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TKR 14 weeks post op TKR not healing

Zolaellie

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Right knee 14 weeks out.... progressed well for first few weeks, then continually has gotten worse. X-rays apparently show it looks good. No Infection found. CT apparently showed swelling, but nothing else. Why am I continually getting worse and not better, pain wise? I do PT twice a week. Physical therapist thinks I need a second opinion....????? My surgeon just keeps saying it is taking me longer than most. BTW I had my other knee replaced by him in August...perfedt results. no pain or swelling after 5-6 weeks. I feel put off by him.
 

Jockette

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Hi and Welcome!

Please tell us the dates of your surgeries and and which date goes with which knee, and we’ll make a signature for you.

Almost always when a member has a second knee done they find out that each one has its own unique recovery, even members who have them done the same day.

As you know, this is a long recovery, an average of a full year. 14 weeks is just a little over 25% recovered, so pain and swelling is not unusual at this point. Your first knee recovered exceptionally well, so I’m sure you expect the same for this one.

It sounds like you started doing more than this knee was ready for and it is rebelling, with pain and swelling. You have to respect each knee for itself and treat it accordingly.

What kinds of things are you doing in PT? You may have to take a step back and give your knee time to recover, and then gradually add things back in.

Your surgeon is correct that it does take time. Because it takes time, I doubt you will be able to get a second opinion because over the course of the year many issues do resolve themselves. Many surgeons will not see someone else‘s patient until the year is up.


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: 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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Zolaellie

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Knee one surgery was August 21, 2019. Recovery amazing. Zero pan/swelling after 5 weeks.Knee two surgery November 15, 2019. This is the knee that has not done well. At this point, the only pain meds he will prescribe are nerve pain (Neurontin), which does nothing. I am seeing an excellent physical therapist twice weekly, (pool therapy),...non-weight bearing exercises in PT; massage therapy weekly, doing everything textbook correctly, including ice, elevation, and rest. Including acetaminophen, and ibuprofen. Extension and flexion are not normal yet. Keeps me awake all night long, even using pillows, ice, heat, etc. Frustrated beyond what I can bear, pain wise. Thank you for your reply and referral to all articles.
 

Jaycey

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@Zolaellie if you stop all that PT and exercise and focus on icing and elevation does this pain ease? Every TKR is different - even on the same person. You may be over working that new knee.
 

sistersinhim

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After your 1st tkr, your right knee had to take on all the work for a while. This could very possibly have caused more damage to it than the left one had. More damage means more repair work during surgery. That means you have more to have to heal from. Try to baby the new 'baby' knee until it settles down. It's very possible that you are overworking it and it's staying inflamed. Resting, icing and elevating it, and just doing your daily activities should let it calm down. I'd stop all PT and exercises until it pain goes way down. They are not helping an already inflamed knee.
 

Tkdbob

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Did you push it the first month? You said is was doing good the first two weeks.
 

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