TKR Something isn’t right..

[mendogal]

At POD 17 I wouldn't worry about working on heel-toe gait because - as you note - the ROM isn't there yet. IIRC even my PT, on my first knee, didn't address it with me until about 6 weeks.
Reactivating the quads seems to be one of those things that's highly variable in timeline. Yes I agree it's VERY demoralizing to watch them wither!!!! However....
at two months my skinny quads could get me out for a nice walk, and now four months out my skinny quads are very happy to walk me two miles nonstop (while preop my robust looking quads couldn't do more than a mile because of the arthritis). Sometime next year, when cleared, I'll get back to serious weight training, but for now I'm happy with incremental increases in daily life.
It Gets Better.

 

[mendogal]

Oh... forgot to note... re lacking strength
to extend the leg to land your heel: IME it was totally a matter of still having insufficient extension. I believe what you experience as lack of strength is your attempt to push past the injured joint's current limitation. Again, patience....

 

[dotski]

Has anyone out there experienced this quads shutdown? It’s so unnerving that my muscles won’t work and are so weak.

 

[Jockette]

Most of us did. It took me a couple of weeks to lift my leg myself. It will happen for you as you heal.

 

[sistersinhim]

But PT said I need to do 5 minutes every 2 hours to get the swelling inside joint out.

IMO this is causing you more swelling, not less. Just walking around the house every hour or so is enough movement for your knee. The peddler is obviously aggravating your healing knee and it's too early in your recovery to be doing it.

Everyone at work, well meaning, said I was going to do great and would be back on my feet before I know it.

Has everyone at work had a knee replacement? Have they had your knee replacement? No two knees are alike, even on the same person. No one, except your surgical team, knows what your doctor had to do inside that knee of yours. I found out things were done to me that I didn't know about. When I read my surgical report it explained a lot of my pain in my recovery. You might want to order yours and read it. It can be an eye-opener.

Has anyone out there experienced this quads shutdown?

This is very common. I even took some members a month or more before their quads fired. It's strange. One day you can't lift it your leg and the next you can! It happened for me that quickly. I just used my old leg underneath my new leg to lift it until it woke up.

 

[dotski]

This is very common. It even took some members a month or more before their quads fired. It's strange. One day you can't lift it your leg and the next you can!

I’m hoping it happens suddenly! Another sleepless night, maybe got a couple stretches of 45 minutes (vivid dreams)… first half of night was spent on massaging trigger points of incessantly aching hip muscles. I have a massage booked this week (I go every 2 weeks but haven’t been yet since surgery. It’s a block and a half from my house and up a flight of stairs (that thankfully have railings). Not sure I would tolerate the table too well.

I’ve read my OR report a few times…it’s the standard typical surgery report and didn’t even include details such as my synovectomy, found out when I asked at my 2 week follow up. All of our surgeon reports seem to say “Patella tracked nicely though a full range of motion”…as happens in OR fantasyland but never anywhere else….

Anyone out there have a Zimmer-Biomet “persona” knee components? Mine is the posterior stabilizing one (replaces the PCL that he removed). It’s supposed to be good as it allows some more natural tibial rotation (mobile bearing) at end range of extension…as a normal knee would do.

I think I can passively get to full extension… but not in standing as my medial quads (VMO) just won’t do its job to get those final few degrees. One positive I guess. Flexion feels like it is regressing since taking it easier.

 

[sistersinhim]

I was having a lot of lingering pain on the medial side of my new knee. I ordered my surgical report and found that my OS had done a medial release That explained that pain! I am sorry you didn't find out anything to explain more about what you are going through.

The first few months after this surgery are quite painful and depressing. I found if I remembered back to a few weeks before and realized that I was better, I felt more optimistic. Some find keeping a journey and rereading the earlier days helps them. I read my thread during my recovery many times to help my depression.

 

[Jockette]

I think I can passively get to full extension… but not in standing as my medial quads (VMO) just won’t do its job to get those final few degrees. One positive I guess. Flexion feels like it is regressing since taking it easier.

It’s very early days for you, in this year long recovery, all this will improve.

You are also probably going through the common Post Op Blues:

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

 

[skcoj1]

My experience with the first day home after the right TKR was that pain killers are not match to the power of ice. Simple as that!!!

