TKR 12 Days Post-Op

[skigirl]

What a wonderful post---that type of thing is what makes all of this "stuff" worth it in the end. It is nice to see you living your life again--congratulations for all your hard work, now you can get the benefit!

 

[daughter stalker]

Awesome! It is great to get back to some kind of normal!!!

Take care!

 

[Whimsy3]

What wonderful news for you, a great milestone to accomplish.

 

[bottomshollow]

PineyWoods. Your recovery is just bouncing right along! And it's going to continue to just get better and better. So happy for you.

Take care and keep us posted. We care.

 

[PineyWoods]

Josephine
Has anyone ever had bursitis occur after TKR? I am 8 weeks post op today and apparently have swelling/fluid in the bursa on the front on my left knee. ( As I look down at my knee it is on the left of the kneecap.)
I'm worried that my 2 mile walk last Saturday did this! Was I being foolish? This showed up on Thursday after the walk on the previous Saturday. My ROM is 0-122. I felt great....like a million bucks....until the swelling and pain on Thursday. My PT suggested that we try the 'tens machine' on it Monday if it's still a problem after much rest, elevation, and ice, ice, ice this weekend. They also gave me exercises for a tight IT band....but that doesn't seem tight to me. I'm not sure I understood the connection between the IT band and the bursa. Or, I can see my surgeon for a possible cortisone shot???
I did read the articles on here about the IT band and did some other internet research. As a result of some of what I read I have an ACE bandage on my knee currently.
I should also mention that I stepped on a bit of broken glass and cut my heel on the OTHER leg so now I'm really hobbling!
Can anyone give me some advice or share a similar experience with me? Did I do something that caused this?

 

[PineyWoods]

This whole deal is the most up and down roller coaster that I've ever been on.......(sigh.....).

 

[denpucc]

PineyWoods - did the change in meds help you because you we're able to push your knee further without any bad after affects (swelling, loss of ROM, etc.)? If so that is wonderful. What I've normally read on this site is that people increase/change their meds so they can push their knee more but end up going backwards. My OS is very concerned about adhesions for me because he saw them when I had arthroscopic surgery in January. He said that the adhesions are caused because the tendons/ligaments (I can't remember) weren't stretched enough to go back in place (or something like that). I'm hoping he doesn't threaten an MUA since I plan on recovering the BS way and not be overly aggressive. Good luck to you and I look forward to more of your posts!

Hugs
Denise

 

[Whimsy3]

Piney Woods my thoughts exactly. Soon as I think I got this....I do something I shouldn't have. This is a slow process and we need to remember that my dear. I think we both are push the envelope people, seeing how far I can do this of that.

 

[PineyWoods]

Whimsy3....I suspect you are right. I've spent today and yesterday in a 'blue funk' over this new issue. I so badly want to get out and do things....and I feel like I can, but............. I just can't seem to sit/lie down any longer. (AND, I sort of feel like people think, "Ok, it's been 8 weeks. How long are you going to play this thing?" Also, some days it's like "Go Get'm Tiger", and some days it's like 'Just leave me in bed'. So people never know what's up for today.)
By the way, my knee looks all lumpy and misshapen. Not that I ever had beautiful knees/legs to begin with but I wonder if that is typical of a 'replaced' knee? Perhaps when every last smidgen of swelling is gone and muscle tone is restored.....?
Where and who did your surgery? If I may ask.

 

[PineyWoods]

denpucc,
I was put on Ultram (Tramadol) when I was released from the in-patient rehab. It just seemed to make me drowsy...not really taking care of the pain. That was why I asked for something different. My OS prescribed Norco. That was better. It was around my 5th week that a LOT of swelling went down and my ROM went up quickly from there. As the swelling went down, so did the pain. Now, at 8 weeks I don't reach for the Norco any more. Over the counter stuff works well. I think using the "Nu-Step" at therapy helped me the most. (Sort of like a recumbent bike...but not making revolutions.) I would get on there and move the seat up as close as I could manage , pull my left knee up as much as I could using the handles, and hold for a count of 5 or 10, or whatever.
It was great....and I was in charge, and soon my ROM was 114. Now I'm at 120 or a bit more. My extension has always been 4 or less. If your OS wants to do MUA, and you don't, maybe you can tell him you want to wait a bit longer. Just keep being patient and follow the BoneSmart mantra! You'll do great.

