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Offline Dave258

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PFJR scheduled for September 25
« on: July 12, 2012, 07:42:35 PM »
As the title says, I am scheduled for a PFJR on September 25.  I saw my OS yesterday, and the final decision was made.  I am a little scared, and not looking forward to recovering from another major surgery.  My OS says I will need to send a couple of days in the hospital, and a couple of days in a Rehab facility.  He was very reluctant to do the surgery because I am only 34, but after 4 knee scopes, micro fracture, TTT, almost a year of therapy, taping.........  I am at whits end!  Everytime I get up, or sit too long, stand too long, walk too much, play with my kids out side, just normal everyday activity, I am in PAIN, so much so that it physically makes me sick.  When I had the Fulkerson TTT I thought I was getting better (here is my post op diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=58292.0) but once I worked my way up to more activity, my pain got worse.

So, now I am playing the waiting game.  Trying to manage my pain, while doing what I can.  I am still in PT 3 times a week, elevate my leg whenever I can, use my Breg Kodiak ice machine (I go through 14-21 pounds of ice a day, I know because my freezer cannot keep up with me so I buy ice at the gas station down the road) and take pain meds.
Does anyone have any suggestions for me on recovery, or should I expect close to what recovery was for the Fulkerson?  Also, can anyone who has been through this suggest some sort of brace that actually helped.  I forgot to ask my OS about one yesterday, but my Pain dr. said I should try an over the counter one before trying to get my insurance to approve one that may not help.  Should I just buy one at the pharmacy, or is there a good one I could get on the internet?

Thanks in advance!
Dave

Offline KW

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Re: PFJR scheduled for September 25
« Reply #1 on: July 12, 2012, 11:51:42 PM »
Don't psych yourself out for a horrible recovery from the PFJR!  I've had 2 and neither was horrible. 

I had my Left done in 2009 @ 34 (4 days shy of my 35th birthday) and my Right done in January 2012 @ 37.  With my 1st I was in the hospital for 4 day - only because it was a holiday and they could not make arrangements for me to leave.  With the 2nd I was only there for 2 days and happy to be sent home.  I never went to a rehab facility I went directly to my own home each time.  For #1 I had someone staying at my house to help but sent them home after 1 day (I don't do hovering well) with #2 I just went home to my nice empty house.  I had easy to heat food ready and friend/family helped with dinner and some things I just could not do on crutches.  PT and a visiting nurse came to the house a few times a week (for 3 weeks) both times and once the staples were removed I was cleared to see my out patient PT (he is so much better then home pt).  Never took too many pain meds with the exception of nights most of the time I found ice was much more effective - I had a cryo/cuff with #2 and that was fantastic!   As for work I never took off more then 3 weeks.  I am an accountant and can work from home.  In 2009 I was able to take off for 3 weeks - actually the OS would not let me take off for less then 3 weeks.  This year due to a change in position I was not able to get away from my computer for more then 1 week.  At 6 days PO I was on my sofa with ice and my laptop working away.  It was a little tough,  but you do what you need to do.


Let me know if you have questions.  I love my PFJR's.  They are fantastic.  I am still rehabbing the PFJR I had done in Jan 2012 but it's almost there. 

KW 
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #2 on: July 13, 2012, 03:57:40 AM »
Thanks for the reply, KW!  I am glad that your PFJRs worked well for you!  I hope mine is as successful too.  I am hoping I will not be in the hospital or rehab long, but I am going to just follow what my OS says.  When it came up in my appointment yesterday, he said the decision will be made when he sees how I am after the surgery and couple days in the hospital.  I HATE being in the hospital, but like my OS said, he wants me to be in the best situation to get the best results from the PFJR.
One thing I did forget to ask my OS is are you under any restrictions once heeled completely.  I hope not!

