TKR Antpitta's LTKR - tick, RPKR - tick

[Layla]

Good Afternoon,
Wishing you a speedy recovery so you're able to get back to tending your happy little farm!
The animals are probably missing you. Take it easy...I'm sure you'll be back to it all soon!
Happy Saturday!
@Antpitta's

 

[Antpitta's]

So, three weeks today since my PKR and things are going pretty well. I had my staples out a week ago: nice clean job and slightly shorter incision than last years TKR - and hopefully will continue healing as well as that one did. I had my first physio session the same afternoon and thankfully that was a 100% better experience than last year and I'm hopeful that ours will be a happy and successful "union"! She did measure my ROM: got to 105 without going beyond uncomfortable which she was very happy with at 2 weeks, and extension at around 5 degrees. She has set me a few exercises aimed mainly at getting my extension to zero which already seem to be working (I reckon I'm zero on both legs now). Nothing I could complain about and she doesn't want to see me for 2 weeks - which is fine by me (and I'm being pretty good about my daily limited exercise routine).

The other good things this time around: I'm sleeping 8-10 hours a night with minimal waking although a little less well the last week since the wound has been left uncovered and sensitive to being touched even by a light sheet (I think a common problem?). I've been off all painkillers for nearly a week - the first time in over 5 years since I first started suffering from knee problems! I can manage going up stairs sequentially hands free (but not going down safely yet) and can already do full rotations on the static bike which I'm doing 2 or 3 times a day for a couple of minutes at max height and lowest resistance (aiming for mobility not strength).

The thing I'm finding hardest is walking. I'm physically able to walk without aids (although I carry a hiking pole for security when walking outside) but my whole walking pattern/gait feels horribly unnatural however hard I try and concentrate on walking "normally". I hope this is a temporary thing: the 3 months pre-op when I was largely immobile due to the pain in my unoperated knee (and often wearing an unloader brace) led to really obvious wasting of the muscles - particularly the quads - in my right leg whilst the equivalent muscles in my left leg were taking much of the extra load/strain and feel really strong. And of course following any significant exercise or walking the swelling which is always present to some degree at 3 weeks really ramps up and restricts motion. I'm icing/elevating of course.

But all in all feeling very positive about the future: so looking forward to proper country walks without pain!!

 

[benne68]

It sounds like you are doing really well for so early in your recovery, @Antpitta's !

the wound has been left uncovered and sensitive to being touched even by a light sheet (I think a common problem?)

Yes, it is a very common issue during the early months of recovery. It does go away. Something that works for many people is to wrap the knee (loosely) in a few turns of plastic/saran wrap. The knee won't be bothered by it and it will serve as protection from the sheet.

my whole walking pattern/gait feels horribly unnatural

Again, very common at your early stage of recovery. You might want to try heel-toe walking. This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. Here is a visual

It's important to slow down and concentrate through the entire step. It can feel awkward at first, but with practice, will become more natural. After a week or two of consistent practice, you'll start to notice a difference.

I also encourage you to keep using walking aids if they help you maintain proper gait so you don't get in the habit of limping.

 

[Layla]

What a nice update! You're doing well and I'll bet it feels wonderful to have both surgeries behind you now.
It is not surprising that you still have a limp so early on. Your body is adjusting and your muscles and balance need time to strengthen. You mentioned the weak quads which is making it more difficult to walk normally.

Often we still follow our old pattern of walking post op. Consider purchasing a new pair of comfortable supportive shoes that don't hold your pre-op wear pattern...if you haven't already.

Focus on the heel-toe walking while using an assistive device until you're no longer limping. I sometimes watched myself in the mirror in an attempt to retrain my body to move correctly.
Be patient, it's still early days and each month will bring more progress.
A great rest of the week to you!
@Antpitta's

 

[Layla]

Happy One Month Anniversary!

Wishing you a great week with blue skies, sunshine...what a day to take a walk in the park. Ice cream, daydream...ok, I'll stop now, but remember that song?
Wishing you that kind of Lazy Day.
@Antpitta's

 

[Antpitta's]

Thanks for the greeting @Layla ... I was just thinking I ought to add an update!
===================================================

I’m celebrating the first birthday for my leftie’s TKR today! And on the whole it has been a pretty smooth recovery with the biggest problem probably being how much it has had to take the strain for my rapidly declining right knee over the last few months.

