Banner - Hide this banner





Author Topic: Partial knee replacement ( knee cap replaced)  (Read 7419 times)

0 Members and 1 Guest are viewing this topic.

Offline likewoa2007

  • Regular Poster
  • ***
  • Posts: 84
  • Liked: 0
Partial knee replacement ( knee cap replaced)
« on: October 29, 2012, 01:12:37 AM »
Hi

I had a partial knee replacement (the knee cap was badly damaged with grade 4 arhtritis bone on bone) and had a lateral release done. I had it 4 weeks ago and I still have pain all around the knee when doing physcial therapy. I still cant descend high steps. Is this normal? I can do small steps but even small steps i cant continuously go down one leg after the other. I need to stop and take my time when going down. I'm 30 years old and just a bit concerned with all this pain. My arthritis pain is gone. I now have another type of pain going around the knee when I try to do a deep squat.


Offline FMRCathelete

  • Forum Faithful
  • ****
  • Posts: 354
  • Liked: 5
  • Cats are great recovery companions
Re: Partial knee replacement ( knee cap replaced)
« Reply #1 on: October 31, 2012, 09:27:45 PM »
Hello-
I was 37 when I had a PKR and I was still on crutches at 6 weeks for anything outside of house, and I don't think I was going up & down stairs "normally" until 6-8 weeks out -and was still painful, but doable.  Had lateral release at 34 -lateral release was MUCH more painful post-op than PKR.  I would say 4 weeks is still very early & I would assume this was not your 1st surgery.  If that is the case you will take longer to recover than an older person having TKR who may have never had a surgery on the joint before.  Are you working with a physical therapist that is certified in orthopedics?  Some that are not don't set realistic goals for younger people after such a surgery.  We also tend to want to be much more active than their average 65+ year old patient (I know there are many older folks that are very active-that's why I said average -not intended to offend anyone).  Speak with your surgeon & try to be very specific about the location and type of pain.  I would not do deep squats until you speak with him/her.  Good luck to you and try to be patient with your recovery -better to heal completely than to try to rush things and impair healing.  Take Care.
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 LindaM

  • Forum Faithful
  • ****
  • Posts: 488
  • Liked: 8
Re: Partial knee replacement ( knee cap replaced)
« Reply #2 on: October 31, 2012, 11:07:55 PM »
Hi there,

Just a question-did your PT assign you to do deep squats or are you just doing them because you always have?  I have two PKRs and had great recoveries(back to work teaching in 6 weeks each time) and my PT didn't just want me to avoid them during recovery, he advised against them as a regular part of my exercise ever.  If you haven't been specifically instructed to do them, don't.  If you have been given them in your PT sessions, dial it back a while until the pain settles down and ask for an alternative exercise that targets the same muscles.

Steps will take time, they are one of the last things you will master, and they won't be comfortable for quite a while.  You will need to build up the strength in your quads and flexibility in your hamstrings, and since your whole body has to readjust muscles and ligaments to your new knee, that will take time. With my first PKR I went one step at a time for a couple of months and one flight was my limit.   I could do one flight of stairs at 5 weeks with my second PKR and my PT was amazed, so don't worry-it will come.  Some of this depends on how long you were limping before you had surgery-I hadn't done any steps for several months before my first PKR due to pain.

Even though I healed fast and recovered well, it was months until everything was completely back to normal with my first knee.  The swelling by the end of the day was an issue for a long time.  The second knee was much easier, but still took a couple of months for the swelling to subside.  And don't let off on the icing even though its been 4 weeks, especially after PT.

Be kind to yourself, the best way to have an excellent result is to be a perfect  patient doing your rehab as carefully as you can.  Now that you are feeling better don't overdo it on the housework, yard, etc. either.

Good healing :)

Linda

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

Offline likewoa2007

  • Regular Poster
  • ***
  • Posts: 84
  • Liked: 0
Re: Partial knee replacement ( knee cap replaced)
« Reply #3 on: November 03, 2012, 01:48:18 AM »
No, my PT didnt assign me to deep squats. I was trying to do them and I cant. I have too much joint pain all around the knee. I do the Leg Press, its supposed to target my quadriceps but instead my hip and glutes feel the workout when I'm done doing that machine. I dont understand why.

I do leg curls on the curl machine. I also do the hip abductor machine as well. I do my lunges and squats but I can hardly go down.

