Knee Replacement...Now Shoulder Surgery

[Ljohnsaw]

I am continuing to improve but very slowly now.  My flexion improved today from 135° to 137° and my extension is still below 1° but not to 0° yet.  The PT lady is still telling me that I ain't normal.  That most knee replacement patients struggle to get to 125° flexion.

All of my PT is now geared toward building and strengthening muscle not toward Range of Motion.

Hmm, did they check to see that your bones are straight, that they didn't crook when you weren't stickered correctly?  Maybe you only have 125° flexion and go way past 0° if you adjust for your crook. ;)

[Magicman]

I think that the surgeon found dote and had to make an executive uneducated decision whether to open the hump or horn face.  He could not open the sweep faces because of possible crook which may not edge out.  The claw turner worked well whereas a chain turner would have caused excess screaming and would have caused possible trauma in the incubation ward.  There is a video showing the two plane clamp firmly holding the new titanium joints in place while the JBWeld cured.  I suppose that the new knee will quit hurting as soon as the pain goes away.

[Old Greenhorn]

I think that the surgeon found dote and had to make an executive uneducated decision whether to open the hump or horn face.  He could not open the sweep faces because of possible crook which may not edge out.  The claw turner worked well whereas a chain turner would have caused excess screaming and would have caused possible trauma in the incubation ward.  There is a video showing the two plane clamp firmly holding the new titanium joints in place while the JBWeld cured.  I suppose that the new knee will quit hurting as soon as the pain goes away.

OK, I think this pretty much signals that you need to get out and about a little more or start stamp collecting to keep your mind busy.

[kantuckid]

I had my hip replaced 8 weeks ago and I just want to be able to put my socks on....... :D

Since my wife must travel two days a week to help provide in home Alzheimers care for her 95 yr old Mother, I bought a frame you thread you socks on which greatly aids solo socks. Tying yer shoes is another thing though! Bending over very far is one of the bugs of a THR.
I attached a clothespin to a cedar stick to assist with picking stuff up.

I said THR is a piece of cake next to my full tear rotator cuff and a guy on a motorcycle forum got all ruffled as his was a painful recovery, etc.. Sure not my experience! Both mine were anterior approach which makes a huge difference in PT time.

Knee replacement is my next senior moment of medical repair in the scheme of aging.
My next knee apt is 1/13 and PA suggested the doc be there as maybe a knee replacements coming. We leave for FL and much outdoor activity such as bicycles and out on the rivers so I'm thinking a 4th cortisone shot then see what happens after a couple more months?
It "works" but gets painfull not long after standing in shop, etc..

What I read on knee replacements magic is doing great!

Whats the full story on crossing ones legs after a knee replacement? WebMD tells me it's not to be done, ever! My concern would be activities like carpentry/building work where one must not only climb around but sometimes get in unusual positions?
What have you been told on leg positioning after PT's over?

[Magicman]

Nothing along those lines regarding my future activities.  

I am still working to improve the extension which is still below 1° but I have not reached 0° yet.  My unaided flexion is 130° and 140° with me applying pressure, so I only need to maintain what I have with flexion.  My "test" score was 68 when I began PT and has now improved to 84.  I have 8 more PT sessions scheduled before I am discharged and I have a Surgeon followup appointment on the 10th.

[Magicman]

My homework PT plus the reduced swelling seems to be gradually but steadily paying off.  My forced flexion improved from 140° to 143° and the unaided flexion improved from 130° to 134°.  I am still slightly above 0° with my extension but there was an improvement there too.  Of course it has been years since that leg/knee was at 0° so I am stretching stuff that is not related to the surgery.  I am confident that I will have a straight but bendable leg when da fat lady sings.

[YellowHammer]

@kantuckid 
I don't know about knee replacement restrictions, but I was also told not to ever cross my legs again, but the reality of it is that I do it as needed and the joints aren't going to just pop out, they are very stable.  I know when I'm doing something wrong, I'll start to feel some pain and stress, but as MM is seeing, he is actually getting an increased range of motion, possibly ending with more so than presurgery.  

