Bilateral PKR A Few Quirks

Thank you for the encouraging words. I have PT today and plan to rest after that.
I think the gait on my right leg is better. Short strides but I can roll on my foot. That’s better than it was two weeks ago.
 
Thank you all for your kind words of support. It helps.

PT today saw an increase in ROM, with left at 101, right 96, unassisted. Strength is 4+ in flexion and 4- on extension in both legs. Left leg feels almost normal when walking, right is better, but still a bit stiff.

I have protected my left knee most of my adult life and I can tell when trying to do steps. I help with my arms when stepping up. Surprisingly, I need less help as I go through the exercise. I have much work to do for the rest of my life with strengthening it now that I don't need to protect it anymore.

Left tendon in the back still goes out. Saturday, it happened more times than I could count, but Monday, it didn't happen at all. It happens with short steps, less than 6 or 8 inches. It doesn't happen when walking to get somewhere. Sitting in a chair seems to set it off more often and I sat in chairs on Saturday almost exclusively.

I guess that is all for now. I have to go into the office tomorrow for 5 hours, so that should add some drama to my recovery. :)
 
I have much work to do for the rest of my life with strengthening it now that I don't need to protect it anymore.
You have plenty of time to strengthen your body, after you heal. You are still in early healing days after this major surgery. Take your time with the strengthening. Some PTs make us feel that we must work work on strength and recover right now, but they don’t seem to realize how long the healing process takes after a knee replacement. Give your knee the time it needs to recover, and then you can work on other things.
 
I phrased that poorly. I meant that I will have to spend the rest of my life making the left as strong as the right, not necessary right now.

End of week 7. Mentally, I’m terribly frustrated and hate my knees. I’m making zero progress on range of motion and heel slides still cause great pain. I wasn’t mentally prepared for the length this recovery takes. I hate sitting. I think I’d feel better if I saw some progress but it’s Groundhog Day. Every day.

I’m icing and resting as much as I can and it doesn’t seem to help

I have my 8 week doctor’s appointment in 5 days.
 
It's really hard to be patient and let our bodies heal but that's what this recovery is all about @SugarPeas. Take a deep breath, don't worry about ROM, and just stick to activities of daily life. It's not easy but it IS the path to your less painful, more successful recovery. As hard as it is to hear you are still VERY early in a long recovery process. Things will continue to improve and we will be here to cheer you on the whole way. :flwrysmile:
 
8 week appointment with the doctor today. I am 5 days shy of two months since surgery.

Dr. said everything is good. X-rays showed the start of bone growth on the implant, which is desired. All the weird quirks of the legs are normal. The initial recovery for a bilateral replacement is longer than if one implant was done, but the overall recovery is shorter than doing one, then doing the other. He said to expect 3 months before things really get better.

The best thing for recovery he said, is quad strength. He wants me to do as much as I feel comfortable doing.

On a personal note, my energy is better. I no longer need a nap after PT or the few hours I have to spend in the office. My balance is also very good. I was able to stand on one leg for almost a minute on the first try. Subsequent stands were less as my leg tired.

My right leg, while still tight and unable to bend past 90 degrees, is stronger and my gait is better on it. When I get tired, the tendon on the left leg and my gait on the right leg act up, but I take that as my cue to ice and rest.

Its still hard not to aerobically exercise and sitting is hard. My once defined quads hide behind my skin, but I'm doing better with it today.
 
Sounds like you're making progress!
 
He said to expect 3 months before things really get better.
More than likely it might be more like 6 months before you feel a lot better. Slow and easy is the best way to recover.
 
So at 6 weeks post op, my Range of Motion has decreased to 98 and 96 from 105. My left leg feels almost like a normal gait and the right is stiff, but I think it is improving.

The notes from PT say my progress is very slow and my prognosis is fair. That is discouraging.