So at 1 year old I only have 2 real moans about it: firstly I still have a very distinct numb patch just below and to the outside of my knee, and secondly there is a small but distinct swelling in the same area. But mechanically great, no pain and just variable amounts of “clunking” which is a little disconcerting but from what I’ve read here isn’t unusual or to worry about.

I’m also just over 5 weeks into my rightie’s medial PKR and that has been a dream in comparison. Initial post-op pain was much less and easily manageable and I’ve been painkiller-free since week 3 for the first time in over 5 years (which should be a relief for my liver and kidneys according to my GP). Sleep was no problem – at least until the staples came out since when it has been a bit more fitful when bedding brushes across the line of the incision. I found I could drive safely after 4 weeks – a few weeks earlier than after my TKR.

I’ve limited exercises to those that worked last time around plus a couple of new ones suggested by my excellent physio. I try to walk outside everyday – around 1km currently – plus whatever just occurs around the house and garden through normal daily activity. I’m also doing 2 or 3 sessions on the static bike daily, just for a few minutes and at low resistance for mobility rather than strength. I’m gradually getting more strength in my right leg quads which had been somewhat wasting away in the months pre-op.

I had another session with my physio last week who didn’t even want/bother to measure my ROM: her words “any experienced physio or surgeon can see you’re doing just fine by how you walked in”! We covered a few questions I had about future strengthening (“not yet”) exercises and general recovery stuff and arranged (probably) a final session in 3 weeks. I have my post-op meeting with my consultant next week.

All in all I’m very happy with where I am now compared to a year ago. I still have stiffness (swelling) around my new right knee – particularly if I’m on my feet for an hour or more at one time, walked further than usual or just over done it a little – but it’s what I expect and know to rest/ice/elevate as appropriate.

When I’ve had issues or worries about my progress just reading some of the threads of other Bonesmarties and the horrors of their treatment and recoveries makes me feel very fortunate with my progress. There are some truly inspirational contributors out there.

I’m sure there will be a few hiccups over the coming months but in the meantime it’s a lovely warm, sunny early spring day in the UK so I’m off outside to enjoy it!

 

[benne68]

Happy one-year an-knee-versary, @Antpitta's Left Knee! And it's great to read that you are already seeing improvement and progress after the PKR.

“any experienced physio or surgeon can see you’re doing just fine by how you walked in”!

YES! This is so true. You are fortunate to have a physio who gets it. So many don't.

Great to hear from you. Enjoy the spring weather and keep us posted on your continuing progress.

 

[Jamie]

I’m pleased to hear your therapist is right on target with your treatment plan. It does sound like you are doing really well. That saying about recovery taking up to a full year applies to your TKR. It may be that your numb area hangs around for a while longer. Nerves are notoriously slow to regrow. But please don’t worry about it meaning some bad. Sometimes it just happens. The swelling on your newest knee is to be expected and also is not alarming. Just be mindful of any pain going along with it, as they are both signs that you may be overdoing things just a bit. You are still early in the recovery process. I know…when the weather finally breaks into Spring and you’re starting to feel better, it’s easy to give in to some of those things you’ve been wanting to do. Just take care and listen to your body. When it says “ouch,” that’s your cue to scale back for a couple of days before going forward again. It’s a real balancing act.

 

[Elf1]

@Antpitta's sounds like you're doing great. We had surgery about a week apart though I had TKR.

I do so love it when your PT gets it. I was lucky with the one that I had after my first surgery and part of the time for this one. He just chuckled when I came in with my walker, 2 days after surgery and I had lights on it. Gotta have fun. Basically the next week I strutted in with my cane and he chuckled again and said wow, you're just carrying that for show! He said my biggest problem is going to make sure you don't so something stupid!

First two weeks were unbelievable, no major pain other then some minor surgical pain. Then something changed and I started getting pain that I had prior to both my surgeries. Doc and I both agreed this week that my knee is beautiful and are working on this other pain issue to figure out its source. Its definitely not a straight line recovery, there are twists, turns and bumps along the road. Keeping a positive attitude, which you seem to have, is definitely a key factor as well as listening to your body. You have this!

