Stella: TKR on July 2nd intro and questions

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Stella

new member
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Jun 23, 2012
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60
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I'm 48 years old, and have had knee issues since I was 16. I've been very active all my life. My knee has deteriorated so quickly. I had arthroscopic surgery last May to repair multiple meniscal tears and clean up the bone spurs. I had ongoing issues after that surgery: swelling, fluid, continued pain, etc. I had the knee drained 4 times. Had 3 cortisone injections (more than I should have) and a series of Euflexxa injections this past January, which were a waste of time and money.

I went from a totally active life to a sedentary life in one year. I am bone on bone and in pain 24/7. I can't wait to have this surgery. I have a new OS that I am fully confident in. He has taken so much time to answer all my questions. He believes because of the shape I'm in, as well as my age, that I'm going to have a fabulous outcome.

I have been all over this forum the past few weeks. I'd like to thank everyone for taking the time to share their stories and offer their opinions. I very much welcome any advice and tips.

My initial questions:

1. This will sound so vain, but I love my legs. They're toned and tan and I was blessed with fabulous skin. The idea of this huge scar is driving me crazy. Any tips on helping the incision to heal with as little scarring as possible?

2. For my hospital stay, are athletic shorts and tshirts the best clothing to bring for post-op PT?

3. I can't imagine I'll be able to get my tennis shoes on for PT. What did you bring/wear?

4. What is the one thing you didn't know (or bring with you) that you wish you had?

Thank you so much!
 
Good morning, Stella, welcome to BoneSmart.

I had what's called 'mattress stitch' to close my wounds, rather than staples. Parts of the incision line have disappeared entirely, so this might be the one for you. I believe this to be a gentler approach than staples, which are designed for speed AFAIK. Maybe your surgeon can give advice?

Baggy underclothing is good, so it doesn't snag on the wounds

Sandals/slippers I found were good.

you will be groggy for much of your hospital stay, watching telly and stuff. Don't worry about it.
 
Hi! Stella, and welcome to the forum. So pleased that you have joined us here. First to address your concerns about the incision scar. You need to talk with your OS as there are several ways to close an incision. My OS used dissolvable stitches under the surface layer of the skin and held together by steri-strips. I will put a thumbnail picture (which you can click on to make larger) of one of my knees at 7 months post op at the end of my post so you can see how narrow and neat a scar can be . How an individual heals also plays a role in the final appearance of the scar.

Next I want to give you a list of links to articles in our Library that are essential reading for anyone having a TKR. The list is fairly long, but the articles are not lengthy and are packed the information you need to have the best possible outcome.
The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Swollen and stiff knee: what causes it?Constipation and stool softeners

Knee Replacement - Where Am I in Recovery?So What Is It Going to Take? The Five “P’s” of Knee RecoveryWork “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

Along with the articles in the Library, I highly recommend Brugioni and Falkel’s Total Knee Replacement & Rehabilitation. The authors are an orthopaedic surgeon and a physical therapist who had bilateral total knee replacement himself. It is available on Amazon in paperback and e-book for $15 and $10 respectively. It covers every aspect of recovery on a week to week basis for the first 4 weeks and then on a monthly basis by 3 month segments for a full year. It is a great resource, answers questions you didn’t even know you had, and has lots of rehab exercises with pictures.

The more you know and understand, the less likely you are to be blindsided by things that are “normal” for this recovery. And maybe it will help with the nerves. It’s the waiting for the surgery that’s the toughest. The surgery is nothing---you’re asleep, your knee is replaced, and when you wake up it’s over. And if you properly prepare yourself, recovery will not seem so formidable.

Just know that we’re here for you to answer your questions and concerns, to give you a place to vent when you need to, and to support and encourage you from pre op to post op through recovery.

Take care, keep us posted. We care.

Left.JPG
 
I don't recall anyone wearing anything but sneakers to PT because they provide the best traction and are safer, especially when practicing stairs and walking without the crutches. Someone can either help you put them on, or you can simply sit in a chair and bend over at the waist to reach your feet to put them on instead of trying to raise each foot up to do it.
 
Wow Judy, your scar is almost not a scar. A wonderful piece of work by your surgeon.

Kathy
xx
 
I don't recall anyone wearing anything but sneakers to PT because they provide the best traction and are safer, especially when practicing stairs and walking without the crutches. Someone can either help you put them on, or you can simply sit in a chair and bend over at the waist to reach your feet to put them on instead of trying to raise each foot up to do it.
That's what I did at the hospital. One thing I had at home was a long shoe horn which helped in the early days with getting shoes on.
 
Thank you all so much!! I will talk to my OS about the use of stitches. I'm off to read all the great info you've suggested. Thanks!
 
Welcome, Stella! You have found the best place for TKA info and support. All of your questions have been answered before here, but I will throw my 2 cents in.
My scar was glued, and is pretty good looking now at 13 weeks, and I anticipate it will keep getting better, so I don't think you need to worry too much about that. I cannot speak for a staple closure, so hopefully some stapled Bonesmarties will chime in here.
I did wear shorts in the hospital under my hospital gown. Don't think you will be doing heavy PT early post-op. If you have read these forums diligently, early aggressive PT works against healing.
I was able to get sneakers on post-op, I did wear thinner socks leaving the hospital to accommodate the slightly swollen foot.
I can't think of anything I wanted/missed while in the hospital. The drugs made everything wonderful.
Wishing you the best!
 