[kantuckid]

One of my KS cousins had both knees done, same time, as did a son's MIL.She is ~ 75, and not a real active person but is mobile now, but in a limpy way. She has R. arthritis so hampered in many ways joint wise. He had such a bad back combined with putting off the knees, he literally had to learn how to walk again, meaning in an upright, erect human manner. He was a lifetime FT farmer and much hard work to get to where he was.
Talking joint movements, I sometimes feel my hip joint catch when sitting a certain way such as on a tractor seat then moving to use the brake while turned backwards to see behind. I find that if I stand erect it gets that kink out.
My hip doc told me I was cleared to do anything I had previously done without restrictions, other than common sense, which I may be short on sometimes when it comes to lifting. Aging is a great teacher to not overdo stuff given the muscle mass loss. I am long past (lets say 50 years back) being one of the strongest, fastest guys in town.  

My local, general practitioner doc is a lady, ~ 45+ years old, who, coincidentally, had her hip replaced by the same Lexington, KY doc as mine. I asked if she ever gets that same kink riding horses as she does and she said yes but it's minor as I described.

MM is my role model for knees. ;D
Keep it up old boy, cause I want reassurance I wont be slowed down too long!
Yellowhammer, my AL DIL is from near you. Her moms a nursing home PT up there and dads got a landscaping business-not the grass mowing version. I forget the small towns name but it's near you.
We stopped before Christmas near Talledega & Munford, AL to buy pecans from a CL ad lady. I gotta say that if it wasn't a " meth house", I'll eat my hat. She seemed OK, well sort of, but the place was creepy and I happen to be one who's been around the block with criminals, done them for a living a long time.
I sure would like to find a regular pecan seller for the future!     

[Magicman]

I had no intention of updating this topic today but..... there are two significant (to me at least) improvements.  

For the past many years, with stairs, hills, etc., I led with the right leg which did the actual climbing, and descended with the left leg which again shifted my weight (work) to the right leg.  In so doing, my right thigh muscles were much larger than the left.

1) Yesterday I ascended and descended stairs without any regard as to which leg/foot led or lagged.  I did this without any thought as to which leg was doing the work.  No pain, weakness, nor hesitation.  

2) This morning my extension exceeded the 0° mark and I am now into the + range.  

I am 6½ weeks past my surgery, have met my flexion and extension goals, and am very pleased.  ;D

[Andries]

Good for you MM, well done.

[realzed]

