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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index

Hello Pauline,

I have not had a TKR yet. I am going to copy a bit of what I originally posted about what is going on with my kneee. I have had 4 knee surgeries in the past 16 months. The first was in January 2009, for a meniscus tear, and a little buckle of synovitis. Should have been pretty straight forward...right? No so much. After that surgery, my knee kept swelling, and continued pain. My surgeon told me I must be getting old (was only 39 at the time), and sent me to a rheumatologist for evaluation. Many, many blood tests were done, and nothing found by her. However, she felt I needed another scope on my knee, and after my refusal to see the same surgeon, she recommended a surgeon who runs a knee institute about 45 mins away. I had my 2nd scope in November 2009, and he found very extensive synovitis, and a plica. He removed both. The swelling and extreme pain continued, and fluid was removed from my knee 9 times from November to April. MRI, CT scan, and xrays revealed a kneecap tracking problem, lots of scar tissue, and worsening arthritis. Another scope was performed in early April, lateral release performed, and scar tissue was removed. I had scar tissue all over my knee, all the way to the tibia. When I woke from that surgery, the pain seemed extreme, but I thought I just did not understand how bad it would be, so I tried to muscle through. 6 days after surgery, my knee was about 3x's the size of the other, I was bruised all the way to my hip, and the pain was so bad, I could not move my ankle, stand, or walk to the bathroom without help, and bursting into tears. Now, I will tell you, I have battled advanced cancer, multiple surgeries associated with the cancer, so I am no all. This was the worst pain I have ever experienced in my life. I called the surgeon, and when he looked at my knee, he immediately admitted me to the hospital, and had to perform emergency surgery for a large hematoma in my knee joint. It took him over two hours to remove the blood clot, and I was in the hospital for a few days with a drain in my knee. Since that time (April 17th), I have had blood and fluid aspirated from my knee three times, and the knee is still terribly swollen, has more fluid in it, I cannot bend it past about 90 degrees, despite the extensive efforts in PT, and I have horrible sharp pains in it all of the time. It appears the scar tissue is back, and is wreaking havoc in my knee. The top of my knee (above the kneecap) is thickened, and is a good part of the reason I physically cannot bend it (it will not bend). Besides the horrific pain when I try to bend my knee, it feels like something is blocking it from bending. I have a large palpable band of hard scar tissue on the lateral side, and one of the scars on the medial side, as well as the drain scar on the lateral side are both sunk in, and alternate between throbbing and having sharp pains all day long.

When I first wake in the morning, I have a small window of time to do a couple of things before the swelling sets back in. By early afternoon, I cannot even put weight on my knee, and the swelling is extreme. When my knee is measured and compared to the good one, it is around 2 1/2 inches larger from my upper leg to just below my knee. In addition, my lower leg, ankle, and foot swell daily in response to the knee swelling.

I have my doubts about whether or not the manipulation will work, since my scarring may be deep in the knee, and he may be unable to break it up this way. My knee is so touchy, my PT really has not been able to do much to it at all during therapy. Even light soft tissue massage causes it to swell. The surgeon took me out of PT until after the manipulation, since it seems to making matters worse. The surgeon said that the more the swelling is down during the manipulation, the better, but that will be impossible. Just getting ready to go to the hospital, driving there, and walking in will cause the swelling to shoot out of control.

I am keeping my fingers crossed, but have a feeling he will need to go back in to correct the situation. I think that the complications I experienced after surgery, and subsequent inability to start PT right away let the scar tissue take hold again. After he removed the hematoma, I was not cleared for PT for about three weeks, because the swelling was so bad, it was tearing the drain hole open in my knee, and would not stop bleeding for about 2 1/2 weeks. I think that was enough to set things in motion with the scarring again. In response to the scar tissue problems, I feel like the synovitis is back again too, and I wonder if the manipulation will make that worse. The synovitis will likely need to be cut out again, as it would not correct itself in the past.

I understand what you mean about wanting so badly to do the things you enjoy. I cannot do anything I want without extreme pain, and swelling, so I sit here feeling depressed. Having joint issues like this is certainly a quality-of-life issue, and we all went through surgery (or mulitple surgeries in most cases) in an effort to gain our quality-of-life back again. It is terribly frustrating when the surgery is not successful.

Keep your chin up, and keep me posted on your progress. If you need a manipulation too, we can compare notes.

All my best,

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