Author Topic: My PKR Experience (Read 21042 times)

JOW_103 · « **on:** April 22, 2013, 09:44:13 PM »

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 · « **Reply #1 on:** April 23, 2013, 04:29:00 PM »

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 · « **Reply #2 on:** April 23, 2013, 06:45:30 PM »

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 · « **Reply #3 on:** April 23, 2013, 07:08:12 PM »

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 · « **Reply #4 on:** April 23, 2013, 07:14:55 PM »

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 · « **Reply #5 on:** May 01, 2013, 04:15:54 PM »

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 · « **Reply #6 on:** May 01, 2013, 09:45:56 PM »

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 · « **Reply #7 on:** May 08, 2013, 04:43:16 PM »

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 · « **Reply #8 on:** May 14, 2013, 08:51:22 PM »

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 · « **Reply #9 on:** May 22, 2013, 06:58:18 PM »

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.

JOW_103 · « **Reply #10 on:** June 03, 2013, 08:02:02 PM »

Week 10 - It's now been 10 weeks since my PKR. Continuing the PT work for another coupe fo weeks. No real change in my overall condition. Have some occasional swelling in my leg when I'm on it for long periods of time. Still have numbness and tightness on the lateral side. Although at times it appears to be getting better, albeit in small increments.

Got the results of the MRI in my right. Looks like more surgery is in my future. This is what the MRI showed.

There is extensive cartilage loss over the medial femoral condyle and
medial tibial plateau, with mild associated subchondral bone marrow edema. Associated subtotal tear or rupture is seen of the posterior root ligament attachment of the medial meniscus, with peripheral meniscal displacement. There is laxity of the medial collateral ligament, reflective of medial compartment degenerative change. Mild to moderate patellofemoral compartment degenerative change is also present.

Looks like another PKR is in order.

JOW_103 · « **Reply #11 on:** June 13, 2013, 05:56:21 PM »

Week 11 - Not a lot of change in how I feel this week. Continuing the PT and still see swelling in leg. Did manage to play my first recreational hockey game this week. I used a neoprene brace and didn't experience any significant pain or swelling. Still can't get rid of tightness and discomfort in lateral part of my knee. Wondering if this is a bit of nerve damage due to the surgery. Otherwise things seem to be moving along nicely.

Maary · « **Reply #12 on:** June 24, 2013, 10:50:50 PM »

I had a right PKR 6 weeks ago. First three weeks were hard - I hated the tedium of resting, icing, elevating, being housebound. A very depressing experience for an ex athlete with no patience what so ever.
However the last three weeks have seen me come on in leaps and bounds. I did not allow my therapist to push my knee past tolerance.
Today my bend is at 120 extension 1.5 and I peddled the bike easily for the first time.
Like you I have numbness and tightness on the lateral side.
Life is getting much better - so much so I'm booked for the left knee in two months time. Not looking forward to another op but I am looking forward to a new lease of life afterwards and getting back to some sport will be great. I know I might not play tennis again - but there are lots of sports I can and will be doing comfortably and cheerfully!

JOW_103 · « **Reply #13 on:** June 27, 2013, 04:40:05 PM »

Week 14 - I have been discharged from my outpatient PT at 12 weeks post op. The numbness in the lateral part of my knee is dissipating and I'm not having the tightness in my knee that I was experiencing. Every now and then I feel it but certainly is a whole lot better. Back to playing recreational hockey with no adverse effects. Overall, very happy with the results. We'll see how it feels in 3-5 years.

I will be meeting with my OS in late July for a followup on my left knee and to plan for what's going to happen with my right knee At minimum PKR is in order if not a TKR. Hoping I can do another PKR as the experience with my left knee was very positive.

LindaM · « **Reply #14 on:** June 28, 2013, 02:35:57 AM »

Quote from: Maary on June 24, 2013, 10:50:50 PM

I had a right PKR 6 weeks ago. First three weeks were hard - I hated the tedium of resting, icing, elevating, being housebound. A very depressing experience for an ex athlete with no patience what so ever.
However the last three weeks have seen me come on in leaps and bounds. I did not allow my therapist to push my knee past tolerance.
Today my bend is at 120 extension 1.5 and I peddled the bike easily for the first time.
Like you I have numbness and tightness on the lateral side.
Life is getting much better - so much so I'm booked for the left knee in two months time. Not looking forward to another op but I am looking forward to a new lease of life afterwards and getting back to some sport will be great. I know I might not play tennis again - but there are lots of sports I can and will be doing comfortably and cheerfully!