I applaud you for all of the obvious determination and the work you approached and followed your TKR with.  
I read along without commenting regarding you preoperative jitters and through your post operative worries and frets about pain and stiffness and lack of range of motion, mainly because I have suffered many of the same frustrations and lack of hitting successful goals along the way with my own TKR, and didn't wish to discourage you in any way or form.
I only wish I could have ended up with the same type of success you have managed through all of it - but in the end, even after 18 weeks of PT, I never achieved anywhere near the range of motion nor the amount of pain free operation you apparently now already enjoy..
It took me almost 3 days before I even got any feeling back in my toes after surgery and that alone had the doctor(s) looking puzzled as they poked me often while standing at the foot of my bed waiting for me to flinch.
I did end up after 6 days leaving the hospital for home, but the only way the pain ever subsided in the least despite meds, was when I was standing - as sitting or lying was near impossible for most of the first month or so.
I mostly after 2 weeks of being home, spent most of my waking hours with a wheeled walker (thankfully it was Fall and not Winter when I had this done) out walking around the streets trying to wear off the pain, which never seemed to stop.  My painful nights turned often into painful days - where I would replace sleeping with being upright and often walking with my walker well into the night or off very very early in the morning as soon as I could manage to get upright and out of bed.
My therapist had me frustrated when I tried my best by even going in the hospital often early for appointments, so I could stretch or cycle as best as I could for 45 minutes to an hour early, trying to limber up sufficiently so I could impress her with my new goals in my range of motion when she got a hold of me - but for the most part the best I ever achieved was barely over 100 degrees bending and after 8 years now of pain, swelling of my knee and lower leg, and painful - often days of not being able to walk any measurable distance - I seemed to have settled at what appears to be approximately 90 degrees of bending angle to live with. 
Stairs - HA.. I look immediately for a hand rail and hop or shuffle up or down - freestyle - not a chance. Lost a great amount of my balance and to this day need to lean up against something for support to put on pants and/or socks..
After my one and only visitation with the surgeon who did the job - I have had no luck trying to get answers from him about what my options are except (a) getting put to sleep and getting the knee physically bent to some degree mechanically which apparently can result in bone breakage while trying to free up whatever binds it (nothing shows on dozens of X-rays) past a point and restart PT all over again or (b) having another TKR done (which I'm honestly now told has about a 50% rate of success on second tries)..
I'm not happy with it to say the least - I can't trust my knee to be steady under me on stairs or be pain-free in most circumstances, nor can I feel good about what confuses dozens of doctors by now when it comes tp why it will swell up every so often and basically make it unusable for a week or so before it all returns to my somewhat 'normal'..
But it is what it is.. I guess.
So I can't begin to imagine how good it must feel to be in your position - and honestly wish you the best for all of your hard work and success with this.
Not to be a 'downer' but despite hard efforts and a lot of time some of these just don't work out as planned - as I've been told often by now.
Just be very thankful yours did and enjoy every minute you get pain free and mobile.
I am now in need of a new hip (opposite side) and I truthfully am scared to death about getting it done as you might expect from my past history of ortho-tinkering.
One doctor told me he would only do replacements for people if they came crawling into his office begging him to fix their hips and knees because he figures the expectations these days are just too high in many cases and many actually believe they will have to give up nothing when having replacements done.. which obviously is wrong, as you can never feel 18 again nor can you do at 70+ years what you could do 'back when' but that doesn't register with many until reality faces them squarely.
I truly enjoyed your saga - keep on truck'in..
Randy            

[doctorb]

Realzed

I know you've settled into your marginally acceptable total knee result, as it's now 8 years old.  I'm sorry it has not turned out as everybody would wish.

But I must encourage you to get a second opinion from someone who only does total joint replacements and who received a fellowship year of extra training in that subspecialty.  

If you can live with what you have, then do so.  Some patients are prone to excessive scarring and struggle for adequate motion.  Some patients have pain, swelling, and stiffness for no apparent reason.  One of my partners who does just total joints tells his patients that 85-90% do well, but a small group do not. If you are unhappy with your result, listening to an expert about your options cannot hurt you one bit.

[Magicman]

Oh Randy, your reply brought tears to my eyes.  First, for the pain, suffering, and anguish that you have suffered and then second, gratitude and thankfulness for the success that I have realized.  I have a good friend that was not able to reach past ~90° flexion so he had to have MUA which is a procedure that you alluded to.  After reading your reply maybe I more fully realize how fortunate I was by having an "event free" TKR.  I walked over 300' the afternoon of the surgery, was discharged the next day, and have never experienced any pain in the knee.  Yes, I took the prescribed pain med, but I always took the minimum dosage, not the maximum.  The second week I was breaking the pills in half and only taking them on PT days.

My purpose and hope for posting this knee replacement was that it would help someone that was facing a similar situation.  There were times when I needed someone to lean on, and each time I got the needed encouragement for which I am grateful.  doctorb and doc henderson provided the "expert" advice that helped me to understand and give me some answers to questions that I had.  

I wish that after the knee heals I would be ready to saw, but sadly I have a shoulder situation that has to be addressed.  It looks like Marty is gonna have to put his "sawing britches" on.

[YellowHammer]

Realzed,
For what it's worth, I'd strongly recommend seeing a specialist from a different medical group, in the nearest big city for a second opinion. I personally know a lady who had a very painful and disappointing TKR and who struggled with it for years.  She never saw another surgeon, said they were all the same, and was told she would have to live with it.  Only after her surgeon died of a sudden illness did she see another surgeon, one who was a specialist in knee revisions.  He said he could help, and after surgery, she is virtually pain free.  