There's really nothing wrong with having a flexion of 98 or 96 at 6 weeks post-op. Most surgeons don't expect even 90 degrees by 6 weeks, so you're a bit ahead of the game.

The problem isn't with your knees, but with an impatient PT and surgeon.
Your PT has no right to tell you that your progress is slow.
It's OK and, considering you had both knees done, I think you're doing very well.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Your body knows what it's doing and your knees are going to recover on their own schedule, not on some artificial one-size-fits-all schedule.

Don't be persuaded into working harder at exercises, in the hope that doing so will improve your ROM - it doesn't seem to work that way.
Knee recovery - Lose the Work Ethic!!
TKR: work “smarter” and not “harder”

In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.

One other thing - although the advertising often says that recovery from a PKR is faster than recovery from a TKR, we've found that usually isn't so. Recovery seem to take just as long. That's been the experience of most people on BoneSmart who've had a PKR.

I walked through Home Depot and bought some shoes that I can slide on. I was exhausted when I got home and spent the rest of the day resting.
I think you probably over did it by doing that, although it's good that you rested well afterwards.
Check your level of activity with this article:
Activity progression for TKRs
 
Here is something I haven't seen mentioned but helped my mental state. I haven’t been able to cut my toenails since surgery. Well, I can but it hurts.
I was reluctant to get a pedicure because of COVID, but I finally went.
They massaged my feet, scrubbed and lotioned my calves and wrapped a warm towel on my legs all while sitting in a chair that massaged my back. It all felt wonderful and left me remarkably relaxed. In addition, my toenails don’t get caught on the sheets!
 
Week 10 - change moves at a snail's pace

My left tendon on the back of my knee still gives out on me a couple times a day, but recovers on the next step. Sitting in a car for more than 10 minutes is painful because of that tendon. If I put my foot flat on the floorboard, it takes some pressure off and I am more comfortable. The straps I use on my icepacks wrap around that spot and seem to make it worse, so I've stopped wrapping the strap around. I wonder if the tourniquet used during surgery caused some damage back there.

My right leg is still stiff, ROM stuck at 90 degrees as it has been for the past several weeks.

My strength is improving as is my balance and I'm more active, going to work a couple times a week, but I only stay 4 hours. I'm tired when I get home, but after resting, I can get back up.

mentally - I'm not as frustrated with the pace of recovery today. The threads on this forum and your support give me hope that things will return to near normal someday. I wish I could do more, but it's only stuff. It can wait.
 
Week 12 - Things are progressing slowly. My strength is better. I can get off the sofa using my arms to push up which I couldn’t do at all.
I walk 1/2 mile into work once a week and I’m not exhausted at the end of the day. I also walk through the grocery store instead of ordering online.
I do need to watch over doing it. On a snowy day, I cleaned out a closet. The next day, my legs were so tired, it was painful to walk and they ached all day. However, they recovered the next day.
I still have to push up from sitting and get in the car back side first. I have to listen to the level of energy in my legs and stop when they are tired. ROM is still stuck at 90.
The pain in the back of my left leg is starting to have good days but it always hurts putting on my socks and shoes.
I think that’s about it for now.
 
@SugarPeas
Sounds like you are coming along, slowly but surely.
Don't forget to ice the back of your knee.
 
You are doing well!
 
I have to listen to the level of energy in my legs and stop when they are tired. ROM is still stuck at 90.
The pain in the back of my left leg is starting to have good days but it always hurts putting on my socks and shoes.
I think that’s about it for now.
Yes, unfortunately the energy drain continues for quite a while but will gradually improve. I always felt like getting my socks on was a form of physical therapy. :heehee:
Hang in there.
 
Week 14 - This update is a few days early.
It is like the dam broke on my recovery. ROM on my stiffer right leg has gone from 90 to 101 in the last two weeks. Left leg is also 101.

PT has increased my weights and I still knock it out. No soreness or exhaustion after PT.

