TKR 2nd TKR - 6/26/2025 - repeating same good BS post op protocols!

[ferddword]

Thank you @Jamie!

 

[ferddword]

Morning Day 4! Woke up stiff/super tight band feeling. I started worrying myself that I slept part of the night with my leg elevated and the stiffness was a blood clot. It’s not (I hope). Just making sure it’s ok I sleep with my leg elevated, right?

 

[Jockette]

I usually slept with my leg elevated. Sometimes in the early days that wasn’t comfortable, because my leg was just so upset from the surgery, but it got more
comfortable with time.

And yes, it’s so easy to fear the worst!

 

[ferddword]

Thanks, Jockette. I guess the early days post op I have to remember that regardless of how I sleep I’ll wake up with it super stiff/tight.

 

[benne68]

I'm another one who slept with my surgical leg elevated after both TKRs, @ferddword. I also iced at night, which helped reduce the pain.

Remember that you are very early days in this recovery. The stiffness you are experiencing is normal. For many us, the internal inflammation worsens during the first week or two -- even with icing, elevating and pain meds. It's just the body's response to the surgical trauma.

I know it's been a while since your first TKR. Be sure to review your thread about that recovery. I found that re-reading my first recovery thread helped me deal with the 2nd TKR better.

 

[Layla]

Good Morning and happy Monday!
It's so easy to let our thoughts go to the bad place early on. I remember it well. Focus on the positive...surgery is in the rear view and brighter days are on the way!

Swelling is a normal part of recovery from TKR, a major surgery and controlled trauma to the body. Overnight you are lying still so fluid will pool in the leg and cause stiffness. This is normal as swelling can peak around this time of recovery. You can engage in some simple movements before rising along with some icing and elevation.

FYI
Common Signs of Blood Clot in the Leg are:
Swelling especially in one leg, often below the knee.
Pain or tenderness not just around the incision, but deeper in the calf or thigh.
Warmth, the skin may feel warmer in the affected area.
Red or discolored skin.
Leg fatigue or heaviness especially when standing or walking.

Wishing you peace of mind and a good day!
@ferddword

 

[ferddword]

Thank you @benne68 and @Layla for the reminders, the always helpful advice and the positive words of encouragement!

 

[karwask]

Hi Ferddword,

Still new to the knee replacement situation having had my hip done in 2021. Got my TRK done on Tuesday so not exactly an expert, but just to chime in.

A similar situation as yourself. I am taking Tylenol along with the Oxy and also Meloxicam and low dose aspirin for blood thinning. So, if you're not already doing Tylenol, you certainly can add that and that might provide a little bit more relief.

I found that after day one to two, some of the initial swelling went down and that helped me substantially in terms of comfort and motion. Not a lot of motion but ability to move a little bit more as in flexing.

Sleeping is an issue but I was very surprised I was able to sleep on my side the very first night which was helpful but could not last the whole night and had to shift out of it. Trying to sleep with leg elevated and straight is just not happening for me, too painful. But, similar to yourself, I am capable of getting that straight and straightening was a big problem for the knee prior to surgery.

Last night I realized for the first time trying to sleep in the recliner was easier than the bed. In the end I switched back and forth. So I think it's an ongoing project for all of us.

With staying on top of my pain medication protocol, able to stay at around a pain level of three maybe four on the worst days. I think that's kind of where one wants to be at this junction time.

I'm extremely pleased with how much just trying to gain a little bit of functionality each day seems to be helping more than any other thing as is advocated by this group. Having a basket on my Walker is life-altering because it prompts me to get up and try to do things throughout the day and each day I can do a little bit more.

Tomorrow is my first PT and I suspect they're going to try and force me and hurt me but let's just see how it goes. I'm pretty devoted to not letting them do that.Each day, as the swelling subsides slightly, I'm able to do a little more bending. This makes me trust the fact that I might be able to heal up mostly on my own without pushing myself so very hard.

Anyway, following along best of luck to you. Let's keep in touch.

 

[Jamie]

It’s good to sleep with your leg elevated. Just be sure not to have the leg completely straight all night. There should be a very slight bend in the knee. And don’t place a pillow behind the knee to get that bend. That can contribute to a blood clot. Make sure any pillows extend lengthwise. Scroll down in the article linked below to see an image of how pillows should be stacked.

