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TKR Almost 3 months

Yellowstone34

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I had a total knee replacement done on November 19. I have not been in very much pain. However, my knee is swollen and when I walk either my knee buckles or the fluid/ swelling in the knee seems to move. My PT says I need to straighten then knee more. I am at -4. I ice and elevate through out the day but it doesn’t seem to help. Is this normal? My in home PT ended Tuesday and I go in on Friday for Pt at the office. Thanks for any suggestions
 

sistersinhim

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:welome: to Bonesmart! We are here to here you get through this recovery. Which knee did you have replaced? We'll add it to your signature for you. You are just beginning a year long journey with your knee's recovery.

Actually, if your knee is totally straight it's +4,

The following are our basic guidelines and should help get you started. As you read more on other members recovery threads, you’ll get a better perspective of what to expect and what not to do, especially regarding PT.

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. Here is a week-by-week guide for Activity progression for TKRs


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.
 

Celle

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Hello @Yellowstone34 - and :welome:
Please will you tell us which knee it is, so we can add that to your signature for you? Thank you.:flwrysmile:

It's only two and a half weeks since you had major surgery. Your knee is wounded and traumatized. It will need time and gentle treatment, so it can heal and recover.

In spite of what your PT therapist told you, you don't need to worry about straightening your knee more at this early stage. Nor do you need to worry about strengthening it. Many people find that their knee buckles at first. That's normal and your knee's strength will improve naturally, as your knee heals.

Your knee isn't lazy or unfit - It's wounded. So be kind to it and don't expect too much from it yet.

I bet nobody told you that recovery from a knee replacement takes a full year, did they? Well, it does, but you will be able to do most things long before that.

There's no need to rush to get ROM (Range of Motion, which is both flexion and extension) 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

And, before your PTs tell you that you have to work hard at your exercises, you need to know that
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. Its ROM will gradually increase as your knee heals and the internal and external swelling decrease.
 
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Yellowstone34

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Thank you. I had surgery on my left knee on November 19,2019. I left the hospital 5 hours after surgery. I am not in any pain just a little worried about my knee. Seems like whatever is swollen in the knee moves when I walk. Also, when I lay down the leg moved on it’s own.
 

sistersinhim

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Seems like whatever is swollen in the knee moves when I walk. Also, when I lay down the leg moved on it’s own.
It sounds like it's fluid moving around. Are you icing and elevating most of the time? That will help your body to get rid of some of the fluid, which will also help with the pain.
 
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Yellowstone34

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I ice and elevate 4 or 5 times a day. I am not in any pain. Just the fluid and swelling that bothers me. Oh and my leg moving for no reason when I lay down.
 

sistersinhim

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For the first month or so I iced and elevated the whole time I was down, whether sitting or laying down. This kept my swelling low. The more you are on your leg, the more it will swell until it calms down from the traumatic surgery it just went through.
 

Celle

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Thank you for telling us it was your left leg that has the replacement.
I ice and elevate 4 or 5 times a day. I am not in any pain. Just the fluid and swelling that bothers me.
You need to ice for at least 45 minutes each session, or it does no good.

Swelling is normal. It's your knee's reaction to the trauma of surgery. Even though it's a nuisance, that swelling is also protecting your knee from being over-used.

The swelling should go away gradually but, for some people that can take several months. It won't happen quickly.
 
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Yellowstone34

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Why do doctors tell you to only do 20 minutes every hours?
 

Celle

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Why do doctors tell you to only do 20 minutes every hours?
This is how Jamie explained it:
"After surgery ice is frequently used as a means to minimize pain and swelling because of the surgical trauma. It's not the same use as you might do after an injury. Following injury, it is common practice to tell patients to ice no longer than 20-25 minutes several times a day. But with a surgical incision, it is perfectly fine to ice your wound as much as is comfortable for you providing that you do not allow your skin to chill to the point of damage. This is why we recommend that people use a towel between the ice source and their skin or clothing. It's also why the ice machines like Game Ready or DonJoy have pads that don't get quite as cold as you can do with an actual ice pack. Icing is an excellent means to control pain following surgery and each individual needs to find out what schedule works best for them.

I used gel packs through the day and night for weeks with both my knees because it felt better than not icing. Obviously, during the day there were periods where I was not in bed or on the couch, so I wasn't icing then. But at night it was both front and back of the knee all night long. It really helped me sleep."
 

Helizabug

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I’m another advocate of constant icing, with the cool ice pump machine, all the time. Right now, I’m well wrapped with ace bandage as I’m less than two weeks out still. I can barely feel the cold on my skin. But if I forget to rewrap with it, I can always tell pretty quickly. My knee heats up, and my knee just aches more than it had been.

If I were using ice packs, it might be different because of the bother of all the switching out. But, I’d still try as much icing as possible during this part of my healing. It’s just hard to stay ahead of it.
 
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Yellowstone34

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I am using an ice machine that kiaser gives all their knee replacement patients. Does this make a difference in how much icing I need to do? Should I be doing the entire area or just the part of the knee that is swollen? Thanks.
 

Celle

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You still need to ice for at least 45 minutes each session.

Ice your entire knee, not forgetting the back of it. There's often swelling above and below your knee as well, so ice that too. Be sure to check that all the area being iced has its skin protected with a towel, so you don't get "freezer burn" - frost bite.
 
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Yellowstone34

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Went to kaiser today. My pt said I needed to strengthen the thigh muscle that is why my knee buckles. He said my straightening was 120 and bend 100. To keep icing and elevating. He was very nice.
 

Celle

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My pt said I needed to strengthen the thigh muscle that is why my knee buckles.
Yes, he's right, of course, but your leg muscles are going to strengthen naturally during the course of your daily activities.

It's too soon to start exercises to strengthen your thigh muscles. That should wait until about 3 months post-op - heal first, strengthen later.
 
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Yellowstone34

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Hello, I am currently in my 7 week after surgery. I can bend my knee to 117 and totally straighten my leg. However, when I walk my leg feels really stiff. Also, my feet get really cold even when I have warm socks and a blanket on
 

sistersinhim

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I had my surgery in June in Virginia and I stayed cold almost all the time even though we hit the 90s some days. I'd have to go outside on the deck to get warm. Your body is concentrating on healing that baby knee of yours. That's a good reason for extremities getting cold. Add to that the icing. I was wrapped in a blanket while icing and still cold.

As you heal, it'll get better and your feet will feel warmer.
 

Love2cycle

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Glad I read this thread. I am a little over 4 weeks post TKR and cold all the time and I am in Florida where it is warm. Even with socks and blankets. I thought it might be from the ice machine but I am cold constantly which is not normal for me. Must just be part of the process!
 
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Yeah I think it's normal for some people to feel cold after such a major surgery. I'm somewhat cold-natured anyway and sorta surprised that's not increased post surgery. Be well!
 

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