TKR BobM's Left TKR Recovery

[bobm55]

Well, I’m laying in a recovery bed following my left knee TKR. So far, so good. No pain at the moment, but know what to expect, having had my right knee replaced back in 2020.

I had the surgery at UCSF and my surgeon is Dr. Stefano Bini.

It was done cement-less, with a Stryker implant, and was MAKO robot-assisted. Oh, and there was no tourniquet.

PT is scheduled to start 2 weeks from tomorrow.

Off we go!

 

[Layla]

Hi Bob,
Wishing you a smooth and steady recovery. Those early days can be tough, but each step forward is progress, no matter how small. Be patient and focus on the better days ahead.
Congrats on your new knee!
@bobm55

 

[benne68]

Glad to read you re on the healing side now, @bobm55 !

Even though you've been on this journey before, I will share our Recovery Guidelines as a refresher. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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

Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

KNEE RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
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
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

Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics

Let us know if you have questions or concerns. We are here to help!

 

[bobm55]

The surgery went well. It was on a Thursday. On Friday night, I began to notice some bleeding. As I got up to go to the bathroom a couple of times during the night, it got worse. By Saturday morning, the gauze was drenched red.

I called the after hours number and a surgeon called me back. They suggested that we go to the emergency room or urgent care to have the dressing changed. My wife drove me there and we spent four hours there. No new bleeding since.

The hospital provided a Breg Polar Care Wave device. It does ice and compression and is much better than just placing ice on the knee.

I am getting up to walk around several times a day and doing lots of ankle pumps and I started doing some quad sets today, but they're pretty painful.

I haven't needed to take any of the oxycodone today (so far) as the pain has been manageable.

I do hope that this knee goes as well as my right one did. I had the surgery done at UCSF.

I'll check in here from time to time and wish everyone else going through their recovery the best.

Warm regards,
-Bob

 

[Jamie]

Great to hear the bleeding stopped. That happens sometimes, but if the dressing stays clear, you’re in good shape.

Most surgeons these days inject a cocktail of pain meds into the incision before closing to keep pain levels low during the first few days. Be expecting that pain may increase sharply on Day 3, as that can happen. It would be good to keep up the low level of movement and lots of icing to hopefully prevent that.

Thanks for letting us know how things are going.

 

[mendogal]

The Breg Polar Care is great!!! I have the basic version (no compression) and wouldn't have surgery without it! Did you know you can avoid constantly replenishing ice by freezing four 16 oz bottles of water instead? Just have four more in reserve in the freezer to swap out as they thaw.

I am a huge fan of quad sets for early reactivation of quads.I did them, a few at a time, while relaxing in the recliner with the ice on. But they ought not hurt!!! So I recommend stopping them for two or three days to get a handle on pain and swelling before even trying a few again.

 

[bobm55]

Thanks!

The Breg came with 8 bags for water for freezing, so I've got the setup you describe.

I'll take it slower on the quad sets.

Regards,
-Bob

 

[bobm55]

6 days post-op, I got my first good night's sleep last night and am so grateful for it.

 

[Jamie]

Hooray!!!! Party time!!!!! Congratulations! Accomplishing milestones are so wonderful.

 

[sistersinhim]

A good night's sleep is such a blessing! It took quite a while for me to sleep well. You are achieving that sooner rather than later!

 

[mendogal]

Oooh and at less than a week post op (sternly staring at my knees: "hear that, fellas?!?! You didn't have to take several weeks!")

 

[Layla]

Congrats on your new knee, Bob! Thankfully the bleeding episode was short lived.

Yay for some restorative rest. It does a body good!
A great day to you.
@bobm55

 

[bobm55]

It seems that that one good night of sleep was an aberration. Sadly, I have not had another since. But there's nothing wrong with mid-day naps to catch up on that much-needed sleep.

If I recall from my first replacement 5 years ago, it took me several weeks for my sleep patterns to stabilize.

Needless to say, early recovery is not a linear process.

My first outpatient PT session is Friday. I've carefully eased into a few at-home exercises. Baby steps.

Onward!

 

[Layla]

I am sorry, but not at all surprised about the sleep. You're in good company, which is cold comfort when all you want is some decent shut eye. Thankfully you have your past experience to know this is only temporary.
Glad you're taking it easy and easing into the exercises.
I wish you the best for your first PT on Friday and hope you'll insist on the same approach there, e-a-s-y does it!
Happy Saturday, Bob…hope it's a good one!
@bobm55

 

[bobm55]

I recall from my prior knee replacement that I lost 10 pounds over the course of a month or so.

I expect that it was due to a reduced appetite, which I'm experiencing now as well. One of the things that I've been doing is supplementing with an Essential Amino Acid supplement. I started it one week before the surgery and will continue it for 2 weeks post-op. The idea is that it assists in reducing muscle loss that can occur following surgery.

I'm 5'8" and 170-ish pounds and since my surgery, 8 days ago, I've already dropped a few pounds.

Have others had similar experiences? I do realize that everyone's body is different and that we all react differently to just about everything. I'm simply curious and thought I'd throw out the question.

And thanks @Layla Saturday is going pretty well so far.

 

[benne68]

Have others had similar experiences?

Yes, I did with my first joint replacement surgery. When I mentioned it to my surgical team, they urged me to add high protein nutritional drinks to my diet because our bodies require extra protein for recovery,

Take at look at the articles on our Nutrition pages here and here.

 

[bobm55]

Thanks @benne68 That’s great advice. Those pages are very helpful.

 

[Lupyhippie]

Great to hear the bleeding stopped. That happens sometimes, but if the dressing stays clear, you’re in good shape.

Most surgeons these days inject a cocktail of pain meds into the incision before closing to keep pain levels low during the first few days. Be expecting that pain may increase sharply on Day 3, as that can happen. It would be good to keep up the low level of movement and lots of icing to hopefully prevent that.

Thanks for letting us know how things are going.

Yep day 3 happened to me this time and it HURT!!! Made me cry it was so bad !!

 

[bobm55]

Had my first physical therapy session this morning, 15 days post-op.

It went as well as could be expected. Surprisingly, I somehow measured zero degrees for straightness. It even surprised the therapist. I recall from my right knee TKR how much I "disliked" the straightening exercises. Regardless, I still need to work on keeping it straight so I don't lose it.

Flexion was around 70 degrees, which is fine. I'm doing my best to take things one day at a time and to maintain consistency with doing the exercises.

And thankfully, I'm weaning myself from the narcotic medication. I expect that I'll be prepared to stop in a week or so. Though it has been helping me get some sleep at night.

I have two sessions schedule per week for the next few weeks to go along with the home exercises.

 

[Jamie]

When you’re wanting to wean off prescription pain medication, you can try using Benadryl or 1000mg Extra Strength Tylenol to help with sleep. Pain during sleep is one of the last things to get resolved, so don’t be surprised if it takes a while to have a good night’s sleep.