KW, did you wear any kind of brace to help with pain before your surgery?  I have PT tomorrow, and was going to ask my therapist what he thinks.  I guess if I think of anything else, I will post here.
Thanks again,
Dave

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #3 on: July 21, 2012, 04:54:42 PM »
Hey Dave!
Looks like we'll be surgery buddies again! I see the super knee OS on the 31st to schedule my PFJR. There was/is a concern about a large lesion on the medial side, so a TKR may still be in the realm of possibility. Will know more in a week...  I'm glad you have a date and can maybe start seeing the light at the end of  this tunnel.
Lisa
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline FMRCathelete

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Re: PFJR scheduled for September 25
« Reply #4 on: July 22, 2012, 02:50:07 AM »
Dave - Restrictions OS gave me after PFJR were no leg extensions or leg curls using a machine/gym equipment.  Also I am not allowed to use inversion table.  Would expect those 2 things would be for everyone, but I would ask your OS.  And I would ask about any specific things you want to be able to do, as mine did not say anything until I asked.  Best of luck to you!
Lat release 5/08
OATS 7/09
PJFR 10/10
Scope, plica removal/synovectomy 1/12
Scope, Medial retinacular release and debridement of excess tissues 2/13
Knee Denervation 3/2014

Offline KW

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Re: PFJR scheduled for September 25
« Reply #5 on: July 22, 2012, 03:43:39 AM »
Definitely ask about restrictions....I have the no weighted extension restriction but more due to the TTT. It was suggested that running be minimal.  I am allowed weighted flexion.  Can't tell you why things are different from each OS.
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #6 on: July 22, 2012, 04:09:15 AM »
Hey Dave!
Looks like we'll be surgery buddies again! I see the super knee OS on the 31st to schedule my PFJR. There was/is a concern about a large lesion on the medial side, so a TKR may still be in the realm of possibility. Will know more in a week...  I'm glad you have a date and can maybe start seeing the light at the end of  this tunnel.
Lisa

Hey Lisa, good luck with your appointment on the 31st!  I cannot wait to get my PFJR, I hope this ends my problems!  I cannot see how it will not, I am no Dr. but, if the main problem is my kneecap, and now it is wearing away at my femur, I saw in the last scope when my screws were removed, this has to help, right????
I hope it helps you also, and we have no more knee pain!!!!
Again, good luck, please let us know how your appointment goes!
dave

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #7 on: July 22, 2012, 04:22:58 AM »
Dave - Restrictions OS gave me after PFJR were no leg extensions or leg curls using a machine/gym equipment.  Also I am not allowed to use inversion table.  Would expect those 2 things would be for everyone, but I would ask your OS.  And I would ask about any specific things you want to be able to do, as mine did not say anything until I asked.  Best of luck to you!

Hey FMR, thanks for the reply.  In my last appointment with my OS when I scheduled my surgery, I asked a bunch of questions, and I made my wife come with me to make sure all the questions were asked.  In the past 2 days, i came up with so many more questions, I started writing them down.  I am going to call my OS Monday to either set an appointment, or see if he will call me just to talk about some things.


Definitely ask about restrictions....I have the no weighted extension restriction but more due to the TTT. It was suggested that running be minimal.  I am allowed weighted flexion.  Can't tell you why things are different from each OS.

Wow, I was not given that restriction after my TTT.  I specifically remember the time at PT where after my TTT that they put me behind the leg extension machine set to only 10 pounds.  I thought my leg was going to explode!!!  After that, i would do leg extensions off the side of the table with just a 2 1/2 pound ankle weight and it still hurt like hell!  I wonder if I should not have been doing that. 
Well this time I am going to make sure I ask!

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #8 on: July 30, 2012, 10:08:12 PM »
Hey Dave,
I got a great recommendation for a pre replacement book from Robin (seeRobinbike).  It's called Total Knee Replacement and Rehabilitation. I know you're not having a total, but the exercises in the front of the book are definitely worth it.  Robin used it for her surgery, and she's doing great! Just thought I'd pass it along. I picked it up for my Kindle, cost about $9.00.  I have my appointment tomorrow with the OS who will be doing my PFJR, hopefully will have a date soon. 
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #9 on: July 30, 2012, 10:56:03 PM »
Hey Dave,
I got a great recommendation for a pre replacement book from Robin (seeRobinbike).  It's called Total Knee Replacement and Rehabilitation. I know you're not having a total, but the exercises in the front of the book are definitely worth it.  Robin used it for her surgery, and she's doing great! Just thought I'd pass it along. I picked it up for my Kindle, cost about $9.00.  I have my appointment tomorrow with the OS who will be doing my PFJR, hopefully will have a date soon. 

