TKR My mother had a total knee replacement and I need advice

Garfan

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She's 66 and due to arthritis had to have a total knee replacement in her right knee on December 1st. The doctors had hoped to have her out of the hospital the same day and beginning physical therapy on the 5th.

Well she didn't make it out until today(Dec 2) after staying overnight and she's having a hell of a time. When she's sitting she's fine. Only minor pain. But when she puts any weight on the leg it hurts like hell. It reduces her to sobbing and honestly near panic. The she gets into proper position and she recovers herself in just a few minutes.

She isn't able to do near the movement the doctors recommend, but she has only been home from the hospital about six hours as I'm posting this. She tries to use a walker but is having a hard time training herself to put her weight on it, and also so my father and I are using my office chair as a wheelchair some. I know this isn't best, but when using the walker besides not putting enough weight on it she keeps trying to lead with her right leg(the replaced one!)

What can we do to help her?
 
Hi and Welcome!

The best thing you can do to support her is, give her time to heal and don’t pressure her to walk too much, or to do the list of exercises that she has probably been given. She has had a very major surgery that has caused a lot of trauma and disruption to her leg.

Right now she just needs gentle movements and short walks, to and from the bathroom, or just around the house. She needs a lot of rest, ice (or some cold source) and she needs to elevate her leg. The following guidelines have “how to-s“ to do these recommendations.

When she is feeling up to it, encourage her to post here so she can ask any questions, and get support from others going through the same things as she is.

Especially read the articles about PT, too often too much PT is given, when what the body needs most is time to heal.

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!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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.
 
Oh my gosh.. I am sure admins will have a lot more info, but as a person who had a replacement, I think She should be resting and sleeping. This was a super gnarly surgery for the first two weeks getting myself to the bathroom and taking a shower was about the extent of my activity. Maybe I would get to sit on the porch. I took my meals in bed. I spent a night in the hospital as was my doctors protocol and for the first 3-4 days never went to the bathroom alone. To best help her let her rest, make sure she takes her pain meds on time (I had a notebook and would write down the time I took so I could reference them), make her healthy nutritious food and lots of water and tea and just let her rest and sleep. Her knee was literally cut out and replaced anll the muscles and tissues were moved to make that happen. It hurts a lot, just be patient with her.
 
thank you for your sympathy and concern everyone.

Should she be keeping the knee wrapped? Should she use the leg straightener she wore home? Because I know she is supposed to move it to keep it from locking up
 
What leg straightener did she where home? Is it a brace?


I know she is supposed to move it to keep it from locking up
All she needs is gentle bends and short walks and her knee will not lock up.


Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
What leg straightener did she where home? Is it a brace?

not so much a brace as one of those wraps that goes around your entire leg and velcros shut and has rods alondgthe side that allows zero motion. I guess it might just have been for the car ride home. I actually had one when I had my knee drained for fluid years ago.

looked it up, I think it would be a knee immobilizer
 
They didn't give you any instructions about it? In my experience reading the posts here, members are only sent home with one of those immobilizers for a specific reason. You should call her doctor and ask about it.
 
They didn't give you any instructions about it? In my experience reading the posts here, members are only sent home with one of those immobilizers for a specific reason. You should call her doctor and ask about it.

ah, then my father might know

one more question, they don't seem to know about. Her knee replacement was the right leg. She had a nerve block put in, but it's left her with some trouble moving her left leg. Is this normal?
 
Last edited:
That could be normal. Manipulations can be pretty rough at times during this surgery, it possible her left leg got moved a weird way in the process. The beginning of the guidelines say:

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.

The first nights and days home can be overwhelming, we’ve all been there. Just encourage her that all will be well in time. Try to help her be as comfortable as possible, though that can be difficult. Have her take her pain medication on a schedule, don’t let her wait until she’s in pain, by then it can be hard to get it under control. Her block is going to wear off, so she needs something in her system before that happens.
 