 

[PineyWoods]

I have a pocket of fluid on my knee. Is there some way I can get rid of it? Massage?

 

[Whimsy3]

Piney Woods-
I live south of Louisville KY and Dr. Been did my surgery. We have a great rapport, he did a very complicated shoulder surgery 5 years ago. Told me I would never touch my head again, hey I do.
Today Flex was at 112, I am slow but it is coming. Extension has been 0 almost since surgery and I do know how blessed I am to not have to work on that hurdle. Mercy I watch the two guys I do PT with and I cringe. They both want to hurt me cause I don't do any extension exercises. I do think water aerobics helps me as much as PT, it is helping my core muscles and that is what I need to walk stronger.

Tonight the grandson and family will be coming for dinner so I will get my workout with him. He loves it when I walk around the yard with him on the Rollator. We live way in the country so my yard is about 5 acres. Last night I walked down to the chickens (way down hill) to close the ladies up for the evening. The dogs and I went slowly and I did OK.

Remember this is a Slow Race.

 

[PineyWoods]

Hey, Whimsey3....
Dr. Craig did my meniscus repair last April. I think he is in with Dr. Been! Good guys!
My flexion today was down to 118. Maybe because I have this weird fluid accumulated in one spot. My knee is hurting now. I haven't had anyone respond to my requests for help or info on here about it. I hope I'm using the forum correctly so I can get a response. I'll probably have to end up calling the doctor about it.
Our daughter and her husband and our granddaughter (18mths) are coming from CA for a long visit in a couple of weeks. I hope to be in good shape to enjoy them! We have chickens, too!
Have a good evening.

 

[Whimsy3]

You call the Dr tomorrow and just make sure you didn't do something to your knee. Where are you doing PT?
Mari

 

[Josephine]

Has anyone ever had bursitis occur after TKR?

It's not uncommon.

I'm worried that my 2 mile walk last Saturday did this! Was I being foolish? This showed up on Thursday after the walk on the previous Saturday.

Did you forget this article? Activity progression for TKRs.

They also gave me exercises for a tight IT band....but that doesn't seem tight to me.

Them's two different things, Piney. A PT can feel things in your musculature that you are unaware of. He s/he says it's tight then it is!

I'm not sure I understood the connection between the IT band and the bursa.

Well, you need to look at the anatomy. Bursa are perfectly normal part of healthy anatomy. They occur anywhere around a joint and may be connected to to joint as a kind of reservoir for the synovial fluid which is the engine oil of the joint. Look here Baker's cysts and other knee bursae.

He said that the adhesions are caused because the tendons/ligaments (I can't remember) weren't stretched enough to go back in place (or something like that).

A new spin on the subject for me! You should read this article to understand what adhesions are really all about MUA (Manipulation under Anaesthetic) and Adhesions.

I so badly want to get out and do things....and I feel like I can, but............. I just can't seem to sit/lie down any longer.

Well, tough! This recovery only lasts for about 8-10 weeks. What's that out of your life? If you rush at it, you are risking getting chronic inflammatory conditions Pain - acute and chronic issues.

By the way, my knee looks all lumpy and misshapen. Not that I ever had beautiful knees/legs to begin with but I wonder if that is typical of a 'replaced' knee? Perhaps when every last smidgen of swelling is gone and muscle tone is restored.....?

It has nothing to do with your replacement, only with your knee! It will likely settle in time.

I was put on Ultram (Tramadol) when I was released from the in-patient rehab. It just seemed to make me drowsy...not really taking care of the pain.