 

[Layla]

Thank you for updating us, Antpitta's. Happy One Year Anniversary!
I'm glad you had a smooth recovery, and sorry you're dealing with a deteriorating right knee.

Regarding the numb area, BoneSmart's Nurse Emeritus, Josephine, who had over 50 yrs experience in orthopedics once shared that after her TKR she had an area of numbness for several years, at some point finally forgetting about it. It came to mind around the time she was five years post op and she realized the area was no longer numb. So it may last awhile.

Hooray for you getting off the pain meds. That has to be a great feeling. Hopefully you're able to continue that for the foreseeable future. It sounds like you're doing very well!

Thanks for your contributions here, you're part of what makes BoneSmart such a great resource. Good luck with your meeting with the consultant next week. I hope you have a lovely weekend!
@Antpitta's

 

[Antpitta's]

Thanks @Layla - although you may have mis-understood as the deteriorating right knee disappeared as of 18th February to be partially replaced by a pain-free variety!

Thanks also to the kind messages from all the other BoneSmart staff. Where would we be without you!

 

[Layla]

Of course, duh...right there as plain as day. So sorry, Antpitta's! I'll blame it on not giving enough time for the cobwebs to clear this morning and not enough java.
Have a great Friday!
@Antpitta's

 

[Antpitta's]

Well, today was the 2 month anniversary for my part-new knee and everything still going to plan.

I had my post-op follow up meeting with my OS 2 weeks ago and he was very happy with the outcome and "signed" me off for the process. He showed me the post-op X-rays which all look excellent and in particular show no problems in the lateral compartment (the original plan was to switch from the medial PKR to a TKR if there was any doubt about the condition of my knee once opened up). He also reminded me that it is still a 6-12 month (or even longer) recovery period however good it feels now!

Then last week I was signed off by my outstanding PT (no measurement of ROM since the first visit) who was also very happy with my progress. In fact our last session ended up with her teaching me some simple pilates exercises for my lower back - more on this below.

So, all good from the medics perspective. My biggest problem currently is that while I can walk 2 or 3 miles without any knee pain I do get lower back pain - and the same if I'm standing for an hour or more. I do have some history of lower back pain after being the victim of a high-speed rear-end collision back in 2010. I spent 3 or 4 years on a mixture of painkillers and having several courses of PT before someone suggested working on core strength. I bought a decent rowing machine and within 3 or 4 months of regular use I was off all drugs and pain-free. Of course I've been off-rowing since my 1st new knee so I'm hoping that now I can re-start rowing (albeit gently at first) I can re-build core strength and hopefully my back pain will resolve). After my last PT session I'm also interested in learning some more pilates: I seem to remember that @EalingGran detailed some on-line resources that might be relevant (if anyone has some names/links or suggestions it would be appreciated!).

A few odds and ends. Some days 1 or the other or both knees click/clunk - sometimes just for a few minutes, sometimes seemingly most of the day. I think I've read on BS that this is normal/not unusual. I'm not worried about it but would be nice if someone could confirm that. While I have no knee pain I still have numb patches on both knees but accept that with nerve damage from the surgeries that this may continue for months, years or ever. I also know if I work/exercise too hard that even if there is little obvious swelling afterwards I will get a "tight" sensation over the knee as a whole (but - touch wood - a good nights sleep resolves things).

I've learnt so much from reading other folks accounts and experiences on Bonesmart. It amazes me what some people have had to endure and the strength they show in adversity. And it does make me realise how fortunate I've been with both knees over the last 13 months - and fingers crossed that there are no major problems just around the corner!

Best wishes to everyone here recovering from or waiting for their procedure.

 

[Jamie]

If you haven't checked your shoes for wear patterns, that's always a good thing to do after knee replacements. Often you'll find uneven wear on the soles that was caused by your body being out of alignment with your bad knee. If you see wear along one edge, that's a sign you need to replace those shoes.

Those noises you're hearing (and maybe even feeling a little) are quite normal and not a concern unless they are accompanied by pain. It's just the soft tissue moving over the rigid parts of your new implant. Eventually your body will get used to the new joint and the realignment back to normal and they should lessen or go away completely.

