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[PARTIAL KR] 10 days in recovery^

Discussion in 'Knee Replacement Recovery Area' started by cuckoo, Dec 8, 2018.

  1. cuckoo

    cuckoo new member
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    Hi
    I had a partial replacement and have (so far) been very lucky with my recovery. I am resting a lot but doing the exercises given by NHS physio. The one I have the most trouble with is the straight leg lift. I couldn't straighten my leg pre-op but the pain I get now is different so I guess things are moving in the right direction!

    Having staples out on Tuesday when I see the physio again so another step forward. It's difficult not to sit for too long at this time of year and inclement weather - no wandering in my lovely garden.

    How long will I be using 2 crutches? I suppose it's as long as a piece of string? Be good to hear from people at the same stage of PKR recovery.
    Cuckoo
     
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  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart!

    Use your crutches as long as you want, until you feel safe and secure using a cane.

    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.

    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
    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
    5. Here is a week-by-week guide for

    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.
     
  3. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @cuckoo, welcome to BoneSmart from another PKR member. What, exactly, did you have done (medial, lateral, patella-femoral) and which knee? Did you have the surgery due to damage from an injury or just long term OA? I went home the day after surgery (a Tuesday) with 2 crutches but was only using one by Saturday and mainly when I went outside and up/down stairs. By end of 2nd week, I wasn’t using anything at all. However, everyone is different and your need for them will greatly depend on how stable you feel and over all strength. Don’t rush it because of what you read others have done! All recoveries are unique. Reading others here is helpful to get perspective, but they mean nothing in terms of how you are doing.
     
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  4. cuckoo

    cuckoo new member
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    Hi,
    Thank you for your reply. I had the inside of my right knee replaced with a titanium and plastic joint. I had a spinal anaesthetic with a nerve block injection in my thigh. I didn't feel any pain for 24 hours and since then it has been moderate.

    Having been told I would be in hospital for 3-4 days, I was pleasantly surprised when I got to go home the day after my op (on 2 crutches). I have OA but also tore the meniscus 18m pre-op (actually did me a favour as I may have had to wait longer as I'm too young at 63!).

    My left knee is now showing signs so I'm hoping this op will give it some support too.
    Cuckoo
     
  5. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @cuckoo, too young at 63? I had mine done this past April at 58! As far as I’m concerned, there is no such thing as an age criteria other than what “age” your knee appears to behave like. I shredded my lateral (outside) meniscus at age 16 and put up with gradual deterioration for 40 years. I really didn’t expect my OS to recommend PKR surgery when he did. When asked, he said that trying shots would only mask the pain, not fix the problem. Haven’t regretted it at all.
     
  6. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I think for those of us who have found Bonesmart we’ve learned that age for knee replacement only matters to certain surgeons. They all have different opinions, on every aspect of knee replacement. If one tells someone they are too young, that person should continue to get other opinions. Surgeons should decide by the condition of the knee, not the birth date.
     
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  7. cuckoo

    cuckoo new member
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    Happy New Year! Thank you for all your comments and suggestions!

    I am now 6 weeks post PKR and still feeling very tired. No stamina. Knee is bending and straightening well but I continue to have the tight sensation around the whole knee that I had before the operation and pain when exercising.

    I don't need crutches or a stick indoors but feel unstable if I go for a walk so I take them both and try none, 1 or 2 depending on how it feels. I have read through the list of stages of recovery but am unsure how it fits with a partial replacement.

    I'm very conscious of making sure I do the right things at the right stage - don't want to rush things but also don't want to under-do it! When I see the physio next week I shall ask the same as last time - what should I not be doing! eg. last time it was don't twist or kneel. Anyone else at this stage? Love to hear from you. Cuckoo
     
  8. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I have a partial and everything that pertains to a total pertains to partials. We only had slight less work done.

    Before surgery I read how partials were a quicker recovery than a total, but that did not happen for me.

    I live in a 55+ community and am one of the youngest, so there have been many knee replacements among my acquaintances, and my recovery has been the slowest of all of them. That caused me a lot of stress early on because people didn’t understand why I wasn’t able to.. (fill in the blank.) I was an enigma they didn’t know what to do with, and I felt they gave me very little support. Maybe they didn’t mean it like that, but that’s how I felt.

    Either way, a partial is still major surgery and 6 weeks is very early in this 52 week (one year) on average recovery. Nobody told me anything about a one year recovery, I learned it here on Bonesmart at 4 weeks post op. I was like, what??

    So, take things slow, do what is comfortable, if it hurts, dont do it, wait a bit, and try it gently again later.

    Keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

    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. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
     
  9. cuckoo

    cuckoo new member
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    Thanks for that. I guess I am suffering from the why can't I a bit as others that had the TKR at the same time as me are taking a lot longer to recover and keep telling me how much bigger their operation was. True, I know but it's still major surgery (words of the registrar). I also had breast cancer 2 years ago and don't really feel fully recovered from that trauma. Still I am very pleased to have had the operation and hope it will keep me going for a good while.
     
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  10. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @cuckoo, I had a lateral PKR on my left knee over 8 months ago. Even today, I have that tight feeling across the front of my knee. It’s mainly due to scar tissue as your knee heals and will eventually minimize or go completely away. I also believe it’s partly due to the numb patch that also exists in the same area. Here are some articles on both situations:

    https://bonesmart.org/forum/threads/numb-area-after-tkr-how-long-will-it-last.5931/

    https://bonesmart.org/forum/threads/tight-band-feeling-across-the-front-of-my-knee.11734/
     
  11. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I dont think it’s that much bigger, don’t let them convince you it was. They have no idea about a partial. It just sounds bigger because of the words partial and total. We still had bones sawed and drilled and an implant pounded into it. A partial is a big deal.
     
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  12. cuckoo

    cuckoo new member
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    OK, so I have now watched the youtube video for PKR and am no longer beating myself up over not being fit yet! Yesterday I had sudden pain more on the 'good' side of the operated knee which was a bit worrying. Today it is feeling a bit better but prickly. Could this be nerve pain?
     
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  13. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    You most likely still have plenty of swelling, as that can take a long time to settle down. Even if you don’t look swollen, that tight feeling indicates it’s still there. I still had plenty at 6 weeks.

    I had pains here, there, and everywhere, which is understandable, you saw the surgery. (I have not yet watched one)

    Our knee can be quite the drama queen so if it doesn’t like an activity, it’s going to let you know.

    I am going to tag @Josephine
    our forum administrator and nurse director to address your concerns.
     
  14. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @cuckoo, it could be. Also, remember that the surgeon didn’t just work on the “bad” side, but also cut into the soft tissues on the other side to open it up and inspect it to ensure there are no signs of arthritis or other concerns that would justify a TKR vs. PKR. So your entire knee is going to hurt at various times.
     
  15. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  16. cuckoo

    cuckoo new member
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    Good morning all, it's good to hear from you.

    Thank you Josephine yes I will answer your questions, if I can.

    I saw the physio yesterday for my 6 week check up - he was very pleased with my recovery and seemed happy for me not to see anyone else (I didn't feel the need); carry on with the exercises and don't over do it - listen to my body. He remarked my knee is swollen and slightly warm but nothing unexpected.

    He suggested that I shouldn't drive until I am completely off crutches and had tried an emergency stop and short trips in case my leg stiffens. I also spoke to a nurse about an upcoming 4 hour drive - she suggested stopping every 45mins and to keep moving my feet.

    Kneeling - should wait until about 3 months when all is healed.

    She was amazed when I said I had had no bruising on my leg! (should have seen my arm though - now that was colourful!).

    Cuckoo
     
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  17. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

    1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    3. how swollen is your leg compared to these?
    ai63.tinypic.com_eta39s.jpg

    4. what is your ROM - that's flexion (bend) and extension (straightness)

    5. are you icing your knee at all? If so, how often and for how long?

    6. are you elevating your leg. If so how often and for how long?

    7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    8. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  18. cuckoo

    cuckoo new member
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    Hi Josephine, thank you for taking time. I don't feel I am doing too badly just unsure of what is normal!
    Here are my answers:

    1. currently stiffness and low level ache so 4/10

    2. I only take paracetamol 1000mg up to 4 x day

    3. slight

    4. I have 120 ROM and full straight leg

    5. ice and elevate if in discomfort 20mins up to twice a day

    6. elevate when at rest in the afternoon/eveningwith break every 30 mins

    7. Activity level low: 20 min walks, washing up, preparing meals

    8. Previously: heel slide x10; knee prop x 10; heel prop x10 mins; towel stretch x 10; knee extension x 10; patella mobilisation x 10; single leg balance x 5; quarter squat x 5
    Just started 6 weeks - 6 months regime of home exercise 3 x daily: knee extension x 10; single leg balance x 5; quarter squat x10;single leg squat x5-10
    All above as advised by Physio
    I don't have any more physio appointments having been successful at 2 week and 6 week checkups
     
  19. Dolly Girl

    Dolly Girl junior member

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    That's alot of exercise. I think you're doing well, you don't want set back from doing too much.
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    A common error but ROM is NOT just flexion. It's flexion AND extension. Thus you have a ROM of 120/0
    Here I specifically asked you to "make it a list and not an essay!"
    Therefore can you please do that as I don't have time to.
     

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