Thank you for the book recommendation Lisa, I will look into it. And good luck at your appointment tomorrow.

As for me, I'm doing the same as I have. PT and ice and try to keep up with my family when I can. PT is actually starting to really hurt, my therapist is taping my knee a different way to try and unload pressure from my kneecap. It helps a bit but PT kills me for the rest of the day. I still have 2 months to go and they keep telling me how important it is to keep my ROM and my muscles moving. I'm trying!!!!!

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #10 on: July 31, 2012, 08:30:57 PM »
This has been a long, hard journey for you and you deserve to have some relief! I know it's hard to wait, but maybe your knee just needs that little bit of time to get strong enough. I got my date, October 12. She will be doing a PFJR +OATS to take care of that medial lesion. I'm so happy that there will be relief, I could just cry! I think now we both can concentrate on pre-rehab, get ready for the big day!
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #11 on: August 28, 2012, 02:51:12 AM »
Hey Dave!
Just wanted to check in. Only a month before your new knee, very exciting! Hoping your prehab is going well and the pain is under control.
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #12 on: August 28, 2012, 03:32:39 AM »
Hey Lisa, I am sorry, I thought I was back on here since you last posted.  Congrats on getting your date, I hope everything goes well for you!  It stinks that when the light is at the end of the tunnel, there still such a long wait!

As for me...  I can't wait for this to be over!  I have been in PT since January of this year, with about a 2 week break for the hardware removal and scope in June.  My knee was better before the scope in June than it is now.  The pain just keeps getting worse, and I am trying my hardest to battle through it.  I feel like I am eating pain pills like crazy, though not more than what my Dr. has prescribed.  I still have pains in my Tibia, where the screws were, and they were taken out almost 12 weeks ago.  The other day I was walking down the steps, I can only do steps one at a time obviously, I was carrying a cup of coffee.  My knee gave out, and I fell backwards thankfully, and not head first.  When I went backwards, my leg slammed forward, torquing my knee.  What a nightmare!  I called one of my Dr.'s to see if I should go for an X-ray, and he said I probably did not do anything to the bones, but definitely aggravated things. 
So, I stupidly push myself during the day and I pay for it.  I use so much ice, I have to buy three, seven pound bags a day basically.
I hope this PFJR fixes my knee!

Sorry for the rant, but it felt good to get it off my chest!  This is putting stress on my wife and kids and everyone around me, so I don't want to add to it by going off on rants like that.

My pr-op appointment is September 19, with surgery to follow on the 25th.  I will post some updates, and see what my OS has planned for me.

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #13 on: August 28, 2012, 09:07:08 PM »
Rant away, that's what we're here for! Do you have a cryo cuff? You may have answered this already, but I've forgotten. It truly is a lifesaver! I got mine from amazon for a seriously reduced price, can't remember the exact amount. Compression and cold in one step, truly amazing. Your kids can lift it and watch the cuff fill up. Fun until you can't feel your feet! Knee games anyone?
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #14 on: August 29, 2012, 01:39:03 AM »
Rant away, that's what we're here for! Do you have a cryo cuff? You may have answered this already, but I've forgotten. It truly is a lifesaver! I got mine from amazon for a seriously reduced price, can't remember the exact amount. Compression and cold in one step, truly amazing. Your kids can lift it and watch the cuff fill up. Fun until you can't feel your feet! Knee games anyone?

Yeah, I have the Breg Polar Kodiak, same type of thing, and it is great!  I use it when I know I have time to sit uninterrupted to ice my knee.  It holds basically an entire 7 pound bag of ice, and last for a few hours.  When I know I don't have that much time, I use an ice bag.  I have a bag of ice on now, and when the kids go to bed I will fill up the Kodiak.  I hope I can bring the Kodiak to the hospital for after the surgery.

