TKR Annie11 recovery

[referee54]

The past two nights I slept good and didn't need to wake up for pain meds.

That is wonderful---heavenly!!

o far so good, pain is not too bad - start PT 3 times a week, things are about to get real!

Honestly, I believe that PT twice a week is enough---three times tends to be overkill for many. Do not hesitate in cutting back if you need to---remember, it is not about working harder---work smarter.

 

[kneeper]

don't forget to ice behind your knee.

 

[Annie11]

don't forget to ice behind your knee.

.

Yes, behind my knee is where most of my pain is. It's now starting to move in front some. The ice makes me so cold - I get chills a lot.

So I'm on Day 6, and my bandage comes off tomorrow - yay! But that's when I'll get more nervous about infection etc

My stomach is my main issue- still getting nausea/headache and taking meds for it, but they cause constipation too! Dr has me on Senna plus twice a day, which Im hoping I could switch just to Colace soon.

I sleep without pain, which is awesome and am now up to 6 hrs straight

Starting PT tomorrow 3 xs a week, but I do feel better after I exercise- I'm getting so tired of laying around. I do laps with my walker as much as possible.

Patience....


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[Annie11]

So I thought I was doing pretty good - almost 3 weeks now and my pain hasn't been too bad, until PT and them trying to reach a good number to report back to my surgeon.

Going into surgery my ROM was about 82-88, so we knew flexion was going to be an issue. After surgery, 76 degrees (then 45 during swelling phase) They pushed me hard the other day to around 80 - which flared everything up more and I'm hurting now.

Yesterday was appt w OS & they asked me to bend my knee back as far as it would go...(in tears) they only measured me at 70 degrees! They did not like that & now are talking MUA in 2 weeks if I don't improve & get to 90 degrees! Ugh

They told me to bend my knee (under) or back as far as I can tolerate every hr for next 2 weeks, this may help... So I told my PT, she backed off & now giving gentle exercises & massage to try & calm down the joint.

My leg & foot are looking good- not much swelling, it's more in joint all around knee. So I'm icing, elevating, and resting more w these knee bends every hr. Praying this works!

Anyone else have MUA or this flexion issue?

I really feel it's too early & to give me more time to heal but they said there's only a small window of oppty for manipulation & that most people do very well with it, feel better.

I have already started working from home, was ready to go off pain meds, looking forward to driving & getting off walker to cane.

They said MUA would set me back some & PT would increase from 3 to 5 days at week! This is crazy...


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[newlybionic]

Don't do any more exercises! I was at 90-95 before surgery and I've taken it very easy following the bonesmart mantras and I'm at 115. Take these weeks and ice and elevate as much as possible for now to get your swelling down. Walking when you need to is your best exercise. You saw that after the PT forced your knee to do too much your knee swelled up so you couldn't even get back to the ROM you had before hand.

 

[Annie11]

When did you have your surgery? I can see much here on the mobile app :/

Yes, I've been taking it easy last few days & elevating more. My knee feels more tight since Wed. I had to start taking more Vicodin - (they make me feel yucky sometimes)

It'll be 3 weeks Monday and each day I feel better & can do more, but so disappointed in the flexion. I don't think I can get to 90 degrees that quick but gonna try! ;)








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[Choc chip]

Lying on my back near the wall with my legs on the wall is the best way for me with ROM. In the past, I would put a light weight on the ankle to help it bend. The other helpful tool was to raise the seat of an exercise bike and rock back and forth backwards and forwards.

 

[Annie11]

Hi All - I am about 3 weeks post op from TKR and doing well except for my ROM.

My flexion going into surgery was poor - about 82 degrees, so we knew this was going to be an issue. After surgery I was at 76, then a week later with the bruising/swelling I was down to 45.

In PT this Wednesday she forced me to 80 which caused some swelling and pain that didn't subside too good over a few days. Friday, I had my first post op appt. with OS.

Of course I was pain when they asked me to bend my knee as far back as I could (in tears) I measured 70 degrees. ugh So now they want to see me back in 1.5 weeks and if I'm not at 90 degrees then they want to do the manual manipulation under anesthesia (MUA).

I've heard good and bad things on this procedure. My main concern is being set back as I would have more pain/swelling, and have to be in PT 5 days a week. I feel like if just given more time I could get there on my own.

The Dr suggested forcing a bend every hour to get it stretched, which I did for one day and I hurt more now and walking is more painful, the joint feels tighter, so I know this is aggravating it further.

I don't have a lot of leg swelling - just around some around joint - I sleep thru the night, no pain unless I walk or do this knee bend. I'm thinking of just doing the heel slides today to see if that's better. (less painful)

Anyway, I go back to PT tomorrow, see what they say. She feels I could get to 90 degrees , but I doubt in one week.

 

[Majic]

@Annie11 My surgeon was far more laid back than yours. At your stage my leg had just come out of a splint, so I had no ROM. After the splint came off he gave me 2 months to get to 90 which I did with the very gentle excercises suggested on this site which were identical to the ones given to me by my PT. She also did loads of massage, but no hands on bending. I got there just and he was happy. My ROM has increased gradually since, and is plenty now for me to do everything I want to do including cycling and ballroom dancing. Elevate and ice as much as you can, even overnight if possible, once the swelling goes down you will see a big improvement.

 

[kneeworn]

Hi Annie I too struggled with flexion post surgery and went into it with like you with a knee that I had not flexed deeply in years. I had a manipulation in March after having my total in the month of December 2016. My therapist tried to ensure me that I needed to keep working but I could not seem to get there.

