Knee Infection* My dilemma.

Chrissyann

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Hello, this is my first time on this forum, I've found it very useful indeed. I had a TKR on the 29th May and it was every bit as painful as my surgeon said it would be. I've been home just over a week and I believe I'm doing well. My problem like so many others is my ROM, the ps came last Friday and measured my flexion, it was 65, he said if it didn't improve I may have to have an intervention in the future, I'm not at all happy about this. My partner was present and is adamant that if I don't loosen my ligaments and try to straighten my knee this might be a reality. My knee is swollen, bruised and stiff, however this is not surprising as well as having a new knee joint I had a varus knee deformity corrected. I've been listening to my instincts and I've rested, elevated, iced, walked as much as I can, dosed myself with pain killers and apart from a little discomfort and feeling emotional I'm getting there. Im pleased the staples come out tomorrow and as it's only two weeks post op I wonder if I'm making the right discision? Listen to the ps or carry on on listening to my body? Thank you for your helpful forum.
 
Hello @Chrissyann and :welome: to BoneSmart! We’re a community of people who’ve all had joint replacements just as you’ve had, so we know what you’re going through.

I think you’re making the right decision... and this reading list I’m giving you will explain all the reasons why. It’s natural, being humans, we think we can surely “do something” that will give us a better, faster recovery. The truth is, we have very little control over healing! Our bodies heal at their own rates, some faster, some slower, and none as fast as we would wish. You are being very wise to be patient, because that really is the best approach!

Please ask any questions you might have, and share any concerns. We’re here to help!

Knee Recovery: The Guidelines

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
5. At week 4 and after you should follow this

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.
 
65 flexion at less that 3 weeks is fantastic. I think you are doing the right thing by giving yourself time to heal. In my view, it's just common sense. To my surprise, my new PT and my GP agreed. Wishing you the best recovery, one day at a time. Hugs!
 
Don't listen to any one but your knee. Read the articles and follow those guidelines. If you do your recovery will be much easier and quicker than if you over exercise. All that would do would be to set your recovery back. Your knee is doing just fine and you don't need someone telling you it isn't!
 
65 flexion at less that 3 weeks is fantastic. I think you are doing the right thing by giving yourself time to heal. In my view, it's just common sense. To my surprise, my new PT and my GP agreed. Wishing you the best recovery, one day at a time. Hugs!

Thank you so much, I feel so much better, I'm a born worrier and just those few words helped no end. Hugs!
 
Don't listen to no one but your knee. Read the articles and follow those guidelines. If you do your recovery will be much easier and quicker than if you over exercise. All that would do would be to set your recovery back. Your knee is doing just fine and you don't need someone telling you it isn't!

Thank you for your support. Yes, I'll do that! Hugs!
 
Everybody's journey is different, but it sounds like yours is starting out just fine. It seems odd that people would be talking about a future intervention when you've barely had time to get started on healing and rehab. I'm guessing those people haven't had a knee replacement surgery. It's way too early for you to worry about your range of motion.
 
Hi, it's so refreshing to hear your thoughts. It was the PS who said if you can't get your rom sorted you might have to resort to having the scar tissue being stretched. What a thing to say so soon after a rather painful operation. Well, I'm not listening to him, I'm taking the advise of people who have been though the same thing and know what works. Thank you so much for your reply.
 
I had a PKR 3 weeks ago and just hit 72 degrees flexion. My PT gave me a high five and told me that as long as it’s slowly improving and not regressing consistently, we’re right on track. Days where it’s more swollen, it’s less flexible, and that’s totally normal. Sounds like you’re doing great!
 
Whoops, not regressing consistently is what I meant.
 
Whoops, not regressing consistently is what I meant.
Even back and forth is normal. Some days you are more swollen than others, so ROM will fluctuate. This recovery is not a straight line, but more like the ups and downs of a roller coaster.
 
Your knee is likely quite swollen and a swollen knee just isn't going to bend. I had the same issue. I just tried to move it through the range I had a few times a day and iced and elevated like crazy.
I gained very slowly until the swelling came down more and then gained more rapidly.
 
Your knee is likely quite swollen and a swollen knee just isn't going to bend. I had the same issue. I just tried to move it through the range I had a few times a day and iced and elevated like crazy.
I gained very slowly until the swelling came down more and then gained more rapidly.

My knee is quite swollen and has decided it doesn't want to bend. It's encouraging to hear that you had the same problem and your knee recovered without forcing it. I'm just a little worried about meeting my surgeon on the 4th July. I'm hoping mine might follow your lead and flex just enough at that meeting. Thank you.
 
@Chryssann,
Welcome to Bonesmart!

You are in the right place. I think the general thought is great ROM should be the goal and right from the get-go. This forum demonstrates that small steps in the right direction and working with the knee rather than against it is the true plan. Dealing with meds, lack of sleep, constipation and/or fatigue, some doctors and PTs also want great ROM-just when the patient is juggling quite a few plates as it is. Stand firm for your knee. Be firm but calm.

