TKR ‘Hard’ knee

[Ravendancer]

Thank you! Yes, I'm doing fine. Walking without a limp and continuing with physio. Still have a long way to go before I'm 'back to normal'...whatever that is now!!? All is good!

 

[Ravendancer]

It has now been 8 1/2 months since I had a TKR on my right leg and 4 months with a TKR on my left leg. Right knee is at 125°. I still have a swollen numb area several inches wide right of the knee cap. Left knee is at 118° and is still quite swollen stiff and numb. I have been out cycling (today 3.5 km) even though it’s a bit painful. My PT said it’s good exercise to help get ROM back and to help heal.
I am a bit concerned with the swelling and numbness on my right knee especially being as I’m almost at 9 months post op. I doing scar tissue massage on each knee for a few minutes each day.
I know that everyone heals differently. I would like to know if I should or shouldn’t be doing something else.
Thank you

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[EalingGran]

I still have a swollen numb area several inches wide right of the knee cap. Left knee is at 118° and is still quite swollen stiff and numb. I have been out cycling (today 3.5 km) even though it’s a bit painful. My PT said it’s good exercise

Do you still ice at all? I carried on icing for about 8 months after exercise- as long as my knee was warm and any way sore.
I am not a cyclist- walking is my preferred exercise. But I do wonder if it's a good idea to push the distance if it is painful? Four months is still quite early on your second knee.
My numb area has shrunk and is now not really noticeable at 18 months- although if I test it carefully, the patch still feels slightly different. It also is more unpleasant if it is accidentally knocked but otherwise I really don't notice it.

 

[Ravendancer]

Good to know that your numb area has shrunk and that it’s taken 18 months. I know it’s going to take time to heal, I just have to patient.
No, I haven’t been icing my knee. My PT says it’s not necessary now
I do get confused with the different instructions on how to heal. My PT and surgeon say to push ROM otherwise it won’t come back fully, whereas BoneSmart says the opposite. Although I agree at 4 months I probably went a bit too far on my bike. I do walk also and that is obviously better for healing as it’s not so painful.
Thanks for your thoughts.

 

[Jockette]

I do get confused with the different instructions on how to heal.

It is hard to figure out who to listen to. But, with so many differing opinions, it seems that they all work, to some extent, for someone. So, do what you feel is right for you. There’s no one right way to recover, there are many ways to recover.

This is why this next paragraph is part of the Recovery Guidelines:

People 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.

 

[Ravendancer]

Thank you. Good advice. I just sometimes get off track a little

 

[Jockette]

I just sometimes get off track a little

Don’t worry, the track is wide, with lots of flexibility.

 

[Ravendancer]

Good to know

 

[EalingGran]

No, I haven’t been icing my knee. My PT says it’s not necessary now

I think your body is a better guide to what works than your PT.
I really liked my Aircast Cryocuff. It was lovely and cool but not as icy cold as ice packs. I would have a really good walk in the morning ( getting back to 10,000 plus steps after a few months) -then ice and elevate with the newspaper or a book in the afternoon.
I also did about 30-40 minutes of gentle pilates for my knee and back most days.
I found that got my ROM back to within a few degrees of my other side without any real pain or pushing.

 

[Ravendancer]

I’ve never heard of a Aircast Crocuff, sounds better than ice though. I’ll look into that. Although I’m hoping that I won’t have a need to ice any more body parts from now on.
Now that a few days have gone by since my extended cycling trip, my knee feels better and I actually think I’ve gained a couple of degrees of ROM. So maybe that was worthwhile.

Like you said, we should trust our bodies more and depend less on what the PT says. I’m all for that.

Might go out for a wee cycle again now.

 

[Ravendancer]

It’s now been 13 months since my first TKR and 9 months since my second TKR. I think I’m doing really well. I’m pretty much able to do everything although my ROM is not where it was Pre Surgery. Although I think I’m around 120 maybe 125. I haven’t seen a physiotherapist for months now so I’m not really sure about my ROM. Both knees are still a little bit swollen with what I think is scar tissue. I think this is limiting me to some degree in bending my knee further. I’m still massaging that scar tissue area. Both knees are tingly and slightly numb still. I do realize that healing takes a long time and I’m wondering if this scar tissue will eventually disappear.

 

[mendogal]

Thank you for the update!

I'm not sure it's "scar tissue" without your surgeon doing a hands on assessment. It can be residual soft tissue swelling or tight quads (possibly with some trigger points that need release before they can stretch fully).

Besides massage, are you doing some ice and elevation daily, and stretching - very slow heel slides seated on a firm chair, breathing into the slow stretch and holding it.

You might use a ball or foam roller, or even a rolling pin from the kitchen, to check for small painful knots (trigger points) and slowly apply progressively deeper pressure, breathing into any one you find, until it releases. If they are present and can be released, the muscle will be more able to stretch.

 

[Ravendancer]

I think you’re probably right that’s it’s soft tissue swelling. I haven’t been icing it. I was under the impression that icing is more valuable immediately after surgery. I’ve read that as time passes, the effectiveness of icing may diminish and become less significant.
I will try a foam ball though along with hand massage and see how that feels.
Thank you for you insights.

 

[benne68]

Hi @Ravendancer

Like you, I had my left TKR in December and I also still deal with soft tissue "tightness" in that knee. As mendogal suggested, icing and massage help. I also have numbness along the side of my knee, which I think is common at this stage of recovery. I remember having it for a long time with my right knee, which is approaching it's 3-year anniversary. All of those issues eventually cleared up with righty, so I do think it's mostly a matter of keep moving and let time do its thing.

Best wishes for continued recovery!

 

[Ravendancer]

Good to know. Sounds like we have similar issues. I am pretty conscious about staying active, cycling mostly.
My knees are still numb and I’m not able to rest in them. I do yoga and have to adjust with many of the positions.
I was thinking that in time this would dissipate but I also wanted to help it along.
Thank you for your response.

 

[mendogal]

Oh re numb areas - in my experience postop numb patches will slowly change over time (up to two years) from numb to "altered sensation" - and in the case of an abdominal surgery was eventually normal after several long years.

 

[EalingGran]

At 22 months my numb patch has shrunk and at a day to day level is unnoticeable. If I actually test it- it still feels a bit " different ". If it is knocked accidentally then it is unpleasant- like hitting the funny bone on your elbow. I can kneel on it now fairly well but too much pressure on just that area is not comfortable. I think it is still gradually improving. Very occasionally I still get zingers- which tells me nerves are still regrowing.

 

[Ravendancer]

Oh I’m so glad to know this. Thank you so much. I can very much relate to the pain when I bang my knee. Not funny at all. Glad it will go away in time. I thought this might be so but needed some confirmation.
Thank you.

 

[Layla]

Hello Ravendancer,
BoneSmart's Nurse Emeritus, Josephine, who had over 50 yrs experience in orthopedics once shared that after her TKR she had an area of numbness for several years, at some point finally forgetting about it. It came to mind around the time she was five years post op and she realized the area was no longer numb.

Small sensory nerve fibers are cut with the incision. In most cases it is a temporary sensation that normally resolves over a period of six months to one year post op.
Hope you have a great week!
@Ravendancer

 

[Ravendancer]

Very good to know it can take that long. Makes me feel a better as to how things are progressing.

Thank you.