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

[Layla]

Hello ferddword,
As a Texan, hopefully you are far removed from the devastation we're all reading / hearing in the news.
Heartbreaking!

My view from the couch rehabbing certainly helps the healing! Peaceful and beautiful.

Blue skies, sunshine...what a view! Nice grill set-up too!

Hopefully knowing the tight band feeling can last for months, even though annoying, makes it a tad more tolerable.

I found it easy to ignore elevation while icing. Not the best choice however because swelling isn't just blood, its also lymphatic fluid. It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

Happy Sunday, hope its a good one!

 

[ferddword]

Thank you @Jockette, @sistersinhim @Layla for the information and tips. Good to know or least jog my memory from my last TKR, it took several months for that tight feeling to lessen. So will stay patient. Also, to keep my legs elevated when icing is a good reminder. I’ve not been elevating when icing lately.

Question - should I continue to take pain meds (hydromorphone and/or Extra S Tylenol) for the tight band feeling? I’ve been taking them both at intervals of now 6 hours as I don’t necessarily have “pain” except for the tight band.

Yeah central Texas got hit hard. Sad and prayers to everyone affected. We moved to beautiful Sedona, Arizona about 5 years ago.

 

[benne68]

should I continue to take pain meds (hydromorphone and/or Extra S Tylenol) for the tight band feeling? I’ve been taking them both at intervals of now 6 hours as I don’t necessarily have “pain” except for the tight band.

Rather than stopping your pain meds, try stepping down a little at a time to see whether it makes a difference in your pain level. You might start by reducing the frequency of the opioid to twice a day. If you can do that without increased pain, save them for break through.

If that goes well, try stepping down the Tylenol from 6 hours to every 8 hours. If you notice an increase in pain, go back to your prior dosage.

 

[benne68]

We moved to beautiful Sedona, Arizona about 5 years ago.

I updated your location in your membership information since we still had you Houston.

 

[Jamie]

I thought that photo looked like Sedona. What a lovely place to live!

 

[ferddword]

Tight band and burning feeling is the prominent feels for me. I’ll try and go:
Opioid - every 12 hours
6 hours in between
EST - every 12 hours

 

[Elf1]

@ferddword yeah, that annoying, weird tight band feeling has a mind of its own. I'll be 5 months post op in a couple days and I still have it! I was telling the nurse last visit that it felt weird like there was a giant cardboard roll wrapped around my knee. It doesn't necessarily hurt just kind of annoying. They love my analogies when I describe things to them!

Even at this point I still experience stiffness early in the middle of the night. But usually once I get up and start moving around it tends to.loosen up. I think its more of an age thing.

If you notice increased pain and/or burning after PT make sure to.let them know at your next session. Especially if a particular exercise seems to cause it. I wss lucky this time with PT as I already knew my.therapist from previous PT. He knew I would point blank refuse to do something that hurt. Just from my experience I would drop back to PT 2X a week, at least for starters. I did 2X a week and if I was still feeling sore by the next appointment I would call and cancel. But that's me. You really seem to be doing well, just don't get ahead of yourself because you're feeling so.good. I had my Doc, Docs PA and nurse and my PT going your biggest problem is not getting ahead of yourself and overdoing!

 

[ferddword]

Hi @Elf1 - yeah definitely annoying. That tight band/burning feeling is pretty intense at times. But I am just 10’days out post op. I was describing it as the strongest duct tape that was taped to my leg and it’s being ripped off - that’s how it feels sometimes.

I have PT tomorrow and will see how it goes.

All the best to your recovery!

 

[EalingGran]

That tight band feeling is incredibly common and mine lasted for several months but diminished in intensity and frequency over that period. Eventually it only came at the end of a particularly tiring day and then stopped altogether at somewhere between 9 months and a year.

I think it was due to slight swelling. The knee is a very small joint and even small amounts of swelling that are not visible can cause discomfort.

Sound like you are doing well.

