Lounge Doctor

TKR _Lisa_’s Left TKR Recovery

_Lisa_

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Hi,

Could you add me? My I had TKR on my left knee on June 28, 2021. It is my first TKR.

Thanks!

Lisa
 

Jockette

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Hi, @_Lisa_ and Welcome to Bonesmart!

I’ve copied your post and started a Recovery Thread for you. This will be a journal for you, and where you can discuss any questions or concerns with the staff and members. You will find a lot of information and support here!

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
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.
 

Jo Wo

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welcome Lisa! I am five days ahead of you with a left tkr. Rest and heal.
 

Noanie

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Hi Lisa , I had my tkr surgery on 13/05 . This site has been a life saver , it’s so much better to have people who know what you are experiencing and can give sensible advice. . Take care and I hope your recovery goes well .
 

Atkinson8

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Hi Lisa, I hope your recovery is going well, and you're comfortable. This site is so valuable if you have questions or concerns - we're all sharing the same experience! Best wishes!
 
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_Lisa_

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Hi folks,

Here is my recovery story (with some questions) for the past week. I had quadriceps-sparing outpatient TKR. I came home with calf pressure cuffs that I have to wear for two weeks to avoid blood clots. I remove them for showers and physical therapy. I am also set up with virtual physical therapy, three sessions of exercises three times a day, which started on the day after surgery.

Post-op days 1-3:

I was told by the discharge nurses to keep my leg extended straight, with no bend, or my knee would heal permanently in a bent position. I tried to do this, but I couldn’t sleep in this position. My leg won’t straighten out fully, and it was painful to try to achieve this. I finally gave up.

I started physical therapy the day after surgery. For the first few days, I could only do two sessions, not three. I couldn’t do a some of the exercises. Some required me to flex my knee beyond a 90 degree angle. I did modified versions of what they wanted and was gentle on my knee because I knew that forcing it would be harmful. At the end of day 3, the pain had improved, my mobility was good, and I was optimistic.

Post-op days 4-5

These were miserable days. The stool softener didn’t work, and I had gastrointestinal issues that took 48 hours to resolve. It was really discouraging, and I quit my narcotic meds for these days because I didn’t want to make the situation even worse. I could not do physical therapy because I was so uncomfortable. I’m now on something effective so this doesn’t happen again.

Post-op day 6

I started back on the pain meds, but I was not taking enough. I did the first session of physical therapy and overdid it. For the rest of the day I had increased swelling and pain. I felt really down and worried that I had already ruined my knee by missing some PT sessions, and also by not straightening my leg the way they wanted me to.

Post-op day 7

This is today, and I am still dealing with increased swelling and pain from yesterday’s PT session. I have not done PT today. Instead, I am taking periodic walks around the house for about five minutes at a time. I am back on my pain med schedule and sticking to it. I have been icing my knee off and on all day. Thankfully I found this website. I discovered that I have not been elevating my knee properly—I really have not been elevating it at all! I am now using a pillow stack for elevation, and I have ordered a Lounge Doctor pillow for elevating my leg. It should arrive tomorrow.

I should mention one more thing. I have three large fracture blisters a couple of inches from my incision. I am keeping them clean and dry, and I cover them with a loose nonstick gauze dressing. From what I understand, they will take another week or so to resolve.

Questions

I am so grateful that I found this website. I wish I had known about it before my surgery. Here are my questions:

Can I sleep at night with my leg elevated in the way this website describes? I took a nap today with my leg elevated, and it was the most comfortable I’ve been so far.

How often should I elevate my leg in a typical day? And for how long?

I am interested in knowing what you all think about three sessions of virtual physical therapy per day. Does this seem excessive? Each session has 6-7 exercises of about 10 reps each. Some of the exercises are gentle and designed to ease me gradually into better ROM, while others are completely unrealistic. I have the option of switching to in-person physical therapy, but this would be difficult to do until my fracture blisters heal.

Thank you if you took the time to read this! I really appreciate it!

Lisa
 

Jockette

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I am so grateful that I found this website.
We’re glad you found us, too!

Can I sleep at night with my leg elevated in the way this website describes? I took a nap today with my leg elevated, and it was the most comfortable I’ve been so far.
Yes, you can sleep this way for as long as you want. I elevated like this any time I was in bed, though I did short sessions the first couple of weeks because my leg was just too upset to like my foam wedge, but it got better as I healed. And, you can elevate your leg a s much as you want, the main thing is to find a comfortable position.

I was told by the discharge nurses to keep my leg extended straight, with no bend, or my knee would heal permanently in a bent position. I tried to do this, but I couldn’t sleep in this position. My leg won’t straighten out fully, and it was painful to try to achieve this. I finally gave up.
I’m so sorry that your nurse has this opinion, because it is absolutely not true! I’m sorry it caused you so much pain and I’m glad you gave up on it. A gentle bend is fine and much more comfortable. The Lounge Doctor that you have coming will give you an appropriate slight bend.

As far as PT goes, just do what is comfortable. No exercise should cause pain. At this very early stage of recovery you don't even need any specific exercises, you only need movements that give your knee mobility, which you will get with short walks around the house.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
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_Lisa_

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Hi Jo Wo!

Thanks for the warm welcome!

