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Author Topic: Significant pain 5 weeks post op pkr  (Read 1067 times)

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Offline meganboc

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Significant pain 5 weeks post op pkr
« on: October 15, 2012, 01:54:26 PM »
HI, I'm a newbie. :)
I had a PKR about 5 weeks ago.  I'm still in quite a lot of pain and still need assistance when walking much of the time.  It's still quite swollen which I suppose is normal.  My pain is on the medial side for the most part.  It also "catches"  which is very disconcerting.  It pops and clicks a lot but I'm guessing that's normal too.  If my leg has been bent I have trouble and pain straightening it out.  Occasionally it goes out from under me.

I should preface by saying that my experience in the hospital post-op was a nightmare.  The PA that was supposed to be in charge didn't want to hear that I was in so much pain and disappeared Friday morning and I didn't check out until Saturday night.  It's quite involved, but my pain level was never lower than an 8.  I was very upset and wrote the PA a letter so he wouldn't do this to anyone else.  I don't know if this effected my appointment but it shouldn't have so it's kind of irrelevant.

Anyway, I called about my knee occasionally going out from under me and she said I needed to come in.  The surgeon basically laughed at me.  I checked the stability which thankfully wasn't significant (he said).  He tested my strength and made this big act about that.  I'm only 41, 5'3" and 125lbs.  Yes I have some atrophy, but I'm by no means unable to carry my weight around.  As for my pain, he told me I shouldn't expect to climb a mountain.  I didn't!  I did think I should be able to get around my house.  In short he blew me off like a hurricane.    This is my 3rd knee surgery.  I'm pretty familiar with my knee and I can tell that the implant area is healing.  It's something else. The PT said it was my MCL.  I should say here that I am devoted to doing my PT although the pain is debilitating after.

After a phone consult, another doctor will be seeing me this week.  He said that I should have been walking unassisted and off pain killers at the end of 2 weeks.  Has anyone else had these issues after a PKR?  I have googled my brains out and can't find damaging the mcl as a risk of the surgery.  I've been going through trying to fix a 1 cm (by this 3rd surgery a 1.5 cm) grade 4 tear on my medial femoral condyle for 4 years and 3 surgeries.  I'm a mom of young kids and I'm losing faith I'll ever have my life back.  I chose the partial for the recovery.  Is anyone familiar with any of this?  Thanks in advance!






Offline Maverick

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Re: Significant pain 5 weeks post op pkr
« Reply #1 on: October 15, 2012, 03:39:07 PM »
Megan Boc, I am very sorry to hear of your struggles.  Although I have not had a PKR I presume that one is in my future.  I had a microfracture a year ago, (see my sig), and I am going in for exploritory arthroscopy in a few weeks to figure out what is causing my pain and to get off the sidelines myself.

I am glad that you are seeing another surgeon.  Would you post your findings as I am very interested in following your progress.

Hang in there!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline seerobinbike

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Re: Significant pain 5 weeks post op pkr
« Reply #2 on: October 15, 2012, 04:22:57 PM »
Hi Meagan,

Let me start by saying that you absolutely should not be having significant pain and still be nonweightbearing 5 weeks post op!  I wouldn't be too concerned about the buckling; it's kind of to be expected post PKR surgery until you can build up the muscles around the quad again. 

I'm so sorry that you had such a bad experience with the whole surgery and I'm so happy that you are seeing someone else!!!!  I wish I knew what to tell you about the MCL but I don't believe there should be any risk to the ligament during a partial. 

Although I don't have any answers for you, I wanted to write just to say keep the faith and hang in there.  It sounds like your second opinion doctor is on your side and hopefully after a visit, you will know exactly what the heck is going on.  When are you due to see him/her?

Keep us posted.  We really do care.

Robin

Jan. 12: PKR.
June 10:  Meniscus surgery.
Most of '09:  PT to help constant knee pain.

Offline LindaM

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Re: Significant pain 5 weeks post op pkr
« Reply #3 on: October 15, 2012, 07:33:58 PM »
Hi Meagan,

Sorry to hear you are having a struggle with your PKR.  Some swelling is normal and you will have it for quite a while.  Even now when I overdo things I have some swelling.  Do you still have any bruising left?  Mine persisted longer this last knee than the first, and that really added to my pain.  What kind of pain is it that you are having?  Is it constant or intermitten?  After surgery is not unusual to have some nerve pain from the nerves that were severed during surgery and they will take time to grow a bit and reattach.  It can be burning that is triggered by the slightest touch of a sheet.  If this is what you are dealing with I can tell you that it usually goes away eventually.  Mine took over 6 weeks. If it is the all day dull ache kind of pain, it could be the stretching that some muscles and ligaments have to do as your body shifts to accomodate the new shape and height of your knee.  With my first knee, everything hurt from my neck down because the angle of my knee was now so different.

