TKR 2.5 mo post R-TKR: stiff, modest flex, pain other than knee area

[kneed to know]

Thank you. I am going to try some of these out. Haha got rid of the underscore anyway.

 

[Layla]

You're welcome! I hope you find one that works for you...let us know IF you do.
@kneed to know

 

[kneed to know]

Welcome to BoneSmart, @kneed to know.

At less than 12 weeks post-op, you are still early days in this year-long recovery. So, let me begin by sharing with you are recovery guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind we are all 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 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
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
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

Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics

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 a 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 history before providing advice.

Dear Benne68. Item 5 link, which sounds like a helpful guide, gives me the error message that I am not certified to access the article. Can you help clarify this?

 

[benne68]

Hi @kneed to know.

You might have seen a recent email or posts here on the Forum about the launch of our new Membership program this past week.

One of the perks of becoming a member of the Insiders Club is that you will have access to our in-depth articles and downloadable materials. You can find out the details here.

If you are finding BoneSmart valuable, we encourage you to take your experience here to the next level so you can make the most of what BoneSmart has to offer. We'd love to have you join us!

 

[Jamie]

@kneed to know .... you can also easily upgrade your current Basic Membership level to the new Insiders Club by clicking on your Username and avatar in the toolbar. You'll see a drop-down menu that displays a variety of options to try out the new program.

Hopefully one of these will suit you. We are just getting started with this program and will be adding new material to view and download in the coming weeks. Watch your email for details about the new features as they are added. If you're not getting emails from BoneSmart because you've chosen to unsubscribe in the past, please let us know and we'll reinstate your email account.

 

[Jamie]

@kneed to know …. Since you were a member of BoneSmart prior to our January 29th Membership Program implementation, I am pleased to be able to offer you one month of free membership in the Insiders Club so you can experience the premium services and see if it’s a good fit for you. Please post here if you would like to take advantage of this special discount and I will provide the code needed when you upgrade from Basic Member.

 

[kneed to know]

Thank you Jamie. I have just now (Sun 2/9) found your Mon 2/3 offer. I would love to use the one month trial offer of Premium. Please send me the discount code.

 

[Layla]

Thanks for supporting the BoneSmart community by joining the Insiders Club. It is so nice to have you!
How is your recovery going at almost five months post op? Let us know, as time allows.
I hope you're having a good week!
@kneed to know

 

[kneed to know]

Thxforcheckin. Still very stiff, but I gravity hang over edge of bed easier & have less pain .my latest Progress index is How Long can I Sleep continuously, which has improved. Still, it would be nice to get Flexion above 90. I do two ROM exercise sessions in on most days . My surgeon offered to try pre authorization for a ? 3 phase scan to check hardware align again, which I am considering. I don't know if this is a different type image than the one he did at 6 wks & showed alignment was perfect ?

 

[EalingGran]

my latest Progress index is How Long can I Sleep continuously, which has improved. Still, it would be nice to get Flexion above 90. I do

It is good to chart improvements however small. Hopefully as you have less pain the flex will also improve.

 

[kneed to know]

I just was able to view Josephine's 10 wk guide, under item 5 in the Welcome Guide . Very helpful, concrete examples. Bless You Josephine, wherever you are.

 

[Layla]

Aww, that's sweet, kneed to know!
Josephine is BoneSmart's Nurse Emeritus and she retired from BoneSmart around 2019 or so.
She was a blessing here sharing knowledge from 50+ yrs in Orthopedics.
Thanks for expressing your appreciation. We appreciate you!
@kneed to know

 

[kneed to know]

I am doing (2) daily 10-15 min sessions of gravity dangling, ROM exercises, & peddling. While my pain is less, my unasst flexion still looks like low 90s & I am quite stiff at patellar tendon + a band laterally from lower IT attachment thru upper 6" of Tibialis anterior. Surgeon is scheduling a 3 phase nuclear scan to check if hardware has loosened.

 

[Jamie]

Did your surgeon ever continue the discussion regarding and MUA? If you’re feeling a “hard stop” when trying to bend your knee, it’s possible you might benefit from this procedure. Do you have a history of developing excessive scar tissue?

 

[mendogal]

@kneed to know
I’m glad your surgeon is taking your situation seriously (vs saying “implant is fine; it’s soft tissue” and sending you home…).

Echoing Jamie: We tend to believe many surgeons are prone to rush patients into unneeded MUAs, but there is definitely a subset of our members who legitimately have formed adhesions and do benefit from the procedure.

 

[kneed to know]

My surgeon has not brot up MUA, tho I feared he would. The nuclear 3 phase scan is set in late May, due to hosp backlog. How would I recognize a Hard Stop & in what position should I test?

 

[Layla]

How would I recognize a Hard Stop & in what position should I test?

Restricted ROM.
It is unyielding, firm / tight.
Your knee feels as though it will not bend past a certain point and it's limiting your function.

 

[kneed to know]

Well, it's always felt like that, even when PT was assisting, but my pain threshold & guarding are mixed in there too. The PT said it felt like I was fighting her when she asstd. One day I had a dif PT who had me do wall slides with my good leg supporting/under surgical leg vs on top as a weight. It let my quad stop guarding & I got a little more flexion. In my rental I don't have a wall next to my bed, so am using gravity dangling over edge of bed for about 10 min, tho that doesn't get beyond 90. So, I guess I at least have a Hard Quad stop & need to find ways to work around that.

 

[Jamie]

The first thing would be not to have the therapist assisting you in your bending and stretching exercises. Have you read the guidelines that were provided in Post #2 of your thread? There are some exercises there to try. The wall squats are good as are heel slides. When doing heel slides, you can use a band or belt to allow you to challenge your knee bend slightly (just to the point of mild discomfort and then hold for a few seconds). This is where you would be most likely to feel what we describe as a “hard stop.” If you’re seeing a therapist still, ask to use the exercise bicycle while you’re there. If it’s set properly, it’s much better than a peddler you use while seated on a chair or the couch.

 

[mendogal]

Re heel slides I add:
They are essentially a stretch.
I always find allowing the body to slowly relax into a stretch is the best approach and it’s certainly been that way for me with heel slides:
Warm up the muscles by just walking a couple of minutes.
Sit quietly, rest, do slow deep breathing. Go into each heel slide very slowly and in the rhythm of your breathing.
Let the first few slides stay inside your comfort zone. Focus on keeping muscles relaxed.
Then let them go into discomfort zone - but continue to keep deep breathing and to let your body and especially your entire leg including quads be as relaxed as possible. Muscle tension is as counterproductive as pain.