The past weekend was overly busy involving lots of travel, a flight of stairs several times, cleanup from an ICE storm, and having to retreat to another location while my house is used for COVID quarantine. Absolutely exhausted on Sunday. My left hamstring began giving out again. Recovery lasted through Monday, but Tuesday was good.

I’m still taking ibuprofen, between 400 and 800 mg, usually everyday, mostly before bed. There isn’t pain, it’s more discomfort and I can’t fall asleep.

I still have to sleep in one position, on my back, toes pointed up but can roll over for some relief for a few minutes. I am starting to fall asleep on my side, but it lasts about 10 minutes before pain wakes me up.
 
Almost 4 months -

I'm still taking ibuprofen, 400 mg, mostly every other day. It's not pain, but more discomfort, especially at night. I had blood work done for a different condition and my kidney function was good even with the ibuprofen. I always make sure I eat something before taking the ibuprofen. Restless legs will crop up from time to time. Ibuprofen seems to calm that down too.

ROM is 113 right, 108 left. I'm starting to use the upright bike in PT. It is difficult on the left leg, but I can get it all the way around and the discomfort lessens after 4 minutes.

Strength continues to improve and to an outsider, I walk normally, but my pace is slow, going faster causes pain. After sitting, I have to stand up for a minute and let my legs warm up or I walk like Frankenstein.

I'm able to walk a mile in 30 minutes and need to rest after, but it only takes a couple hours to recover.

My left leg still gives out occasionally, but after days of activity instead of hours.

Going up stairs is difficult. Right leg doesn't need support but my knee sounds like popcorn with all the crackling. Left leg needs support and when it's tired, I just go up or down with my right leg.
 
It sounds like you're coming along quite well for just 4 months!
 
5 months -

I was released from PT last month with a ROM 116 and 109 for right and left knee. Since I don't have PT anymore, I won't have anymore objective measurements.

I've been in the gym twice a week since release focusing on a bike ride warmup for 15 minutes (it takes about 5 minutes to ride without tightness), leg press, leg curl and leg extension. Those are the only machines for hamstrings and quads. I add a few bonus machines for me, arms and shoulders, to make good use of my time.

The leg curl and leg extension are on the lightest weight (36 lbs) and I have to use both legs to complete the rotation. I can't move the weight with one leg, but I will allow one leg to do more of the work than the other.

The leg press does allow me to isolate one leg, so I make sure to work that machine to the limit of my capability. My right leg is stronger than the left, 50 lbs vs 35 lbs, 30 reps on each leg. I also use the leg press with both legs and set the weight at 85 lbs. 30 reps of this and my legs are tired when finished.

The left tendon behind the knee is definitely the weakest link in this recovery. There have been days when I am unable to do the leg curl, on the lightest weight, because of pain. I think I will NOT use that machine for a few weeks and see if the tendon improves.

My nutrition crazy kid says I need to make sure I eat protein for recovery, so I've been adding a protein shake after the gym. They don't seem as exhausted the next day since I started that. I also try to include protein with every meal.

On non-gym days, I am able to work in the garden, weeding and cleaning up or going for a short walk around the neighborhood.

My legs get tired after days of work, instead of hours; however, it takes days for them to recover, instead of hours. I used a leaf blower on uneven, hilly ground for 2 hours on a Saturday and didn't recover until Tuesday.

My kid's friends were making fun (not in a mean way) of the way I walked the other night, so that still needs to improve. It was playful and I'm happy to have a rapport with the friends because so many kid's friends are nervous around parents, but I was keeping up with the young adults as we walked through a downtown.

I still have to push up from a sitting position and am terrified of the stool in the kitchen, least I fall off. I also have to warm up when I start walking to get the stiffness out.

Ibuprofen is used sporadically, for that tendon, which I hope will improve with time. Tendons take a long time to heal so even though I have considered contacting my doctor about it, I will give it a few more months to see if it improves.

That's it, see you next month.
 

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