PKR Frustration

Mia

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I had a LTKR on October 28,2021. I’m frustrated with tightness in my knee and when I’m walking my leg feels like it’s gonna give out feels weak in my lower calf and top of ankle. I told my PT and they told me it’s the way I’m walking I’ve been very careful the way I walk heel to toe so this is frustrating me
 
@Mia - not a helpful response from your PT - surely you are walking a certain way to compensate for the tightness.
Healing from a TKR can take a full year and during the healing process lots of changes take place. What is your ROM like and your activity level?
You have found a great forum with good advice from members who have gone through this surgery. There is a range of articles that address healing from this major surgery. I am sure one of the moderators will be along soon to give you the links. One of the causes of what you describe could be IT band tightness and or weak muscles which is common after this surgery. Sometimes we just do too much and cause swelling and tightness. My cure all is a few days of taking it easy, icing and elevating to see if there is any improvement. If not and it persists then maybe a follow up with your OS to check would be a good idea.
 
My rom is 127, I ride the bike at home 3 times a day in 10 min increments, I do housework I live in a tri-level so I do stairs several times a day. I can’t avoid them. I walk on an average 5 to 7 thousand steps a day.
 
Hi and Welcome!

Stiffness/Tightness is a normal occurrence after this kind of major surgery, and can last for months. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.


While riding a bike gives a new knee good mobility, 3 times a day for 10 minutes may be a bit too much for you at your stage of healing. Maybe try cutting that back a bit, especially since you are doing so many other daily activities and lots of stairs.

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

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

6. Access to these pages on the website

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.
 
Welcome @Mia. It sounds like you're super active for 12 or so weeks out. I agree with @patriciad, the PT should have given you more details about what's unusual or damaging about your gait. Are you still using any walking aids? Can you call your PT to find out their thoughts?

My PT told me to straighten my feet when I walked, I told him I have "out-toed" all my life and that's just how I walk. Imagine my surprise when after his insistence, I realized that I was able to walk comfortably with my toes pointed in front of me after this second surgery. Also, I had to get new shoes. It may sound strange but the shoes had a "memory" of my pre-surgery gait which was all about protecting the knee. After surgery, I started getting foot pain that I resolved by just using new shoes.
 
Thank you for the response. I did go out and buy a new pair of shoes for that same reason. I was just concerned because I am scheduled feb 4th for a RPKR then I’m gonna have 2 weak legs. To answer question I only used the walker on the second day only
 
@Mia, if you're gearing up for a 2nd replacement surgery, you definitely want to make sure you're recovering leg is ready for the work. Give the PT a call about how you can improve your gait or ask at your next PT visit, after all they work for you. As @Jockette mentioned, it may be as simple as dialing your current activities back to allow the knee some rest time.

We're all different and even recovering each knee is very different (as I have learned) but at just over 4 months, I still get the tight band feeling around my knee when I've done too much. A few days of rest and ice usually resolve it. By the way, your frustration is well earned - this TKR recovery is not for the feint of heart but hang in there. Time is our friend.
 
I am scheduled feb 4th for a RPKR
Which PKR are they planning, Medial, Patellofemoral or Lateral? We’ll add that information to your signature.
 
Well I had my rpkr on feb 4th medial it seems to be different from my ltkr not being able to take pain meds it’s seems to hurt more around the back of my knee already started pt yesterday
 
If you haven’t read through the recovery guidelines in post 4, please do. Make sure you are icing and elevating.

What are they having you do at PT?
 
I am icing and elevating they are having me do heel slides ,ankle pumps, leg lifts I didn’t do well with that they measured rom at 90 and led straightening -5
 
From what I've read of those who've had PKRs, the recovery is very similar to a total replacement. Please take it easy this early on, ice, elevate and concentrate on just walking to the bathroom and doing simple stretches. 90 ROM this early is excellent. Keep us posted on your recovery!
 
It sounds like you're doing well so far. Keep up with that icing and elevating. Remember you can ice the back of your knee also.
 
Welcome to the “other side” and it sounds like you are doing well. I have had the same surgeries as you just on the opposite knees. Total on the Right and Partial Medial on my Left. Early weeks recovery was similar with both though pain with the PKR was easier to manage overall. It’s still quite a journey to recovery and you’ve made a great start. Sending healing wishes to you.
 
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I think you are very brave having both knees done so close together and probably very sensible as you get over both knees sooner. I need to consider having my right knee looked at but for me the memory of the first knee is too raw - I didn't have a bad time but as most people on here will say 'recovery was not what I expected' I need to get over my left knee and then might consider my right. Well done you and I wish you well with your healing but take it easy. I have found doing less improves the leg more!!!
 
Today is day 7 since surgery. I’m experiencing sharp pain where the staples are it feels like the staples are moving I did not feel this with my first knee surgery. I checked the incision they look intact
 
It is not unusual to have pain in the staple area, they were inserted into a fresh wound.

I know it’s really hard not to compare your two surgeries but don’t expect them to be the same, as they rarely are.

Hang in there, this is all temporary. :flwrysmile:
 
Day 7 already. There is all sorts of different pains and tingles that pop up all over your leg after surgery as I’m sure you remember from your first surgery. Ice helped me tremendously with it all. Sending healing thoughts and wishes your way.
 

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