TKR March 9th RTKR

[jtrahan]

Hello Everyone .
I had my right knee replaced on March 9th. I have used this site before for my hips and it has been very helpful. I came home yesterday and have been able to manage the pain. My experience with hips is pretty good but my knee is totally different. I have a few questions. I am assuming the massive amount of swelling is normal? My range of motion was better in the hospital and when I try to flex it at home the pain is extreme. After they removed the drain I think the swelling increased. Ice seems to be very helpful and I am also taking my medication regularly. At this early stage should I be concerned about my range of motion or will it get better as the swelling goes down. Thanks for your help. I’m home alone dealing with this so any help would be appreciated.

 

[FourCats]

Welcome to the knees!! Yes, swelling is normal and why it is important to elevate and ice as much as possible. For the first couple of weeks, I iced at least 8 hours every day.

Range of motion is the last thing you should be worrying about. Reducing the swelling will help it. Right now, moving around inside the house is all the exercise you need.

I managed both of mine while living alone. It can be done and I hope you did some pre-planning in regards to meal preparation. I became friends with my dust bunnies and we lived together in harmony! Do be sure to have someone who can check in with you and get things from the store you might need.

It is a long, often difficult journey but this board is awesome.

PS - beautiful chicken!!

 

[Sara61]

to BoneSmart

From what I have heard hip & knee recovery is completely different.
Swelling is very normal and will last several months, it will increase if you do too much activity, make ice your best friend, it will help enormously plus do not over exercise the knee, at the moment all you need is daily living activities x

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
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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


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.

 

[jtrahan]

Thank you for the quick replies.

 

[Roy Gardiner]

I am assuming the massive amount of swelling is normal?

Yes

when I try to flex it at home the pain is extreme

Please don't do it, pain is bad

At this early stage should I be concerned about my range of motion

Absolutely not

will it get better as the swelling goes down

Yes,

Keep following the guidelines, relax, and don't worry. Recovery is in weeks and months, not hours and days.

 

[benne68]

Hi @jtrahan and welcome to the other side of your TKR. Please, please don't worry about anything right now but recovering from all the trauma your body has been through. At only 2 days post-op, you should ice, elevate and rest.

Like you, I had a THR before my TKR -- I came home from the knee surgery expecting my recovery to be similar to my hip recovery. WRONG! It has been harder and has taken longer. (At almost 6 months post-op, I am still recovering, although I'm doing really well).

I had the same surgeon for both hip and knee but his post-op instructions to me were very different. With the hip, he told me to "start walking as soon as possible"; for the knee, he told me "your only job for the first two weeks is to rest and recover." It was great advice.

This is a recovery that takes time and patience. Keep us posted on how you are doing; we're here for you.

 

[jtrahan]

Thank you for the information. During my two hip replacements I had an epidural and twilight injection. For some reason the anesthesiologist couldn’t perform the epidural this time. So I ended up having generic anesthesia . Not only is my knee sore but my chest and throat is killing me. I feel like I did 100 sit-ups. Everything hurts. Although the pain has been manageable with a little Oxy and Tylenol, this surgery has been nothing like the hips. I’m just going to take it one day at a time.

For both my hips I had a nurse come to check my vitals and then a physical therapist came to the house for two weeks before I went to outpatient therapy. They have since changed the protocol and nobody comes to the house. Do you think I would be okay waiting to start pt once I start driving? I’m by myself and can’t bother anyone to drive me to therapy three times a week. Thanks

 

[FourCats]

One day at a time is key. Don’t rush PT; just getting around the house and daily activities is more than enough.

If your doctor orders home therapy they should fulfill his order. I only had in home PT for both knees provided by the local home health care agency. Push a bit and see if your doctor’s office can’t make it happen. At least someone will be checking on you.

 

[glidefloss]

Hi @jtrahan , as others have said, swelling can be pretty intense as the attached picture shows (a couple of days after my RTKR) my right leg literally double the size of my left. I thought that the main source of pain the first few days was from the swelling and not the knee itself. Bending the knee with so much swelling wasn't the most fun thing to do!

