TKR 6wks, doing great

[np7]

77 and had been pretty fit, but knee pain reduced my activity level so not in such good shape anymore. 3 meniscus repairs prior to surgery; after surgery, my surgeon indicated I was i in pretty bad shape and must have pretty high pain tolerance. In my favor, I suppose is that I am not really overweight. Because of knee pain for several year (and lower back too) I had gotten into the habit of doing a knee/back PT routine several times a week, especially prior to surgery as I wanted to be in the best shape possible for recovery. I had had to give up certain exercises because of pain.

The approach my surgeon & physical therapist have taken is quite different to what I see in this forum. Started PT exercises while in the hospital--I was only there 30 hours or so--continued at home. 5 weeks for me now and have a list of about 20 drills I go through twice a day (most days), about 5 of which are my own doing for my back. The "official" PT routine started with both ROM and strengthening. The step up/step down may be the most difficult. Some days I do spend too my time in addition on my feet--shopping or other things around the house. Not smart.

All of which brings me to pain level. Yes I have pain and it does affect my sleep, but I just stay in bed longer. Taking 10mg of oxycodone/day (occasionally 15) plus acetaminophen. Frequent elevation and always ice after exercising.

I am really curious as to what, how much, pain meds others are taking at this stage??? Maybe I should allow myself more.

 

[Pumpkin]

@np7
Welcome to BoneSmart, glad you joined us!

You'll notice that I have moved your newest post and started your recovery thread. For several reasons, we prefer that you have your own recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• With your own recovery thread, you will see the posts and advice others have left for you.
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts?Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

np7

20 drills I go through twice a day (most days), about 5 of which are my own doing for my back. The "official" PT routine started with both ROM and strengthening.

Some days I do spend too my time in addition on my feet--shopping or other things around the house.

Sounds like you are doing too much, too soon and setting back your recovery.
Recommend you slow down and let your knee heal with a focus on Rest, Ice, Elevate, and Medicate on Schedule as prescribed.
Once your knee has settled down you will start forgetting to take your pain medications weaning off naturally.
Then you can increase your exercise and activity slowly, paying attention to your knee and back it off when it lets you know with pain, stiffness, and swelling.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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. 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 Closure​

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.

 

[Oregon mom]

I have to agree with @Pumpkln , mainly because she's pretty much an expert, but also because I'm recovering two total knees and have also learned I need to slow down, which like you mentioned on my thread, is not something athletes are good at.
At this stage, I'm almost to starting week 4 post op, I take:
5 mg oxycodone every 6hrs
600 mg ibuprofen every 6hrs
1000 mg acetaminophen every 6 hours
I have a great med minder app and I have it set to alert me every 6 hours, even at night.
I think l'll be able to start titrating the oxycodone down probably this week.
This is only my opinion, but it sounds to me like you are just doing way too many drills and reps. I did the pre op workouts too, and they were so helpful. But post surgery it was imperative for me to stop all the working out. Post surgery is a completely different animal. Small walking jaunts are good for now. Stretching, balancing, more stretching. I've found that if I avoid getting too inflamed, I see progress the next day.
I can feel my body burning calories and using the food I'm eating to rebuild. My muscles are weaker, but I can understand why. I had double tourniquets and both my knees blown inside out.
You might want to explore doing a whole lot less for a while. I know it's hard, believe me.

 

[np7]

Oregon Mom (BTW I am still not sure of the protocol on this site)...

Thanks very much for the good suggestions. Since my PT (via video visits) is the only person I have had guiding me she is the one voice I have been listening too until I connected with Bonesmart (thank you Pumpkin). Now my approach is more balanced: no drills today but I did have to do some home repairs, which I know counts too.

 

[np7]

Visit today with my surgeon. Extension perfect; flexion 120. My pre-op flexion was 115, so I guess that is pretty good. Slight pain, taking 5mg oxycodone a day and on my way to none; still taking Tylenol, close to 4000 a day.

Gave up the cane at 17 days. Walking level ground is fine; stairs not so easy. Although I gave myself the day off today, I am still committed to twice a day PT exercises but am going to discuss going to 1X with my physical therapist (all video visits) on Wednesday.

We all have to find our own path through this vail of tears and I hope yours is not too rocky. We will break through the mist into the sunlight.

 

[Miggie]

Welcome np7! Sounds like you are doing great. I am two weeks post op, so behind you in recovery. I hope you continue to improve every day. Have a good night.

 

[Pumpkin]

@np7
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Pumpkin]

np7,
Glad you are doing well, stairs are usually one of the last things to you will be able to do normally.
Going up first, then down.
Patience it will happen.

 

[np7]

Approaching a decision point as to whether/when to schedule TKR for my other knee. The earliest my ortho doc allows if 3 month after the first, which would be later in Nov. Any one with experience with this? Comments?