Elevation: Doing it the right way

 

[ferddword]

Hello @karwask! Thanks for sharing. Yeah it really is experimental to see what works for us. And truly working out the patience muscle. Good luck in your journey. Let me know how PT goes - I’m going to wait until probably the 3rd week before I do my 1st one. I’m bracing myself when I call them later today to reschedule - wonder if they will chastise me for not doing PT right away.

 

[ferddword]

@Layla. What do you think of this cushion I got from Amazon?

 

[Layla]

Hi again ferddword,
Looks like it will do the trick!
I have a Lounge Doctor so can really only speak from experience on using the LD.
What would we do without Amazon, hate so say that, but it's so easy!

Toes above nose (knee and foot higher than your heart)
You're supporting the entire leg, not just the heel or knee. Hopefully it feels comfortable and will help with swelling and tightness. You're on your way!
@ferddword

 

[ferddword]

Ok. Thanks @Layla . It was considerably less expensive and yeah it is supporting the whole leg. I was worried on getting one that put too much force on the knee. But this one seems good. Just have to experiment how much to use while I’m sleeping.

And Amazon is dangerous! On demand next day shopping!

 

[Jockette]

I see that your leg cushion has an inset, to raise the foot a bit. Make sure you use that, to give your knee that slight bend Jamie mentioned, as well as allowing your leg to continue in an upward position towards your foot, which will help, over time, with swelling. Without that insert, just that knee bend, then a straight leg, is not the best for you right now. I’m actually not sure when that is ever a good idea. Here are some photos of examples that show this in the article on Elevation, from the Recovery Guidelines.

 

[Layla]

It was considerably less expensive

Yes! I struggled with the price myself. Seemed like a lot of money for a hunk of foam.
I consoled myself with the fact that I may need another joint replaced one day as I'm not getting any younger.
I do find it relaxing even eight years later to elevate while watching tv or reading in bed, so at least I feel I got my moneys worth. The one you purchased will work just fine.

 

[ferddword]

Anyone use Pico 14 for their incision? I was still groggy when they were telling me but I have a tube coming out from my bandage. It says it’s a negative pressure wound therapy.

 

[Layla]

I haven't used that device, but maybe someone that has will stop by to comment.
Here is an article that may be of interest -

https://bonesmart.org/forum/threads/pico-negative-pressure-wound-therapy.36203/post-908717

I hope you have a peaceful evening and sleep well tonight.
@ferddword

 

[ferddword]

Thanks @Layla. Just took a shower and wrapped up the area with Glad Press and Seal. All went well and feel much lighter/clean!

Curious on compression stockings - how long should you continue to wear them? I need to wash the ones that I got from the hospital so for now I’m using the ACE bandage wrap over the wound dressing. A bit tight so it serves as a pseudo compression.

 

[Layla]

The TEDS protocol really varies from surgeon to surgeon. It seems less surgeons are prescribing them these days. Your surgeon may prescribe the compression socks if he feels you have any risk factors, or simply because of his training or experience. From what I've read here, 2-4 weeks seems average, but I heard from my surgeons PA that they often tell you to wear them more often, or for longer periods of time than they expect the average person will, because they likely know most despise them and won't fully comply, lol.
If you're a strict rule follower, check with your surgeons office to see what they recommend. Then when your sentence ends, you have a ceremonial bonfire and BURN THEM.

Staying mobile enough is important because it is one of the most effective natural ways to prevent blood clots. Do ankle pumps while just sitting around too.

Week 1
Focus on short walks within the home, at least every hour or two that you're awake, such as trips to the bathroom or kitchen. Avoid activities like cooking or housework at this stage. Continue with ankle pumps and gentle knee bends to promote circulation and help prevent blood clots. Prioritize rest, ice, and keep the leg elevated as much as possible to support healing.
Week 2
In addition to the activities from Week 1, begin incorporating short walks around the home 3-4 times per day, aiming for approximately five minutes each. The goal is to build endurance gradually. Avoid pushing through pain or fatigue. Stop and rest before reaching the point of discomfort, or exhaustion.

Have a good night's sleep!
@ferddword

 

[ferddword]

Thanks again! Hahahaha I will look forward to the ceremonial blaze! Yeah I keep pretty active with the ankle pumps, knee bends, and general walking around for 5 mins - 4-5x a day.

Have a good evening!