Knee Infection* My L T K R Diary 2020

[Defender]

Wel it's come as no surprise due to having a lock down with this world wide virus that my revision appointment has been canceled.
It was due this coming Friday.
I had a phone call today to say that instead of attending they will be calling me.
I am now 6 weeks post op and all is well apart from my knee is still so swollen which worries me with only a 70 degree bend.
It's really holding me back.
I shall be putting my concerns across.
Ohh will this swelling ever go my life consists of elevating and icing with no progress.

 

[Lindylee]

Oh dear, I'm sorry to hear that. Maybe they'll decide to see you after they calll. I hope things improve soon, it must be tough not knowing what's going on.

 

[Defender]

Oh dear, I'm sorry to hear that. Maybe they'll decide to see you after they calll. I hope things improve soon, it must be tough not knowing what's going on.

Thanks yes I am a bit concerned I would have expected the swelling to start getting better but it just seems to go on with no improvement.

 

[Lindylee]

My leg is nothing like yours, but is still much bigger than the other. The size doesn't seem to be changing at all, which is really bizarre. Nothing I do makes any difference, but it hasn't affected the functionality of the knee or leg. I'm beginning to wonder if it's going to be like it permanently. I've tried the breathing exercises etc that Crickethip recommended, but it's still the same.

Let us know how you get on with your telephone consultation.

 

[Defender]

Well I had my phone call today which took place as appointments are cancelled.
The call was from my surgeon.
I told him knee was still very swollen he said keep pushing he suggested sitting on a high chair or stall dangle my operated leg and push it back with the heel of my other leg.
He said not to use ice but to use heat now.
KEEP PUSHING was his main emphasise.
I am still concerned at this 6 week stage and 70 degree bend this has boosted my fear of not being where I should be.
This swelling is going nowhere fast.
He said an appointment will be in 4 months time.
Apart from being here I am now on my own.

 

[Andypandy]

@Defender I had my PT call yesterday advising all patients being discharged and referred back to Consultant who will advise for future sessions if needed. Regarding your swelling, I am at 9 weeks and still experience, as soon as I walk etc., I have to stop and ice. I believe this can go on for quite some time, so disheartening but definitely 1 step forward 2 back. We have to accept this is a long journey and we certainly need patience. Take it easy and hopefully you will see improvement. Xx
@Celle Are we classed vulnerable with this virus going around. Thanks x

 

[sistersinhim]

He said not to use ice but to use heat now.
KEEP PUSHING was his main emphasise.

This is so wrong on a knee that is still painful and swollen. Heat increases inflammation and swelling, which increases pain. You still need lots of ice, not heat. Pushing through pain also increases inflammation. Your knee's pain is telling you to stop. There's a reason for that. It's not ready for it. As it heals you can do more things, but, you can not force your knee to heal any faster than it will. But, you can sure slow it down by doing the wrong things. Please let your knee's pain be your guide. We know, we've been there.

 

[Defender]

ice

He said not to use ice but to use heat now.
KEEP PUSHING was his main emphasise.

This is so wrong on a knee that is still painful and swollen. Heat increases inflammation and swelling, which increases pain. You still need lots of ice, not heat. Pushing through pain also increases inflammation. Your knee's pain is telling you to stop. There's a reason for that. It's not ready for it. As it heals you can do more things, but, you can not force your knee to heal any faster than it will. But, you can sure slow it down by doing the wrong things. Please let your knee's pain be your guide. We know, we've been there.

Yes I agree makes you wonder why they all seem to want to push so hard.
I certainly don't remember having to push that hard with my other knee although the swelling didn't last this long but all I did back then was just walking about as necessary
Strange he suggests heat now.
So glad I found this group.

 

[Pumpkin]

I am still concerned at this 6 week stage and 70 degree bend this has boosted my fear of not being where I should be.

My OS said he expected me to be at 90 degrees by 3 months, you have plenty of time to gain ROM, you are still very very early in this year long+ recovery.

Here are the ROM number of a few of our members who were very slow to gain ROM, but they all got there. Remember the tortoise won the race.

Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months and still this now at 1yr 10 months

Bertschb’s ROM history
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



TortiTabby's ROM
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
It has now been 26 weeks and all I do is ADL.
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better.

 

[Celle]

@Defender , It's becoming pretty obvious that doing what you have been doing is not working for your knee. You've tried it and it hasn't worked, so you have nothing to lose by trying something different.

It's your knee and you alone have the right to choose what happens to it.While others can advise, you also have the right to choose whether or not to accept that advice.
CONSENT: what it means and how it can be used
Saying no to therapy - am I allowed to?

Your surgeon says to keep pushing, but you've been doing that and it hasn't helped at all. In fact, it's contributed to keeping your knee swollen.