BTW, my own mother has had two TKRs done, one in each knee, with different surgeons.  Very different results. The first one was not entirely successful, required weeks of rehab, and also required a MUR, which was not a pleasant experience.  A year or so ago, with hesitation, she had the second knee done by a "superstar" specialist, and it was an amazing recovery.  Two different surgeons, two much different results.

Anyway, I'm sorry to hear of your pain, I wish you all the best.  

[Ianab]

I suspect that limbs are also a bit like logs. 

You can be the world's best sawyer, with a perfectly running mill, and then you open a log and things aren't exactly as you expected. The world's best sawyer (or surgeon) will have the experience to recognise the problems, and make the best they can from the situation. But it won't always come out 100%. 

With a sawmill we find tension / shake / rot / embedded metal etc. I'm sure surgeons come across comparable complications. 

[chet]

I suspect that limbs are also a bit like logs.
With a sawmill we find tension / shake / rot / embedded metal etc. I'm sure surgeons come across comparable complications.

I think my Doc found all of the above when he just tried ta repair my shoulder.   :

[kantuckid]

Randy, that was a saddening tale. You explained it well enough but I'm in that camp of keep trying and hope you don't preclude talking with another provider.
I've seen dramatic differences in simple procedures such as my own trigger finger injections, as done by different providers.
Others here who've had joints repaired/replaced and re-gained our lifestyle need to provide encouragement from our own experiences.

I have a neighbor/friend who needs a knee but will not talk about any surgical procedure, period.
I have a BIL who needed both knees, opted for one, then told the world he'd never do the other one cause it hurt too much during PT, etc. It's his body.

One of our sons had a sports injury, then a botched elbow surgery and got his fix from another doc who showed us the issue that was done wrong as a means of avoiding pointing fingers at another ortho doc.

I hope you find a path to a better result.

As a non-medical person, but former athlete and coach, I still am well aware of the profound differences in all of us and know that must greatly affect any results we can hope for.

[realzed]

I certainly do appreciate the feedback to my own tale - but make no mistake I meant it all in the hope that some who may yet intend to undergo or have to, such procedures as TKR's - as some words of warning strictly with the intent of letting them know that not all of these procedures work out perfectly every time and not all instances will pan out as well as Magic Man's.  
Additionally, I wasn't in any form, trolling for sympathy - it was just a realistic tale of the polar opposites that can and sometimes do  unfortunately occur, despite even with I'm sure even the best of doctor's efforts sometimes.
I have the good fortune of now being riddled with somewhat severe Osteoarthritis (palindromic in nature) and it's really slowly starting to disable me over the past 3 years or so. Many of my own symptoms as I described earlier, may be somewhat rooted in that bigger issue - but so far visits to experts as far away as 5 hours driving from home have produced no solid or valid answers or even good guesses to this point as the number of causes or results from this seem as varied as the numbers of 'experts' one can seemingly find..
I have had 2 shoulder surgeries additionally prior to the TKR that worked out well for me - so maybe the luck of the draw and/or odds just finally caught up and worked against me with this knee deal..
But again I wasn't looking for sympathy and truly meant and intended the congratulations to MM for his diligence and hard work because as I stated - felt I really could relate to all of it.  
Its just so hard to take when it doesn't pan out and you can feel a fair amount of your independence starting to slip somewhat as one realizes vulnerability and 'feeling their real age' rather than always acting somewhat more like 40 years younger and far too often sometimes foolish!
The big question for me at this point isn't whether to try and do something about my (or as I often refer to it as 'the' knee - as it tend to feel as if it is foreign matter in my body that belongs elsewhere) joint - but more how do I deal with the upcoming and impending hip and possibly other issues I know will have to be dealt with eventually.
Its pretty hard to come to grips with taking on another one of these deals - when you seemingly can't get past what still lies right in front (or in this case under) you - in this case.
I loved to take walks, and fire up my basically new 261CM and work on  cutting up wood, and I guess somewhat foolishly thought I needed something to distract me and possibly help exercise myself free of pain and aggravation when I ordered a semi loaded with hard maple going on a couple of years ago - and some of it still lies partially untouched due to my inability to tackle it in the regular and productive manner I optimistically thought it would push me to - and that I think has proven to me just how 'mind over matter'  just doesn't work the way the phrase or I intended.
I really do appreciate the kind words of encouragement - if it was easy to access even more expert help than I have already seen from here to try to get a better handle on this over the past 8 or so years I would have done it, but at this point I almost consider that I should turn the page and try to address what I have coming, instead of dwelling on what it appears I can't and must live with going forward, if that makes any sense.
I had a neighbor who also underwent a TKR and watched me struggle often times in doing some outside chores (and I'm sure noted me with my 'walker' days and nights) only to occasionally pop over and do some deep knee bends displaying just how well she had made out (which you may imagine - I really didn't need to witness) but even for her I felt mostly happy that it brought her some relief, despite the urge often to throttle her at the those very times.. :D.      

