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Author Topic: Crepitus after Bilateral Total Knee Replacement  (Read 8504 times)

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Offline vholiver1

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Crepitus after Bilateral Total Knee Replacement
« on: September 06, 2010, 10:50:09 PM »
I have had a lot of physical problems in the last few years. I always had problems with my right hip (dysplasia), bad knees (genus valgum), over-pronation, and a relatively mild scoliosis. Perfect imperfect specimen. Well, I guess one thing feeds on another, because I ended up with fallen arches/flat feet, osteoarthritis in both of my knees and my right hip, and lumbar spinal stenosis, brought on by arthritis in my spine. I have had my hip and both knees replaced, I wear orthotics in my shoes - no big deal, and I go for corticosteroid injections in my spine.

This is a knee forum, though, so I want to ask a question about my knees, my left knee to be exact.

I don't know if these two things are related, but when I had my BTKR's done (at the same time), I was learning to walk up and down stairs at the SNF. I was having a difficult time because, frankly, it hurt like hell, and when going down the stairs one day I stumbled. I fell about 2 or 3 stairs before my PT caught me. She said I wasn't hurt - at least the prothesis didn't get out of place, but the knee  hurt a lot afterwards, and they iced it up for me. The next day it was "ok" and although I had to spend an extra week in Rehab, it did not seem that any damage was done.

After that, though, I had severe pain alongside the outer knee, and it took quite a few months before that cleared up. The prevailing view was that I had probably pulled a tendon or something like that. It did eventually heal, though, but the left knee has never been as strong as my right knee.

After it healed, though, I started getting a grating, grinding noise in my knee. I asked my doctor about it, and he said it was nothing I needed to worry about. I'm pretty sure it's crepitus - from everything I've read the symptoms are pretty classic - but it's a problem for me anyways. When it's been grinding, crunching, grating (so many words you can use to describe it), the knee aches. Sometimes a little, if I haven't been doing a lot, but if I've been out walking a lot, when I get off of it, it just aches like crazy. I usually end up icing it.

Fairly recently, though, when I wake up in the morning it grinds a LOT. I will usually stretch my legs and move my knees back and forth before I get up, and like I said it grinds, but after I move it back and forth for a while, it seems like I get it oiled or something, and after that it's mostly ok. This morning, though, which is what prompted me to write this, my knee felt very stiff and when I went to move it, it sounded and felt like nuts being chopped in a grinder - the only way I know how to describe just how crunchy and loud it was. It hurt, and it took quite a while of moving it back and forth for the grinding to subside.

This seems to be getting worse, and the achiness seems to be lasting pretty much all day.

I'm getting so sick of feeling lousy all the time. My back is a real problem in progress, and we just bought a new mattress in hopes of my getting some sleep, and now this crepitus stuff seems to be becoming a problem. I hope not, but that's how it seems.

I feel like my husband is starting to think I'm a hypochondriac, and sometimes I wonder about that myself, but this stuff is not in my head.

Has anyone been dealing with this crepitus stuff and TKR, and what happens when you have it. Is it a sign my knee is damaged or anything like that? Is it something I should bother my doctor about again? (I hate to bother him unless I really need to - he is a wonderful surgeon, but not so great in the examining room. Polite, but not a lot of patience - he is VERY busy.)

Thanks.
 :(

Offline Lottiefox

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Re: Crepitus after Bilateral Total Knee Replacement
« Reply #1 on: September 06, 2010, 11:50:51 PM »
Hi there

Can I ask how far out you are from the double TKR? How long after your op was the stair stumble and how long ago was that event? What is your ROM like in the knees; is the problem knee more restricted than the good one? Do you have your "natural" kneecap or has this also been resurfaced?

I am afraid I can't offer any specific TKR advice, but you might want to post your questions and story down in the TKR section of the Board as well, as sometimes the people on there don't always see the general posts. There are a lot of really helpful folks down there and I am sure this crepitus sensation will ring some bells with someone. From a real TKR lay point of view I would probably say if the pain and sensation are getting worse (and to be honest, having been through BTKR you aren't exactly being a hypochondriac!) then it is worth speaking to your doctor. Its your knee and he owes you proper follow up care. Better to have wasted a few minutes of his time for what is hopefully nothing out of the usual than to worry, wonder and possibly be able to do something simple to get yourself back on track.

