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

Yeah I’ve been reading thru more of my 1st TKR journey in 2016-2017 and I really didn’t do PT but twice in 9 weeks. Just daily activities and barely any exercises and everything turned out fine. So I doubt I’m going back to PT. Will keep everyone posted.

At 2.5 weeks, knee is blocky, tight, swollen. And sometimes I have that burning feeling down the lower left side of my leg. Still icing/elevatint prob a total of 3 - 4 hours/day. Do some stationary bike. Tiny bit of extension stretching. And just walking around sometimes with 1 crutch. Sometimes without.
 
My incision seems to be closed up and scabbing. The NP said to remove bandage when I shower and let water run over it, pat dry, hydrogen peroxide, then cover with a bandage. But should I continue to cover it?
 
It's not the customary postop care I see used in northern California
HOWEVER
she's on your medical team and if she says cover it, then cover it! You do want protection from disturbing the scabs or promoting exposure to infection.

The sensations of tightness and at times burning, the swelling, definitely expected at your stage.

That outer side of your leg burning - that for many of us the the maximum area of numbness from the trauma to little sensory nerves. As the nerves come back online, reaching out to reconnect, often times they send incorrect signals. This is called dysesthesia and it can show up in different ways on each person. Burning, pain, or a feeling like a mild shock (zingers!) are most common. A smaller number of us experience either cold or wetness or itch or odd friction like fabric brushing over the area (my left leg did that particular one on and off for a year and it was just plain WEIRD).
 
ferddword said:
then cover with a bandage. But should I continue to cover it?
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I would cover it when going out but maybe leave it open to the air for a while in the house after showering. But as @mendogal says consider what your team says.
Wound management protocols vary a lot and your team knows the surgery protocol and what closure method they used.
 
Good Morning and Happy Tuesday!
ferddword said:
remove bandage when I shower and let water run over it, pat dry, hydrogen peroxide, then cover with a bandage.
Click to expand...
I was instructed the same, with the exception of the hydrogen peroxide. Didn't receive any instructions to use HP. When in doubt call the office, as long as you're not calling them frequently, lol... they certainly won't mind having a member of your surgeon's care team contact you. If you do call, at the same time ask what they recommend if you choose to use something on your scar once it's completely closed.

Sometimes the skin around your incision becomes dry and itchy while healing. Although it is okay to put lotion or cream on the surrounding skin if it is uncomfortable, you should not apply anything close to or on the stitches or incision without the approval of your surgeon. It normally takes four to six weeks for the incision to fully heal and close. You don't want to risk infection by applying a product near an open area before that time. Some of the more common creams and lotions used on a healed incision are Bio-Oil, Vitamin E Oil, E45 Cream, Palmer's Cocoa Butter Lotion with Vitamin E, and Coconut Oil.

The one exception to the guidance in regard to applying products topically over your incision is a product called ACTIVE AntiMicrobial Hydrogel Spray. This product contains hypochlorous (HOCL), a compound made naturally by your body to promote healing. It can be applied to your incision at any point during recovery - it's a germ fighter as well as a healing and moisturizing agent. Discuss its use with your surgeon before using it. You will find a link at the top right of the page in a sidebar ad you can click on.

Have a great day! :wave:
 
Thanks @mendogal @EalingGran @Layla. I’ll probably cover it when I’m out and about and sleeping. When I’m at home, I’ll leave uncovered. But I’ll give my doc a call. I see her in a couple weeks anyway.

The tightness, numbness, burning feeling seems to just be a constant even though I’ve been taking pain meds on a schedule. I’m thinking it just comes with the recovery territory and the Iovera shots I took before surgery are starting to wear off.
 
ferddword said:
The tightness, numbness, burning feeling seems to just be a constant even though I’ve been taking pain meds on a schedule.
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Small sensory nerve fibers are cut with the incision around the kneecap or outer knee area, causing temporary sensations that normally resolve over a period of six months to one year post op.

While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.

Numbness can last for months, normally easing over time. Burning is usually a sign of nerves waking. Tightness from swelling, while unpleasant, is normal also.

Hopefully some dedicated icing, elevation and gentle stretches bring periods of relief. If you feel these symptoms are increasingly worse, at that point consider checking in with your OS for some advice or reassurance.

See ya later! :wave:
 
Hi folks. 3 weeks was on Thursday. Everything seems to be going pretty good. Skipped PT all week and will probably do the same this coming week. I had a few bursts of energy this week so I checked into the ODIC twice this week. Last couple of nights though I’m really getting the tingling numbness and burning feeling below my knee, more around my shin and upper calf. I’m still on my pain meds schedule so I guess it’s just part of recovery. But been hard to find a comfortable position to sleep.
 
Have you tried icing at night? I used to rest my knee on the opened iced water jacket of my Aircast Cryocuff and refresh it if I woke.
Sharp tingling sensations can be just sensory nerves that were cut regrowing.
I found that scary until I read here about "zingers" and realised what they were. It is not something that surgeons mention and it isn't really covered in any literature I have read. They can be really sharp.
They fade away over the months.
I haven't had any for a long time. Later on I really welcomed them as a sign the numb patch was healing.
 
ferddword said:
I had a few bursts of energy this week so I checked into the ODIC twice this week.
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Two check-ins in one week! Too bad they don't give out punch cards and prizes. :heehee:
Hopefully lots of icing and rest gets you out of jail quickly :fingersx:
Now...behave yourself young man! :wink:
 
Those tingling and burning sensations can just be part of recovery, but they can also come as a result of overdoing things. So, you would be wise to watch how much of those energy bursts you give in to. You’re still VERY early in your recovery and it’s easy to get over the line with activity as you start feeling better. But your body is still healing.
 
Hi yall. I’m going to continue skipping PT and just go about daily living. I also get on the stationary bike for 10 mins 2x/day. I’m doing some light stretching but since it’s still swollen I’m still not flat (close maybe 8-10 degrees) and I’m probably flexed at 100-110. Not sure though since I haven’t measured since the PT pushed for the numbers a week ago. Should I do any additional stretching/exercises?
 
Thanks @Jockette for this valuable reminder. I think that’s where I’m at - feel good enough to try and do more. Whether it’s chores and stuff around house and exercising- thinking if I exercise/stretch more my recovery will be faster. Patience is a virtue!
 
Nope, continually "doing more" is counterproductive during the first months.

Short walk, then rest, ice, elevate. One set of one exercise, a little light stretching, then rest, ice, elevate. One light chore or up for a meal, then, yep!, rest, ice, elevate.
With my second TKR, right after the one month mark I noted a milestone: for the stiffness after sitting in a chair long enough to eat a meal, my knee demanded a short walk in the house rather than immediately elevating.

So it does slowly transition to a little more activity. But bear in mind, even folks who aren't postop are advised to increase time or resistance by no more than 10% increments!
 
Thank you @mendogal - I’m going to try and stay patient. You’re right though. It sometimes feels better after sitting to walk. My PT called yesterday and said they were checking on me and wanted to make sure everything was going well. I told them I’m skipping PT again this week and will let them know when I will come back. They warned me about my ROM. I said I was doing fine.

For me, below the knee is tight, a bit painful and numbness around the shin/right side of calf. Still on ES Tylenol every 6 hours.
 
ferddword said:
They warned me about my ROM. I said I was doing fine.
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Good for you! These PTs love to threaten us with the "window of opportunity" myth so we will come back.
(I think what they are really worried about is losing revenue if we don't come in!)

Try to exercise that Patience Muscle -- you aren't even one full month post-op.
 
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