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TKR 8 weeks post RTKR sudden pain outside knee

music lover

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Hi Everyone! Happy to finally be participating on the forum.
My problem is that after 4 weeks of smooth sailing post op, with a lot of PT and home exercises and cycling, I suddenly at 8 weeks have severe pain and some tightness on a numb portion of outside knee which when changing position, especially while sitting, getting up from sitting or moving while sleeping. I don’t worry about noises, which I have when I walk, also not before 8 wks post-op, but the sudden pain concerns me. I don’t see surgeon again for another week but I’ve been pretty down for 2 wks. I never had any of this with my LTKR 6 years ago. Ideas??
 

Jockette

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Welcome back and Congratulations on another new knee!
with a lot of PT and home exercises and cycling, I suddenly at 8 weeks have severe pain and some tightness
No TKRs are the same, even in the same person. It sounds like this knee is not ready for this level of activity. I suggest you slow it way done and let it settle down and then restart, but slowly.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful 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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access to these pages on the website

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.
 

sistersinhim

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@music lover, when was your latest surgery, what was it, and which knee was it done on. The latest surgery you have listed in your signature is a left TKR on April 20, 2015. We need to add your latest surgery to your signature so we can know how to better advise you.
 
OP
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@sistersinhim Thank you for asking. I really would appreciate advice. Going through a difficult time, just like so many others. My latest surgery was November 24, 2020, so I am approximately 9 weeks post-op on my RTKR. I had my left knee replaced in 2015.
 
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Cjackso21

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Hello,
I have had TKRs on both and many revisions TKRs. I had a similar experience with my last TKR last year. Was doing great but started having pain after maybe 6 weeks that I drew on a picture of my knee where it was and sent to the doc. He told me it was likely severe tendonitis. I did ice and heat and anti-inflammatories and eventually it went away. I suspect mine is complicated from all my other surgeries but just letting you know mine finally went away. Good luck!
 
OP
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Thank you kindly. I need all the reassurance I can get. Have been working so diligently since day 1 and was doing great until week 4/5 and then sudden downturn. I can handle tightness or whatever else it throws at me, but the new pain worries me..only with certain movements but it’s severe and constant. Part of my problem is I had a relatively uneventful first TKR on other knee 6 years ago, other than a lot of tightness, but not this kind of snapping pain. Thanks for listening.
 

FCBayern

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Sounds like you are doing more than your new knee appreciates @music lover. Many time PT hurts more than it helps no matter what the "experts" say, how many of them have had TKR?
Prior to my TKR I was aware of the BoneSmart gentle approach to recovery as opposed to rigorous PT. I was lucky enough to find the site before my TKR. Even though I knew about the BoneSmart approach my OS was all about PT and "whatever ROM you have when your scar turns silver is all the ROM you will ever have." He was the trained surgeon that has done many, many replacements, he must know what he's talking about right? So off I went to my first visit to PT, about 2 weeks out from TKR. The next day when my knee was more swollen and I was in much more pain I opted for a BoneSmart recovery. I never went to another PT session. That was one of the best decisions of my life. Not only did I suffer less pain, but my ROM has continued to improve over two years. I've been hiking over rough terrain for good distances, scuba diving, and just living a happy active pain free life with more ROM than I ever thought I would have again after many painful years. I've now had a hip replacement with equal success following a BoneSmart approach. You don't have to suffer needlessly to have an amazing recovery. If you go back to the recovery guidelines you were given at look at activity progression, I'm guessing you're doing much more than the guidelines would suggest.
 

PegGar16

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It is good that you are seeing your OS next week. You might have just tweaked something (tendon, muscle , IT band, nerve). Is there anything that relieves the pain?
 
OP
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I appreciate your response so much. Thank you. Your comments make so much sense and the more gentler approach has crossed my mind, especially these past 2 weeks of agony, after having had a good start prior to that. I wonder if my having had a previous TKR 6 years ago made me a bit cocky this second time around and thought I could exercise my way through to a quicker recovery. I did follow the PT’s directions though in terms of types of exercises and amount per each per day. In honesty I did wonder about the extreme amt. of time suggested and 3 long sessions per day, rather than spreading out into more short bursts of stretch throughout the day. I see my surgeon for follow up on Wednesday. I hope I haven’t done anything wrong and that the problem and pain will self correct again over time. I will mention this approach to my surgeon when I see him, in a non threatening way, because I know he is really into PT. Thank you again.
 
OP
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@PegGar16 Hi, and thank you for your comment. It really helps a lot to hear from others who have gone through this and similar surgeries, some on here have gone through multiple surgeries of different types. Re: pain meds, at the moment I am only taking Tylenol and Celebrex and it barely gets me through. I am definitely suffering. I was prescribed hydromorphone post surgery along with Tylenol, Celebrex and Gabapentin (which I stopped after the scrip ran out), but only for 4 weeks. I have been too afraid to ask for more because, after having had the same family dr for decades, he retired and I now have a new GP who doesn’t know me at all and I am afraid to ask for narcotics. I know I need them a bit longer though in order to heal and not be so anxious about the pain. I would like to ask the surgeon when I see him. Do you have any advice on that?
 

PegGar16

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Did you new family dr take over your old ones practice? The reason I ask is if he did all your records should be there. It can't hurt to ask your surgeon when you see him. Also be straight up with him...this isn't your first replacement and he should listen when you are telling him you are concerned about the pain. You didn't have this issue with your last one....you are not a rookie with this :)
 

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@music lover, if you still need pain meds you just need to be assertive and tell them you need them. I know that's not easy, but it's not like you a have a history of asking for them right? You need enough to be comfortable doing daily activities of life, and you don't need to be doing ANY other PT, that's only going to lead to more pain.
 
OP
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@PegGar16 i will definitely bring up pain relief when I see him, even though I’m nervous to do so. There is so much negativity surrounding the use of opioids, they are very reluctant to dispense. The recovery protocols have completely changed since my first surgery In 2015. Thank you for your continued interest. Means a lot. Support of others goes a long way to healing, and people who have not gone thought it will never understand how difficult the process is. A friend of mine had a hip surgery just before my knee replacement and kept asking why I wasn’t better already, making me feel like a wuss, but I did’t feel like telling her that the two surgeries are completely different.
 
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@FCBayern You are definitely right on both fronts, I shouldn’t be afraid to ask and I have already, at your suggestion, started to do gentler, and spaced out stretches and activities, “slow and steady wins the race.” It felt a wee better today but mystery pain still there. I so badly need to sleep more then 2 hours at a time. Exhausted from lack of sleep. bye for now. Talk soon.
 

FCBayern

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Sorry your friend upset you @music lover but you are right these two surgeries are MUCH different. Not to discount how major a surgery hip replacement is, but the recovery for my knee was longer and more difficult than my hip and I had straight forward recoveries for both. Do your best to tune out those people and we who have "been there done that" will be here to support and root you on.
 

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