I had a partial knee replacement one year ago. Swelling and stiffness, 3 years after total knee replacement Posted by bengalady @bengalady, Oct 9, 2019 I had knee replacement 3 years ago. Sometimes the pain doesn't go away and last the entire night. During this time I suggest using ice, compression, tylenol, NSAIDs, and narcotic medication. The next day I had a PT session and after about 10 minutes of light therapy, it swelled again. Arthritis An additional test to consider under these circumstances would be white blood cell scan. Before that could happen I had to have a Covid, Staph and MRSA test. It does appear that your knee symptoms may be related to your recently found sensitivity. @Barbara This means healing complications aren't rare. Arthritis Rheum. -, Vivegananthan B., Shah R., Karuppiah A. S., Karuppiah S. V. Metallosis in a total knee arthroplasty. The effusion may cause stretching of the joint capsule, which can cause some discomfort. I was sent to the ER but after a couple of hours the swelling went down to about 20% more than how it was before this incident. Since then 3 of my fellow co-workers have had the same procedure and they are pain free, no swelling and are can perform normal day to day activities. Blood work showed everything normal but CRP, which was 3x higher than the outer normal range. Lateral radiograph of the replaced knee demonstrates the loose patella prosthesis and surrounding osteolysis. I had a knee replacement about 4 months ago Im still with pain and my knee still little warm . 166170, 2006. That I would have to learn to live like this. I think I am progressing well, no pain except for the swelling. Yang, Steven, MD1; Dipane, Matthew, BA2; Lu, Conrad H., MD3; Schmalzried, Thomas P., MD1,3; McPherson, Edward J., MD2 I am new to this website. Thanks so much. You should be around week 10 now, how is your progress? I still need to go to PT and still exercise (stretch), but its very painful when i try to do my stretches. Clinical photograph of the discoloured soft tissue and large effusion secondary to metallosis in the replaced knee. I don't want to have another surgery. I went back to therapy on Monday at 9 am and did 1/2 hour therapy, by 6:00 pm my upper thigh swelled so bad and I was in so much pain I called the Dr and he said it was bleeding inside around the surgery sight. However the second knee replacement was done about 3-months ago, and I ended up having a severe allergic reaction to the surgical glue so PT was postponed for about 1 week because of the swelling. In my experience, most patients have up to 6 weeks post-operatively to regain an acceptable range of motion following knee replacement surgery. This can present a challenge in certain circumstances. These include prep solutions, skin glue, suture material. We never force patients to have surgery and will assist you in finding a solution that works for you. Metallosis after knee replacement: a review. The right failed after 6 months and the second repair was deemed sub-optimal because the bone surface was already deteriorating and the they couldnt get the anchors to attach properly. The hip however has a very substantial soft tissue envelop and is considerably deeper than the knee. Unable to load your collection due to an error, Unable to load your delegates due to an error. This is why it is important to be seen by your orthopedic surgeon. I recommend you have your orthopedic surgeon evaluate the wound as soon as possible. Some of these risk factors are modifiable, which means that improving these conditions lowers your chances of developing them in the future. Most people report continued progress with regard to pain, swelling, motion, strength, coordination, and endurance for an entire year. Thank you for any feedback you can give me. (1,2,3,4) Also known as knee arthroplasty, the surgery makes use of plastic and metal parts to cap the ends of the bones of the knee joint and the kneecap. Regardless, I highly doubt bone demineralization is causing any pain. Arm site still has rash and itchy. A manipulation involves intravenous sedation and gentle progressive pressure applied to the knee to help it to bend. Luckily, the average person can easily fight off infection, and cellulitis is not a very common surgical complication. Lee- I am happy to hear about your successful early knee replacement rehabilitation. Not very happy about this. It is very uncomfortable and stiff at night. She barely even looked at the report I showed her. Blood-thinning medications can also contribute to a draining wound. Your knee swelling should significantly improve. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). This custom device was made by Smith and Nephew. Swelling and warmth is a normal part of the healing process which will improve for months. I am almost 6 weeks post-op from bilateral tkr. Orthopedic surgeons performed about 520,000 hip replacements and about 581,000 knee replacements in 2006. If you have normal redness, heat, or tenderness, take your recommended pain medication and elevate the pressure with icing and elevation. Thank you for any advice. Metallosis of a knee implant is important to be documented in literature as it highlights metallosis as a broader phenomenon than just of the hip. Within hours of their surgery, my patients are often able to begin walking with the assistance of a physical therapist and a walker. official website and that any information you provide is encrypted If you are concerned at all, you need to see your surgeon. If you notice signs that your incision might not be healing correctly, contact your surgeon right away. I am concerned that it will not go away and will need other alternatives. We tested the patient for allergy to zirconium. What should I ask my orthopedic surgeon? FOIA For this reason, I recommend you contact your orthopedic surgeon ASAP for evaluation. My specific question is the swelling. This surgery is typically recommended for people who have suffered a severe knee injury or severe arthritis. What is the best course of action. I was reassured this was not abnormal, and could take up to a year to resolve. The explanations for your situation (differential diagnosis) includes: infection, stress reaction due to poor bone quality or malalignment of prosthesis, early loosening, sensitivity or allergy to the metals or other materials used in the prosthesis. It could also be possible to improve the patellofemoral mechanics by surgically medializing the tibial tubercle (improving the quadriceps angle of pull on the kneecap). Manipulation Under Anesthesia Schaffrath DigitalMedien GmbH, Skin Discoloration Following Total Knee Replacement. Valerian root can be found in supplement form, and also in some herbal teas. I have been back to my hospital and they xrayed my knee and it has been damaged. While material allergy is a possibility, the most important thing to consider is infection. In general, pain following hip or knee replacement is mild, with redness and warmth around the joint and a slight bruise or ecchymosis. At six weeks following surgery, I would expect improvement, not deterioration. Accessibility Finally after the Covid restriction to stay at home lifted a little I was able to go to an osteopath who took an xray, measured me for a brace and told me to go back to the surgeon. My injury had included a strained ligament and a very large Baker's cyst had also formed.Before the surgery I asked the surgeon to please make sure to get rid of the Baker's cyst. The question of metal sensitivity is legitimate- I have been diagnosed with Osteopenia which I believe has been caused by revision surgery. Knee Replacement What is your knee range of motion once warmed up? Unfortunately, if your body is hypersensitive to some of the materials used in your partial knee replacement, and your knee is not behaving properly, it will need revision to a prosthesis that does not contain the materials you are sensitive to. It gradually did. I am obtaining all records to take to him. Ive consulted my surgeon and my PT and they have no answer. I hit my ROM targets--130 flex and 0 straight. Occasionally a patient may have an allergic reaction to the materials/chemicals used during surgery. One issue I've had that no one has an answer for is that I've had pain in my foot ever since the 2nd day of my surgery. My impression is that you may need further surgery. Basically- the differential diagnosis includes: referred pain from your back or hips; anterior knee pain due to patellar (kneecap) maltracking or hip weakness; instability of the knee; poor range of motion in the knees; stress fracture/reaction; infection. Post-Op Days 1-2 When you wake up after your TKR surgery, your knee may be in a continuous passive motion (CPM) machine. Use plenty of ice, and make sure your knee range of motion is maximized. I feel my knee is really not right. I am in constant pain, I have told this to my surgeon with every post surgery monthly visit. DVT is widely recognized as a major risk factor facing patients who undergo total hip arthroplasty (THA) and total knee arthroplasty (TKA). Seven patients developed necrosis over the patellar tendon or tibial tubercle, of whom 6 were treated with muscle flap coverage. official website and that any information you provide is encrypted Introduction. This happens when blood vessels burst due to injury, bruising, or an allergic reaction . The swelling is very infrequent unless I walk on it for 8 plus hours at work and even then its minimal. Road biking for about 1-hour is OK, if I take Aleve. Check out my viscoelasticity article to understand why this technique works better. While our bodies can fight off other infections on their own, infection with our joint replacement joint does not require surgery. I realize some of the above discussion gets a bit technical, but this can