Lounge Doctor

TKR “MUA No Later than 12 Weeks“

Jockette

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Best wishes!

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!)​

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.
 
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Rain Dancer

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Arrived home from the hospital at 4:00. Was met at the door by home nurse and physical therapist. Nurse administered antibiotic by IV and will return tomorrow for one more treatment. Quads are firing—was able to do straight leg raises and lift my leg onto bed! Really happy about that. I am ignoring the directions to ice only for 20 minutes. Took first Tramadol and Tylenol because nerve block starting to wear off. Had my first bone smart moment and wouldn’t let hospital therapist push down on my leg when it was raised in straight leg position.

I am really pleased so far. I haven’t mentioned this in pre-op posts, but I have a BMI of 45, which I hope to change to lengthen the life of this knee. I was pretty active for someone my size, and I did a lot of pre-op exercises. Because of no co-morbidities, such as diabetes, no heart or lung issues, and normal blood pressure, my surgeon said that I was not at a higher risk. I am mentioning this so that other morbidly obese folks may feel encouraged. My surgeon never mentioned my weight. I brought the subject up when I asked him whether I should wait for a year and try to lose weight. That is when he explained about the co-morbidities.
 

Gardenplotter

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Rain Dancer, congratulations on your new knee and best wishes for your recovery!
Amazing that you were able to do leg lifts already and kudos for standing up to the therapist for your baby-knee.

…Because of no co-morbidities, such as diabetes, no heart or lung issues, and normal blood pressure, my surgeon said that I was not at a higher risk. I am mentioning this so that other morbidly obese folks may feel encouraged. My surgeon never mentioned my weight. I brought the subject up when I asked him whether I should wait for a year and try to lose weight. That is when he explained about the co-morbidities.
I was also told about my BMI, and that I had to be below 35 for them to do the surgery, I did not know that co-morbidities were the real issue. One of my coworkers was just asking me about that, since she was told she couldn’t have a TKR due to her BMI being too high. Thank you for that info.
 
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Rain Dancer

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Day 2 so far—got about 2 hours sleep, but I expected that. Up about every 2 hours to use the bathroom, which was good because the walking helped ease the stiffness. Swelling is significantly down because iced and elevated all night. Pain is manageable. No nausea from tramadol. So glad that I hired a home aide service for 36 hours because I live alone.
 

Jo Wo

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Yes, the need to walk every two hours is good for the stiffness as well as clot prevention.
 

Sisterpat

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Welcome to the other side! I was able to do leg raises right after my 2nd TKR, but 2 days later I could not even lift my leg, so don’t be surprised or discouraged if that happens to you. After the nerve block wore off completely I was down with “log leg” for about a week.
 
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Rain Dancer

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My knee naturally is swollen from surgery. I am under-medicated because of the problem I have with needing to have drugs compounded to exclude cellulose. Things had just started to calm down and the physical therapist arrived. I followed the Bone Smart way and refused to use a strap to do heel slides. My flexion went from 74 yesterday (unassisted) to 64 (unassisted) today. I can see the direction that this is headed. The pain climbed up after she left. So I cancelled the PT appointments that were scheduled for tomorrow and Saturday and will start back up with them next week. I will cancel more sessions as necessary.
 

Jockette

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That was a wise decision to cancel your PT appointment. Your ROM number went down because your swelling went up.

All will be well, in time. Rest, ice, and elevate however high you are comfortable with. I had problems elevating toes above the nose in the beginning because it hurt too much. Short sessions are ok if that‘s all you can tolerate. When I was not in bed, my elevation was my leg on an ottoman.

Also,it’s ok to have a slight bend in the knee, keeping it totally straight is very painful, and not necessary, though many of us are told it is necessary.
 

Jockette

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That’s great, the Lounge Doctor will give you that nice, gentle bend.
 
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Rain Dancer

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Day 3–rough night. Had to stop taking Tramadol because of raging insomnia (6 hours sleep in 72 hours) and nausea. Now on a combination of Tylenol and Advil, which is working much better. I am not thrilled to be on Advil, but I have no choice because I can’t get anything compounded until the middle of next week. Got to see my incision today when home nursing removed the ace bandage and bulky dressing and replaced them with an island wrap. I wish that I had taken a photo because it looks wonderful! No visible bruising, which is amazing. I have taken multiple laps around the house with the walker. The knee already feels real to me.
 

BBCG

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Ah, yes, Rain Dancer, the insomnia has bit me both TKR recoveries, too, so I'm sympathetic... I react poorly to opioids so Tramadol was the relief I sought first time in recovery in 2016. Good for you to stand up for your new baby knee, too! I'm so thankful you found Bonesmart pre-surgery, too... it DOES make a difference!

Is there anyone you can call to get the compounded medication you need? I've offered to help a friend here with things for her THR, but she did so well no help was needed. A friend might really appreciate being able to help you?

I saw that you had someone coming in to help you for a few days and I did that also, this time because my husband is legally blind. I had a friend stay with us for 4 days (it worked perfectly for her too, as she and her husband were about to move up near us), and she was a God-send to have to hep us out. She drove me to PT as I didn't have any way to get there otherwise, except for a taxi or Uber!

I'm 12 weeks out from my 2nd TKR and sometimes also have insomnia so I'll watch to see if you're up and posting if I'm awake!
 
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Rain Dancer

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Day 4. Feel like a new woman after 5 1/2 hours sleep last night. Had gentle PT today. Extension is 3 and flexion is 50. I am looking longingly at my cane. I hope to be able to use it soon. Knee feels strong and stable.
 

Jo Wo

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Wow, that is a good long stretch of sleep, especially for your first week in recovery. One step at a time, you will progress to a cane when it is the right time. There was a period of time when I could use the cane but would still use the walker when tired later in the day.
 

BBCG

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And, I graduated to a cane around the house within a few days, but used the walker outside, then replaced the walker with crutches outside and still used the cane inside... we walk on some wide bike paths so the crutches were to make sure bike riders and faster walkers knew I'd not be speeding up!

I bet that much sleep really felt good!!
 

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