I ride a recumbant bike and when I crank up the resistance I feel the workout going to my groin.

I dont know why.


Offline carty

  • MINIgeek (20-50 posts)
  • **
  • Posts: 49
  • Liked: 0
Re: Partial knee replacement ( knee cap replaced)
« Reply #4 on: November 03, 2012, 09:31:11 PM »
With the leg press there might be 2 issues:
1. As a patient of, I assume femoro-patellar pain for quite some time, you might have learned to engage hip flexors, glutes and hammies more, to take off load from quads, to take off load from kneecap. It happens even without recognizing it. Now you need to relearn. It really is a matter of concentrating, which muscle group to activate.

2. It depends on angles, if you do leg pres with glutes or quads. leg press can work both. The smaller the angle in your hip is, means the higher you place your feet, the more you engage your glutes. Try to place your feet lower.
Depending on where you train, some leg press machines are just s**t and never work quads properly.

You may be able to do minisquats with your bodyweight. Here again, keep you torso upright, to engage quads more than glutes. Can also be done on a wall, with a ball in your back to roll up and down. It's not necissary to go down deep, quads are working the first degrees of flexion.

Offline LisaDX

  • Forum Faithful
  • ****
  • Posts: 165
  • Liked: 1
Re: Partial knee replacement ( knee cap replaced)
« Reply #5 on: November 08, 2012, 05:59:29 PM »
Had to join in, as I am 4 weeks post PFJR. I am concerned about the curls. My OS and PT both told me that these were not a good idea, because they ask your new knee to use muscles in a way it's not ready for. I am, or will be soon, allowed to do short arc exercises. These might be kinder to your knee right now. Agreed with others that even though you are weeks post op, ice is still your friend. I was told just a few days ago that I need to be icing 3 times a day and that swelling, even if you don't think it's very much, will inhibit how you can exercise, ie., ROM. Good luck!
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 KW

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1408
  • Liked: 1
  • My new PFJR...Love It!!!!
Re: Partial knee replacement ( knee cap replaced)
« Reply #6 on: November 09, 2012, 01:36:37 AM »
likewoa2007 - You need to slow down.  The pain you are feeling is your knee telling you that you are not yet strong enough for these exercises.  A PFJR is no small surgery and takes quite a while to fully recover from.  It is going to take a good 6+ months to really feel like yourself again.  Follow the instructions from you OS and PT.  Doing exercises not yet approved can cause additional damage.
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 likewoa2007

  • Regular Poster
  • ***
  • Posts: 84
  • Liked: 0
Re: Partial knee replacement ( knee cap replaced)
« Reply #7 on: November 12, 2012, 03:47:46 AM »
IS it normal at 6 weeks out that I still have difficulity going down high stairs. I can lower my leg to a certain point and then my foot just drops down. (no control all the way through going down high steps) Little steps I can do just not high ones. Is this to be expected?

Thanks

Offline LindaM

  • Forum Faithful
  • ****
  • Posts: 488
  • Liked: 8
Re: Partial knee replacement ( knee cap replaced)
« Reply #8 on: November 12, 2012, 05:45:36 PM »
Are you describing the foot coming down hard because you can't set it down gently or are you talking about foot drop-that you can't control your ankle?

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

Offline likewoa2007

  • Regular Poster
  • ***
  • Posts: 84
  • Liked: 0
Re: Partial knee replacement ( knee cap replaced)
« Reply #9 on: November 14, 2012, 01:53:12 AM »
No, My partial knee cant go down deep enough to lower my good leg down because there is pain. So my operated knee can only lower a bit alllowing my foot to touch ground on the ver low steps. I just cant touch the ground if its a hight step so then I just let my good leg touch the ground without the control of my operated knee getting it down if that makes sense to you
.

Offline LindaM

  • Forum Faithful
  • ****
  • Posts: 488
  • Liked: 8
Re: Partial knee replacement ( knee cap replaced)
« Reply #10 on: November 14, 2012, 02:18:09 AM »
Sounds pretty ordinary to me.  What is your ROM in the knee with the partial right now?  With less than full ROM and swelling to boot that kind of limited motion is not unusual.  With my first PKR I took a couple of months to go down steps normally and longer to go up the steps without trouble.  I had been limping a long while like you and had to build up muscle so I could support myself on the operated knee when I took that next step down.  It actually sounds as if you are doing pretty well if you can do even small steps already.

Hang in there-you are on your way back to normal.

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