Bilateral TKR "There is joint effusion"

[HoneyB]

I, personally, found icing over-rated. Time and rest reduced swelling for me.

I have enjoyed icing, but not elevating. I've tried all sorts of things including a Lounge Doctor and stacked pillows, and I've never been comfortable while elevating. Thankfully, I didn't have a tremendous amount of swelling with either knee. I prefer to sit on the sofa with my legs extended.

 

[DOUBLE TKR]

Beginning week 9. I saw my surgeon two weeks ago and I was prepared to hear him tell me I needed to try harder, or something, since my ROM hadn't improved at all (and still hasn't) since my knees were about 70. I walked in with a cane and sat in the chair with my knees bent slightly. When he walked in, he asked me to straighten my legs (I'm at -2 and -6), and I was able to, and he said I was doing great! I said, I am? He told me I had no idea how far ahead I am at this point than many others. I was relieved and surprised.

I am struggling mentally with relaxing about this stiffness thing. Like others have said, I guess it's hard to know when I may have overdone something, and it seems like it doesn't take much to affect them. I have plateaued, or so it feels, for the last three weeks or so. I have stopped taking Norco/Vicodin and am taking Tramadol with acetaminophen 2-3 times a day, so not a lot of pain. My PT said she expects stiffness for at least 12 weeks with a bi-lateral TKR. Gosh, 3 months? Well, I'm already at two months, so I hope I see some improvement soon. I love to walk, but it seems like the next day I'm paying the piper for it. This is the hard part now -- waiting! I am doing PT 2/week and they never push. I am icing with the ice machine for at least an hour generally once a day. OK, this is a long haul and I am thankful I can come to vent at BoneSmart!

 

[Roy Gardiner]

I love to walk, but it seems like the next day I'm paying the piper for it.

Standard advice, just walk a little bit less each day until you don't get a reaction.

Lots of rest, ice, elevate. Stretching exercises, too, every day. No pain!

 

[Spex10]

But stretching exercises hurt!

 

[Jockette]

But stretching exercises hurt!

Then you’re stretching too far and holding it too long.
“If it hurts, don’t do it”

 

[Spex10]

But then I'm stuck!

 

[SusieShoes]

At a little over two months you are doing fine. Your OS has seen hundreds, if not thousands, of TKRs and you can take his word for it.

The stiffness may last more than three months. If it does, don’t worry. It will still go away.

If you hear a lot of us saying to be patient, it’s because we went through just what you’re going through. We weren’t necessarily patient either. What we learned, though, is that patience is really the only thing one can do!

 

[Knees2]

I had a bilateral knee replacement on 5/29/18. The pain is controlled with tylenol and acetaminophen and 1 tramadol at night. My left knee is doing great, the right knee is still very stiff. The stiffness can really drive me crazy. I realize I just need patience, I am hoping the next month will bring me relief from the stiffness. Still icing, elevating and doing light exercise at home. So I understand the frustration you are feeling.

 

[DOUBLE TKR]

Knees2, it's a mental challenge, isn't it? I come to BoneSmart for reassurance that nothing is 'wrong' with my knees. I will feel better if I could perceive ANY more flexibility than I am experiencing! I am lucky in that I don't experience pain at night, but I do take my Tramadol and acetaminophen twice a day along with a prescription-strength anti-inflammatory in the morning. Sigh. I'm certainly doing tons better than a few weeks ago, but this nagging concern about stiffness . . . Patience. Aargh.

 

[mlwreader]

My PT said she expects stiffness for at least 12 weeks with a bi-lateral TKR. Gosh, 3 months?

I wonder if Ms. PT has had a btkr? How would she know what to "expect"? Sorry, had to get that off my chest. lol

I am at about 11 months, and I still experience some stiffness. Not all the time, and only if sitting on an extra low seat. I noticed this Sunday when out to lunch with my family. None of it interferes with me being able to do just about anything I want to do. But I am still slightly swollen in my right knee, and righty still complains when we are going upstairs. I will say that the morning stiffness is completely gone, so that is great. And none of it even compares to the bone on bone pain I had in both knees prior to surgery.

How about you? How does your stiffness compare to what you went through prior to surgery? I bet you're not having any joint bone on bone pain any more.

Just keep coming to bonesmart and share all your worries and complaints and fears with us. We have all been there and know exactly how you feel. Hang in there.

 

[DOUBLE TKR]

The funny thing about the head of the PT team telling me stiffness for at least 12 weeks is normal is that it relieved me. I don't know why I am uptight and worried about ROM, except that, as I said, it seems to me I haven't progressed with flexion at all. My knee is just plain tight and not very bendable. BUT -- I hear you, BoneSmart! Patience! I don't know what my surgeon even does MUA, and I know I would refuse, but I don't even want to hear it.

What also strange for me is that I experienced little pain prior to surgery. I was one of those weird ones. I experienced pain if I overdid it, even though in a couple of places I was already bone on bone, but I could still walk somewhat briskly on the treadmill for 20 minutes and have a little swelling, but only a little. However, as I told my surgeon, I had pulled back significantly on activities, so I was self-correcting as my knees deteriorated. But I seldom took pain meds and never had throbbing knees at night -- because I didn't do much!

Vanity of vanities, through the challenge of recovery, I am still amazed that I am no longer hyper-extended knock-kneed. And I am happy to report that my extension is nearly zero. So some progress there.

 

[DOUBLE TKR]

Is there any place in particular to share stuff we've learned that may help people preparing for knee replacement? For instance, I didn't know I needed a toilet riser with two arms. I had purchased a toilet riser from Amazon that was just a riser and didn't realize until I was in the hospital that I needed those arms so I could push up. Had to rush to get the right device before I got home.

