TKR 11 Months Since TKR still swollen and sore

[karmakat]

So, I just read BoneSmart philosophy for sensible post op therapy. Found it very interesting since almost ALL the ones noted as bad are the ones my PT has given me to do! I'm almost 3 months out from TKR and still have more pain and stiffness than I thought I would. If often aches after PT. My question is, you note the "bad" exercises, but what do you consider "good" exercises? Doesn't help us to see only the bad. Is there a forum that shows the good/easy ones? ( I did have a PT person that forced my knee back and though I didn't scream, tears came to my eyes!!)

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[Jockette]

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.

If you want to do exercises, these are ok.
Extension: how to estimate it and ways to improve it
Heel slides and how to do them properly

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

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

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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​

6. Access to these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[benne68]

did have a PT person that forced my knee back and though I didn't scream, tears came to my eyes

So sorry this happened to you, @kamakat.

It sounds as though your PT doesn't have the right training/experience to deal with joint replacements. I was fortunate to have a PT who did, and he told me that most therapists use the exact same approach for TKR patients as they do for people recovering from sports injuries -- even though they are two very different recoveries.

My PT's protocol was simple: heel slides, gentle knee bends, peddling an exercise bike with no resistance and walking. As I got stronger, my walks got longer and I very gradually added low resistance to the bike. I'm now a year out and have great range of motion and can do everything I want to do.

Please check out the articles that @Jockette shared above. And, if you haven't already, read through other members' posts. You'll find LOTS of discussion about this topic!

 

[karmakat]

A little concerned as to my progress. I don't have an actual follow up until January and am wondering if I should go sooner. At 4 months, my knee still hurts when I bend it. I had 3 months of PT and was told I was doing great. I stopped and continue at home exercises daily. It aches sometimes and most pain is behind the knee when I try to bend it and radiates down the leg in the back. I still do the heel slides, but they hurt. Knee is still swollen and warm to the touch a little. Any thoughts? Not going as good as I expected at 4 months.

 

[Jaycey]

@karmakat Swelling and discomfort are very normal at this stage. At only 4 months out you are not even half way into a process that can take one year or longer.

Sounds like you are not icing and elevating. Please start doing this again. Ice for 45-60 minutes several times per day. This will decrease the swelling that is causing you pain.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Jockette]

It aches sometimes and most pain is behind the knee when I try to bend it and radiates down the leg in the back. I still do the heel slides, but they hurt. Knee is still swollen and warm to the touch a little. Any thoughts?

In addition to more icing and elevating, as Jaycey suggested, you may be overdoing the exercises. Stop doing these heel slides since they are painful. I’m sure by now you are active and going places and that is all the natural PT you need. Give your knee a chance to settle down and sort itself out.

 

[karmakat]

I'm 11 months since surgery and still surprised I still have some swelling and soreness. When I try to bend my leg to the side as to look at the bottom of my foot or to pumice it, I can't hardly do so. It hurts to move in that direction. And it's still a lot bigger than my other knee. Anyone have such a problem?

 

[WFD]

I'm at almost 15 months since an arthroscopic surgery (almost two years since my last open surgery), and I'm in a similar situation. Is the pain you mention on the side of your knee? That may be the medial or lateral collateral ligaments. Were you bow-legged or knock-kneed before surgery? People that have these conditions and have their legs straightened during their TKR often complain of pain in these areas.

I had become bowlegged in my surgical leg because the medial meniscus was gone and the medial joint space had narrowed over the years. When my leg was straightened during my TKR I ended up with pain in the medial collateral ligament, presumably because it was being stretched after the surgery straightened my leg. I still have it to a lesser degree, 2 1/2 years after my first TKR.

 

[Jaycey]

I'm 11 months since surgery and still surprised I still have some swelling and soreness.

Very common - many of our members report swelling at this point. Keep icing and elevating when you can. Gentle stretches to increase range of motion. This is a long recovery for some!

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[EalingGran]

Is the pain you mention on the side of your knee? That may be the medial or lateral collateral ligaments. Were you bow-legged or knock-kneed before surgery?

Agree with WFD. I was very knock kneed before my PKR ( over 20 degree valgus). Because my lateral arthritis had collapsed the knee on that side it also stretched and stressed the MCL. Although my leg is now pretty well straight ( very slight knock knee to match the other side , I still had marked pain for several months and slight pain medially even now at 7 months. My knee still gets a bit generally sore and a bit warm by evening. I am hoping this is normal but still sometimes worry it is a sign of something wrong.
Due to see my surgeon in 2 weeks for a follow up and hope to be reassured.