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #15 on: September 10, 2012, 02:20:24 PM »
I have 15 days left.  I cannot wait!  I have my pre-op physical next Tuesday, and pre-op appointment with my OS on Wednesday.  I have a bunch of questions written down to ask him, one that I have been meaning to ask him for a long time is what type or PFJR system he is using.  I have seen a bunch of different ones on the internet, and watched a few surgeries on youtube.  They look pretty much the same, but some look easier as far as what the OS has to do because of the tools that the company made to go with their implants.
My OS has let me stay awake during my scopes and hardware removal, I am going to ask him if I could stay awake for this to watch.  I know this is major surgery, so I doubt he will let me.
I will let you guys know what goes on.  Hope everyone is doing well!
Dave

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #16 on: September 11, 2012, 05:37:06 PM »
This is so exciting! Finally on the home stretch. I'll be watching your PFJR closely, am following only 3 weeks after. Nothing but great results for you!
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #17 on: September 12, 2012, 05:35:40 PM »
Hey Lisa, the home stretch it is!  I just got home from PT, and boy does it hurt!  But after just reading someone else's posts about breaking her knee cap and ending up with MRSA and now having her leg amputated above the knee, I feel like my problems are very small!
But, does MRSA go away?  I had MRSA in my knee back in November 2010, and that is when all my problems started.  Guess I will have to talk to my OS about it again.
Can't wait to see my OS next Wednesday to get my pre-surgery questions answered.  I got a letter in the mail from my insurance company, saying they approved me staying in the hospital for 3 days.  I am hoping that is all it will be!  My OS mentioned sending me to a rehab place already to make sure I get me knee and leg back to where it should be because of how long this has been going on. 
Well, I guess I will post again after I see my OS unless something else comes up.

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #18 on: September 19, 2012, 08:46:57 PM »
Well, I was supposed to have my pre-op appointment today.  Went to my OS office only to find out he had an emergency in the OR, and was now running hours late.  I had no problem waiting an hour or so because I had nothing else to do.  His secretary said I could come in Friday morning, and see him right away, so I figured I would do that.  So, I will see him then and update after.

Hope everyone else is doing well!

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #19 on: September 21, 2012, 10:32:27 PM »
Went to my OS today.  He did another full examination to see if there have been any changes to my knee that he could tell from the outside.  He then explained to me exactly what he was going to do.  He explained that the incision may look a little weird because he has to meet it up with the scar from when I had the Fulkerson done last December. 
After that, my wife and I assaulted him with questions!  I told him how nervous I was now, and even that I thought about canceling the surgery.  Told him all of my reasons why, and he reassured me that everything will be OK, and answered all of my questions in detail! 
My surgery is on Tuesday, he said he will try to get me in the first half of the day.  He said I will be kept in the hospital until Friday, then sent to an inpatient rehab facility for a week.  Because of the constant problems, and 5 surgeries over the last 2 years, my leg has withered away to nothing despite the continued physical therapy.  He said going to the rehab facility will ensure that we start off on the right foot, (no pun intended) to help recovery go as smooth as possible.
I am not planning on bringing my laptop to the hospital/rehab so you guys may not hear from me until about 2 weeks after my surgery.  I will have my iPhone on me, but it is not the easiest to post from.
Hope everyone else is doing well!
Lisa, if I miss you before you go in, good luck, I hope everything works out well for you!
Dave

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #20 on: September 23, 2012, 04:10:01 AM »
I'm so happy that you're finally going to get some relief. I like the idea of a rehab facility after the hospital. I imagine they will be better able to control your pain while you get those muscles back in shape. Maybe your wife could post something for you so we will know how you're doing. I'm expecting glowing reports! Especially since mine is coming up soon, too. Surgery buddies rule!
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #21 on: October 06, 2012, 02:55:46 AM »
Sorry I have not posted in a while, things have been hectic! 

I had my surgery on Tuesday 9/25 as planned, and everything during the surgery went as planned.  I was given a nerve block, and had a q-pump with a catheter put in my leg to pump in Novocaine to the femoral nerve to help with pain control after the nerve block wore off.  I woke up from surgery with my leg in an immobilizer, and wrapped from the top of my thigh down to my toes.  My other leg had a compression stocking on it.  I spent 3 hours in recovery, and felt pretty good during that time. 

When I was moved, I was brought upstairs to my hospital room.  My leg was still numb from the block, so I felt pretty good.  My wife was able to bring my kids to come and visit, and I felt well enough to talk with them.  They had started to give me oral pain meds, percocet I think.  That night around 1 am, the block wore off, and here came the pain.  The nurse must have called the anesthesiologist that was on call about 5 times in an hour.  I have been on pain meds for so long that no matter what they gave to me, nothing helped.  After about 45 minutes, the nurse hooked me up to a PAC (patient controlled analgesia) machine, that basically was able to give me a dose of dilaudid every 6 minutes.  Within an hour or so, it caught up to the pain, and I was able to relax a bit. 

