TKR Cbet’s TKR Questions

Cbet

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I had my TLKR surgery May 5th so I am just 2 weeks out, currently using a cane but walking without it in the house but I walk with a very stiff leg, my ROM isn't what I think it should be. I was off my pain meds 3 days after I got home because I was so nauseated and they were making me feel awful. Took Tylenol for the next week but have taken no pain meds for last 5 days because pain is manageable for me. Not able to lift heel to do leg lifts but can lift leg to get into bed with no issue. I really notice that my right knee is compensating for my stiff gait which isn't a good thing but I am already signed up to do that one next so praying it doesn't give up on me before that surgery is scheduled .... what is the best time frame to do the second knee I have heard 3 months ....
 
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@Cbet Hi and Welcome!

I‘ve started a recovery thread for you, so we can answer your questions throughout your recovery and support your healing journey.

It is very early days for you, so your walk will be a little off, it will improve as you heal.

It would be best to talk to your doctor about the best time for you to do your other knee.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are 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: The 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
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
2 1/2 weeks and my knee is stiff and ROM is not great .... able to walk and sleep but knee is stiff, stiff, stiff. Is this normal ?
 
I had stiffness on my left knee (12/9/2000) for a long long time. I would say a good 8 months. I had my second knee replacement on right knee on 5/11/22. I am 11 days out and like you very stiff. I try to practice heel toe walking but more often than not I default to a stiff leg. It is a constant effort to remember heel toe. But, based on my left knee I know it gets better
 
Yes, it's absolutely normal, @Cbet ! You are only a few weeks into a year-long recovery. Your knee is stiff and swollen because of all the sawing and hammering the surgeon did.

It's much, much too early to be worrying about your ROM. Your goal right now should be to let your poor knee recuperate from all that carpentry. As the internal inflammation goes down, the stiffness will begin to resolve and your range of motion will increase.

So, at this stage of recovery, the best thing you can do for yourself is to ice and elevate as much as possible. Certainly, get up a move about taking little walks throughout the day and do some simple stretching, but don't push.

And don't worry. What you are feeling is normal for so early in your recovery. It will improve -- it just takes time.

:flwrysmile:
 
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Here's an article you might find helpful, @Cbet

 
@Cbet I was very stiff at 2.5 weeks it felt like a tight rubber and around squeezing the inside of my knee. I walked like a “pirate” my pt said. I just did a couple of short walks (maybe 2-4 houses and back) and LOTs of ice AND Elevation and just moving around the house. My ROM was -4/50 at that point. My surgeon (who has had tkr) said 30 minutes Ice 10 min movement all day- I did more like 40/20 but did find short frequent movement helpful. listen to your body (not the “numbers”) & lean into healing.
 
Thank you that is exactly how I am feeling, the pirate walk or zombie walk. Yes it totally feels like a tight band. Love this forum, so much amazing information everyone is very knowledgeabl. Thank you
 
Thank you that is exactly how I am feeling, the pirate walk or zombie walk. Yes it totally feels like a tight band. Love this forum, so much amazing information everyone is very knowledgeabl. Thank you

@Cbet if it gives you hope I am at 7.5 weeks and did slow rotations on my bike for 12 min this morning @7 weeks was measured at 0 /105. Slow and steady like the bonesmart articles say. You have to heal first before you bend or strengthen. Every day Leg gets a little looser and feels more normal. Even though I am not where PT says I “should be” I truly believe in following your instincts and listening to your body. I make about 6- 10 degrees of ROM a week the bonesmart way (lots of ice & elevating mostly ADL and things I love like stretching & yoga and now bike) and I don’t worry about the “threats” by PT anymore. When I have down moments it helps to refocus on why I had the surgery and my goals post op. We will get there. Hang in there!
 
How can I get added to the May marvels ? My left total knee replacement was May 5th, 2022.
 
You are now on the list:
 
So, I am 3 weeks out from my surgery. I find that my incision is tight and seems to limit how far I can bend my knee. Will this ease?
 
So, I am 3 weeks out from my surgery. I find that my incision is tight and seems to limit how far I can bend my knee. Will this ease?

How is your incision bandaged? Once bandages removed I told PT my incision was prohibiting ROM … they said it wasn’t so I pushed ROM and wound up opening up about 2” on the top portion of my wound fortunately it was superficial and had to stand down for a few days until it closed. Massaging the incision site with scar oil once healed has helped the skin become more supple and not puckered, the biggest limiting factor (for me) was Swelling - which will also make the skin tight.
 
It will eventually smooth down. I am on my 4th replacement. The other 3 did smooth down. Have you had other surgeries? How did they heal?
 
My bandages came off 11 days after surgery so it isn't the bandages. They just closed it super tight with internal stitches and glue, when all is said and done hopefully you won't notice the scar at all (which I am thankful for). This is my first major knee surgery so nothing to compare it with. I just feel tightness and worry that I may split the incision. I know that I am only 3 weeks out but it scares me that my ROM is behind what it should be.
 

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There is no “should” when it comes to ROM, especially at only 3 weeks out. Is your PT telling you it’s not good? We are all different and heal at different rates, and swell at different rates. There are so many factors that affect our ROM. When the swelling goes down, and as you heal, the ROM will improve by default.

Also, Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.
 
Thank you, I appreciate all of the knowledge and encouragement that the members have offered me. My PT has been great not pushing me and stopping when I say I am in pain. I guess that my expectations on recovery are based on previous arthroscopic surgery where I bounced back fairly quickly so 3 weeks seems like a long time for this surgery (although I recognize this was a major surgery I continue to revert back to comparing recoveries) I will try to stop worrying and be patient and know that rest, ice and elevation are my best friends right now. Thank you again
 
guess that my expectations on recovery are based on previous arthroscopic surgery
Yes, it can be a shock when you compare it with arthroscopy. But you have to remember how different the two surgeries are. Arthroscopy uses small incisions and there is minimal disruption to the surrounding tissue, while a TKR requires a huge incision, shoving around muscles and other soft tissue, lots of sawing and hammering, and other insults! It still amazes me that our bodies can recover from all that work.

I found this chart really helpful in understanding why it takes so long:

1652123217285.png
 
I was wondering if anyone else is experiencing leg spasms when they lie down....I get this odd leg spasm in my recovering leg, it can happen 5-10 times before it settles ....it is a very odd sensation. Anyone else getting these?
 
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