Hi, Jockette is right the first 2-weeks are overwhelming! If your dad wasn't given discharge instructions for the immobilizer, I would call the on-call doctor. I couldn't stand anything on my knee/lower leg/foot. I had to sleep when I could in a recliner. I bought the wedge to help keep my swelling down and used that a couple of times a day. Routine pain medication and ice really does help. Possibly a laxative! It is great she has you and your dad for support.
 
I was given an immobilizer splint just like the one you describe and I was told to use it only at night if I wished and never during the day as moving the leg and knee was important to healing. Your mother's doctor may have different intentions so as others have said, you should check with the doctor's office.

I found it very useful to wear at night for the first few weeks as it functioned a little bit like armor and protected my surgical knee when my other knee bumped it while sleeping. I elevated with a flat wedge so there were no problems that way.
 
I had a femoral block for my TKR, and was given a knee immobilizer to keep my knee from collapsing during weight bearing during the early days. When your knee wakes up, you no longer need the immobilizer.
Try having her wear it while walking to see if it helps. The rest of the time the immobilizer should be off.
 
Hello and Welcome! Thanks for joining us. I hope your mom is feeling a bit better today.
Initially recovery can feel rather paralyzing for some, especially if you're dealing with intense pain. It can be frightening also. Hopefully she was able to get some restorative rest last evening and is becoming more comfortable now that's she's home. It sounds like she has loving and capable caregivers in you and your father so hopefully she takes consolation in that. Please know that we're here whenever you need support.
Wishing your mom all the best!
@Garfan
 
Before your mom was discharged, she should have been seen by PT to be sure could manage at home. I had to walk steps and demonstrate that I could get in to the car. If you weren’t there during her discharge your dad will probably know. Also she should have been given very precise written instructions regarding what to expect at home.
Hopefully she is taking her pain meds on a regular basis. It’s a pretty brutal surgery and those pain meds are needed.
 
thanks for all the support.

She did a bit better yesterday and did well today for part of the day, but probably sat for to long between movements because the improvement was definitely gone by this evening and there was some seepage on the bandage over the top of the incision.

The doctor apparently said if there was seepage bigger than a quarter she needed to get back to the doctor, which is concerning
 
Please don't hesitate to contact the doc on call for your questions and concerns. Hopefully, some additional help and support will be put in place tomorrow. You're doing your best to care for her.
 
Some seepage is normal, so try not to worry, even if he wants to see her. She’s only 3 days post op in a long, slow recovery, that takes an average of a year. Lots of rest right now and gentle movements are good.
 
Great news to read your mom did better today! Getting tired toward the end of the day is normal since TKR is major surgery. Try not to be alarmed by the bit of drainage, but don't hesitate to check in with her surgeon's office if it will offer you, your dad and mom peace of mind. Her OS's care team may be willing to view a cell photo you forward of her incision / bandage which may ease any concerns you have. Your mom will have some pain and discomfort as she begins healing, but I think once she has several more days under her belt and has established a routine, you'll all feel more confident in the process. Hang in there, it will get better! :yes:
@Garfan
 
This is a great site and glad you found it. The advice/encouragement is spot on but there is no other way to say it “TKR sucks”. On my 2nd one (7+ weeks ago) but swore after the first never again. Lets face it most of us want & need to walk so this is a in demand surgery. Tell your Mama to take her meds to keep ahead of the pain, don’t due excessive exercises but try to move a bit. Everyone heals at a different rate and also has different tolerances to pain. I have low pain threshold, high drug tolerance and am a sad-sack patient but I do remember it will get better. Good luck!
 
@Garfan
I was 65 when I had my first TKR. At 69 I'm having second TKR next month. Unless I had found Bonesmart prior to first TKR I would have probably been like your mom.
Read everything the advisors send to you. Then have your mom read it. Any other questions call her surgeon's office directly.
The first week or two are painful. Make sure she takes her pain meds as prescribed. Pain control is a huge part of recovery. Make sure she is getting enough hydration.
She will need help walking to the bathroom for awhile.
This is a bigger surgery than most patients are prepared for.
Any questions you or your mom have can be answered here or by her surgeon.
I hope she can relax and heal now that she's home.
 

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