Hello. I am a 78 year old female who had bilateral TKR Feb. 3, 2021. I quickly gained a good range of motion and “graduated” from Physiotherapy at about six weeks. I continued doing exercises at home and walking and bike riding, both outdoors and the exercise bike. At about six months, I felt my progress was not what it should be so consulted with a physiotherapist again. What bothered me was although I had good function and 120-130* bend, my knees felt as if there was a band on them—as if my skin was too tight. No pain, just a tight feeling. I could still walk and do stairs. She thought I was doing well but modified a few exercises (none of which are strenuous, except wall squats ) and started massage around my knees. The massage did help in that when I would get up and walk right after, the stiffness was gone, but the effect did not last. The stiffness does not really interfere with function—yet. I wonder if this should be a concern or will it gradually abate. I almost think it is worsening. The right knee is worse than the left—which was the case before surgery too. Any comments will be appreciated. Had I seen this site right after surgery, I might not have pushed so much. I hope I have not done permanent damage.
Bilateral TKR Three years after bilateral TKR
- Thread starter Ladytwo
- Start date
Hi and Welcome!
The stiffness you describe is very common. It will lessen as you continue to heal. Here’s an article about it from the Bonesmart Library:
bonesmart.org
We have found with those who have bilaterals that each knee will often feel differently from the other knee, while healing. Here’s one explanation by one of our members:
“I watched a bilateral knee replacement when I was a nursing student. The patient happened to be a neighbor. It was quite a comfort to him that I was there. I was not that physically close to the surgical area because that's a super-sterile area. They wear space suits so they're not even breathing near the wound. I was by the patient's head. They did the left knee first and then the right, which went easier because they'd figured out the correct components on the left which means there was more tourniquet time, more putting on and taking off of components, and generally tweaking of the artificial joint on the left. So it was no surprise that the patient's right knee recovered more easily and with less swelling. Who knows how much each of our knees get tweaked and manipulated during the surgery, resulting in more tissue trauma?”
This recovery can take an average of a year or more, so you should still see lots of improvement, in time. I doubt you’ve done any damage, permanent or otherwise.
The stiffness you describe is very common. It will lessen as you continue to heal. Here’s an article about it from the Bonesmart Library:
Tight Band feeling across the front of my knee
That tight band is caused by scar tissue but not the adhesions type of scar tissue. When the surgeon opens up the knee, he has to undercut the skin and superficial structures from that centre line to each side of the knee in order to get good access all round the bones. Part of the healing...
bonesmart.org
We have found with those who have bilaterals that each knee will often feel differently from the other knee, while healing. Here’s one explanation by one of our members:
“I watched a bilateral knee replacement when I was a nursing student. The patient happened to be a neighbor. It was quite a comfort to him that I was there. I was not that physically close to the surgical area because that's a super-sterile area. They wear space suits so they're not even breathing near the wound. I was by the patient's head. They did the left knee first and then the right, which went easier because they'd figured out the correct components on the left which means there was more tourniquet time, more putting on and taking off of components, and generally tweaking of the artificial joint on the left. So it was no surprise that the patient's right knee recovered more easily and with less swelling. Who knows how much each of our knees get tweaked and manipulated during the surgery, resulting in more tissue trauma?”
This recovery can take an average of a year or more, so you should still see lots of improvement, in time. I doubt you’ve done any damage, permanent or otherwise.
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:
3. Do what you want to do BUT
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.
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.
Thank you. It is very reassuring to hear that the tightness is common and the explanation makes a lot of sense. Interestingly enough, the incision on my left knee seems to have healed better than the right, so perhaps that mirrors what is happening inside. As I became more active, I got away from icing and elevating (which I did quite religiously at first) so maybe that is a factor in my perceived worsening too. I think I will try pampering myself a bit and maybe go back on the acetaminophen which I had stopped. Thanks again.
Have been icing a bit, elevating, using compression braces and taking Tylenol for just four days and have noticed an improvement. Also do physio exercises every other day instead of every day. It seems I need more patience and a longer outlook to achieve a natural stride.
Good thinking, LadyTwo! It's a bit like learning to "read" the unspoken comments by someone, only you need to begin to "read" your knees! I sometimes forget that my newer knee is only 5 1/2months old and I forge ahead like it's old hat...until my knee, or leg, etc, complains!
Oh, and everyone I know who had Bilateral knees also says they are each different, too! Hang in there! Instead of learning to read tea leaves, you're learning to read your knees...like all of us here!
Oh, and everyone I know who had Bilateral knees also says they are each different, too! Hang in there! Instead of learning to read tea leaves, you're learning to read your knees...like all of us here!