 

[Layla]

Hi Antpitta's
Happy Two Month Anniversary!

I am really sorry to read about you getting rear ended in a high speed collision resulting in years of pain afterward. That's awful. I hope the rowing brings relief once again.

EalingGran is away from the forum for a few days so I will leave the name of the Pilates Instructor she has shared on the forum. If you do an online search for Katja Pilates the classes are on Youtube.

One more voice confirming the noises are normal. Now you've heard it twice.
Many ask about noises that come from their new joint. They describe a clicking or popping sound or they may have a definite clunk in a knee or hip when walking. While these unexpected noises are irritating, they are usually not a problem. The soft tissues around your new implant must settle in with each other and adjust themselves to work smoothly together with the hard metal, ceramic, or plastic parts of your prosthesis. If the noises or sensations are accompanied by pain or swelling, or if a new noise develops all of a sudden, let your surgeon know. Over time the clicking and clunking should subside.

Thanks for stopping by...it was nice to hear from you.
@Antpitta's

 

[sistersinhim]

He also reminded me that it is still a 6-12 month (or even longer) recovery period however good it feels now!

Your doctor is correct, and it's the same whether a PKR or TKR. It takes an average of a year to totally heal from both of them. I wish all doctors would tell their patients this. There would be much less anxiety over their so-called-slow-healing!

 

[Layla]

Happy Three Month Anniversary, Antpitta!
I hope you're doing well and have time for an update. We'd love to hear from you soon.
Until then...all the best!
@Antpitta's

 

[Antpitta's]

Thanks for the reminder @Layla !

3 months and a day since my PKR (and 14 months since my TKR) and things continue well! At times I have to remind myself that it is only 3 months but happily I'm basically pain-free in both knees which was just a dream before surgery. How quickly we forget the "pleasures" of bone-on-bone life!

I'm gradually increasing activity - my wife & I are both life-long birders so there is always the desire to get out into the countryside and we've been upping the distances so several 2-3 mile hikes in recent weeks carrying all the regular gear and over a mixture of surfaces. So far no problems - perhaps just a little stiffness the following day which I guess is just a little reaction/swelling for new levels of activity (& an excuse to put the legs up for a while!).

In fact the only regular reminder I have of the surgeries is that slight tightness around each/either knee after a harder than usual days activity. But it is temporary - and discomfort not pain. Oh, and the clunking (which is kind of weird but not painful). And the numb patch on each knee ...

The lower back pain I'd been experiencing in recent weeks is still an issue but less so - I've continued with the pilates exercises my PT suggested and have re-started on the rowing machine (but only gently for now) so I'm hopeful I'll get over that in due course.

The big event for me the last week is I finally got around to re-roofing one of our lambing sheds! It's only been leaking for 18 months and the least I could do after my wife & daughters have had to do most of the farm work. Apart from anything else that has been probably several hundred trips up and down ladders removing the old roof and laying a new one - lots and lots of knee activity!! But no knee issues apart from still feeling wary about physically kneeling on my new knees and no thoughts of ROM (more than adequate for ADL)!

As to the future, I have my annual trip to visit my sister in Canada in the autumn (fall!) and my wife & I are currently trying to confirm a trip to Northern Peru later this year - so looking forward to fully enjoying the Andes after the limitation our last two trips. Finally, I recently found out my cousin is due a PKR next month. I'll make sure to let her know about Bonesmart (and be on call if she wants to talk knees!).

As always, best wishes to everyone here about to undergo surgery or on the recovery journey thereafter.

 

[Jamie]

Wow, this is a wonderful report!!! You’ve done amazingly well with this latest surgery. Look at you….climbing up and down ladders! It sounds like you have some enjoyable things planned for the coming months. We’d love to see photos of your trips. Your fellow BoneSmarties really do appreciate knowing how much life there is to live after joint replacements.

 

[Layla]

I love your update, Antpitta's, such good stuff!
Sounds like you're engaging in some healthy activity, namely hiking while birding and you have one trip planned and another you're trying to confirm. Your back living life to the fullest. I'm happy for you!
Thanks for mentioning you will suggest your cousin check out BoneSmart. It's appreciated.
Stop by again sometime, we love updates!
@Antpitta's