How long was it until you could control the quad and do straight leg lifts?  Even at 4 weeks, when I stood up(especially at night when I was tired) I sometimes had my knee give.  It had to do with the quad not engaging automatically as it should.  Be mindful of having your knee set beneath you and do work hard on those exercises with the band that have you stand and pop your knee in and out.  The stiffening is pretty annoying, but is probably due to your knee (and everything around it) protesting to being moved just after it got comfortable and relaxed.  You are doing a lot a stretching and strengthening and just like any other muscle, with overuse it will stiffen as soon as you are still.

I completely sympathize with your distress at being in pain.  I limped nine months before my first PKR and it took about that long after until I had everything-back, hips, legs,-adjusted to my new knee and was walking normally without a limp or pain ( and that included cortisone shots to the trochanter and tush).  That being said, I was back to work each time at 6 weeks teaching full time.  I'm sure you are icing, but are you being really diligent about it?  I lived with my ice machine on every evening for at least 3 months post-surgery each time to manage the swelling from being on my feet.

Popping, clicking, and feeling your knee are normal.  One day in a few months you will stop noticing it because it will be your new normal.  You will also get used to not pivoting on your knee in the same way you did  since this new one has less give and to being a little more gentle rolling over in bed.

Hang in there.  Every knee is different-mine sure were!  Normal recovery is the average of those who heal faster and slower than you, and nobody every feels they are healing fast enough.  Keep up the PT, but if it leaves you in excessive pain, tell your PT that it is too much.  Mine wanted me to do 2lb. weights really early.  I had excessive pain, and started with a roll of quarters instead (it weighs 1/2 lb.) and worked my way up. 

You are going to beat this pain, but it may take a while.  We will be here for you, so feel free to post the concerns and complaints that you don't want to burden your family with.  We understand.  Robin and I went through our PKRs together this year and helped each other along.

Linda :)
>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline seerobinbike

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Re: Significant pain 5 weeks post op pkr
« Reply #4 on: October 16, 2012, 12:35:18 PM »
Hey Meagan,

Me again.  Apparently I shouldn't post before coffee.  When I read this, I read PKR but was thinking meniscus.  So forget everything I said and please accept my apologies.  Hope that I didn't freak you out. 

Linda is right.  Everyone heals at very different speeds and everyone's perception of pain varies of course.  That said, here is an excerpt from my diary at about 5 weeks post op:

Monday, February 6,2012

"Rest did help the knee and it felt pretty 'normal' yesterday.  It was a still stiff but could walk pretty fluidly without a single crutch.  I was able to do all my previous PT exercises plus the ones given to me at PT on Friday but took it down a couple of notches.  I worked NO muscles to fatigue, I just did what I felt the body could handle.  I've also decided to not stay on the bike for 20 minutes X 2; instead I did a total of 25 minutes broken into two sets.  Oy vei.  LOL...I love saying that.   I really, really want to ride sooooooooo badly that I don't want to get off the bike after a crappy 12.5 minute workout.  You can't even call it a workout.  But I've got to remind myself that I'm not doing it for cardiovascular reasons....I'm doing it to get the knee to loosen up a bit so that sometime in the near future I can be back on the bike.  I never realized how addicted I am to a good sweaty workout.  (Slight sigh.)  Knee was so good last night that for the first time since surgery, I took only 1/2 of vicodin before sleep.

I had PT first thing this morning and told T. about my knee puffing up after the last session.  We talked and decided that we both needed to tone it down a bit.  I told him exactly what I was doing for exercises and he suggested breaking down the two sessions per day into three per day.  I totally agreed.  Thank God that I have the time to do this!!!  After our discussion, the session continued on with some work on a reformer.  I worked my quads, calves, ab/adductors and hip flexors using a tiny bit of resistance.  I think I did 15 reps for each set.  Well, apparently even this was too much because before I could even get out of the door, my knee was achy.  Muscles are fine tonight but my knee is once again swollen.  Dang.  What a sissy it is.   Came home to elevate and ice the thing for an hour but it's still puffy and hurting just a bit.  Ah well. I hope that a good night's sleep will help my knee settle down so I'm able to do more SLR's tomorrow because I really miss those a alot.  NOT.  Really, I hope it's better because I'd like to get in a good day of strength and stretching and then head out sans crutches for a nice lunch with a good friend.  We shall see."

I found it helpful to read about others experiences.  As I said I did keep a diary so if it's at all helpful to you, take a read.  You will see that I was still on pain meds. at 5 weeks and definately still had a ton of pain. 

Whenever I'd get discouraged or felt like I was not healing as fast as I thought I could be, I'd remember the words of my surgeon who patted me on the leg while I was at the hospital and reminded me not to get discouraged and kept saying 'Just give it three months and see what happens.' 

Best wishes!

Robin

Jan. 12: PKR.
June 10:  Meniscus surgery.
Most of '09:  PT to help constant knee pain.

Offline seerobinbike

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Re: Significant pain 5 weeks post op pkr
« Reply #5 on: October 16, 2012, 12:39:01 PM »
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=58553.0

Here is a link to my diary.  Skip a few pages and read where I was at at about week #5 and you shall see. :)
Jan. 12: PKR.
June 10:  Meniscus surgery.
Most of '09:  PT to help constant knee pain.