TKR 2 new knees in 7 weeks

[Caribbeanlover]

My surgery was moved up a day. Monday, I had a LTKR with Dr. Thomas Gautsch. He specializes in the lateral approach to spare the quadriceps muscle. My arrival time at the surgery center was 10:15. After filling out the paperwork, I was called back and prepped for surgery. He prefers to do a spinal anesthesia along with a nerve block below the knee. Dr. told my husband everything went fine. Once I could use the restroom and walk 2 times around the center, I was allowed to go home. The ride home was uneventful and I was able to eat as soon as I was settled in my recliner with my leg elevated and iced.

I just had my right knee done on September 30. So one would think I would be prepared. But I guess I totally wiped it from my memory. The nerve block wore off a couple of hours ago and I’m about a 10 for pain. Hoping the 10:00 meds kick in quickly and I am able to get a good nights rest. Last time the Oxycodone made me very sleepy but it is not having the same effect this time. Anyone had that happen to them?

 

[Jockette]

Here’s a refresher course for you:

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

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

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.​

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​

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.

 

[ouchie!]

So you’ve had two TKR in two months? Wow you are so brave! My right one was done on the 17 September, but I’m going to wait a good year before the other is done as I’m just not brave enough to do it yet. I had a spinal too and I must admit the pain was a 10 once the spinal anaesthetic wore off. I was a bit delirious and told the nurse why am I shut away in this prison cell! How embarrassing. They put me on 20mg of Morphine which helped and other meds but no idea what they were. My pain relief was a bit erratic I felt and sometimes I had to ask for more and other times nurses were on the ball and ready with the next lot.

My consultant told me before my op that I would be in a lot of pain, more than I was before my op, for a good 6-10 weeks post op and he was right. However, I am now at 9 weeks and on Cocodamol 30mg/500mg with 200mg Ibuprofen which helps. My pain is now more a 5, so hang on in there, it will get better. Most of my pain is from the thigh muscle now so I’m walking a bit more and doing physio, but still resting and icing afterwards. My thoughts are with you and please chat when you need to. I wish I knew about Bonesmart before my op! Take care.

 

[Roy Gardiner]

My right one was done on the 17 September, but I’m going to wait a good year before the other is done as I’m just not brave enough to do it yet

Obviously, your timing for your 2nd op is entirely yours. For balance, and for the benefit of other readers, I suggest they consider a shorter interregnum. To say it again, I am offering no criticism of your choice.

One's full recovery does not begin until after the 2nd operation
The worry during the gap time is always there (or would have been for me)

I went to the opposite extreme and had both of mine done together. I am a strong advocate of this approach for those for whom it is suitable.

As to bravery, I'd rather have one trauma than two; and I was scared that I'd just not do the 2nd one because of it!

 

[Layla]

I just had my right knee done on September 30. So one would think I would be prepared. But I guess I totally wiped it from my memory. The nerve block wore off a couple of hours ago and I’m about a 10 for pain

So sorry! I hope you were able to get some sleep last night.
Hopefully you haven't wiped the benefits of ICE from your memory,
remember...your old friend?
Ice, Ice, Ice and hopefully with meds on schedule, elevation and rest, it will all be manageable. Lots of comfort to you, CL. Thanks for sharing your journey with all.

 

[ouchie!]

Good point @roy about maybe some never getting the 2nd one done. I know of 2 people who’ve done just that, that is never got the 2nd one done so they never got the full benefit and still in pain and hobbling. I think because my care wasn’t always great as well as developing a haematoma and allergy to the plaster, being a carer for my husband and not having someone to help (apart from staying with my sister for 2 weeks) I just couldn’t face it. I struggled to cope emotionally, but of course we are all different and glad it worked for you.

 

[benne68]

I'm sorry you are in so much pain, @Caribbeanlover.

Your comment about how different this recovery is so far from your first one is a reminder of something we often say: No two knees are alike, even two knees in the same person! Every recovery is unique. Many of us who have had both knees replaced have had the same experience -- that the second one was unlike the first one.

Here's hoping you can get the pain under control with ice and elevation so you can get some rest.