It's been my observation on here that often when people say that certain meds don't seem to help, they are not taking an adequate dose often enough. Could this be the case with the Tramadol? Were you taking only one 6hrly? Because the effective dose for the early days after surgery is 2 tablets (100mgs) plus 1,000mg Tylenol (paracetamol) which is what I took for the duration of my recovery. In my view, Tramadol is the most effective pain med for TKRs though there are some people that it doesn't agree with.

 

[PineyWoods]

Josephine
Thank you for your response. I still don't really understand how a tight IT Band affects the bursae but I will see my OS on Tuesday. I did read the article on Baker's cysts and knee bursae. I understand Baker's cysts as I've had that under each knee. Those drained on their own and were quite painful for some time.

As for my PT diagnosing a tight IT band..... it was just a guess on their part. They didn't actually 'feel' that. I've been doing the exercises they suggested for it. I seem to be able to do those easily with no discomfort.

The reason I mentioned my 'lumpy knee' was because 3 of us at PT were comparing our knees and they all looked very similar in shape and we were all at various months post-op from 1 to 9 mths. We thought it was amusing.

You mentioned that this recovery takes 8-10 weeks. I was thinking more like 6 months actually. Either way, I thought I could easily do a 2 mile (easy) walk with rests...and I actually did very well. I wondered if the walk could have contributed to the fluid filled bursae which the PT attributed to a tight IT band. And if so, would it have taken several days to show up?

Thank you for taking the time to respond to so many! We all appreciate BoneSmart.org!

 

[Josephine]

I still don't really understand how a tight IT Band affects the bursae

Because a 'tight' ITB or any muscle is so because it's in spasm and/or inflamed. All part of the same process really. As is the bursa symptoms part of the inflammation. In short, it's all sore, inflamed and angry.

I wondered if the walk could have contributed to the fluid filled bursae which the PT attributed to a tight IT band. And if so, would it have taken several days to show up?

Exactly! Most of this issue is caused by over-working the muscle before it's ready. At 9 weeks, it's not yet ready for that kind of activity. You did read the articles Judy left for you in post #2 of this thread? In particular this one Progression of activity for TKRs. If you missed them, I suggest you go back and read them. If you did read them, I suggest you go back and read them again!

 

[PineyWoods]

@ Josephine This is all I could find in the article about walking. Am I missing part of it? Or is it in a different article? Either way, I won't be doing that long of a walk for awhile!

Weeks 4 and 5

Increase walks around, out in the garden or street, to 20 mins, longer if you feel up to it.

 

[PineyWoods]

Finished my last official PT this morning with a ROM of 0/123. Finally! I was very impressed with the therapists as they were just what anyone would want who has had a knee replaced! Compassionate, encouraging, and they let me go at my own pace.
I still have some notable weakness in that leg so I am going to continue going a couple of days a week for strength training as part of their fitness plan....no appointments necessary, I just go in as I want to and use their equipment. I still have some pain but I noticed this morning that I was able to walk down the stairs without doing it one step at a time.
Most of the swelling is gone now...but I still have that 'lumpy looking' knee shape. As for the pain...not constant, just some soreness depending on my activities of the day , I suppose. I look forward to seeing my surgeon on Oct.1. I think he will be pleased, as I am. I know that it is still not 'well' at this point but I'm much encouraged. However, I will still and forevermore more declare it to be a 'roller coaster ride'.
Hang in there everyone.

 

[Whimsy3]

What great news. My last day is this Friday for PT, I am so happy. I love doing water aerobics and although PT helped me gain ROM aerobics is helping me gain strength. Most morning I wake up and have to think which knee is new. Still have off days, but like you said it is a roller coaster. I go back to work in Oct, my boss has been super and really wanted me to be strong and healthy before I returned. OK so it is just 3 days a week but those three days I am on my feet 9 1/2 hours.