[YellowHammer]

It goes without saying, but I'll say it anyway.

You are a GOOD person, @realzed

I'd like to meet you.

Yellowhammer

[realzed]

Ha - I'd like to meet all of you characters as well - great bunch of guys and we all think somewhat different as I can tell which is good - but mostly all somewhat alike at the same time.. which is even better!
I have or had - relatives on my mother's side of the family in Atmore Alabama that I had contact with at a point years back - but I'm sure they have passed on years ago now..
Thanks for your very kind words!

Randy

[kantuckid]

Hey Randy, "Like they say", there's always someone worse off than myself.
A childhood friend of mine died shortly before our 50th HS reunion in 2011. He was Fred K., a never married guy, who'd been a superb athlete in HS but focused on following his Dad into becoming a pharmacist. He lost his Mom before I even knew her and worked in his Dad's pharmacy often so not much time to be social back then aside from athletics. He was a center on a VG HS football team and a 6' 5" forward on a VG HS basketball team. He owned and operated his pharmacy in Carbondale, CO (coal mining town) for his whole career, then retired to work as a fly fishing guide out there. He went into the Steamboat Springs, CO, hospital for a routine knee scoping, cleanup operation and never left there, dying from a hospital infection.
In a somewhat related story line, occupation wise, our left tackle on the same team was also a small town pharmacist in Alma, KS and died back when AIDS was an unknown story.

[Magicman]

Today was a kinda big day for me.  I figured what the Dr. would say, but I wanted to hear it.

Discharged with no restriction/limitation nor further prescribed PT.  I will continue to do my PT homework to maintain/increase the knee joint flexion and extension, but it is exercises that everyone should be doing anyway.


 
The frontal X Ray showing the replacement hardware.  Also note the good bone separation on my right knee (on left).  Dr. said that the right knee should never have to be replaced.


 
The side view showing the hardware and also showing the patella (knee cap) that got a composite "veneer" where it contacts the hardware.

So now what?  Weather permitting, I am ready to start contacting sawing customers.  I am thinking maybe one job per week until I feel comfortable.  Dr. said that too much activity could/would cause some swelling so I'll take it easy and continue to use my ice pack.

[Ljohnsaw]

Sounds great!  Way to go! 8)

Dr. said that too much activity could/would cause some swelling so I'll take it easy and continue to use my ice pack.

But, how much activity do you see sitting in your ride-along chair? ;)

[Andries]

Congratulations, with some tenacity and determination, you got your reward!
Also, thank you for using excellent judgement on posting X-ray images, rather than the anatomical parade of pictures that you've been throwing up in the past. 
Like the gals say, leave some room for the imagination.  smiley_gorgeous smiley_gorgeous smiley_gorgeous

[Jeff]

Those pictures are detailed enough to see the Gorilla Glue!