 

[ferddword]

Thank you @EalingGran. Whenever it lets up in intensity it feels almost normal. So look forward to getting past it.

 

[ferddword]

Did my 2nd PT today. PT said seems I’m doing pretty good and actually said knee needs to heal so don’t do anything in excess to go backwards. He didn’t even bother measuring my ROM. He massaged a bit and tested my extension. He said it’s pretty much flat. Watch me walk without the walker and gave me tips to make sure my gait is correct.

All in all good session a bit sore but certainly encouraging.

Now if I only get this giant tight rubber band and duct tape off my knee.

 

[Elf1]

@ferddword that sounds like a good session and like you definitely found a good therapist. Don't forget to ice and elevate a bit tonight.

I feel for you with the giant rubber band/duct tape. This whatever it is around my knee is just plain old annoying. I sometimes feel.like it hinders my knee bend. I can bend pretty good but I'm trying to get it where I bend my leg behind me and touch my foot. That's how I put my shoes on after THR.

 

[sistersinhim]

It sounds like you have a very good therapist. What a blessing!

 

[Layla]

I like him! It sounds like you have a great PT.

gave me tips to make sure my gait is correct.

Wondering if he mentioned heel-toe walking for your gait, or if you practiced it your first time around?
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. It takes a concentrated effort, but can m make a difference.

A visual if you're not familiar -

Have a great rest of the week!

 

[karwask]

Hi All, thanks so much these last few tips and things are enormously helpful. It's a process for sure and knowing what to expect and how to react to what comes about is really important and I was missing some of this information no matter how much I've tried to be prepared for this so thanks again.

 

[Jamie]

That’s what we’re here for, @karwask and we’re glad to be of help to you. Your good feedback makes our day!! Thank you.

 

[ferddword]

Thanks everyone! Went for my 2nd week visit to OR nurse. Changed my bandage and removed the wound vac. The stitch is still pretty fresh but it’s closed up for most part. However, felt like he rushed thru the appointment (he said they were running behind). He said my bend was “only” 90 and to let my PT know I should be at 110 by week 2? He did say its goody extension is pretty flat.

I dont think he was all there for my appointment and was just going thru the motions. I’ll look forward to my appointment with the surgeon in a couple weeks.

 

[EalingGran]

He said my bend was “only” 90 and to let my PT know I should be at 110 by week 2?

No one ever measured my bend that early on and I really can't remember what it was- but probably not much more than 90. I now have a totally mobile joint with only about 5-10 degrees less than my perfect other knee. The only thing I can't do is a standing quad stretch on the PKR side or sit fully back in child's pose.
There is a peculiar obsession with ROM in some surgical teams and PT practices. It can end up being counterproductive if inflamed joints are forced to move more than they should in the early weeks.
Gentle but frequent exercise will get your ROM to its best level.
What was your bend like before surgery? This is one of the best predictors of what you can expect. Also some implants are more mobile than others. There are implants used in cultures which prioritise squatting or sitting cross legged (like India) which are designed to be extra mobile.
I have a very mobile implant ( Oxford fixed Lateral). They had to change this type of implant from mobile to fixed bearings- as it was so mobile that over 10% of patients had dislocations! So there is a bit of a balance between mobility and stability.
You can ask your surgeon what is the maximum bend with your implant. But remember this will take a long time to accomplish. I gained my final 10 degrees to 150 degrees in my second year after surgery. Patience really is a virtue with knees.

 

[ferddword]

Thank you @EalingGran. Yeah I’m not too worried about it. My rt knee replacement I pretty much didn’t do anything for the 1st 2 weeks and rehabbed organically per the BS protocols!

I’ve been a bit more exercise/stretch focus this time around, but I’m still keeping the heal 1st mantra going.

 

[karwask]

I'm in the midst of week 3 and I'm not at 90° either. My PT is measuring me every time I go but so far not putting tons of pressure on me for more results but only have been to the first two.