Revision TKR 3 weeks post op TKR

[amains]

Hello,
I feel like I need help and answers to some questions. I had TKR on 10/22/20 2 weeks out at my 1st post op visit the Dr found by xray that my femur had twisted and he had to go in to do a revision. One week later he went back on & completed a revision. I am now 2 weeks and 4 days since the 2nd surgery. After reading older posts I think most of the things I am experiencing are normal but I wanted to post where I felt like people would understand what I am going through. Nausea, diarrhea, range of motion problems, stiffness, exhaustion, leg cramps to name a few. I take my pain meds-Percocet- appx every 6 to 8 hours, muscle relaxer every 6 hours at night (cramps are worse at night) I do pt 3xs a week. I ice 2 or 3 times a day and also use my CPM machine occasionally. PT pushes me like I know they should but pushing me to the point of tears isn't what I think should be happening, I do take pain meds before therapy ( I went without them once and it was unbeaeable). I barely sleep, don't eat much. Any ideas suggestions etc on what I can do to make things better? I am only 48 years old and I feel like I am 88 years old since having this surgery. I may be being to hard on myself but I completely expected recovery to be much different than this. Any advice is greatly appreciated.

 

[Celle]

Hello @amains - and

Please will you confirm the full dates of your knee replacement and its revision, and which knee it is, so we can make a signature for you? Knowing the exact date will help us to advise you appropriately in the future.
Thank you.

I'm really sorry you had to have your knee revised so soon after the initial surgery. That's going to make your recovery progress a bit slower, I think, as your poor knee has had two assaults on it.
Aim for a slow and steady recovery, no matter how much other people push you to recover faster. Your knee is going to follow its own schedule and it shouldn't be expected to conform to a one-size-fits-all programme.

also use my CPM machine occasionally. PT pushes me like I know they should but pushing me to the point of tears isn't what I think should be happening, I do take pain meds before therapy ( I went without them once and it was unberable).

No, they should not be pushing you and your knee. Therapy should only be to the level of moderate discomfort, not to the point of pain. If it hurts, it is more than your knee is ready to do at this early stage of recovery. Painful PT is doing more harm than good, keeping your knee upset and inflamed, which could slow down recovery.

Your knee isn't lazy or unfit, needing lots of exercise. It's wounded, needing gentle treatment and gentle movement. It needs time to start to heal.

In spite of what you're probably being told, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

And, in any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase, whether you do formal exercises or just let your Activities of Daily Living (ADLs) be your therapy.

You should never need to take pain medications just so you can get through PT.
Pain is a warning sign that you are doing too much for your new knee. Mask that pain and you may unwittingly do too much, slowing down your recovery.

You are in charge of your knee's recovery because it's your knee. While others may advise, you have the right to choose whether or not to accept that advice.
To help your knee, you need to speak up for it and refuse to do those painful exercises. Don't allow your therapists to push or pull on it, either.
Saying no to therapy - am I allowed to?

Instead of doing all those painful exercises, spend much more time resting, icing and elevating your knee, to try and reduce the swelling that is preventing it from bending further.

This is a year-long recovery whether you're 48 or 88, I', afraid. The good thing about that is that you have all the time in the world for your knee to improve. There's no need to rush anything.

 

[Celle]

Here are some useful articles to help you through recovery:
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.​

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. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Cjackso21]

Hello, so sorry they had to go back in so quickly! I’ve had many revisions and thought that pushing it right away in PT was the way to get healing faster. My latest doctor said to do nothing the first 2 weeks after the surgery! I was skeptical but I did that. This last revision was absolutely the easiest I’ve had. Not sure it if was that or the robotics or the nerve block. As for muscle cramps, I have started taking electrolyte tablets I found at WholeFoods called Nuun which finally worked. Took a little while but no longer have cramps that used to wake me up many times a night. I also ice right before I go to sleep and then use pillows to prop my knee to comfort. Hope this helps, good luck.

 

[Sun catcher]

So sorry you had to go through this. I am 3 weeks out of TKR I ice a lot! I have had about 15 Orthopaedic surgeries and have found frequent icing to be really helpful. I am probably icing more than not icing during the day. I also make sure I ice before bed. I use to have horrendous leg cramps, I started taking Magnesium 200 mg daily and eating a banana and cramps are not a problem anymore. Ask your Pharmacist. I hope you are feeling much better soon!