TKR RTKR. 17/2/23

Anniemof

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I had a RTKR on 17/2/23, my day zero, as I call it. I'm six weeks post op and my knee still feels very tight. My bend is currently about 90, which is no better than 3 weeks ago. My extension is ok and I'm managing things around the home and small walks outside with my sticks. I only attend Physio every two weeks and if I try to push the bending as they say, I pay for it for the next two days. I ice and elevate all the time but my knee remains swollen and tight. My mood however is low and I am beginning to feel this is the worst thing I've ever done. I can't imagine when I'll be able to drive or take my dogs out, ( it's the little things I miss ) I'm interested to know if anyone felt like this at 6 weeks and also had this awful tight non bending knee. Sorry for the whinging I feel it's hard to stay positive at the moment.
 
You are not whinging, just expressing how difficult this is. At 6 weeks I would have pretty much written what you have.

I'm right knee. At my surgeon's check at 6 weeks he said I could drive. I was sceptical but a few days later I pushed myself to do it. I feel I am safe driving but my knee does not like it and gets sore. However I'm keeping going as I need the freedom.

I'm coming up on 11 weeks and I can see some green shoots. Less pain more bend.

Like you i was at 90 at 6 weeks. Surgeon and physio were OK with that. Physio last week was at 105. Physio admitted I'm not the fastest but thinks I'm doing well for me.

I still have moments of depression and frustration but am getting there. You will too.

I think my greatest tip would be the ice, elevation and frequent moving, even if that is just a trip to the loo!

Hang in there it will get better.
 
Thank you Haylingislander for your reply. I really did not think this was going to be as hard, probably not many do. I'm glad you're beginning to see the light at the end of the tunnel.
At times this feels like a very lonely journey. My surgeon was very up front and informed me, it was a hard op and and even harder recovery, boy was he right.
I think it'll be a slower journey for me but hopefully I'll see some small progress in the coming weeks.
 
Like @HaylingIslander my zero day was Jan 17. My progress at 6 week PO was very similar to yours. My break through was just after week 7. That was the first time I got to sleep more than a couple of hours in a stretch. It took a couple of starts but now I get 6-7 hours in a row. I took the advice of someone here and began taking Tylenol PM at bed. Two at first and after a week or so, I cut back to one. My knee is behaving. As people here will tell you to be on guard not to join the OverDidItClub (ODIC). I managed to join a couple of times. Once I took a 7 hour road trip and paid dearly for the next 4 days. On another occasion, I hist some golf balls and then went to the Y to ride the stationary bike. Took much fun for one day, my knee told me about it for 3 days. Ice and elevation are still on my daily schedule. Take care. Once you get to some semblance of normal sleeping, you'll feel a lot better,
 
Welcome to BoneSmart, @Anniemof! I'm so glad you found us.

Everything you described in your post sounds normal for just six weeks post-op, so please don't worry about your progress. You are still very early days in this year-long recovery!

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

Just keep in mind we are all 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 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.

If you want to use something to assist with healing and scar management, 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.

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
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.
 
I only attend Physio every two weeks and if I try to push the bending as they say, I pay for it for the next two days. I ice and elevate all the time but my knee remains swollen and tight. My mood however is low and I am beginning to feel this is the worst thing I've ever done.
Please don't let them push you to bend. Your knee is telling you that it is still very swollen inside and forcing it will only make things worse.

Also the post-op blues is a very real thing that hits all of us at some point in the early months of recovery.

You'll find article about both of these things in the links I just left you above.

Please stick with us. We are here to help!
 
It all sounds about right. By 6 weeks I was tired, frustrated, sick of pain and swelling. In the 2 weeks following gradual changes started happening. Decreased pain, swelling, better sleep, less pain meds.
Just keep icing, elevating, resting and you will see better days. At 11 weeks post op it keeps getting better.
 
Thank you everyone for your kind replies and useful information. I have been following Bonesmart's advice. My physio used the catch phrase, " no pain no gain" only once. That was when I pushed my leg and payed for two days after.
I'll keep going with the gentle knee slides. stretches, walking and daily activities and hopefully will see changes soon x
 
You will, Annie... and you'll not only see changes soon, but likely without suffering any setbacks stalling your recovery, from over exercising or aggressive PT.
I hope you have a nice week. Happy Monday!
@Anniemof
 
Happy Two Month Anniversary!
I hope you are enjoying progress since we last heard from you a couple of weeks ago.
Feel free to share an update next time you're on the forum. Take good care!
@Anniemof
 
