TKR 2 weeks post op - RTKR

ProgressAtLast

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I had my RTKR on 10 November so today is 2 weeks and 1 day. Got back to the ward at 4pm on 10 November so I didn't get out of bed till 9am the following morning. I was not in a good place - no sleep all night and couldn't put any weight on the leg at all. Was starting to regret having it done. Fast forward 24 hours and I was walking up and down the corridor and to and down the stairs and I was told I could go home. What a difference a day makes.

Physio is going well so far although the stiffness is still an issue for me. Flex (on bend} is 100 but still need to work on straightening as that was the main problem pre op as I couldn't straighten.

Had the staples out today and the knee already feels a bit more me. I have been given extra exercises and told to start walking more (heel to toe).

Taking 2 paracetamol and 1 Codeine 4 times a day and so far have not needed to use the morphine. Pain seems under control during the day but I still cannot sleep in bed as I cannot get comfortable on a soft mattress so luckily I have a recliner sofa and have been sleeping on that.

Positives for me are I have more mobility and less discomfort and can see the long term benefits of the op which is good as I need my left knee done too when I have recovered.

Negatives are the night sleeping and the continued stiffness but hopefully both of these will improve with time.

Any tips would be gratefully received. Thank you.
 

Layla

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Hello and welcome to recovery. Congrats on your new knee!
The stiffness will ease as the swelling goes down and elevation will help that. Check out the article on elevate under Number Two in the Recovery Guidelines below. Sleep will improve with time also. Try pillows, lots of bed pillows helped me. I surrounded myself with them to rest an arm or leg on for more comfort.
You seem to be off to a good start. Take extra care in Physio to abstain from engaging in movement that causes you any pain.

Best Wishes on your healing journey! Feel free to stop back and share updates. We'd love to follow your progress.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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

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 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.
 

Jockette

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I have been given extra exercises
This early you don’t need any formal exercises, gentle stretches and short walks are all you need.

Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

panammaniac

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Welcome to the recovery side! You will get lots of great guidance here as we have all been through it. I’m just over 7 weeks now. You can expect swelling for at least a few more weeks, and as the swelling subsides your will gain more ROM. I still have a tiny amount of swelling that comes back if I try to do too much. Everyone recovers differently, but I started to get back to “somewhat normal,” with most swelling gone and able to walk without any aids, around the 5 week mark. I’m still icing frequently and that has been my savior. If you don’t have an ice machine I strongly suggest getting one. I’m down to taking just 3 doses of Tylenol a day. That combined with the ice machine keeps the pain in check.

Sleeping is a tough one for a while. Most of us had issues with that. I swapped out my bedtime dose of Tylenol for Tylenol PM for a couple weeks and that got me over the hump.

Best of luck, and we look following your recovery!
 

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Congratulations on moving forward! I had my surgery 11/8 and also need my left knee done. I'm resting all I can and the motion is returning in my knee. Overall, glad I had the surgery. We can do this!
 
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ProgressAtLast

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Thanks everyone for all your help it is really appreciated. I have been doing exercises but definitely making sure I have not caused any pain to my joint. Rested a lot, took meds regularly and used the ice. I work from home but hadn't planned to return to work till the New Year which would be 7.5 weeks post surgery. I have a sitting down job at a computer so do you think this is possible.

I have been wondering when to schedule my second TKR on my left knee and was looking at February/March time which would be around 4 months after the first op. The only deadline I have after that would be going to Australia in mid Oct 2023 which is a long 25 hour flight but would be 11 months after op 1 and 7 months after op 2. Any advice on this would be welcomed.
 

sistersinhim

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I work from home but hadn't planned to return to work till the New Year which would be 7.5 weeks post surgery.
Going back to work at 7 weeks is extremely optimistic. We suggest taking at least 4 months off and then doing a phased return where you work half days for a week or so to get your knee slowly used to it. Being at home is a big plus since you can set your own work schedule but a sitting job can be quite uncomfortable and you'll need to get up every hour or so to walk around, plus you'll need to ice and elevate during your work day.

There is no way we can tell you if you'll be ready for your trip or not. 7 months is pretty early to be thinking about a 25-hour flight, but you might be one of the blessed ones that recover more quickly than the average person does.
 
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ProgressAtLast

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Going back to work at 7 weeks is extremely optimistic. We suggest taking at least 4 months off and then doing a phased return where you work half days for a week or so to get your knee slowly used to it. Being at home is a big plus since you can set your own work schedule but a sitting job can be quite uncomfortable and you'll need to get up every hour or so to walk around, plus you'll need to ice and elevate during your work day.
Thank you
 

benne68

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I work from home but hadn't planned to return to work till the New Year which would be 7.5 weeks post surgery. I have a sitting down job at a computer so do you think this is possible.
I also have a work-from-home-in-front-of-the-computer job, and I was able to return to work part-time at about two months post-op.

