TKR 8 weeks post TKR

[CherieP]

New to this site and 8.5 weeks post TKR. Surgery date 28th Feb 2022. I have been going to PT twice a week and doing excerises at home. 4 weeks post surgery, I was re-admitted to hospital for 5 days with a Pulmonary Embolism. I was on total bed rest for 3 of those days. I went back to PT the day after discharge and was advised by OT to take it easy and not to get my heart rate elevated. At week 6 I saw my OS and he was not very happy with my progress because I was still using one crutch and could not do a straight leg raise. He made me feel like I was being lazy. In the past 2 weeks I feel that I have made progress and I can now do straight leg raises. I can bend to 90 degrees and nearly all the way straight. Yesterday I couldn’t walk well due to the constant swelling and “clicking” in the back of my knee. I had a really bad night with it (I am keeping up prescribed pain meds) and this morning can hardly walk on it all. Feels like 1 step forward. 10 back! I’m getting very depressed and frustrated not being able to do much. I’m elevating and icing regularly. I know that every recovery is different, however, it is really hard not to compare myself with others at PT who were operated on after me and are back driving and walking well. The PT have extended my therapy for another 6 weeks and my OS wants to see again in 4 weeks and has scheduled an X-ray the morning of the appointment. Should I get the X-Ray done earlier? I feel if there is something amiss it would be better to know now! Would appreciate any advice from anyone that has suffered a setback with PE post TKR.

 

[Jockette]

Hi and Welcome!

By having a PE, your body has more to recover from. It will, but it takes time. I’m sorry your doctor was not more understanding about the whole picture that is your recovery. Be thankful that you have a PT who does understand, and has advised you to go easy with the rehab.

It is not necessary to do a lot of exercises in this recovery. Yes, movement is important, but it should be as you are able. Healing is what is important. Healing after a joint replacement does take an average of a year, so 8.5 weeks is early weeks. Most of us are not told this before we have this surgery.

In the past 2 weeks I feel that I have made progress and I can now do straight leg raises. I can bend to 90 degrees and nearly all the way straight.

This is definitely progress!

Yesterday I couldn’t walk well due to the constant swelling and “clicking” in the back of my knee. I had a really bad night with it (I am keeping up prescribed pain meds) and this morning can hardly walk on it all. Feels like 1 step forward. 10 back!

It might be that because you had such good progress, you did more than your knee was ready for. This has happened to all of us. We call it the ODIC (over did it club) We also call this recovery a rollercoaster, because of the steps forward, and the steps backward. This is very normal.

I’m getting very depressed and frustrated not being able to do much.

We feel like this when we have not been properly prepared for this recovery. Try to adjust your expectations, and I know it’s hard to do that. (been there!) Also try to remember, where you are now is not where you will end up.

Should I get the X-Ray done earlier? I feel if there is something amiss it would be better to know now!

While I can’t say for absolute sure, but there is most likely not anything wrong, other than overdoing something, which increased your pain and swelling, but if you would feel better having an X-ray sooner, you can always ask. I thought for sure I had done some damage to my knee in the first weeks and in my case, it was “just” swelling, from my PT‘s aggressive “therapy.” After this I learned to say no to certain things at PT.

 

[Jockette]

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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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 to 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 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.

 

[Sara61]

I'm past 4 months post surgery & only now am I starting to not use my crutch- I still like it close by for reassurance, like you my surgeon thinks I should be running a marathon by now, I had a set back at physio 4 weeks post surgery, whereby a junior physiotherapist lifted my leg straight many times causing severe pain and this in turn caused the inability to walk, put weight on it for several weeks after, my surgeon wasn't interested...he had done his perfect job so I went back to basics, and started again, my knee will recover without PT its slowly gaining strength by simply waking, I have a small mini peddler that I use a couple of times per week, I do knee raises with knee bend and I avoid straight leg raises completely they did me more harm than good.
Our knees are recovering from surgery, all surgeries are different as are all recoveries, it's hard when you see others better than yourself, but again maybe less work was needed, age, weight and fitness levels all play a part, so just ignore them & let yourself body heal at its own rate, swelling is caused from over activity, its a vicious circle, your bend will improve once the swelling goes down.
Clicking is part of the hardware, this is totally normal, my left knee (2019) continues to Click away, now the right has joined in, its part of the process and my knees saying hello
Try not to worry, & stay away from straight leg raises your knee is not ready for them xx

 

[mtnplayva]

I'm a little farther along than you and did not have a PE. Most of what you are experiencing sounds normal to me. I am using a quad cane still as my knee gives out randomly so I can't trust it. The doctor makes me feel like I am crazy and just afraid to walk. He says I am just weak and there is nothing wrong with the structure of the knee. It's very frustrating and depressing! One thing I have found out - too much activity (exercises, walking, standing) makes my knee worse for days. I am still going to PT 2x a week and do home exercises 3x a week but am thinking of stopping to see if it helps with the walking. My ROM is 0-115 so not where they want it but close enough. I do not have clicking but everyone that I know that has had a replacement says theirs clicks when they walk and is most notable if it's quiet. If getting an Xray helps with your anxiety then I say get one now. This recovery is much different from what I expected and that has not helped my anxiety and mental state. I truly hope your recovery experience improves in the coming days.

 

[mtnplayva]

New to this site and 8.5 weeks post TKR. Surgery date 28th Feb 2022. I have been going to PT twice a week and doing excerises at home. 4 weeks post surgery, I was re-admitted to hospital for 5 days with a Pulmonary Embolism. I was on total bed rest for 3 of those days. I went back to PT the day after discharge and was advised by OT to take it easy and not to get my heart rate elevated. At week 6 I saw my OS and he was not very happy with my progress because I was still using one crutch and could not do a straight leg raise. He made me feel like I was being lazy. In the past 2 weeks I feel that I have made progress and I can now do straight leg raises. I can bend to 90 degrees and nearly all the way straight. Yesterday I couldn’t walk well due to the constant swelling and “clicking” in the back of my knee. I had a really bad night with it (I am keeping up prescribed pain meds) and this morning can hardly walk on it all. Feels like 1 step forward. 10 back! I’m getting very depressed and frustrated not being able to do much. I’m elevating and icing regularly. I know that every recovery is different, however, it is really hard not to compare myself with others at PT who were operated on after me and are back driving and walking well. The PT have extended my therapy for another 6 weeks and my OS wants to see again in 4 weeks and has scheduled an X-ray the morning of the appointment. Should I get the X-Ray done earlier? I feel if there is something amiss it would be better to know now! Would appreciate any advice from anyone that has suffered a setback with PE post TKR.

How are you doing? Did you have an x-ray?