I also didn't know until I got home that our guest room bed (master bedroom upstairs, so forget that) was too low and I had a hell of a time getting off it. I am 5'9" and low furniture and bed were horrible. My husband had the insight to pile cushions from our two couches on top of each other, which was perfect, so I've been sleeping in our living room, in front of the fireplacce! But it's comfortable and it worked. And I can watch TV from here

I also found a decent free-standing toilet assist device when I didn't need the riser anymore. Amazon, of course.

 

[Jockette]

Yes, we have a pre op forum:
https://bonesmart.org/forum/view/knee-replacement-pre-op-area.8/

 

[DOUBLE TKR]

Well, this is a bit dumb of me. I ended up posting a question for me on someone else's recovery thread! I figured out how to go back and delete it.

is MUA ever good to do? No one is suggesting that for me, but shouldn't I have improved a little bit more over the last month or so -- somewhere around 70? I am so stiff that I have to concentrate to let my knees bend the way you would during a normal walking gait -- if I don't concentrate, I walk kind of stiff-legged. I believe today that if, when I see my surgeon for my 12+ week post surgery appointment in about 10 days, he says I need MUA, I would say no. I keep looking at the two lists of ROM progression that are "slow," and I'm slower than that. I think my bottom line question is, at what point should I worry a little that something may not be OK? It really does feel discouraging.

Another question. Above both of my knees, pretty much following the last inch or two of incision, I have lumps. Not big and round, but just kind of bumpy and sensitive when I press on them. Any idea what that is, those are? My PT said it might be scar tissue that that I could massage those areas with some good pressure.

I am doing so well otherwise and I feel darn lucky. Some of the recovery stories I read here sound very challenging and difficult. I have very little pain (aside from stiffness), I sleep well, I have finally returned to my bed upstairs and can sleep for a while on my side (with a pillow between my knees). Going up and down stairs is slow and deliberate -- and going down requires a lot of hip action to help get my leg down to the next step! I am relatively active with daily activities and scoot around the house without a cane. I can drive, although I feel a little tension in my knee going from gas pedal to brake. For a bi-lat TKR, I am probably in good shape. Except for ROM!!

 

[Jockette]

All those things you mention in your last paragraph are good things. We all recover at our own pace. ROM can continue for a long time, so there really isn’t any rush to get it, like surgeons and PTs want us to. I don’t understand what their rush is, all I know is their rush stresses us out!

My recovery from my partial has not gone well, but even in spite of that, at 17 months, my ROM continues to improve. I have not been measured since my one year check up but I can feel it’s better now than it was then.

Some people have what we consider fabulous ROM numbers, and yet still have pain.

Personally, I’ll take the low pain, slow ROM route any day, especially knowing what I know now 17 months post op!

Try to relax, there are so many people who have too much to say about how we’re NOT doing, who don’t even understand what we’re going through. Try to tune them out and come here for encouragement, all of us here understand, even if we are on different time tables.

I don’t know what to say about the questions you have, I will have to leave those for someone with more experience.

 

[sistersinhim]

You are stiff because your knees are swollen. With that swelling comes lower bend. Get that swelling down by icing and elevating and less activities. Your knees aren't even 1/4 of the way healed. Time is needed. With that time, you have to have patience. Just use your knees gently in your daily activities.

 

[DOUBLE TKR]

Week eleven. Finally made it upstairs to sleep in my own bed. have to do some hip action to get up and even more to get down, but it was wonderful to get back upstairs.

Finally got back to our local YMCA to resume upper-body resistance maintenance with some Nu Step movement included for my knees. Took the week off from PT due to a planned road trip that was cancelled.

I have to remember to let my knees bend to the degree that they can when I walk -- otherwise, I walk like Frankenstein (still stiff). A personal trainer up at the Y said she tells knee and hip joint replacement clients to get in the water. She said just treading water with a flotation device would be very good for my knees and people have reported good recovery progress doing it, so I decided to take her up on her advice and have been to the pool twice. I felt quite good doing it.

But, I received a gift that I didn't anticipate and I was thrilled. I have always been a swimmer and occasional snorkeler. The last time I snorkeled, which was several years ago, I couldn't kick my fins because of so much pain in my knee, so I had to quit. Haven't tried swimming since, so I was uncertain what I would experience in the pool.

Just for grins, I put aside my flotation support after a while and tried a little actual swimming. I discovered that I could kick without that pain! Still no ROM improvement, but that little gift allowed me to swim a couple laps.

I have no idea when I will be able to get on and off a toilet without an assistive device, but some day ...

 

[Jockette]

You’re doing fine. That’s great you were able to swim a bit!

You have tons of time for your ROM to get better. Mine is better now at 17 months than it was at 12 months!! My knee is still a bit stiff but relaxing slowly so that my bend is better.

11 weeks is early days!

 

[SusieShoes]

Be cautious about that Nu-Step; it may be a bit much for your new knees. Your knees will tell you if it is. If you're having no post-swimming pain from your pool visits, that's great. Follow what your knees say about if it's too much or doing good for you. I loved getting back into the pool, and even more that the pain I'd felt on swimming was gone. It's wonderful to be able to swim again. Just take it slow and be gradual about every new activity. Don't join the OverDidIt Club! (It's very easy to join. Most of us manage to do it at some point in recovery!)

 

[sistersinhim]

Be careful in the pool. I went back to the Y and got into the pool and swam a half of a lap. The pain the next 3 or 4 days was very uncomfortable. I didn't go back until my 5th month and swimming was fine then. The water adds extra resistance, which is like weights being added to you leg. It's very early to be swimming. I hope that you had no added pain from it, cause swimming is a great activity!