be a complex problem. Not to worry you, but perhaps another opinion is warranted here as it seems you are doing significantly worse than we would normally expect at this stage. Driving There is a muscle type lump over knee. Just got back from a 100 km walk in Ireland :-). This is not possible at this point as revision surgery requires a stem. I had tkr in January 2019, and know we are in april 2020. Common materials used in total knee replacement include: Cobalt, chrome, nickel, titanium, polyethylene, polymethylmethacrylate. My recovery has been hindered by femoral nerve damage diagnosed by nerve conduction study last week and I was started on Lyrica for extreme muscle spasms at night (the Lyrica works and I call it my miracle drug!). Maybe there is scar tissue formed? If you had been feeling well and this is new onset warmth and stiffness, you need to follow-up with your orthopedic surgeon for evaluation. The pathologist immediately evaluates the tissues for the presence of acute inflammation/infection, guiding the surgeon's decision. Should I be worried??? If so, an off the shelf solution is available from Smith and Nephew- this uses oxinium (oxidized zirconium) and titanium. In the hospital, the healthcare team may give you a blood thinner to prevent deep vein thrombosis, which may add to the bruising. I am 9 months post TNR and am active ; cycling 60k twice weekly,aqua aerobics twice weekly etc.I have no pain but find that my knee is very stiff still.Is this normal? I still have some swelling and discomfort but I am able to function well by doing my exercises daily, going to outpatient Physical Therapy, and icing. Individuals indicated for total knee arthroplasty (TKA) are most often elderly, among whom limb arterial diseases are not uncommon 1.In fact, chronic lower extremity arterial insufficiency is estimated to exist in 2% of patients undergoing total knee arthroplasty 2.Popliteal artery occlusion after total knee arthroplasty occurs at a low incidence (0.03-0.17%) 3, 4, 5 but can be . doi:10.1371/journal.pone.0091755. I apologize, I haven't been able to get on this website as often as I would have preferred lately. Non-operative treatments should be maximized prior to making the decision to proceed surgically. Then was sent back to the doctor that did my knee and he said he had to take the fluid out of my knee when he did this it was all blood 40 ml. My Blood ion tests showed slightly elevated but very low for a bi-lat replacement. I'm so thankful that I found this site and can breathe a sigh of relief. I cycled, did deep-water exercises, and eventually walked longer distances. The best way to do this is by CT or MRI scan with metal artifact reduction sequencing. (even within the same patient each knee replacement can feel a bit different during rehab) It may be that you have been doing a bit too much, too soon. The Sedation Rate and the C Reactive Protein have never been normal. Because knee revision systems use titanium on the tibial component and any stems/augments we had to obtain a custom fabricated revision tibial base and stem made out of zirconium. I am at 130 degrees in both knees, so movement is good. Smoking slows blood flow in the body, so it is best to quit cigarettes before surgery. Hernigou P, Poignard A, Nogier A, Manicom O. Rev Chir Orthop Reparatrice Appar Mot. doi: 10.1302/0301-620x.93b2.25099. There were many options to be looked at before having surgery again because of the possible situations for his pain. If these are elevated an infection is more likely. While some discomfort is normal in the early postoperative period, this is expected to improve over time. I had complete knee replacement 4 months ago. This is a potentially serious complication. 2014, Article ID 202801, 2014. That is how much pain I am in and I have a high threshold for pain. I am at 125 ROM. 11, no. Night pain is very common early-on following knee replacement surgery. It is possible you have a sensitivity to one or more materials used in the prosthesis. I would recommend patience. Last medically . Was this present immediately after surgery, or has it developed gradually? Ever since the surgery, there has been a reddish area notice below the end of the scar on my leg. Have you considered aspirating/injecting the cyst? Wowyou have been through a lot with these hips. Hello 2014 Sep 3;96(17):1476-84. doi: 10.2106/JBJS.M.01248. His answer was: No problem there, it will go away by itself when I repair the meniscus. If there are concerns with the healing of your skin, let your surgeon know immediately. Different patients experience varying degrees of pain and inflammation ranging from almost none to quit a bit. Nearly all stems are titanium. I would not go directly to an early revision based on the scenario you describe. Asked the surgeon about my prosthesis and of course it containes metals I am sensitive to.
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