Bilateral TKR Bilateral TKR - it does get better

[Sara61]

What great report @Fran55 You'll see more improvements as the months pass.
I do envy you having had both knees done at the same time, here in Portugal unless you have had a serious accident, bilaterals are not done, usually they do knee replacement many months if not years apart, Out patient surgery here also does not exist either for knee replacement minimum is 2 nights hospital stay if in a private hospital or 5 nights in a public hospital.
I'm almost 1 year post surgery and noticed around the 8th month I started sleeping thru the night, now I sleep really well with no pain in my new knee at all - what bothers me now is the other one which is probably jealous from all the attention the new one got l

 

[Fran55]

Oh @Sara61 thank you for the information that you struggled with sleep as well. I was beginning to think it was just me for a while there. I expected pain still at this stage but not the sleep issues. I have been “googling” and trying to find out about it. There does seem to be some research that Indicates sleeplessness can go on for months but It is inconclusive. It is great to have someone recount their own problems.

I knew about three and a half years ago I would need my right knee replaced (the surgeon gave me 3-4 years - it made 3). My left knee gave up very quickly when it’s problems started in July last year. I returned to my surgeon regarding the right knee in March.Tests showed the left knee wasn’t as bad but he said it would need replacing in the not too distant future so we discussed it and I made the decision to have both done. I have not regretted it. Only one trip to hospital and I was only in one day longer than those that had one knee done.Yes it has been tough (not as bad as I expected) but I couldn’t have imagined trying to get one knee better while the other one was in a bad way.

As an aside - my husband and I had the absolute joy of a short visit to Portugal three years ago. We flew into Lisbon, had a stunning train ride to Porto, had a couple of days there, did a river cruise down the Douro and returned to Lisbon for a couple more days. Oh how we wished we had been able to see more. What we saw we found stunning.

 

[Oregon mom]

I found that taking one Diphenhydramine (benadryl) at bedtime really helped me get to sleep and stay there for awhile. I actually started taking one tablet at night to combat the itchiness the oxycodone was causing.
I hope you get some relief soon!

 

[Fran55]

Thanks @Oregon mom - I hope so too.

Oh gosh I am glad I didn't have the itching from the Oxycodone!!

PS I have an aside for you too. I am loving noticing where people are from and noting that across the world we are having the same issues. Six years ago my husband and I drove from Seattle to San Diego. The most stunning part of the trip was the Oregon Coast.

 

[Fran55]

Well tomorrow marks 6 months since I had my Bilateral TKR. Things DO change in that time. Of course my knees are still not “better” completely; both my surgeon and the moderators and advisers on here say it is a 12 month recovery. At the half way point I am happy. Everything is still improving week by week.

Having two knees replaced at the same time is not easy. However, when my surgeon and I agreed both needed doing, to me it was a no brainer. I have never once regretted it.

Whilst I am not sure I was prepared physically ( 65 and overweight) I did try to prepare myself mentally beforehand. I was determined I would cope and do everything I needed to do. I have commented on another thread that I think I must have envisioned I would be screaming in pain. I wasn't. It was VERY painful but not as bad as I had imagined.

I still have some pain, mostly on standing from sitting for too long. My knees are happiest when I am walking. If I just had the energy to keep walking! I think it was @Jamie who put a quote on here that “motion is lotion”. It sure is. The pain has also reduced to just the knee area. Initially the pain went from well above the knee to well below. A muscle down the outside of my right leg above the knee has been giving me some pain recently but it is improving with stretching. The tight band feeling we all suffer is also diminishing. I can still feel it but it doesn’t hurt, it is just – there. I still elevate my knees when sitting although I don’t ice as much anymore.

I am walking better. I haven’t used a walking stick since about the 8 week mark and that was only in case I needed to balance myself and not fall over (my big fear but I haven’t yet). I no longer “waddle” as I used to a lot pre BTKR when my knees would hurt. I did initially after but I was very conscious of getting my gait right.

My sleep pattern is still not back to normal. It is the thing that has most annoyed me. That is the other time my knees tend to hurt. I have always been a restless side sleeper. I can now sleep some nights without a pillow between my knees which is great. When I have a done too much some days and my knees are bothering me a bit I will use the pillow. Rolling over and getting it into place can sometimes hurt on these occasions but at other times it is not a problem. I still wake several times a night having rolled around and managed to get the knees into an odd position. Considering where I was six months ago though the pain when I am in bed is MUCH better.

I still have strong painkillers (Endone – slow release and immediate release) left from a repeat prescription after hospital discharge. I dropped to Tramadol soon after and my GP gave me another script for it a few weeks ago for when the knees have done too much but I try not to take it. I continued to take Paracetamol for some months but dropped that too. I was over taking medication. If the knees have a few bad days what I do now is take Paracetamol regularly for several days until the knees settle and then I can stop again.