Well, over nine months now and still feel the “band” across my knees (right one especially) but it may be very gradually improving. What annoys me right now is that I used to walk softly, but now it seems that I clump along noisily and not with a smooth gait. How can I work on that?
I am eight months out from bilateral and still have the tight band feeling. Some days I feel that I am walking totally naturally and can get up a fair amount of speed, others such as today I feel as though I have a pair of logs with the odd twinge of pain. I suppose practice will make perfect, and it takes a year or more to recover completely, particularly from bilateral. The strange thing is that good and bad days are entirely unpredictable with me.
Reporting in again at 18 months post Bilateral TKR: still learning as I go and still gradually improving. The “tight band” feeling around my knees is lessening and I feel as if I can walk more naturally now. During last winter, however, while cross-country skiing, I discovered my balance was way off! I had trouble on the smallest ups and downs and basically avoided trails because of it. I skied in my flat fields. I also discovered, and maybe should have known, that I now have no ACLs and maybe no PCLs, and that these ligaments are critical in balance because they are proprioceptors receiving and giving feedback about body position. I hope I’ve got that right. For a while I despaired about ever being able to ski trails again, but I have been going to physiotherapy again to work specifically on balance and a normal gait and I do believe it is helping. Next winter will tell the tale. Any feedback or sharing of similar experience would be appreciated.
@skigirl can probably relate. I don’t know how often she’s on here these days, but if she sees the tag, she’ll come talk with you.
Some of us take longer than others with our recovery, and after a very tough first year, and I “only” had a partial, I saw a lot of improvement in my second year, so don’t give up hope!
skigirl
Former BoneSmart staff member
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Amy I mostly ski alpine trails but I skied at five months after rack knee replacement! I could not find anyone who would do two at once.
My knees are now 20 and 21 years old I have skied as many as 100 days on them in a year. I never really think of my knees now!!
The balance issue is a big one but I found that things evened out. Whenever I can, I stand on
One leg than the other to test my legs I can stand for two minutes on just one leg but it took work and time to get there. I am sure you will make it too.
I just had my hips replaced and I can see that my balance is off again, so I am also working on gait making sure I roll from my heel through my forefoot, if I am in line or standing I stand on one leg for as long as I can, then the other leg, I do in the kitchen while talking with friends . In church. Whenever I can, it gets easier and easier the more that I do it and it gives me a tangible measure of improvement! Stick with PT, strong legs will propel you across the snow!!
My knees are now 20 and 21 years old I have skied as many as 100 days on them in a year. I never really think of my knees now!!
The balance issue is a big one but I found that things evened out. Whenever I can, I stand on
One leg than the other to test my legs I can stand for two minutes on just one leg but it took work and time to get there. I am sure you will make it too.
I just had my hips replaced and I can see that my balance is off again, so I am also working on gait making sure I roll from my heel through my forefoot, if I am in line or standing I stand on one leg for as long as I can, then the other leg, I do in the kitchen while talking with friends . In church. Whenever I can, it gets easier and easier the more that I do it and it gives me a tangible measure of improvement! Stick with PT, strong legs will propel you across the snow!!
greeneyedjan
new member
Hi I sent you a person message, I hope to hear back from you. Thanks!
New report: still doing Physio for balance and strength and still improving. I think I can honestly say now that my knees are better than before surgery. I can go straight downstairs and up without a railing. I walk normally now and my balance is improving. Looking forward to the big test when the snow comes.
Well, the snow came, sort of, and my balance was better! Still doing my Physio. My concern now is that tight feeling across my knee is no better, even worse on the right knee, and it seems to be spreading up my thigh. Doesn’t really interfere with function, but I feel it and maybe don’t walk quite naturally. Would massage help? It is now over two years since my TKR. This tightening up annoys me. It’s not pain. Wearing a compression sleeve seems to help a bit. Any thoughts?
My knees seem to bend and straighten well —no pain, but I still have a tight feeling of stiffness across the front of the knee. It does seem to affect my balance and walking, maybe my hips. Does this ever go away? Is there anything I can do to alleviate it?
@Ladytwo I’m sorry you still have that tight feeling. I think that can linger for some of us.
By the way, I merged this new thread with your original recovery thread, to keep your history together. I just reread it and I see it’s been an issue all along.
Have you connected with your surgeon about it? Maybe a check up would be a good idea.
By the way, I merged this new thread with your original recovery thread, to keep your history together. I just reread it and I see it’s been an issue all along.
Have you connected with your surgeon about it? Maybe a check up would be a good idea.
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