Around 9 am that morning (Wed 9/26), the nurses said I was green.  That tried to give me any nausea medicine they could, but nothing helped.  That had to take me off the PAC.  By 10am I was in the worst imaginable pain that my body has ever been put through!  Again, they tried different meds, and the nurses spoke to the on call anesthesiologist who finally said he cannot just keep mixing medicine.  I was in so much pain that I was so surprised that my body just didn't pass out.  My wife tried to talk to anyone she could, and no one had an answer on how to help me.  My OS's office is connected to the hospital, so she went there to try to get my OS.  This was around 4 in the afternoon.  When she went, my OS was coincidentally just getting to my room.  When he saw what shape I was in, the s**t hit the fan!  Within 2 minutes, I was hooked up to the IV with a bag of morphine, and an anesthesiologist was in my room to give me a shot down the catheter in my leg to numb it once again.  I was sound asleep within 15 minutes.  I woke up later that day much more comfortable, and found out that I was getting morphine every 3 hours now to stay on top of my pain.  That happened the rest of that night, and into the next morning (Thurs. 9/27).

That morning, my pain doctor came to meet me, got me off of the morphine and back on to all oral (stronger) pain meds.  Physical therapy was finally able to meet with me on Thursday too.  Walked a little bit with a walker, and started the CPM machine.  later that day, walked again with walker.  Once the pain was under control, I felt pretty good!

Friday, 9/28 walked with walker again further than I had yet.  Therapist said I was doing well.  I was going to be discharged from the hospital that day, my OS still really wanted me to go to an inpatient rehab center.

So, on Friday 9/28 I went to inpatient rehab, and have been here ever since today is Friday 10/5.  I have been doing PT sessions twice a day, and have progressed from a walker to a cane now.  I still do a CPM machine 6 hours a day and am up to 75*.  But when I work with my therapist, I can already bend past 95*.  I am glad I took my OS's advice and came to rehab, it has been great!  I am being discharged on Sunday, 10/7.

I really do not think I can keep up with a full post op diary again this time.  I will try to post again when I go home.

Hope everyone else is doing well!  Lisa, good luck on the 12th!

Offline LisaDX

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Re: PFJR scheduled for September 25
« Reply #22 on: October 06, 2012, 04:22:10 AM »
I'm so glad they finally got your pain under control! Sounds like you're making good progress. A cane, really?! I'm impressed! Hope everything keeps going well.
1975 Left Knee arthrotomy, no diagnosis
1984 Left Knee arthroscopy, no diagnosis
1987 Left Knee Lateral Release, successful
2007 Right Knee Lat. Release, unsuccessful
2011 chondromalacia patella, PF OA
        Arthroscopy, chondroplasty
2011 Diagnosed MS

Offline Dave258

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Re: PFJR scheduled for September 25
« Reply #23 on: October 12, 2012, 09:44:08 PM »
Hello everyone, Lisa I hope everything goes really well for you today!
I was discharged from inpatient rehab on Sunday, 10/07/12.  Because Monday was a holiday, I started PT on Tuesday.  I already noticed the strength and movement I had lost just since my last therapy session on Saturday.
I went to PT on Tuesday, Wednesday and Friday this week.  Pt is going well, I am using a step machine, riding a bike, doing some leg kicks then it is massage, ice and stim. 
I had my first follow up with my OS's PA yesterday, he removed the bandages I had which were some special bandage that had silver made into it to keep everything sterile, under that I had steri strips.  The PA said I was doing well, and that the next six weeks may be tough, but I have to just be strong and get through them.  He told me I can walk around my house without the cane, and gave me a green light to do all exercises at PT.
Hope everyone else is doing well!

Offline stereohearts143

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Re: PFJR scheduled for September 25
« Reply #24 on: October 01, 2013, 07:41:46 AM »
Hey David,

I sincerely hope your rehabilitation has been fruitful, and that your knee troubles have disappeared.

Would you mind updating the rest of us on what your status is?
R antero-lateral condyle / trochlea ACI 2.0 x 2.5^2 July, 2012