I have had a couple of trips away and I must admit my knees aren’t too happy with long car journeys yet .These were two occasions when I had to pop some Tramadol. I am off on another tomorrow so will need to pack some. I am no martyr!!

I don’t think my recovery has been a remarkable one by any means. The knees still hurt sometimes, that’s a fact. Compared to the arthritic pain before my BTKR though it is now much less and getting better all the time. I continue to chuckle when conversations happen like one did at the Podiatrist the other day. I still can’t manage to cut my toenails properly. I saw a different one this time and explained why I was there. He processed what I had said and went – “Both knees?? At the same time??!! Why??” . People seem to think I was crazy.

If you are just starting on your Bilateral TKR journey or considering it know that it will hurt. Know that it will be a JOURNEY of some duration. Try to reflect each few weeks on where you are at compared to before. That will get you through.

Oh, and most importantly -follow the advice on here regarding avoiding aggressive physiotherapy. My surgeon doesn’t allow it. My knees and I love him for it.

 

[Jamie]

Congratulations! I think you're doing really well. And you've been able to make some trips? That's amazing this early as traveling can be very hard on new joints. Hang in there....it's all going to be worth it.

 

[Mrs. Ciz]

@Fran55
I’m 18.5 weeks post op from BTKR. I finally caved and called my regular doctor about getting some prescription sleep medication. I’ve been back at work teaching middle schoolers face to face for the last 6.5 weeks, and I have been EXHAUSTED. Last week I asked my doctor for Ambien, but she prescribed Trazodone for me to try first because it’s non habit forming. The last two nights I’ve only woken up twice versus my usually 6-8 times a night. So it is working.

You are very lucky that you still have access to pain meds. I got cut off at 6 weeks, so now I only take Tylenol and Advil every six hours. If I don’t take it, I can feel it! I am slowly getting better. The horrible pain behind my right knee from my tight hamstring has FINALLY disappeared. Thank God! I thought it’d never go away. I still have tightness across the left knee cap but not the right. Standing in one place still makes my legs and back ache, but walking is so much easier. I do have to stretch a ton, especially my right leg which wants to stay bent, so I don’t limp. If I stretch before I get up after sitting for a long time, I move so much better. As you said - motion is lotion!

 

[Fran55]

Well today marks 7 months since my bilateral TKR. There have been some changes.

The knees themselves continue to improve. I am really happy with the progress I have made. The knees are still a bit tight and there is occasional pain but nothing too bad and overall things are so much better than before the surgery. My ROM is 115 and 0 for both knees and I am happy with that.

There have been other issues however that are now making life difficult.

I had a blood test about two months before my surgery and everything was great.When I went to see my GP the day after I was discharged she thought I was pale and I had another blood test. My white cell count had plummeted. I do have some autoimmune issues which may have caused it or had a virus at some stage. it is slowly coming back up but meanwhile it explains why the fatigue I thought would have passed by now lingers on !

My surgeon's protocols of no aggressive physiotherapy were great ...but! While others were practising how to stand without the use of hands I had to do the opposite for the first few months. This meant I was bending my wrists back a lot. We then had a small second wave of Covid 19 back about about July (Sydney, Australia) and I sewed 110 masks. The two of these resulted in me developing De Quervain's Tenosynovitis in my wrist ( basically RSI). I have just had my second cortisone injection for this and am finally seeing some improvement.

In several posts on here I read where people mentioned their IT Band. I had no idea what this was. I do now and boy can it hurt! I am now back seeing my physiotherapist to see if he can help. We have interesting discussions about physiotherapist's ideas and those of my surgeon!! He is however making headway with the pain on the outside of my knee and upper leg while under instructions to go nowhere near my knee!!.

So - I still have never for one minute regretted the surgery but could have done without the extra bits

 

[Fran55]

It is now 9 months since my Bilateral TKR.

My knees are really good. There is still some residual stiffness and a little pain if I have had a big day but I am so happy with them. When I think back over the months I realise that we have to celebrate the small gains. I was so happy each month or so when friends and family would comment on how much better I was walking. I remember the first time I could roll to my side in bed, the first time I could manage to sleep with a pillow between my knees and the jubilation when I could sleep on my side WITHOUT a pillow between my knees and roll over without pain!

Knee replacement (especially both at the same time) is certainly a journey and is one I haven’t yet finished but is also one I have never regretted.

Now I have to just get further improvement in a few other areas the TKR resulted in. I still have De Quervains Tenosynovitis in my right wrist and thumb. I have had two cortisone injections. The first did nothing but the second just before Christmas gave me some relief. There is still some occasional sharp pain when I twist the wrist certain ways but I wear a Thumb Spica Brace and am hoping for further improvement.