I was 'kicked' out of the surgery center at 6AM - "NEXT"!!! LOL. That day the home nurse and PT were at my home. WOW!!! No rest for the weary. During the day I did the usual protocol of meds prescribed by the surgeon. When it came to that evening, I felt my knee was getting warmer and warmer. I had to break protocol and take another Oxy. It seemed like the ice packs just couldn't deliver the chill I required. About mid-nite I finally called the surgeon. He got back to me within 15 mins. I told him I need to remove the cotton batting/surgical dressing so I can get ice on the knee. Once it was removed, immediately my pain level went down from 150 to 5. AH!!!!!! After that I didn't need another painkiller!!! The surgeon/nurse should have given you a number to call 24/7 incase of any issue.

 

[mendogal]

Re massage: don't attempt to be face down!!

Your therapist should have wedges and pillows that allow you to be side lying on your non-surgical side with your affected leg fully supported at a level horizontally level with its hip and with a slight degree of flexion that's comfortable for you.

Lying on your back with pillows under your legs, yes.

My therapist did wonderful pelvic, hip, and upper thigh work that opened and relaxed things. Aaaahhhhh.

 

[dotski]

(Edited for privacy reasons)

 

[dotski]

A little milestone today (POD18): ventured downstairs to the basement where my road bike sits on a stable bike trainer (in easiest gear with least resistance). I stood on my right surgical leg while lifting my left leg behind and over the seat. Then shifted my right leg sideways to the right to make room for the pedal to get to its lowest point. Then lifted my right foot onto pedal, then my left. I did a few gentle pendulars back and forth (I’m a long ways off a full revolution!). Assessed seat height and will raise it. Determined that I will need to wear my bike shoe clipped in on left so I have perfect control of the pedal so I can baby the right side and not push too far.

And none of this hurt!!! I’ve been icing for the past hour or so with foot elevated to be safe.

I hate the stupid foot peddler. In a reclined position you are fighting gravity and my heels would rub on the ground. I was constantly shifting my upper body around to get stability. It was anything but relaxing.

But on a real bike seated directly over the pedals you have this beautiful help from gravity to keep all the right muscles relaxed. And you can adjust the seat height.

Poor hubbby’s honey-do list just got bigger- haul that sucker up to the main floor so I can do pain free stretches several times a day for a few minutes daily, without burning all my matches going up and down stairs.

 

[sistersinhim]

I did a few gentle pendulars back and forth

Rocking the pedals back and forth is a perfect way to get started. Don't be surprised if you can go backward before forward. Most of us did.

 

[Layla]

That is a milestone, dotski. Good job! All of the little victories along the way certainly lift our spirits.
I hope hubs gets it upstairs for you soon and you continue to enjoy progress.
A great week to you!
@dotski

 

[CricketHip]

That's an uplifting discovery for you! (your road bike on a stabilizer) good for you!
Hopefully your husband will get that upstairs for you, pronto!

Take things one day at a time, that's the best that any of us can do. You aren't even 3 weeks post op yet.
Enjoy your massage, that was always very helpful for me.

 

[dotski]

Thank you all for such kind and encouraging words.
About extension - I was wrong; I definitely have room for improvement there. I got down on the floor for a change of scenery and to stretch other body parts (1 legged downward dog served me well, lol). A knee can look flat on a bed…but not on a harder surface!
Then watched a Hugh Grant movie with hubby and forgot about myself for a couple hours.

 

[dotski]

Question about incision and scar healing…
Here is my incision. I’m cleared to shower and have a couple times. I’m told I can leave it open to air; however now that I see it, and this little suture sticking out, a few scabs…I’m not comfortable leaving it uncovered as I’m concerned my clothing could catch and rub on it, potentially contaminating.

I’m in a small town without great resources but I’m aware that there are products out there (I’d have to order online) that can help compress and shape a scar while healing.

 

[Jaycey]

@dotski Just leave your scar to open air. It is closed and your clothing will on contaminate it. Please do not put anything on the scar. Let nature take its course.

 

[dotski]

@dotski Just leave your scar to open air. It is closed and your clothing will on contaminate it. Please do not put anything on the scar. Let nature take its course.

Thanks. Is the little piece of string sticking out anything to worry about? Or will it just eventually fall out?

 

[Jaycey]

Is the little piece of string sticking out anything to worry about?

It may fall out. Or when you go to your next appointment have someone pull it for you. Nothing to worry about.