TKR 4 months out and still have an achy and stiff knee

Sun_Lover

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Hey everyone! It's been helpful to read the comments here from others that have also had a TKR and experienced the frustrations and concerns that come with it. I had a TKR on my left leg on September 6, 2022, after tearing the posterior root of the medial meniscus two years before. I didn't have any arthritis when it happened. But it developed quickly in that knee after that.

My last appointment with my surgeon was at 6 weeks post-op and my next appointment is at the 1-year anniversary, so quite a lot of time in between and I've had so many questions. My biggest concern and fear now is what's normal and what isn't. My knee is still pretty achy around the joint line on both sides and especially at night and it's also still a little stiff. I'm aware of it with every step and really feel it when I'm going downstairs with that extra stretch that creates. It also will just randomly give out at times when I'm walking and so I'm reluctant to try to carry my 2-year-old grandson, especially on stairs. When I was still doing PT, the therapist thought that maybe it was loose if it was giving out and that I might need a revision! Yikes!! But when I emailed my surgeon and explained what was happening and what the PT said, I think he got a little offended by it. I was wondering if I should come in and have the doctor check it out, but he simply wrote back, "The PT is wrong. You don't need a revision. You just need to strengthen it." So what do all of you feel? Is this normal for it to just give out unexpectedly?

After 10 weeks of very painful physical therapy, I got my ROM back good - flexion is 130 degrees passive and 133 active and last time it was checked I was at 4 degrees extension. It's interesting that the posts here say that PT shouldn't hurt, but my therapist obviously didn't know that. There were so many times that I had tears streaming down my face and I was gripping the table with white knuckles as he pushed it! And it would hurt a lot more for hours afterwards. Sigh... Since it's still a little stiff, I'm continuing 3 sets of 10 on my heel slides once a day. But it still being achy and stiff at 4 months has taken me by surprise.

I really thought at this point it would just feel normal like my other knee and I would only need to work on getting it stronger. But that hasn't been the case. Plus, there is that awful numbness on the entire lateral side of my knee. Ugh! Does it get better too? The good news is that the inside/medial side of my knee finally is feeling better now. For weeks it felt like I had a 2nd degree burn or road rash and I hated having anything touch it, including my sheets at night. That made for a lot of sleepless nights. Anyway, I'd appreciate your thoughts and ideas...
 
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What you are feeling is normal for a knee that is only 4 months old. That's 1/3 of the way healed. It normally takes at least a year for TKR to heal. I will leave you your very own recovery articles. Each is short and will give you an idea of what to expect. Also, I'll add your name to our September Team Thread. There you will see members that had a TKR in September and will be able to read all about their recoveries.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY 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. At week 4 and after you should follow this
Activity progression for TKRs

6. Access 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 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.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep
 
I am about 7 months out with one knee and about 3-1/2 months with the other. They are both stiff at times, the newer one especially. I can't really say they ache, except in that first minute or so after getting up from a chair, bed, car, etc. when they have been in one position for awhile.

As far as it giving out, mine both still do occasionally. Not to the point where I think I will fall, but definitely my heart skips a beat. I have always had that happen though, and I think a lot of people do. My husband whose knees are perfect says he gets that occasionally.

But we are all different and so our our knees. You are carrying around your grandson, which is great; I am not comfortable yet carrying my cat. As for stairs, I still hold on for dear life to the railing and the wall. It sounds like you are doing great. Of course, your doctor is the final word on whether something is wrong, so if you still have major concerns or it gets worse, make an appointment with them.
 
Is this normal for it to just give out unexpectedly?
It did for me, too. Lots of stuff has been removed and the body needs to get used to that. It goes away.
Plus, there is that awful numbness on the entire lateral side of my knee
That usually goes away too, it did for me. Just takes time.

With your excellent ROM I'd say you're doing fine. I'd keep up or extend your stretching programme (no pain, mind!) that will help make the aching go away.
 
Thanks so much everyone for your encouraging comments and helpful insights! The PT I had didn't have a lot of experience and I think he made it such a fearful experience. He would always compare me to other patients that he felt were doing better and challenge me that I needed to push through the pain more and work harder. Sigh... Sounds like what I really need to work on now, is to relax more, trust that my body knows how to heal and every now and then take a few big, deep breaths. :)
 
Comparisons like this are not good. Every person/ TKR experience and outcome is different! Keep reading here where it is clear that TKRs vary. Some days you'll have more pain than others -- some days you'll feel not up to dealing with discomfort. Other days are great as time goes by. It's a process that has variables on how you feel as your body heals.
 
Welcome! I wish you had found Bonesmart prior to your surgery. Water under the bridge now. I’m going on nine months post op with my second. I had the “giving out” feeling for probably four months and it just sort of went away. I actually forgot about it til I read your post!

Marie
 
Hi-I’m about 4 months from RTKR. My ROM has been excellent but my knee still gets stiff and quite sore especially medially as the day goes on. Tall steps are difficult and cause discomfort going up and down. I saw my orthopedist yesterday and he spent time with me and wasn’t concerned. Suggested gentle quad strengthening exercise, peddling exercise and time/patience. The cold weather definitely bothers me more.
 
Hello and Happy Tuesday Hobiecat!
It's not too late for icing and elevation for the stiffness and discomfort. At only four months post op, in an approximately year long recovery, you have quite a bit of time to make progress.

Weather changes do affect some of us. It's especially true for patients with arthritic joints who have not had a joint replacement, but also the case even after you have a new prosthetic in place.

Weather changes are predicted by changes in barometric pressure, which is the weight of the air pressing against the earth's surface. These changes can trigger pain and stiffness in the area of the prosthesis. The activity of bone adapting and growing around the metal leads to the sensitivity felt during weather and pressure changes. These sensations normally disappear within one to two years following surgery.

With lots of patience and more time, you should be back enjoying all that you love. Thanks for the update!
@Hobiecat
 

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