Hi Maary,
As a gentle way you can increase your ROM under your own control, put your foot up on the second stair or on an armchair so you have something for balance and gently lunge forward. You will be amazed what a 5-10 lunges two or three times a day will do within a couple of days. You are at the stage when you feel good enough to overdo things-be gentle with yourself. I was back to teaching at 6 weeks, but I was still icing for several weeks more every night.

Good Healing!

Linda

P.S. Great to hear you are doing so wel JOW

JOW_103 · « **Reply #15 on:** July 26, 2013, 03:47:43 PM »

Saw the OS for the last time in regards to my left knee PKR. He is very happy with the result as am I. I think he was surprised I have had no loss of flexion or knee bend. He said I should be happy with my implant for years. We'll see.

Discussed the plans for my right knee. OS wants to wait a bit before doing any thing. He says I still have cushion there although he sees the slightly displaced medial meniscus, bakers cyst and bone edema as well. He also said my knee is getting flex to the outside and if we wait to long he won't be able to do a PKR because they can't correct the misalignment. I told him I would like to preserve as much as my own joint as possible so we agreed to take another look at it in November

JOW_103 · « **Reply #16 on:** November 14, 2013, 08:45:30 PM »

Well 8 months since my left PKR. Happy to say everything is still working well. My last x-ray showed some cement had broken off and is floating around in my knee. OS didn't seem to worried about it so I guess I shouldn't either.

I have scheduled a PKR of my right knee for December 3 of this year. I will be so glad when that happens as the pain is nearly intolerable. Hoping he can do the PKR but he won't know for sure until he opens it up and starts sizing the implant and straightening the joint. If he can't align my knee properly it's going to be a TKR. I have a planned tripped to Sedona, AZ the day after Christmas so I hope to be back on my feet as quickly as possible. I will post updates to this thread as I progress in my recovery on my right knee.

JOW_103 · « **Reply #17 on:** December 02, 2013, 07:34:11 PM »

Big day tomorrow. I am scheduled for my right knee PKR tomorrow at 1:30 PM. Although I won't know until after the surgery if I had a PKR or TKR. My joint is out of alignment by about 5 degrees and that is the limit for what the surgeon can correct using a PKR. He quoted me a 60/40 chance of a TKR when I met him during my pre-op visit two weeks ago. I think he he's leaning more TKR although he is planing a PKR. I will find out tomorrow. Either way, it's another long journey to get back to normal after the procedure. For sure it's worth it to be finally pain free. I'll be posting my progress here so people can learn from my experiences.

mcirish · « **Reply #18 on:** December 12, 2013, 09:32:24 PM »

JOW, glad to hear things went well with your PKR. I hope that the second implant is a PKR as well. I am scheduled for a PKR on Dec. 27th and I am very apprehensive.

Question for you or anyone: How does the pain, discomfort and recovery compare to an ACL reconstruct. post op?

I have had 2 ACLs done, the second to prep for this PKR procedure and I was a really trooper after my second. Returned to work and taking stairs without crutches 4 days post op (prob. a bad idea I know). Everything turned out great, but I have a 2 y.o. and try to lead an active life so I just want to know what to expect.

JOW_103 · « **Reply #19 on:** April 04, 2014, 06:30:15 PM »

I have officially reached the one year anniversary of my PKR procedure. I am happy to report that everything is well. Implant is performing as expected and the only issue I've had is a small piece of cement break off the back side of the implant. The pain I was experiencing prior to this surgery was immense and I'm glad I made the decision to have the PKR done. I would certainly recommend this to anyone with uni compartmental damage to their knee. I have full extension and ROM in my left knee after the PKR so back to where I was prior to the surgery.

Hopefully I can report back over a longer period of time and still have the same positive results. It would be great if those that have had a PKR would report back their results. Especially those that have had them done a while ago.

katiejarr · « **Reply #20 on:** August 22, 2014, 08:51:12 PM »

Quote from: greatfulgann on April 23, 2013, 06:45:30 PM

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?

What is the difference?

JOW_103 · « **Reply #21 on:** December 17, 2015, 03:08:29 PM »

I am happy to report I've had my annual checkup with my OS and my PKR is performing and functioning fine. No limitation on my activities and now don't need to go back to the OS for another two years. Currently have 2.7 years with the implement. Hope to continue to post here with long term updates from time to time.