TKR Antpitta's LTKR - tick, RPKR - tick

[Antpitta's]

Thanks @Jockette for the info etc. I'm happy to stick to this original thread and will probably just look to rename it once the op is done (as by then at least I'll know if it was a PKR or TKR!).

Anyway, just a week to go and fingers crossed everything goes as well as last time. It's a pity that our otherwise brilliant trip to Ecuador in November meant that my surgeon didn't want to operate for at least 12 weeks after flying to reduce the risk of DVT as by the end of a couple of weeks hiking in the Andes I was heavily depending on using 2 hiking poles and putting up with rapidly increasing pain in the unoperated knee (which has only continued to decline since then).

It probably wasn't the best idea either for my 7 month "new" knee as it really had to take the strain so although I continue to experience zero pain from the actual joint I did some damage to my quads and calf muscles which have been slow to recover since. But I guess that continuing to compensate for the arthritic knee means they could really use a little rest as well.

So, nearly time to get packed, dig out the ice machine, stock up on some good books and try to avoid Covid and the flu bugs for another week!

 

[Jamie]

Surgery is coming soon! So sorry you had to wait so long after your Ecuador trip, but it will be worth it. There may be a period of time that your March knee will still give you a little grief as it picks up the slack for your new knee. But that will pass and hopefully you’ll be on your way to new adventures.

 

[Layla]

Wow, a trip to Ecuador hiking in the Andes had to be an adventure you'll never forget.
Sorry there was pain involved. The discomfort had to put a damper on your activity level. Soon you'll have two new knees and once you're done healing...think of the possibilities!

Wishing you a smooth surgery and comfortable recovery for you upcoming TKR. May this surgery bring you even more strength and mobility. Take care and stay in touch!
@Antpitta's

 

[Layla]

Best Wishes tomorrow!
I hope you have an uneventful surgery and an easy peasy recovery.
Stay in touch!
@Antpitta's

 

[Antpitta's]

Thanks @Layla. I can't wait to get this done as the last few weeks have been tough with pain in the unoperated leg and hard work on the good (operated) leg that has been taking all the strain! I'm just hoping that the on-the-table decision by my surgeon regarding PKR or TKR is very obvious (I don't mind which so long as the result is good!).

I've done less pre-op exercise this time round (due to pain in the bad knee) and as I've been using a prescribed unloader brace at least part time it's obvious my muscle condition in the unoperated leg is notably worse than on the new/good/exercised leg so I will need to work on that over the next few months. I'd settle for anything close to as good and (IMHO) quick recovery this time around! We managed trips to Costa Rica, Colombia & Northern Ecuador late in each of the last 3 years so - needing a target as extra motivation - we've already planned to make it to Southern Ecuador late this year! Fingers crossed we feel able to confirm that by the end of July.

So, all packed, recovery room set up, cryo-cuff unpacked and ready to go tomorrow afternoon! I see Tuesday is one of the most "popular" days this month according to the pre-op list so best of luck to all Bonesmarties on the table tomorrow and look forward to hearing how things went. See you all on the other side.

 

[mendogal]

@Antpitta's We’ll be waiting for you!!!
Just remember, slow and steady wins this race. You’ll need a good three months of healing and regaining ROM before you work on strength … but take it from me, rebuilding is definitely possible!!!!

 

[sistersinhim]

I'm praying for a good outcome for your surgery today. Please let us know how you are doing.

 

[Antpitta's]

A happy good post-op morning with my new partial (consultant happy that TKR not required).

All went to plan - 39 minutes under the tourniquet - and no negative reactions to the anaesthetics (I had epidural plus sedation). Reasonable nights sleep (with usual hospital distractions) and mix of painkillers worked well without side effects.

Just had 1st brief session with PT - just the first lesson (refresher) using walker, crutches and stairs. All good and obviously less pain so far than last years TKR. So, subject to satisfactory bloods and x-rays I expect to get home later today ..... then rest/ice/elevate and start the long old road to recovery! I'm sure there will be bumps along the way ...

Wishing everyone else on this path a good recovery.

 

[sistersinhim]

Yay! You have a new knee and are doing well. Remember to not overwork or your knee will get angry. You don't want that!

 

[Layla]

Congrats, Antpitta! You sound happy and off to a good start! Glad you slept well last night.
Safe travels home today! Hope to hear from you once you're all settled into your recovery nest at home.

Was your PKR Lateral, Medial, or Patellofemoral? If you share that bit of info we can add it to your signature.
All the best as you begin healing!
@Antpitta's

 

[Jamie]

It’s great to hear you’re doing well. Remember that the surgeons usually inject wonderful pain meds in the incision to help with pain control for a few days. Because of that it sometimes is easy to overdo things. Right now, you only need gentle bends and stretches throughout the day to keep the joint mobile. Walking about the house every hour or two is great too. You should have lots of resting, icing, and elevation time for a while.

