Did you have a new (plastic) patella places as part of your TKR? Or did your TKR include retaining your original patella?
Patella replacement as part of a TKR is one contributor to problematic post-operative patellar inflammation. Not all TKRs include a patella replacement.
The patella is a sesmoid bone that is encased in the quadriceps tendon. How well the patella tracks depends on what is called the “Q angle” (a measure of angulation between the pelvis and knee. Women have a higher Q angle then men (owing to a wider pelvis in women) and hence have more problems with ill-tracking patellas. How well the patella tracks also depends on the strength of the quadriceps. The better the muscle tone/strength of the quadriceps, the better the patella tracks.
Poorly tracking patellas (patellas that move slightly off of the ideal line, like driving a car onto the tracks at a car wash and being slightly off the grooves rims) are the primary source of prepatellar bursitis.
Hopefully as your quadriceps muscle continues to improve in strength and muscle tone the patella inflammation eases.
If you have naturally wider hips, this would leave you more prone to patella inflammation post surgery. This is not a variable that you can control. Male orthopedic surgeons can be less sensitive to acknowledging the role of women’s wider pelvis structure and patellar inflammation. A woman’s pelvis is wider in order to provide for pregnancy and birth.
If your surgery included a new patella, then your recovery would be longer with more expected inflammation that a comparable TKR without a new patella (original patella preserved).
Eleven weeks post TKR is still early . . . . Inflammation would be expected. Inflammation has a purposeful role in healing. It is the body’s natural mechanism by which an influx of collagen, fibrin, and macrophages comes to the area. Not all inflammation is “bad.”
Bottom Line: Do not be overly discouraged by the patellar bursitis and inflammation. Frequent range of motion, allowing for a slow and sustained stretch, low total repetition for any one session. Followed by icing. Too much range of motion, excessive repetitions, performed too quickly/high velocity are to be avoided.
If you have access to a warm therapy pool or warm (not hot) whirlpool that would be ideal.
Just as with the tortoise and the hare, “slow and steady wins the race.”
Post Edited ((Seashell)) : 8/5/2018 5:49:41 PM (GMT-6)