TKR mikb314159's recovery thread<

[Josephine]

New pain problem. When I lay down, elevated or not, for more than 30 minutes I get 9 to 10 level pain in my knee. If I move my leg to a different position, the pain subsides and then comes back within about 20 to 30 minutes.

I suggest you go back and my advice in post #31

 

[mikb314159]

Yes.
But now a new problem.
Now during the day, when I try to lay down I get bad pain in my knee. If I get up it’s fine, just hurts laying down in any position.
HELP! HELP!

 

[sistersinhim]

Are you elevating your knee with a little bend in your knee? Trying to hold it completely straight is terribly painful.

 

[mikb314159]

Hello,

I’ve tried quite a few positions.
Including elevating with a pillow or two, with my knee slightly bend. And yes, with it straight it is much worse.
Also, putting ice on my knee when laying down makes the pain worse. But I endure to give the ice some time.

 

[sistersinhim]

Eventually, the ice should numb your knee. At least, I hope so!

 

[Poctdb]

@mikb314159
Buddy....is it getting any better?

 

[mikb314159]

Update: Was doing much better two weeks ago. Was able to bend 90° and overall everything was better coding walking etc.
So Doctor was OK waiting a while longer and seeing how So Doctor was OK waiting a while longer and seeing how I did.
Well since that time it’s like I went in the opposite direction. My knee is extremely stiff all the time and as far as degrees in bed and I’m probably at 80°. Dr. now wants to do the MUA tomorrow morning.
I’ve been extremely resistant to having the MUA, but at this point I don’t know if I’m gonna get better,
Any help is appreciated.

 

[sistersinhim]

pdate: Was doing much better two weeks ago. Was able to bend 90° and overall everything was better coding walking etc.
So Doctor was OK waiting a while longer and seeing how So Doctor was OK waiting a while longer and seeing how I did.
Well since that time it’s like I went in the opposite direction. My knee is extremely stiff all the time and as far as degrees in bed and I’m probably at 80°. Dr. now wants to do the MUA tomorrow morning.
I’ve been extremely resistant to having the MUA, but at this point I don’t know if I’m gonna get better,
Any help is appreciated.

I have a feeling that when you started doing better that you became more active. This would cause more inflammation and swelling in your knee. This will cause swelling, which worsens bend. Even if you don't see swelling outside, you will still have swelling inside your knee. Any amount of fluid in there will restrict bending. I suggest you do not have the MUA. You have already reached 90, so you know your knee will do that. You aren't even 3 months out and your knee will have lots of ups and downs for the next few months.

 

[mikb314159]

Hello,
Thank you for the reply. Bad News / Good News. I had so much pain overnight that I did not sleep. So, I cancelled the MUA. I think what caused the extreme pain was my fault. Prior to going to the Doctor on Tuesday, I did several sessions of extreme bending / stretching of my knee. And I mean extreme.(Tears) Never experienced that much pain before. Well I did have some success as for as knee bend, probably 100 degrees. But I paid dearly for that.
The next day Wednesday, I had the extreme pain and I could barely get myself up out of a chair. I was totally drained. And that continued all day and night. And even today I am a bit weak.
So today I took it easy. Lots of elevation and ice. Knee is very stiff.
Where to go from here?
I am very upset at this point with the whole thing. My Daughter is getting married on October 26, and I was wanting to walk her down the isle without any problems.
Thank you so much for your help. Michael

 

[Celle]

@mikb314159
I'm sorry you're in so much pain. In forcing your knee with so much pain, it sounds as if you gave yourself a Manipulation Without Anaesthetic. There's a reason why they give you an anaesthetic for an MUA - because forcing your knee hurts.

BoneSmart advice is always "If it hurts, don't do it," because painful activity is counter-productive.

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.​

Forcing your knee to bend has upset it, making its soft tissues angry and inflamed. Treat your knee gently and it should settle down.

It's not even 3 months since you had your TKR and ROM can continue to improve for at least a year after surgery. There's no need to rush, no deadline you have to meet, no theoretical window of opportunity.

You still have about 6-7 weeks before your daughter's wedding - plenty of time for improvement, as long as you don't upset your knee again.

Have you seen bertschb's record of how his ROM progressed,slowly but surely? It may help you to feel more confident that your ROM will also improve:
"I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM."

 

[Jockette]

My ROM has continued to improve not only after my one year anniversary but also after the 2 year anniversary. I did not have full ROM within the first year.

I am proof there is no window of opportunity. It’s time and, most of all, healing, that allows us to regain ROM, and it will happen, but at it’s own pace, not ours.

 

[sistersinhim]

I am also proof that there's no window of opportunity. I never even took formal PT or did exercises, just ADL, and my ROM came in just as quickly everybody else's.

 

[mikb314159]

6 month update: At 13 weeks my Doctor insisted on MUA. Which was done a few days later. I was at 93 degrees before that. Now after 3 months PT I am at 116 degrees. But that’s not all great. Knee still feels very stiff when waling and have pain flare ups. Plus I know have developed lower back, hip and right knee pain. Doctor believes it’s related to my walk. That my left knee needs to be straight when passing under me. I have been working on that. I did go on a 2 mile slow walk the other day, which is good.
But, I am very frustrated with all the problems. Feel like I’m never going to recover.

 

[Spex10]

You will. Hang in there. I find going up and down stairs to be a practical way of exercising. Both my knees are now OK. I don't kneel but suspect that's more psychological than physical. I live a normal life, go to Aquafit classes for cardiac and resistance exercise and yoga for stretching work. Both are social and fun.
Keep on keeping on, try not to fixate on your knees and any limitations and live life with that old pain gone. Good luck

 

[mikb314159]

You history of ROM is amazing. I was dismayed the other day when my PT told me that my knee replacement was not designed to go much more than 120 degrees .

 

[Spex10]

That'll do you fine though. Just think - the pain's gone!

 

[mikb314159]

@mikb314159
Buddy....is it getting any better?

Still going slow but better. Still on and off pain and stiffness. Have reached 117 degrees ROM.
But it seems like it taking forever to recover.
How is it going for you?

 

[mikb314159]

Hi and Welcome to Bonesmart!

I’m sorry your pain level is so high. I am going to tag @Josephine,
our forum administrator and nurse director, to come and advise you.

I will also leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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:

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​

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

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​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access to these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

What should i expect at 7 months? Still have on and off pain and stiffness. And I am having issues now with my hips and lower back, which I never had before.

 

[kneeper]

Congrats on 117! It does feel like forever, but 6-7 months is not the end of the story by any means. I still got quite stiff if I was on my feet for an hour or walked a lot, but it did improve. I'd say at 1.5 years I was doing things that required bending more easily than at one year, but I couldn't tell you the exact measurement.

 

[mikb314159]

Congrats on 117! It does feel like forever, but 6-7 months is not the end of the story by any means. I still got quite stiff if I was on my feet for an hour or walked a lot, but it did improve. I'd say at 1.5 years I was doing things that required bending more easily than at one year, but I couldn't tell you the exact measurement.

Update:
Getting close to 1 year since knee replacement. Can walk ok with some pain. Going up stairs is ok. Wake up every day with knee pain. ROM about 110. Overall on the miserable side.