 

[mendogal]

Welcome to the healing side again!!!

My ortho team was firm in telling me that in the early weeks Less Is Better.
Rest, ice, elevate, good nutrition, and a short walk every hour or so. Some ankle movements and, if you want, while icing and elevating, some quad sets…that’s about it for a couple of weeks!

 

[Jamie]

You may have seen our Recovery Guidelines before, but I’ll post them here for you as a refresher:

Knee Recovery: The Guidelines
(Administrative Note: For those reading this thread, please be aware that these links are a premium service and only available to Insiders Club Members).

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:

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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

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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 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.

 

[Antpitta's]

Thanks all for your supportive comments - and reminders on the BS "rules" for recovery! I have re-read!

I was discharged as planned yesterday afternoon and trip home (45 minutes) went smoothly although I was feeling quite shattered by then. So, tucked up in nest by 4pm after which I slept through for 14 hours apart from 3 or 4 wakings for bathroom visits & pain killers to schedule.

While I appreciate the full affects of the local painkillers used during surgery may still be masking things I'm optimistic that pain/meds won't exceed my experience with last years TKR. For now I'm just taking 1000mg acetaminophen (Paracetamol) and 30mg Dihydrocodeine every 6 hours. I will be delighted if I get away with that being sufficient over the next few days. I was also sent home with a bottle of oral morphine in case of breakthrough pain but hope not to touch that (I didn't for last years TKR).

So, looking forward to mostly rest/sleep/gentle stretching over the next few days. First PT appointment late next week - and I will be firm with them if they get all aggressive with me!! Fortunately this isn't my first rodeo and I know what worked for me last year so will follow the same approach this time unless something obviously isn't working.

@Layla - this was a medial PKR and can I change my thread title to "Antpitta's LTKR - tick, RPKR - in recovery"

 

[Layla]

Glad you're home, Antpitta!
Lucky you...you had some restorative rest already. Fourteen hours, minus a few bathroom breaks is awesome. It sounds like you're prepared if the meds you're currently taking aren't enough to keep you comfortably mobile.

First PT appointment late next week - and I will be firm with them if they get all aggressive with me!! Fortunately this isn't my first rodeo and I know what worked for me last year so will follow the same approach this time unless something obviously isn't working.

Perfect! It is encouraging to read this, no stints in the dreaded ODIC for you!
Hope today is a peaceful one.

 

[Antpitta's]

Second full day home about done and things still going really well. Focus has been on rest & recovery so far with just regular short walks (mostly bedroom to bathroom & back) and "exercises" limited to those suggested to help reduce clot risk rather than work on mobility/function.

Compared to last years TKR I'm so far sleeping without problems, taking less painkillers than pre-op and have better flexion 2 days in than I did 2 weeks in last time. I have a little bruising coming out on my thigh and as you would expect a degree of general swelling around the operated knee. Of course it is still easy enough to twist or overextend the new knee accidentally (which can be excruciatingly painful) but general pain levels are lower and stability of the joint all improvements this time around. While I've taken on board that the overall recovery time for a PKR may well be similar to that of a TKR it does make me wonder if having half your original knee still present almost acts as a "guide" for the new knee? Whatever, I have no intention to push recovery any faster than my body tells me it wants to go.

In fact the only thing I got wrong so far was despite getting everything ready pre-op, that while I got my cryo-cuff machine out I didn't test it still worked. Sadly I found out when I went to use it for the first time yesterday that the mechanism in the lid that releases the pressure each cycle had failed. Replacement ordered (UKP 70) but it will be Tuesday before it arrives. Grrrrrrr - stupid of me not to test earlier! Thankfully at least it is still possible to use with a lot more manual interaction.

 

[mendogal]

That activity level should be good for a couple of weeks, just increasing the walking as tolerated and doing a teeny bit (fetching a beverage or snack, increasing personal care)

 

[EalingGran]

Sounds great apart from the Cryocuff issue.
Will be interested to see how you find the PKR compared to the TKR knee.
Go easy on the chores on your farm for a good while.

 

[sistersinhim]

It sounds like you are on the right track for your recovery. We have found that recovery from a PKR is similar to a TKR's recovery. You have already done that and know what to expect. You'll do fine!

 

[Antpitta's]

Go easy on the chores on your farm for a good while.

I'm fortunate in so far as my wife has retired and got "used" to having to do most of the farm work last year following my TKR so I owe her a huge debt of gratitude for taking the strain for more or less two full years.

Fortunately we have a couple of local "real" farmers (ours is just a "hobby" farm so we don't have all the heavy kit!) who have been very helpful when it comes to tasks like moving large feed bales/mucking out cow pens etc which are beyond her physically. Also both our girls are currently living at home - and can expect to be on the overnight lambing schedule which is traditionally my domain! So all three have a vested interest in me having a steady and solid recovery.