Your knee can't bend well right now, because the swelling is physically preventing it from doing so. The most important thing to do is to get rid of the swelling - and continuing to push hard won't do that . It will make it worse. Using heat won't help, either, because heat brings more blood to your knee and, hence, more fluid.

My advice is try this for a month:

• Stop all exercises, except for using your knee during your normal activities of daily living.
• Use all the time you would have used in exercising in resting, icing and elevating your knee.
• Check these two articles, to make sure you're icing and elevating properly:
  Ice to control pain and swelling
  Elevation: the do's and dont's
  

You've probably heard this before, but it's true:
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

And this:
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase, whether you do formal exercises or just use your knee during the course of you normal daily activities..

 

[Celle]

Pumpkln has given you some examples of people whose ROM developed slowly, but who still had good results.

My surgeon has different ideas from yours. He doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week.

After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day.

His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

I've had three knee replacements and followed my surgeon's recommendations. Each time, I have achieved excellent ROM, with little formal exercise. My first knee replacement was a PKR that lasted for 11 years. I now have a TKR in each knee and I can do anything I want to with my knees. I think they are now fitter than I am!

 

[Defender]

Many thanks to you all for the advice
It's much appreciated and will now only listen to what my knee is telling me and the advice given here.

 

[Jamie]

@Defender....I know it must be terribly frustrating to hear two totally different approaches to recovery. but Celle is right. What you've been doing isn't working and taking 2 or 3 weeks to try something different can't hurt you. If you religiously ice as much as possible and only do gentle bending and stretching several times a day along with a little walking around your home, you just may see some improvement.

Some people have a tendency to swell more than others. And some get swelling because of something connected with a particular surgery. It can be something related to the surgical procedure itself (such as a lot of tissue and bone manipulation). Or it can be a therapy program that is too aggressive for this particular surgery (each procedure and it's recovery is unique). Or it could just be the way the wind blows (a little humor meaning swelling sometimes just "is" and has no logical reason). But whatever the case, when you've got it, you need to do things to get the inflammation down. Working hard and heating up those inflamed tissues won't do that and can actually make the pain/swelling cycle worse.

Please let us know what you're doing (or not doing) each day. We care about you and how you are doing with your recovery. We don't enjoy throwing ideas out there that are contrary to your surgeon, but in this case I think our experience with patients who've been through what you're experiencing just might be helpful. We honestly see many people who finally get on top of their swelling once they ice like crazy and and let their knee rest for a while.

Hang in there!! We're here for you.

 

[Defender]

Thank you so much Jamie.
This thread is chapter in my life which I will never forget
This forum is where I come to meet friends that have helped me through that chapter.
which I will never forget.

Many thanks to you all.

 

[Lovablenut]

Defender - surgeons are brilliant. They can enable us to recover mobility. But only our bodies can tell us how much, how far and precisely when. All of these experiences will be different. Don't be discouraged. Instead be encouraged by each measurable step. They are there.

 

[Lindylee]

It's tough when you get conflicting advice, but I'm a great advocate of doing what you feel is right for you. My chiropractor says our bodies are very good at telling us what they need if we listen to them and use our instincts. You know the pushing hasn't helped so time to take a rest.

At my first assessment my physio had me sitting on a raised couch so my leg hung freely and asked me to gently bend my knee without pushing and I did find it bent further like that, but no way would I push it.

 

[Defender]

Well it's been 7 weeks since my L T K R and all is good I am virtually off pain killers.
But my biggest problem and worry is my my R O M stuck on 70 degrees try as I may I see no improvement I am icing elevating and walking as necessary and doing light excercises
The swelling does seem a little better but still quite swollen and the skin on the top of my shin and kneecap is still very tight
I am now regretting having this done
I woke this morning and actually said to my wife I wish I had my old leg back.
I just pray this is not my life

 

[Flash1955]

Please don’t beat yourself up, as we have all been told on this forum, time and patience is crucial to our heeling. Please stay positive and give your knee time to heal.

 

[Defender]

Please don’t beat yourself up, as we have all been told on this forum, time and patience is crucial to our heeling. Please stay positive and give your knee time to heal.

Thanks I had my R T K R in 2018 and I remember it's a marathon but didn't have this problem for this long I do remember the R O M was a problem but I seem to have hit a brick wall with this one
The swelling is proving difficult to go.
As I am an active person this is really getting me down.

 

[TrixieRuby]

I am still concerned at this 6 week stage and 70 degree bend this has boosted my fear of not being where I should be.

My OS said he expected me to be at 90 degrees by 3 months, you have plenty of time to gain ROM, you are still very very early in this year long+ recovery.

Here are the ROM number of a few of our members who were very slow to gain ROM, but they all got there. Remember the tortoise won the race.

Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months and still this now at 1yr 10 months

Bertschb’s ROM history
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



TortiTabby's ROM
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
It has now been 26 weeks and all I do is ADL.
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better.

This post is so useful to me! Thank you for this range of motion report!