first week.  Got extension to -2 but lost a little of that over the course of the week.  Can already walk with just one crutch without any problems.  Had surgical staples removed this week.  Incision is dry and well healed and no infection. Followed up with surgeon who says knee looks good and implant looks good on x-ray.

Week 3:  Swelling is going down each day and knee is feeling good. Knee bend has improved from 102 to 110 , 115 and now 120 degrees.  Extension is almost 0.  Overall very happy with results so far.  I am walking without crutches or cane and not taking any pain meds.  I have been discharged from in home visiting nurse care and in-home PT.  Last in-home PT kneed bend got to 124 degrees.  Starting my out patient PT for the next 4 weeks.

[Mistyd]

So glad you are doing so well after surgery! YAY!  Do you know what type of implant they put in?  I ask because it looks like that is the road I am heading down (patello femoral)   Enjoy your upcoming pain free existence


God Bless,

Misty

[greatfulgann]

I believe JOW is referring to a partial not patella-femoral replacement?  Partial knees seem to have better results and faster recovery. 

JOW did you have a medial compartment partial knee replacement? 

[JOW_103]

I had a medial compartment arthroplasty.  What we layman call a PKR.  The doctor used a Zimmer implant.  This is the website that describes the implant I received:
http://www.zimmer.com/en-US/hcp/knee/product/unicompartmental-high-flex.jspx

This company also offers a patella-femoral implant as well but I did not have that type of surgery.

Also, in addition to correctly the medial defect due to the OA, he realigned my knee to correct the slight misalignment I had.  My knee is now aligned over the center of my knee as opposed to the medial alignment I had prior to the surgery.

[JOW_103]

Week 4 - Had first outpatient PT session today.  Knee is a bit swollen as I slipped on some stairs in my home and really twisted my surgically repaired leg.  Fortunately, I didn't do any real damage to it.  Therapist says I look really good for only slightly three weeks past surgery.  Only got knee bend to 115 degrees today and extension was about -3.  She is going to have me continue with the same exercises the in-home therapist had me doing.  Next appointment is Saturday and then twice a week for the next 4 weeks after that.  Making progress in small steps is the goal and I seem to be doing that.

[JOW_103]

Week 5:  Completed 2nd and 3rd visits to outpatient PT.  Making some progress.  I asked therapist about numbness I have on lateral part of my knee.  She said it's pretty common with this procedure and that the nerves should regenerate after a couple of months.  Not sure on this one but will keep an eye on it.  Having some problems with pain on the outside part of my leg.  Therapist said the fibula head appears to be locked up a bit I need to wok on loosening it.  Overall making good progress and therapist keeps telling me everything looks good.  Having some problems sleeping at night due to discomfort at night.  Wake up about every hour and half and then fall back to sleep.  Makes it tough to get good nights sleep.  Two more weeks of physical therapy to go unless I am prescribed more.  Hopefully will continue to make big strides forward.

[LindaM]

Its great to hear you are doing so well.  I have 2 Zimmers too and hopefully you will be as pleased with them as I am.  The numbness is normal-don't fret too much.  You can expect some pain around the knee for some time as your body adjusts to the new knee.  Everything has to either stretch or tighten up to adjust to the new angle of your knee and your hips and back may have to do some adjusting as well.  It will all settle down in a month or two.

Sorry to hear you are not sleeping well.  Now that you are more active you may need to consider taking something like motrin before bed to help with the muscle aches your PT and added activity are giving your muscles.  Hopefully this will resolve soon. 

Good healing

Linda

[JOW_103]

Week 6:  PT is moving along  3 more sessions scheduled unless I get extended which is likely.  Still working on flexion and stretching.  Therapist has been using kinesio tape after each session to help control the swelling.  Believe it or not it really seems to work.  I could actually see some outline to my knee rather than just a big ball due to the persistent swelling.  If you've never used or seen this you should check it out.  You can Google kinetic or kinesio tape and learn more.

[JOW_103]

Week 7 - PT one again today.  I asked the therapist to measure my knee bend as I hadn't done it in a while.  Got my knee bend to 130 with a little pushing from her so very pleased with that.  One more session on Friday and I find out if I have to continue PT or will be discharged.  They have also added a bit of weight training to my sessions as well as balance exercises.  Have started going to my own gym and using elliptical machine with no incline and no resistance.  Feels good to be getting closer to normal.  I have an appointment with my OS tomorrow morning so we'll see what he thinks.  I would like to get back to plying hockey again so will ask if I can resume some light skating before I get back into a game.

[JOW_103]

Week 8 - Physical Therapist decided to extend me for another month.  He wants to make sure the strength in my knee is OK.  Never really felt I lost any strength but they know best so I guess I'll be continuing PT for another 4 weeks.

Met with my OS.  He says the knee looks really good.  They took a joint spacing x-ray to make sure both legs are still the same length.  Everything is fine.  We started discussing what's going to happen with my right knee.  It has the same issue as my left.  Trying to determine if I can get away with another PKR.  X-Ray shows no spacing between the joints on medial side.  Had an MRI last week and will discuss with OS next steps.

Still have the numbness on lateral side of my left knee and pain and tightness on the outside part of the knee.  I have started to resume some light skating since I want to continue my recreational hockey play.  Skated real easy for about 3 minutes prior to my team's last game.  Felt good and no adverse effects to the knee.