 

[Peaches0000]

Hi np7, I had my 2 surgeries around 4 months apart- it would have Have been exactly 3 , but it was cancelled because of Covid. I honestly didn’t think I would do it so close together, but my left knee became my anchor knee & quickly got worse- I am really happy now that they are both done so close together. Not sure that I would have wanted to go through it again. I was already in a fog, used to surgery pain,not going out, icing & elevating, taking pain meds. I had all of the equipment already, so it’s just been 1 long recovery, but now I can walk for hours, work full time, sleep on either side , and can look forward to 20-30 years of being able to walk pain free, so it’s all good.

 

[np7]

thank you peaches. For the first surgery Were you on opiods or similar and, if so, how long off them before the 2nd TKR? At 6 wks I seem to have difficulty stopping the last 1-2 oxydodone a day because of both day and night pain.

Prior to surgery, I was aware of pain in both legs and had had meniscus repair on both so I am thinking that if I dont get the second one done soon, I will still not be able to achieve the ability to hike in the hills that is my goal.

Hope others with both knees done--but not at the same time--will also respond.

(Am I really the oldest participant in the forum )

 

[Celle]

(Am I really the oldest participant in the forum )

Nope! I beat you by almost 2 years. I have had both my knees replaced.

My mother had her first TKR at 82 and her second at 85.

 

[Bikeknit]

Approaching a decision point as to whether/when to schedule TKR for my other knee. The earliest my ortho doc allows if 3 month after the first, which would be later in Nov. Any one with experience with this? Comments?

I just had my second knee done a week ago, almost exactly 3 months after the first. It was a little disconcerting to face the surgery again so quickly but I realized that I wasn't going to be walking comfortably without both knees. The first couple of days post-op I wondered if that was so smart but now that I've shaken off the 1st week yucks I am so glad to be on this side of things and dreaming of everything I'll be able to do with 2 good knees. As my physical therapist says, I've lost the dip I made every step.

 

[Eddy]

These posts have been very informative for me and it is encouraging to see how others have coped with their second TKR. I hope to have mine early next year which will be around 4 months after my first. What I've noticed is the muscle wastage on my repaired leg. It seems very weak. Walking is fine but stairs are more problematic. Still it's only 4 weeks today since surgery and it feels stronger every day. I have to say i can't imagine having both knees done at the same time. Its seems a daunting prospect given the trauma of just one TKR. Chapeau to those who have done it!

 

[np7]

If any of you have had a 2nd TKR--like BikeKnit--soon after the 1st, did you do anything to prepare for the 2nd? Was there a particular hurdle you wanted to get over before having the second? In my mind being able to rely heavily on the recently replaced knee seems to be critical. My ultimate goal is simply to be able to do extensive hiking in the mountains, and it sure seems impossible given this week's X-rays of my knee with the original equipment:
"Severe degenerative arthropathy of the left knee with narrowing
of the patellofemoral and medial joint spaces and mild varus
angulation." I guess I knew that anyway.

 

[Bikeknit]

My doc wanted me to get to 120 flexion and 0 extension before he'd do the second one. It's a little tricky to get your new knee straight when you walk cause your other knee is still damaged! I would think if your new knee can support you fairly well and you've regained function you'll be able to work on both. At 7 weeks things just started getting better for me so I got there in time.

I'd ask your doc if he has goals or expectations before he'll do the second knee. I was surprised to find out mine did onlyonl when I didn't meet them. You can read a little more about my progression on this in my recovery thread.

I felt exactly as you do. I want to be able to hike and for that I need 2 knees.

 

[Bikeknit]

I just saw you are at 120 flexion and 0 extension already! I'd say go for it if your surgeon thinks you're ready.

 

[Peaches0000]

hello np7, I got the boot from Oxy around 4 weeks, then I went to hydrcodone for another 2 weeks, then Tramodol for another 3 weeks- so that’s basically 9 weeks of meds, but only 1-2 a day. My Dr. did not set any goals for me before my second surgery. Thank God, because I would have failed them all- My extension was 9 and Rom 105 when I had my 2nd surgery, but it didn’t seem to matter, I was not limping or in any pain. You are already way ahead of me before your 2nd TKR. I am -2 and Rom 120 on both knees now and am happy- I can do anything with them that I need to do. Do not worry about your new knees ability to support your future TKR, My right TKR surgical knee was far superior as an anchor leg , it feels as strong as a tree trunk. LoL Using my left knee for support is what caused it to go south prematurely and made me do the other surgery so quickly. Your doing great and I am sure will do just as well the 2nd time around.

 

[np7]

Peaches0000 & Bikeknit -- thank you both for your encouraging comments. My plan is to call Monday and schedule the second which would be just before or after Thanksgiving. I believe the clinic owner--Sutter Health--require 3 months in-between; at least my Orthopedist/surgeon said that is his clinic's policy.

I have been on one oxycodone for a couple of days now and today trying none. Lots of Tylenol and got back on Celebrex too, mainly to allow max use of my "good" knee. (NSAID's are contra-indicated for me as I have Crohn's disease, but that doc said OK to use Celebrex) . We will see how that goes.