Welcome, Stella! I never, ever, ever thought about what to wear on my feet at the hospital. I guess I'm glad that you brought this to my attention. I THINK I can find my gym sneakers. It has been a couple of years since I could go to the gym. Anyway, I bet your legs will always be beautiful and your scar will heal perfectly. I don't really care about a scars on these old legs. :heehee:
 
I had arthroscopic surgery last May to repair multiple meniscal tears and clean up the bone spurs. I had ongoing issues after that surgery: swelling, fluid, continued pain, etc. I had the knee drained 4 times. Had 3 cortisone injections (more than I should have) and a series of Euflexxa injections this past January, which were a waste of time and money.
You right about that- the whole thing was a waste of time and effort. Sorry but I hate hearing people have been dealt BandAids instead of splints! And there is no limit to the number of cortisone injections a person can have, only the frequency which is generally agreed to be about 3 months. Cortisone shots: are they safe and is there a limit to how many?
1. This will sound so vain, but I love my legs. They're toned and tan and I was blessed with fabulous skin. The idea of this huge scar is driving me crazy. Any tips on helping the incision to heal with as little scarring as possible?
Which do you value most, your vanity or being pain free? There's a pay-off for everything in life. But I wouldn't start grieving too soon as it's quite likely your scar will heal to a point where it's almost invisible. But for pity's sake, don't start rubbing oils and expensive salves into the scar to get it to heal better - they don't work and our bodies need no help at all to get good healing.
2yrs 9 m red.jpg (click to enlarge)

2. For my hospital stay, are athletic shorts and tshirts the best clothing to bring for post-op PT?
I just took my usual 'shlumpies' which I wear around the house; these are fairly old skirts and at cotton tops some of which I've had for years. But they are comfy and that's the most important thing.
3. I can't imagine I'll be able to get my tennis shoes on for PT. What did you bring/wear?
Slippers! and since we don't have PT in the UK, anything else was moot.
4. What is the one thing you didn't know (or bring with you) that you wish you had?
My leg lifter. Oh what I wouldn't have given to have had my leg lifter!

aflagsforworship.co.uk_jo_pic_images_leglifrdr.jpg
 
Josephine- I thought I was the only one who owned 'shlumpies'!
 
I have never heard of a leg lifter! It's on the list.

I have my pre-op bloodwork and my pre-surgery knee replacement class at the hospital tomorrow. I can't believe how quickly this week is flying by.

It's almost here. Thanks again everyone!
 
Stella, Welcome to Bonesmart. I also was concerned about how my leg was going to look. I have always been told that I have nice legs and I did not want a scar "messing that up." I wanted nice neat stitches or maybe plastic surgery. Now I laugh at the thought. My surgeon only does staples, and honestly I like my scar, it is a badge of honor, and it doesn't look bad either.

I wore a hospital gown both days, and that was just fine. I wore the slipper sox for therapy, they have rubber/non-slip stuff on them, and that worked just fine as well.

I did not have any regrets about not taking something with me. I did however have my phone, my ipad, chargers for both and an extension cord so that I could be charging them and reach in bed to charge them...

Here is my scar, it is only 9 weeks old, and I have gotta say it looks pretty good.
2012-06-28_KneeScar.jpg

Relax, you are going to be fine and you will be OK, scar and all. Hang in there. :friends:
 
That is one fine looking scar BJ! I have been naughty and been in and around my pool without blocking my scar. I tan easily and so the scar has darkened but I think it looks great for 13 weeks. Will try to post a pic later.
 
Thanks Jancat! I think it is funny how my perspective has changed. I have three sons and the boys have always been proud of their scars. As a matter of fact they have times showing off scars with the guys, the bigger/uglier the better... Lol...

But for me I am happy that mine does not seem to be ugly, and yet it is a sign of what I have gone through. Looking forward to seeing yours.
 
Closure of this surgery is varied. I had mine done where there is a great competition for a TKR patient. He uses a plastic surgeon stitch when closing. My incision sites are almost undetectable. One important point, when you are out in the sun, cover the incision with band aids. The sun tends to turn the scar purple.(not in everyone).
We strongly recommend a running suit for post op. Get out of the gown ASAP. Bring a large button up shirts to work around the IVs. This is a mental issue. You are not sick. Your outfit helps lift your personal esteem.
Foot wear: I suggest Crocs. They have a very cushion feeling
Best of luck. You are doing the right thing by gather information.
Best of luck
David
 
We strongly recommend a running suit for post op. Get out of the gown ASAP. Bring a large button up shirts to work around the IVs. This is a mental issue. You are not sick. Your outfit helps lift your personal esteem.

David
Good points. They wanted me in a gown b/c of the iv. :( I did bring a pretty coverup to wear out in the hall, which made me feel better. I may try the large shirt option for the next knee...
 
Well, I'm up, showered and ready to go!! Thank you all for all the great tips. See you on the other side!!
 
Hope it all went well for you, Stella - I'm quite sure it did. You're most likely in recovery now, but not sure what country you're in or what the time difference is, if any. Anyhow, looking forward to your update on the other side.

Kathy
xx
 
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