Later after the manipulation I had better flexion and slowly it began to tighten back up. The adhesions were recurring and a new therapist began to work with my knee at around a year later. I considered doing it again but he begged me not to saying that every time they did the manipulation it would tear the tissue and cause more inflammation for me and lead to more scarring. He worked with me getting me to about 105 to 110 on a good day after warm up eventually. He stressed that the stretching we do is something we must do each day for the rest of our lives. Not just in therapy. He said that typically we do not bend our knees to it's maximum range every day so a total knee will say "hey your not bending that far so I don't have to anymore and stiffen up." He said I must do my bending exercises everyday for the rest of my life to keep my flexion.

So do your stretching and bending the therapist gives you each day. It is important. Hang in there. And remember your knee is still angry and healing from surgery. I used to worry my therapy was increasing the swelling so I thought it needed a rest at times. Now I think while the tissue was still pliable I should have bent it more. Swelling at this time is normal I think. Keep urging it further. Good luck!

 

[KarriB]

I wasn't allowed to bend my new knee for a month due to infection. I was very worried it would never bend and I'd be walking like a peg leg forever. But not bending or pushing helping the soft tissue to heal and after a month I began non-aggressive bending. No one pushed my knee, in the beginning just rocking back and forth on bike pedals and heel slides as well as massage. By 4 months I was riding a few miles on my exercise bike. Eventually I got to 115 and last summer, two years later realized I could squat in the pool.
You don't have to have an MUA, if you feel you need some time to let your knee settle down that's your choice. Three weeks is really early in the recovery process. Ice, elevate and rest that knee to get your swelling down.

 

[Jaycey]

@Annie11 You will notice I merged your 2 threads into this recovery thread. Please keep all your recovery posts on this thread so we can see your history and better advise you.

I would disagree with having MUA so early out. Please go back and read the recovery articles we left for you earlier on this thread. Ice and elevate to get that swelling down. Your ROM will come if the swelling is controlled. And forcing a bend is only going to add to the swelling. Give that poor knee a rest and don't worry about ROM at the moment.

 

[kneeper]

Especially given where you were before surgery I think it's too early to consider an MUA. For me, much of my progress came after week 4 as the swelling went down.

 

[Annie11]

Good news - I got to 90 degrees at my 4 week mark, so MUA needed! Thank goodness... It was mostly the swelling that was keeping me from bending. Off the walker, can drive now and walk better.

 

[Annie11]

I had a manipulation in March after having my total in the month of December 2016.

Hi Kneeworn - wow I didn't realize they could do a manipulation that far after surgery. They did tell me yesterday to be careful that it could stiffen up again and I could lose my ROM. Hoping to progress the next few weeks as I haven't been 90 degrees in years!! LOL (They said I was only 75 going into surgery)

I'm guessing you have to exercise for the rest of your life to stay limber, esp. in our cases where we had poor ROM to start with. Going to be tough for me going back to work as I sit all day and have over an hr commute, ugh.

Thanks for info - very helpful!!

 

[referee54]

Good news - I got to 90 degrees at my 4 week mark, so MUA needed! Thank goodness... It was mostly the swelling that was keeping me from bending. Off the walker, can drive now and walk better.

I am not sure---are you having an MUA, or have they said that you do not need one?

 

[kneeworn]

Annie I made a bad typo on my earler post to you. My LTKA was December 2010. I double checked the manipulation date it was May 2011. Sorry about those wrong dates.

Hope your swelling is improving and thus your ROM.

 

[Celle]

Good news - I got to 90 degrees at my 4 week mark, so MUA needed! Thank goodness... It was mostly the swelling that was keeping me from bending.

I hope you mean that the MUA was not needed. That's great news!

In view of your pre-op ROM, I believe that you should anticipate that your ROM will progress slowly, and allowances should be made for that. Some of your tendons and ligaments will have shortened before your surgery and it takes time and gentle treatment for them to lengthen again.

Don't ever force it or let anyone else try to force your knee to bend - that would only do harm, by irritating you soft tissues and increasing swelling.

We tell people so often on BoneSmart that it's only the swelling that prevents the knee from bending. I'm glad you've realised that. Remember it as time goes by.

 

[Annie11]

Good news - I got to 90 degrees at my 4 week mark, so MUA needed! Thank goodness... It was mostly the swelling that was keeping me from bending. Off the walker, can drive now and walk better.

Oops sorry ---No MUA needed I meant.


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[Annie11]

I hope you mean that the MUA was not needed. That's great news!

In view of your pre-op ROM, I believe that you should anticipate that your ROM will progress slowly, and allowances should be made for that. Some of your tendons and ligaments will have shortened before your surgery and it takes time and gentle treatment for them to lengthen again.

Don't ever force it or let anyone else try to force your knee to bend - that would only do harm, by irritating you soft tissues and increasing swelling.

We tell people so often on BoneSmart that it's only the swelling that prevents the knee from bending. I'm glad you've realised that. Remember it as time goes by.

Thanks!!

Yes, I agree! I knew I couldn't do the exercises every hr and force it - it was way too painful, so once I rested and elevated w gentle stretching it went down. The PT realized too and has been much more gentle on me. And in less than 2 weeks I went from 70 to 90 degrees on my own. I'm so glad as I didn't think the MUA was needed & felt it was too early. (This surgeon's team is very aggressive)




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