However, be aware of two big issues impacting your ability to work:
  1. The biggest issue holding me back from returning to work at all was the "brain fog", which continued for several weeks after I stopped taking the opioids.
  2. For most people, post-op fatigue continues to be a challenge for several months into recovery. I often still needed an afternoon nap, so wasn't able to work a full day until about three months out.
Some other considerations:
  • I found that sitting for extended periods very uncomfortable; even with my surgical leg elevated, the knee would get stiff and painful. The first week I ended up switching to my laptop a couple of times a day so I could lay on the couch with my leg up and iced.
  • Once I became more comfortable sitting, I set an alarm to remind me to get up and walk around for 5 minutes or so every hour. (If you do this, be sure the alarm is far enough away that you have to get up to turn it off or you may be tempted to hit snooze as I did the first few days....:heehee:)
  • Also, be sure to take longer breaks during the day for real walks. It's important to keep the knee moving.

Good luck! Let us know how you do.
 
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ProgressAtLast

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4 weeks post surgery. Swelling and bruising are almost gone and stiffness improved in the lower leg and thigh but the knee still feels like a brick and still has a numb section of skin to the right of the knee. Still use an ice pack 5 times a day and have stepped up physio as I need to get more flexibility (bending and straightening). Still struggling to spend more than 15-20 minutes standing /walking but definitely seeing a slow improvement. Thanks for all the kind messages and support from family and friends and advice from Bonesmart.
DSC_0045.JPG
 

Jockette

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have stepped up physio as I need to get more flexibility (bending and straightening).
All you describe is normal for your stage of healing.

Be careful stepping up the physio as it can often backfire and cause more pain, swelling and stiffness. You don't need more physio, you need more time.

Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

benne68

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still have a numb section of skin to the right of the knee
Your incision looks great. And, yes, that numb area is totally normal. It does slowly shrink over time. ( I still have a small area that is numb and I'm more than a year out, but it doesn't really bother me or interfere with movement.

Sounds like you are doing very well for four weeks post-op. Be patient. This is a recovery where the "tortoise approach" trumps the hare!
 

Layla

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Happy One Month Anniversary!
Your incision is healing nicely and it sounds like you're doing well.
I hope you have a wonderful holiday season with those you love and a happy, healthy 2023.
@ProgressAtLast
 
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ProgressAtLast

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So I am now 5 weeks post right TKR and I stopped taking my painkillers last Tuesday (Codeine and Paracetamol) after talking to the hospital. I wasn't prepared for some of the withdrawal from the Codeine mainly feeling the pain again in my left knee which is still to be done and hasn't been hurting while taking meds plus the additional stiffness which was masked, chills, diarrhoea, palpitations, increased blood pressure and fuzzy head. After 3 days withdrawal symptoms a bit better other than feeling a bit emotional. I have an appt with the surgeon next Friday and a follow up xray in February when we will decide when to do the left knee. Still doing physio twice a day and using ice packs and even though the knee is stiff the movement bending is okay but not brilliant although straightening is better but walking without a crutch is worse which I think is due to feeling additional pain without the meds. Still feeling fairly positive and totally understand there is a long way to go but thought I would give an update.
 

sistersinhim

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You can ice all day and all night long if you need to. As long as you have a cloth between you and the ice pack, it's perfectly safe to do and is a great pain reliever and swelling reducer. For the first 3 months or so I iced the whole time I was sitting or laying down. That really helped with the after-surgery pain.
 
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ProgressAtLast

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You can ice all day and all night long if you need to. As long as you have a cloth between you and the ice pack, it's perfectly safe to do and is a great pain reliever and swelling reducer. For the first 3 months or so I iced the whole time I was sitting or laying down. That really helped with the after-surgery pain.
Thank you. Ice pack definitely helps and I will be keeping up with that moving forward
 

Layla

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Happy Two Month Anniversary!
Hopefully your left knee is not hindering your recovery and you're enjoying steady progress. With any luck you'll be able to schedule your Left TKR soon and get back to enjoying all you love without the pain. Happy 2023!
@ProgressAtLast
 
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ProgressAtLast

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Hi. 12 weeks today and I have to say progress is going well. I only have one concern. I have an appt with my surgeon tomorrow and we are discussing knee number 2 in March 2023. The concern is going up and down stairs following the second operation.

Going upstairs is not too bad but given when coming down stairs you lead with the operated leg I have tried replicating this now and my first operated knee doesn't bend enough to allow my other foot to go onto the step below.

Anyone had this?

Any ideas?
 

trinket

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Hi. 12 weeks today and I have to say progress is going well. I only have one concern. I have an appt with my surgeon tomorrow and we are discussing knee number 2 in March 2023. The concern is going up and down stairs following the second operation.

Going upstairs is not too bad but given when coming down stairs you lead with the operated leg I have tried replicating this now and my first operated knee doesn't bend enough to allow my other foot to go onto the step below.

Anyone had this?

Any ideas?
Have you tried reversing the leg you start off with going down? I have been starting off to go down with the non-operative leg. Have to say that going up is easy and good, but I freeze at the top of a stairway and have to give some thought to which leg I want to lead with to go down. I'll bet four weeks from now will make a big difference for you.
 

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