Hi, I'm not making great progress, especially with my bend. Phsyio got me 100 but that was really hard work and I'm now in the Over did it club, back on stronger pain meds today and resting and icing. I know for a fact I'm not naturally bending 100 as my knee remains swollen. I've booked to have a massage privately next week, so I'll see how that goes. I have specific quad tendon discomfort, along with everthing else, and I'm wondering if anyone else has had this?
This is a very hard proceedure and recovery and at this moment in time is the biggest mistake I've ever made. As Chez said in her song, If I could turn back time. Sorry for moaning. xx
 
so I'll see how that goes. I have specific quad tendon discomfort, along with everthing else, and I'm wondering if anyone else has had this?
I had definite tightness and soreness in my quads all the time for around 2- 3 months and I think a lot of people here have had it longer. I think it is what a lot of people refer to as the tight band feeling.
I am pretty sure in my case it was linked to some residual swelling. It gradually reduced until I only noticed it in the evening and now it has pretty much gone.
 
Your bend is just fine for 2 months post op and all the swelling you have.

Phsyio got me 100 but that was really hard work and I'm now in the Over did it club, back on stronger pain meds today and resting and icing.
We all have different timeframes for healing, and how fast our swelling goes down. Try not to stress about your ROM and let your body heal the way it wants to. Forcing more bend than your knee is ready for is counterproductive, as you now see, with the additional swelling you have and the Over Did It Club. Don’t let your physio bend your knee again, it’s not helping.

I had a low ROM my whole first year but I had a lot of improvement in my second, and even my third year! There is no Window of Opportunity

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.
 
I'm going to tell the physio, next time, that I'm not pushing again to gain a set number of degrees. I know it's not natural as I have swelling, it's arbitrary number as I can't achieve it under normal circumstances. It's set me back as I'd been making progress on my step up on the stairs, walking, light bends, peddling and stretching.
I do want to make headway on my bend , as I can't drive yet, which is very hard, but I need to do it at my own pace. I've realised, I'm not one of those people who are going to be back to normal at 6 weeks. Sadly. xx
 
It's set me back as I'd been making progress on my step up on the stairs, walking, light bends, peddling and stretching.
ROM is not everything. You are improving well in these other areas. It all counts, but our medical teams do seem to focus too much on a ROM number.

I do want to make headway on my bend , as I can't drive yet, which is very hard, but I need to do it at my own pace.
This is the way to do it. We are all different, though at PT it seems too often we are all treated the same.

I've realised, I'm not one of those people who are going to be back to normal at 6 weeks. Sadly. xx
It is very rare for anyone to be back to normal at 6 weeks, no matter how many stories we hear. They are just that, stories.

For most of us, this recovery takes an average of a year. :console2:
 
Hi! I will just reinforce what other members are saying and add that this is a long road. I’m at the 6 month mark after a TKR on my right knee. I don’t think I was properly prepared for how brutal an operation this is and how it affected me psychologically- I was in a type of shock for several weeks. The point is that you are making progress - it may feel as though you aren’t but look back and you will realize that gradually you are able to do more.
For me, finding this website was one of the most useful and helpful aspects when I realized that it is not a competition and that your knee knows what it is doing!
Personally I have found that I still pay for it if I do too much but pre empting by taking 400mg of ibuprofen the night before makes a huge difference. You will find your way! Good luck!
 
Thank you for you replies. I really feel this is one of the hardest things I have ever done and would not do it again. Like you Penelope Anne, this has had a awful effect on my mental health ( which I've never had problems with ) I think my familly and friends are at a bit of a loss as to how to cope with my mental state. I'm going to see a massage physio privately, to just try something different, so hopefully that might help, but I'm not going to push my bending as it sets me back days. This website helps me and I like to follow how others are getting on. x
 
I'm at 12 weeks and worry about my rom. Worry I haven't pushed enough etc. I have suffered with anxiety and depression on and off for most of my adult life. Learnt to deal with it but this operation has been a real challenge to that.

I think for me part of it is that we can't just recover but we have to rehab. I'm constantly concerned whether I am "getting it right" and this is so triggering for me.

On a lighter note the other things I struggle with is people walking at me in supermarkets, and feeling like I have to keep up with family and friends when walking. Can't face another can you slow down request :tantrum2:

Let's just keep doing what we're doing and hope for the best.
 
I think we constantly think we haven't worked hard enough at ROM. Mine just doesn't budge at the minute as my soft tissue remains swollen. I follow a physio on Youtube he said most people with slow ROM work harder at ROM not less. Lets face it we want to back to a normal life.
You're right we have to carry on and hope xx
 

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