Good luck and I hope things get sorted,

Lottie x
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline vholiver1

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Re: Crepitus after Bilateral Total Knee Replacement
« Reply #2 on: September 07, 2010, 02:51:53 AM »
Hi,

Thanks for responding. My BTKR was a little over a year ago. The stair tumble was while I was in Rehab, about a week after surgery. ROM is good - I don't remember exactly how many degrees, but when I was in PT I was considered "flexible" and passed the milestone quickly. Both knees have about the same amount of motion, but the left knee - the one with the crepitus - is significantly weaker than the right one (which I think is strange, considering my right side had both the knee and the hip replaced.) I got so that IF ONE MORE PERSON HAD CALLED ME THE BIONIC WOMAN I WAS GOING TO SCREAM!!! Okay (deep breath)...  I'm cool now...

Interesting question about the patella - I really don't know. Never thought to ask, just assumed they always put the natural one back (although I do know it gets modified). I actually wish I had been a fly on the wall during those operations. I know what they did, but I can't believe they actually did that to me. I am morbidly curious.

I will post over in the TKR section - thanks for the suggestion.

And thanks, also, for reminding me that I'm probably not a hypochondriac. It seems like once you've gone in for surgery, done PT and all that - people think you are all done - that you're finally "well", whatever that is - and they don't want to hear anymore. My husband thinks everything is all good now, I should be able to go spend a whole day at the county fair. Tried it last year, and it was a total disaster. My son had no idea that this was major surgery - his wife said "well, it was scheduled, you knew what they were going to do. What's the big deal?" Her father had killed one of his knees in an accident, so I think that's why the attitude - it was not dramatic like her father's accident was. I wouldn't care, except I do think she affected my son's attitude.

It doesn't have much to do with my knees, more to do with the spinal stenosis, but when I went out and started walking to build up strength in my knees, instead of things getting better, they got worse. That's when I found out about the arthritis in my spine, which degraded to spinal stenosis. I had thought the pain I was getting through my lower back was from my knees (I think I need a lesson in anatomy). I expected that pain to go away after the surgery, but it didn't. Now I get to visit the Pain Management Clinic for chronic pain. I am none too anxious to have any surgery on my spine. No way. No how. But I get sciatica pain frequently, really really bad muscle spasms, and I often get numbness in my feet and walk like a drunken sailor.

Actually, a question - is there a reason why I would get osteoarthritis in so many placess? I know that rheumatoid arthritis spreads all over the body, but I thought osteoarthritis was localized. Is it common to have it hit in so many places?

Wow, I really got off track. I'll have to keep saying to myself "we're talking knees here. knees. knees..."

But...  I am more than just isolated parts. And I "talk" too much.

Offline Lottiefox

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Re: Crepitus after Bilateral Total Knee Replacement
« Reply #3 on: September 07, 2010, 09:26:14 AM »
Hey,

Don't worry about talking too much! This is the one place where you can vent and talk knees (and other bits) as much as you need to. I can't believe that your family think a BTKR is a walk in the park...I know they probably just want you to be up and dealing with it (which you clearly are) but having a hip done too, plus spinal stenosis - wow, they need to start living with pain each day and accepting what two new knees and a hipe are like to rehab! Anyway, thats my little rant over!

In terms of OA attacking various parts of the body - I think it just happens when your biomechanics are a bit faulty. I am 41, fit, active, not overweight, always been really nimble and busy and flexible...but my feet are slightly flat, my ankles rotate, my knees rotate the other way and through too much running with weak hip and glute muscles and bad pronation I have worn out my kneecaps, and starting to wear the medial side of my knees. I also have OA in both big toe joints which I assume is because my feet don't take the weight evenly, and pretty sure that my hips might follow suit in later life.....I have been tested for RA and other inflammatory diseases as it seemed odd to me that things suddenly all wore out at the same time but tests are clear. Its god ole wear and tear - so new parts will be in my future I am sure unless something else gets me before the knees finally have it! How was it having both done at once? Was that because they were both in a bad state and one wouldn't have coped with doing all the work, or just your surgeon's preference? Its a hellishly brave move, I applaud you. I'm battling on with PT, staying active and various potions and lotions.....time will tell how they hold up long term.

I hope you get some answers on the crepitus, it sounds nasty and that otherwise your new knees are doing well..... :D

Good luck,

Lottie x :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....















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