Fracture blisters can happen when a bone is fractured, but they can also be caused by bone and soft tissue trauma during the TKR procedure. They occur in around 2-3% of TKR cases. They are large and fluid-filled, usually with blood or a clear fluid. Mine are clear, so they supposedly will heal a few days faster than the other kind. They usually take 12-14 days to resolve, and draining them is not recommended due to the infection risk. They are quite gross looking, so if you are brave, Google them to see some images.

I will be glad when they are healed.

Lisa
 

Sisterpat

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Welcome, Lisa and congratulations on your new knee! Remember this is a year long recovery and it simply cannot be rushed, so relax. Jockette gave you all the answers you need. Stick by the guidelines here and you will do well. Do not overdo or let anyone else work you to the point of pain! Just say NO! It is your knee and you are in charge.
Many of us have trouble sleeping for quite a while after surgery. Try to grab naps during the day so you can get some rest.
You have support here. You are not alone!
 
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_Lisa_

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Jockethe,

Thanks for all the info and support. It’s so helpful!

Lisa
 
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_Lisa_

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Hi everyone!

I thought I would post an update now that I am nearly three weeks post-op. I have transitioned to a cane for about 90% of the time. I can go on several ten-minute walks outside during the day. I am doing two or three sessions of gentle stretching and strengthening exercises each day. I avoid the exercises that are aggressive or cause me pain. Yikes! There is one where I am supposed to lie down and bring my bent knee (at maybe 120 degrees) almost to my chest! No way. I have been so much more comfortable and less swollen since I adopted the no-pain approach to the exercises. I ice my knee frequently and I elevate often. Sleeping for more than three hours at night is still difficult, but I do get at least one three-hour stretch and several 90-minute sessions during the night.

One more thing that’s going well are the stairs. Stairs are so easy! Pre-surgery, my pain was intermittent, but the instability in my knee was awful, and I had a lot of falls in the two years leading up to the surgery. I have not felt this safe on stairs in years—even while still using a cane and recovering from TKR!

I have a question. For some reason, I find sitting in a chair at my desk or riding in a car to be really uncomfortable after 30 minutes. Have others experienced this? I try to vary my positions throughout the day. I’m really curious about the discomfort while sitting in a car or a normal chair. I can’t figure out why that would be so unpleasant.

By the way, I really recommend the Lounge Doctor pillow for elevation. I got the inflatable version. It has been a lifesaver. It totally changed my comfort level. Within a day of using it, I had less swelling and pain. I’m going to buy another so I have one upstairs as well.

Wishing all my fellow TKR folks the best!!
 
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Jockette

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I find sitting in a chair at my desk or riding in a car to be really uncomfortable after 30 minutes.
This is quite common, it gets better as you heal. Here’s an article from the Bonesmart Library about it:

Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/
 

FourCats

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I find sitting with my leg down to still be uncomfortable after about 45 minutes. It feels like it gets heavier and usually ends up a bit swollen. From what I have read here, it’s normal. I try to pay attention to how long I’ve been sitting and make sure to get up and move every 30 minutes or so. I also continue to elevate and ice several times a day.
 

Sisterpat

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Lisa, sounds like you are doing great and handling this recovery like a true BoneSmartie :flwrysmile:. I still find it somewhat uncomfortable sitting in the car for lengthy periods, though it is getting better. And, of course, I always remember all those times I was in such pain in the car and getting out of the car before I had my knees replaced and know one day this will all be behind me. Try to hang in there and time will resolve the problem.
 

kneeper

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One more thing that’s going well are the stairs. Stairs are so easy! Pre-surgery, my pain was intermittent, but the instability in my knee was awful, and I had a lot of falls in the two years leading up to the surgery. I have not felt this safe on stairs in years—even while still using a cane and recovering from TKR!
So true--I had lots of instability before my first tkr and was so excited about how strong and stable it was post surgery--even while recovering. Just take it slow and steady--which it sounds like you're doing.

I have a question. For some reason, I find sitting in a chair at my desk or riding in a car to be really uncomfortable after 30 minutes. Have others experienced this? I try to vary my positions throughout the day. I’m really curious about the discomfort while sitting in a car or a normal chair. I can’t figure out why that would be so unpleasant.
Having your knee bent and your legs down leads to more swelling due to gravity. It will get better but for the meantime just keep those periods in the chair limited. As the weeks go on you'll be able to sit for longer periods in between the elevating.
 
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_Lisa_

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I feel like such a slacker for not posting after all of you were so kind to answer about my most recent update. Thank you! I got really busy this past week with some work things that I had to take care of remotely.

A friend came over and measured my flexion, which is at 95 degees. My extension is only at 20 degrees. I am doing virtual PT with exercises three times a day. I am at 33 days post-op. I feel that the flexion will come naturally, it has improved 5 degrees since last week. But the extension seems not to change despite the stretches. Should I be worried? I feel like my gait would be much improved if I could extend my leg more, but I do not want to force it.

Other things are improving--I can sit for longer periods and I can now sleep for four-hour stretches, which is amazing.

Hope you are all doing well!
 

Jockette

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Extension can take quite a while for some of us, especially if we had issues with it before surgery. This is a year long recovery and at only 33 days post op, it is far too early to be worried. You have lots of time for improvement, and you are improving in other areas. It will come as you heal. :console2:
 
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_Lisa_

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Thank you! I will try to be more patient with my knee :^)
 

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