Though the days will seem to drag interminably slowly at times, each one that passes will bring a little bit of relief. You'll be loving your knee soon enough!

All the best on your recovery/rehab!!

 

[jtrahan]

Thanks. I have noticed that the tightness in my knee is much greater now than it was the day after surgery. I try to bend it but the pain makes me nauseous. I spoke with a physician’s assistant at my doctor’s office and he said I shouldn’t worry about the home pt. He said when I find a place I want to go for outpatient pt let them know and they will send over the script. I’m just going to do some walking around the house, light stretching and use my Breg ice machine. Thanks for everyone’s help.

 

[Jaycey]

@jtrahan Please don't worry at all about bending that knee. Once you get the swelling under control your ROM will just naturally increase. But this takes time and tons of patience.

 

[jtrahan]

Good Morning,

I am now 12 days post op and I am still having difficulty sleeping in my bed. I was successful one night but last night, I became uncomfortable and ended up back on the recliner. One of the issues I am having is when I sleep in the bed I am required to wear the knee brace to keep my knee straight when I sleep. That brace is really uncomfortable and it not only irritates my skin but my knee gets super hot. I was wondering if anyone has any suggestions to make this more comfortable. Thanks

 

[2chains]

Are you able to use a pillow case between your knee and the brace? They are typically much thinner than a towel. I use bamboo bedding which is much cooler but they are typically expensive.

 

[Jockette]

Why are they having you sleep with a brace? Were there any complications with your surgery? I’ve never worn one but many members have reported how uncomfortable they are. Call your surgeon‘s office and tell them how uncomfortable it is for you and ask why they want you to wear it, if they haven’t already told you.

 

[jtrahan]

Thank you for the replies. I believe they want me to use the brace when I sleep so I keep my leg straight. I guess the doctor doesn’t want me forming scar tissue during the healing process. I’m not really sure why, I’m just following the protocol they told me when I left the hospital. I have tried the pillow case, but it’s still gets really hot.

 

[Jockette]

In almost all cases of this recovery, a brace is not needed unless there is a certain issue. Wearing it just to keep your leg straight shouldn’t be necessary. You have lots of time to regain your extension, at only 12 days post op, you are very early in the game.

Keeping your leg totally straight can be very painful, a gentle bend is fine. The following article about elevation does mention the question about keeping the leg straight.

Elevation: Doing It the Right Way

Updated September 11, 2022 by Jamie Proper elevation is one of the best ways to help with pain and swelling following either hip or knee surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate your...

bonesmart.org

 

[Jockette]

I guess the doctor doesn’t want me forming scar tissue during the healing process.

Keeping your leg straight has nothing to do with the formation of scar tissue.

Some scar tissue is necessary because without it, we would always have an open wound. Normal, necessary scar tissue thins out over time as you heal.

It seems the medical community frequently tosses out the term scar tissue, like its just waiting to pounce on you if you don’t do _____(fill in the blank)

The “bad” scar tissue, which can have a negative effect, is correctly called Adhesions, and they are actually rare.

 

[jtrahan]

I slept in my bed without the brace last night and it was better. Tonight, I’m going to use a small pillow under my knee because even without the brace it was still painful laying with it straight.

 

[Jockette]

It can be a lot of trial and error to get comfortable, especially in bed. I used my elevation wedge, but early on like you are, I couldn‘t last all night with it until I healed more and my upset leg settled down a bit.

 

[jtrahan]

Thanks, I tried last night and lasted about an hour and was back on the recliner. It’s not only keeping the leg straight that is difficult but the skin is still irritated. My entire knee feels dry and itchy. I didn’t have stitches or staples. Instead, the doctor used glue and some kind of adhesive strip. The strip came off yesterday and the incision is healed. I suppose I am being to impatient. I go back tomorrow for my two week check up. In the meantime I’ll just keep elevating and icing.