You are the one who must manage the pain not the doctor. It’s you in the night, it’s you in the day when others are gone. Do not be hard on yourself. Set simple goals like checking your gait—heel, toe, roll the knee. Or set a goal of carefully managing meds that work for you and stick to it. Measure success your way. Set a goal of seeing a better plan of getting in and out of the shower. Have a friend over who makes you laugh. Make a goal of reading one Bonesmart article again or over again. Most therapy businesses focus on ROM and extension not whole-life activities that bring joy and blessing. Focus “whole life” you’ll find Fear goes away and joy returns. Your doctor can’t kidnap you in the night and force an MUA on you. Go into the July meeting confident since you are the owner of the knee. :)
 
My knee is quite swollen and has decided it doesn't want to bend. It's encouraging to hear that you had the same problem and your knee recovered without forcing it. I'm just a little worried about meeting my surgeon on the 4th July.
Your knee can't bend well when it's swollen. The swelling physically stops it from bending.

Concentrate on trying to reduce the swelling, with lot of rest, ice and elevation. As the swelling improves, so will your ROM.

Try not to worry about your visit to your surgeon. It's not for another 3 weeks or so and you have time for improvement.
And, as mum2fencers said, "Your doctor can’t kidnap you in the night and force an MUA on you. Go into the July meeting confident since you are the owner of the knee."

You have the right to say what will happen to your knee. If your surgeon suggest an MUA, just say something like "It's still improving. I'd like to wait a bit longer."
 
@Chryssann,
Welcome to Bonesmart!

You are in the right place. I think the general thought is great ROM should be the goal and right from the get-go. This forum demonstrates that small steps in the right direction and working with the knee rather than against it is the true plan. Dealing with meds, lack of sleep, constipation and/or fatigue, some doctors and PTs also want great ROM-just when the patient is juggling quite a few plates as it is. Stand firm for your knee. Be firm but calm.

You are the one who must manage the pain not the doctor. It’s you in the night, it’s you in the day when others are gone. Do not be hard on yourself. Set simple goals like checking your gait—heel, toe, roll the knee. Or set a goal of carefully managing meds that work for you and stick to it. Measure success your way. Set a goal of seeing a better plan of getting in and out of the shower. Have a friend over who makes you laugh. Make a goal of reading one Bonesmart article again or over again. Most therapy businesses focus on ROM and extension not whole-life activities that bring joy and blessing. Focus “whole life” you’ll find Fear goes away and joy returns. Your doctor can’t kidnap you in the night and force an MUA on you. Go into the July meeting confident since you are the owner of the knee. :)

Thank you, I'll take your advise, it's so welcome. The pressure to get this ROM is great, even YouTube videos are expressing this and I think it frightens people. Fortunately I found your forum and I know that I'll read listen and take heed of others experiences. I will go into that meeting with confidence knowing you're all behind me. Thank you all so much.
 
Hello, this is my first time on this forum, I've found it very useful indeed. I had a TKR on the 29th May and it was every bit as painful as my surgeon said it would be. I've been home just over a week and I believe I'm doing well. My problem like so many others is my ROM, the ps came last Friday and measured my flexion, it was 65, he said if it didn't improve I may have to have an intervention in the future, I'm not at all happy about this. My partner was present and is adamant that if I don't loosen my ligaments and try to straighten my knee this might be a reality. My knee is swollen, bruised and stiff, however this is not surprising as well as having a new knee joint I had a varus knee deformity corrected. I've been listening to my instincts and I've rested, elevated, iced, walked as much as I can, dosed myself with pain killers and apart from a little discomfort and feeling emotional I'm getting there. Im pleased the staples come out tomorrow and as it's only two weeks post op I wonder if I'm making the right discision? Listen to the ps or carry on on listening to my body? Thank you for your helpful forum.

The PTs have the best of intentions, and yet I felt AWFUL for the first year or so, because the numbers for my ROM were not where they wanted them to be. We tried all sorts of things (dry needling, massage....every trick in the book), and my leg wasn't straightening. I cried in the PT room a few times when they floated the idea that it might never straighten, or that the surgeon might need to go back in if he thinks it's not responding. The best thing I ever did was stop worrying about the numbers. The 2nd best thing: get the muscles back on board. Easier said than done, but when I started pilates reformer with a physio, my VMO came back to life within days. After that, it was just a matter of getting all the muscles on the leg back to where they were meant to be.

Do the exercises regularly, but keep taking those breaks that you're taking. This really is a full-time job, and it will remain so for a while. I am at 2 years and 3 months today. Would you believe my ROM is still improving? Yoga has helped loads. In the last 6 months, my extension and flexion has improved as the muscles and ligaments became more limber.
 
Yoga and movements that don’t force or torque are helpful.

It is sad to see pressure applied to get ROM right away. Many of us have dealt with pain prior to deciding to have a TKR. We wait and we try alternative methods. Finally we go the whole way only to be told on the other side that we must work at getting ROM. It was our decision to have it and its our pain to manage. But manage it holistically and not just focus so it’s “the knee and me.” It’s me and my life, and the big healer is time. In that time let’s be wise and take care of us in all areas. :heehee:
 
@Chrissyann Keep in mind that it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle,
and Time to heal.

Our range of motion is right there all
along just waiting for that to happen.

You are only 2 weeks out and it’s way too early to worry about ROM and a bunch of exercises. Right now you need to rest, ice and elevate so that your knee can heal.
 

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