TKR kneequery-what is normal after knee replacement

[kneequery]

I had my surgery on 4/3/24. My knee is so sensitive that even a cover on it at night is so irritating that I do not sleep. I am taking about 5 gabapentin a day for the nerve pain. In addition, I thought the vice grip around the top of my knee would be dissipating by now and it is the same. I elevate and ice unless I am at work.

Exercise is PT and riding the bike at the gym with low tension or the eliptical at home with low tension.

Both are so restrictive and I am getting virtually no sleep. Suggestions??? Is it normal???? How long does it last???

 

[kneequery]

Sorry my surgery was 3/4/24 not 4/3/24.

 

[Roy Gardiner]

Welcome to BoneSmart

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

The Recovery articles:

The importance of managing pain after a TKR and the pain chart​

Swollen and stiff knee: what causes it?​

Energy drain for TKRs​

Elevation is the key​

Ice to control pain and swelling​

Heel slides and how to do them properly​

Chart representation of TKR recovery​

Healing: how long does it take?​

Post op blues is a reality - be prepared for it​

Sleep deprivation is pretty much inevitable - but what causes it?​

There are also some cautionary articles here

Myth busting: no pain, no gain​

Myth busting: the "window of opportunity" in TKR​

Myth busting: on getting addicted to pain meds​

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Roy Gardiner]

Sorry my surgery was 3/4/24 not 4/3/24.

So for us non-Americans that is 4th March 2024 ?

So you are upcoming 2 months, very early days in recovery.

Both are so restrictive and I am getting virtually no sleep. Suggestions??? Is it normal???? How long does it last???

Yes it is normal, it will gradually improve, you must be careful not to overdo things

Exercise is PT and riding the bike at the gym with low tension or the eliptical at home with low tension.

Low tension is good. If you have pain with any of these, or pain or stiffness after, back off. No pain, more gain!

 

[benne68]

My knee is so sensitive that even a cover on it at night is so irritating that I do not sleep.

This is a common complaint.

At the suggestion of others on the forum, I wrapped my knee -- loosely -- with plastic food (Cling/Saran) wrap before bed. You just wrap around a few times so it sticks to itself. I found it protected the incision from rubbing against the sheet. Lots of our members recommend it.

 

[mendogal]

Tight band feeling after knee replacement is one of the most common complaints I read from members, and it sure bothered me.

Josephine, our Nurse Director Emeritus, explained it quite nicely:

That tight band is caused by scar tissue but not the adhesions type of scar tissue. When the surgeon opens up the knee, he has to undercut the skin and superficial structures from that centre line to each side of the knee in order to get good access all round the bones. Part of the healing process is when those flaps reattach themselves to the main body of the leg. This healing creates a thin layer of scar tissue across the front and sides of the knee. But scar tissue isn't anywhere near as flexible as normal tissue so it feels like a tether or a clamp across the knee if there is any swelling and during later normal activity.

It will gradually reduce in size and thickness over the following months until it reaches a point where it's not substantial enough to cause this sensation, same way as does the incisional scar in the skin. But be warned that this can take several months to dissipate completely and sometimes or every time, lots of walking or standing can make it worse. It differs greatly for every individual.

This should be regarded as pain and treated as such. In the early days, take your prescription meds. In later days, take some otc meds like paracetamol (Tylenol).

 

[benne68]

Hi @kneequery! Wondering how you are doing since tomorrow will be the two-month anniversary of your surgery. Please give us an update when you have a chance!

 

[kneequery]

I am doing great with the suggestion to use cling film to battle nerve sensitivity. Works like a dream...no one at PT had ever heard of it.

 

[Sleepy]

Tight band feeling after knee replacement is one of the most common complaints I read from members, and it sure bothered me.

Josephine, our Nurse Director Emeritus, explained it quite nicely:

That tight band is caused by scar tissue but not the adhesions type of scar tissue. When the surgeon opens up the knee, he has to undercut the skin and superficial structures from that centre line to each side of the knee in order to get good access all round the bones. Part of the healing process is when those flaps reattach themselves to the main body of the leg. This healing creates a thin layer of scar tissue across the front and sides of the knee. But scar tissue isn't anywhere near as flexible as normal tissue so it feels like a tether or a clamp across the knee if there is any swelling and during later normal activity.

It will gradually reduce in size and thickness over the following months until it reaches a point where it's not substantial enough to cause this sensation, same way as does the incisional scar in the skin. But be warned that this can take several months to dissipate completely and sometimes or every time, lots of walking or standing can make it worse. It differs greatly for every individual.

This should be regarded as pain and treated as such. In the early days, take your prescription meds. In later days, take some otc meds like paracetamol (Tylenol).

What is considered early days?

 

[mendogal]

In terms of prescription medications for pain? That's an individual matter between you and your physician.

 

[Layla]

In the instance you're questioning, I'd consider "early days" the length of time you and your surgeon determine you need prescription meds for pain. Beyond that point, OTC meds should suffice.
Early days can mean weeks, or even the first few months of recovery when you consider possibly having the implant for life, or at the very least, many years to come.
@Sleepy

 

[benne68]

...no one at PT had ever heard of it.

I know! That's what makes this forum so valuable -- there are literally thousands of us and we constantly learn from one another!

Glad you are doing well.

 

[Sleepy]

In terms of prescription medications for pain? That's an individual matter between you and your physician.

No. I meant just generally early days.

 

[mendogal]

Well, out of a one year recovery? A good clue is looking at healing...
If we consider the basic healing of muscles (which take longer than 4-6 weeks for full recovery) and bones, tendons, and ligaments (tendons and ligaments also continue to readjust structurally for longer than the healing period) then 12 weeks/3 months seems like a sensible was to consider "early days": the first quarter of the year. But there's no actual definition.

 

[Layla]

Happy Two Month Anniversary!
Have a wonderful week, kneequery!
@kneequery