My gait obviously changed. As I noted in my previous post 2 months ago I have had IT Band issues (which apparently attaches to the tensor fasciae latae muscle). It is still a problem although the pain was originally from my thigh to my knee but is now only just above and to the side of the right knee so improvement is happening slowly.

Since my last post I have also developed Achilles Tendonitis in my left heel. This again , is from the gait change when my knees were able to move as they should.

If anyone has suffered from any of the above and has some suggestions I would be happy to receive them!

These three things were unexpected and are painful and annoying BUT the knees are good and for that I am grateful and happy.

 

[Jaycey]

@Fran55 Glad those knees are behaving! Thanks for the update. I hope you continue to see progress with this recovery.

Thread title changed for you.

 

[Geoffa]

Since my last post I have also developed Achilles Tendonitis in my

My first TKR left knee 9 years ago was very good albiet I developed serious pain in my left ankle, actually it was awful, especially at night, after lots of analysis and MRI the diagnosis was orthotics to sort an alignment problem. The cause was, the ankle was prior to the TKR never fully loaded and after the TKR it was not ready for the new load.
It took about a year to get it right!!

 

[DJL1967]

@Fran55 Thanks for the updates over the past few months. I am having BTKR surgery sometime this year and I am so grateful for this forum. I have learned so much from people like yourself sharing your experiences good or bad. I'm glad you are progressing well with the knees but sorry you are having other issues. Hang in there, with your positive attitude you will get past these other hurdles just like you did with the knees.

 

[FCBayern]

Great report @Fran55. I continued to see improvement thought my second year of recovery, I think even those smaller issues will resolve with time.

 

[Fran55]

Could Admin please change my thread title to Bilateral TKR - it does get better. 12 month follow up. Thanks.

On Monday I had my 12 month check up after my Bilateral TKR in May 2020.

I am really happy with my knees. Every few weeks after the operation I would notice the improvements. I listed some of those in previous posts. Last Sunday I noticed the most recent change. I had dropped one of my sewing rulers down between my cutting table and sewing table and had to move the table to get to the ruler. As I bent down I realised that my knees didn’t hurt when I bent down. That hasn’t been the case for years!

The specialist was happy with my progress. I have no trouble walking. Going up stairs is fine. Coming down not so good – not the knees , just the IT band on my right leg. My left knee ROM is 125. My right was only 118 when the physiotherapist measured them last week. The doctor commented that it was the worse knee to start with. He actually doesn’t go too much on measurements. He just goes by sight and looks at the function of your knee. He also agreed that the IT Band issues I am having on the right leg may also be contributing to that.

As my specialist didn’t allow any physiotherapy after my operation I have been reticent to allow the physio to do too much near the knees. The physio can now go for it – he will be happy!

The doctor had a good poke around on the IT band. He is hoping it will improve over the next six months. If not, he may look at a small operation to release the band. I have been so impressed with my surgeon. His protocols of no aggressive physiotherapy and his belief that knees will heal by themselves given time is still not the norm. From what I have learnt from others who have not had this I feel so fortunate.

My Achilles heel issues have significantly improved. New shoes and custom orthotics seem to have done the job. The tenosynovitis in my wrist is also just about gone.

Even with the extra problems I have not regretted having both knees replaced. The arthritic pain is gone. My daily life is so much more comfortable.

For those starting out don’t be discouraged if your knees don’t improve as quickly as you would like or think they should. Recovery IS painful but I knew that pain would get better unlike the arthritic pain which was just getting worse. It is not a sprint but more of a marathon but the journey you are on is worth it. I am an overweight 66 year old who is by no means fit but I managed it. My life is so much better.

 

[Ghostpipe]

Thank you, Fran, for taking the trouble to follow up although you no longer have a great personal use for the forum. I am 9 weeks post bilateral and am feeling dispirited after a surprisingly painful short shopping trip, you’ve restored my faith in my eventual recovery!

 

[Fran55]

@Ghostpipe hang in there. It's "a long and winding road" but it will get better. Even 12 months on a big day out will leave me with some discomfort but everything I have read says improvement will continue.
Be kind to yourself!

 

[Sisterpat]

Thank you, Fran, for such an optimistic report! It gives us all newbies much hope. Did you have problems sleeping? When did they resolve? It’s driving me up a wall!

 

[Fran55]

@Sisterpat - well that took a while! It took a good 6-7 months I am sorry to say. I struggled with sleeping until I was able to sleep without a pillow between my knees. It then just became more comfortable to sleep I think.

 

[Sisterpat]

Thanks, Fran! At least it gives me a timeframe and HOPE!

 

[Sisterpat]

No, but I’m for anything that might help. Please let us know if it works for you.