 

[Caribbeanlover]

My decision to have the 2nd one done so quickly was mainly financial. We have a high deductible which we never meet but did this year and like Roy stated I too was scared that if I didn’t go forward I wouldn’t do it at a later time. Plus my left knee was the one that hurt me the most. The ortho started with the right knee because it had more bone on bone and was structurally lacking. I admit I questioned whether I would be ready. My husband is the best caregiver and has been nothing short of encouraging. He bought me a game ready machine for icing so icing and elevation are going on 24/7. This shooting pain is just relentless and intense. Thank you all for words of encouragement; I greatly appreciate you.

 

[benne68]

My husband is the best caregiver and has been nothing short of encouraging.

You are so fortunate to have that kind of support during recovery -- especially with two surgeries back to back. Just think, by spring, both knees will be healed and ready for anything!

Slow and steady!

 

[Jockette]

My husband was awesome, too, in helping me through my recovery.

 

[Caribbeanlover]

When they say don’t compare your 1st and 2nd TKR, they are 100% accurate. I am 9 days post op with my left knee and it has been a monster. I am at my wits end in trying to figure out what is going on and how I can alleviate pain, swelling, discomfort, and sleeplessness. I am exhausted and feeling helpless. My 1st TKR on September 30, 2024, I did not experience these same sensations. In fact, I was numb all around my knee area up until about 6 1/2 weeks post op. This knee decides to have full feeling with constant throbbing/pain since day 3 when the nerve block wore off. It is unrelenting. The swelling is a constant and doesn’t seem to go down. I have contacted my OS, even sent pics, but he seems to feel it’s just at its peak. I have a game ready and ice 24/7 with short breaks for walking. I have my toes above my nose 24/7. This OS makes you wear the compression stockings on both legs and use portable compression DVT cuffs. All of which seem to be putting more pressure on the areas that are painful. The bandage covering the staples is different. It is a thicker skin colored with a gel feel to it. It is really thick and doesn’t seem to be as giving to bending. I wonder if this is the root of my pain. On the bright side, I only have 6 more days until my follow up. Thanks for listening and I am open to any and all suggestions to try to find some comfort and quit 2nd guessing my decision to have the 2nd knee done. I realize I have put my body through 2 major surgeries in a 7 week span. I am just hoping I see some relief soon.

 

[Roy Gardiner]

You are 9 days into your TOTAL recovery, both knees are healing.

Not much comfort when you're in so much pain, but the doc is right I expect, this is the peak.

I never did anything with compression stuff. I'd check with the doc do you have to wear it if it's giving you grief.

In a month's time the world will be very different. Fat lot of use that is now, sorry.

 

[Layla]

You're a brave one, going back for more after only six weeks! I am sorry you are struggling and the first recovery was going better for you. As far as the compression socks and the DVT cuffs, if you call and ask for more "time off" of either, or both, they might allow it. It is my understanding they take into consideration the lowest common denominator when they set those guidelines, figuring many will wear or use the devices less than prescribed so set more stringent guidelines with that in mind, it's only a phone call and worth a try.

Happy Two Month Anniversary, Righty! I hope you have a nice Sunday and week!
@Caribbeanlover

 

[Spinlawyer]

I'm finishing week 1 of recovery after LTKR and I'm scheduled for 1/27/25 for my RTKR, so it seems you are my role model. Hopefully it will get better sooner.

 

[Caribbeanlover]

@Spinlawyer
Thank you! I had my 2 week follow up yesterday and all looked good. My surgeon does the side/lateral cut to spare the quad muscle. They removed the staples and I can remember that was the turning point with my RTKP. I was finally able to do a complete cycle on the bike and my bend started to get a little easier everyday. I just wish I was out of this Tennessee cold that seems to cause the dreaded aches and pains. I was naive enough to believe the docs when they say it disappears once you have a replacement.

I hope your recovery is going well. I know we will both be glad we have had these worn out knees replaced; though it may be a few months down the road. Glad to answer any questions if I can. Have a blessed day with a lot of rest, ice, and toes above your nose.

 

[Caribbeanlover]

Here is a pic from my OS visit yesterday

OS was happy with my progress and removed staples. I have therapy today and hoping for a complete turn on the bike. That tight bandage (which was a lot different from my first knee) has really hindered my bending even when I walk. If this weather in Tennessee would just warm back up a little; I don’t need any additional aches and pains.

 

[Caribbeanlover]

This cold weather in TN is wrecking havoc on these new knees. I was naive when OS said all that would go away. Hopefully, its just still early for that. What I do know is that I was in tears for about 4 hours yesterday with constant pain in both knees. The ice seemed to make it worse. A lady at therapy said she could feel the metal in her knee get cold and stay cold with icing. I guess I never thought of that. This knee continues to be difficult. I thought once my bandage was off and staples were out that I would see some relief. That happened on Tuesday and each day since I seem to get more swollen and the tightness has intensified and I am finding it extremely difficult to walk. Add to that all this lying around has my back pain starting to act up. Any suggestions are welcome.

 

[Layla]

Hi Caribbeanlover!
So sorry for the pain. No fun! Wondering if using a heating pad on your back while icing, on the lowest setting, to avoid overheating, will ease the back discomfort? If it sounds like something you can tolerate maybe try this every few hours for 15-30 mins and see if it helps?

Some people do feel weather changes in their joint. It's especially true for patients with arthritic joints who have not had a joint replacement, but also the case even after you have a new prosthetic in place.

Weather changes are predicted by changes in barometric pressure, which is the weight of the air pressing against the earth's surface. These changes can trigger pain and stiffness in the area of the prosthesis. The activity of bone adapting and growing around the metal leads to the sensitivity felt during weather and pressure changes. These sensations normally disappear within one to two years following surgery.

While icing you may want to place a little bit of a thicker barrier between your bare skin and the ice source and see if that helps.

I hope yesterday was a better day and this weekend is even better.
@Caribbeanlover

 

[Caribbeanlover]

Today marks 11 weeks since my RTKR and 4 weeks since my LTKR. I am still struggling with pain that just won’t go away. It is so hard to find any comfort. It hurts when I am sitting, it hurts when I am standing, it hurts when I am elevating and icing, and it hurts when I am lying down. I guess the short of it is it just hurts. The hurt can be so severe and constant that I am in tears. I feel so helpless. While my incision has closed/healed, the tightness on both sides is unbearable at times. Add to that the shooting pains both up and down my lower and sometimes upper leg and I feel like I stay in a state of pain induced anxiety. I am beginning to wonder how much more I can actually take. The sleepless nights don’t help any of this.

 

[Layla]

I am really sorry you continue to struggle. You mentioned the discomfort when your sitting, standing, laying down, icing / elevating. Does it bother you when you walk? Possibly trying to walk or get a little more active will serve as a minor distraction from the pain, as your body continues to heal.

You are very early into the process of recovering from two major surgeries which was controlled trauma to your legs. It's no surprise you're still hurting.

If you're no longer on prescribed meds, and you're not taking any OTC meds and you're able to tolerate Tylenol, consider taking Extra Strength Tylenol at 1000 mg, every six hours, but no more than 4000 mg in any 24 hr period. You must also calculate anything else containing Acetominiphin into the 4000 mg so you're not exceeding that amount. Possibly you have a post op visit coming up and if not, you may want to call your surgeons office to speak with a member of his care team for advice.

As for sleep - Read up on Magnesium
Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

Pillows may help you get comfortable in bed, making it easier to fall asleep. You can experiment with different arrangements to find what works for you. I gathered up several so I could rest a leg, or arm easily enough, whatever felt comfortable. I suggest making up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness. Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down. Limit caffeine throughout the day and consider natural sleep aids such as Valerian, Chamomile or, Magnesium which is my personal favorite.

Apply ice for a time before bed to reduce any swelling and numb the discomfort. Try some relaxation techniques if you feel they may work for you such as deep breathing, prayer or meditation or even some gentle stretching may help relax your body and mind.

Most large grocers carry a variety of teas such as Celestial Seasonings - Sleepytime Herb Tea,
Yogi Teas, Bedtime, Bigelow Cozy Chamomile, all of which may help you relax...at least worth a try.

Time will also help, but that takes patience, especially when you're restless and tossing and turning all night.
Wishing you many nights of peaceful sleep soon! Hugs
@Caribbeanlover