TKR Claire's recovery journey<

Clairebear

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Hi. I'm 52 and had a TKR right knee on Sept 21st.

Initially the pain was horrendous but it's settled down a lot now. I'm walking with one stick and doing ok but I'm concerned my bend is still only 90 degrees which is the same as it was immediately after the op. It feels like there's a tight band around the front of the knee which is restricting the bend. I do the exercises my physio has given me several times a day but I'm worried I'm not progressing as I should.
 
17 days is still early. I wouldn't be worried, your knee has experienced a severe trauma and needs some recovery time. The best I can remember with my first knee replacement it was around the 6-8 week mark that I experienced a big increase in ROM. Try to be patient. :)
 
I am sure a Forum Advisor will be along soon to give structured advice. At 17 days you are doing just fine. The entire recovery process can take a year or more. For now focus on rest, elevation and icing. Good luck in your recovery journey.
 
Thanks, that makes me feel better. I need a pain med review as on tramadol and they make me nauseous so try not to take them which doesn't help when working on the ROM.
 
Welcome to Bonesmart, @Clairebear! 90 degrees at your early stage is wonderful! Most OSs don't expect that until 6 weeks out. The best things you can do now is elevate, ice and medicate. I will leave you our recovery articles. Following these will help you to have a less painful recovery.

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
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
5. Here is a week-by-week guide for 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

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.
 
Hi. I've been reading alot of the advice on here and rather than pushing my knee with the exercises I've been given by my PT I'm listening to my knee. I feel my flexion has improved a little and my pain is certainly a lot easier. I also appear to have a straight knee too which is a big improvement on last week. I'll see what my physio has to say tomorrow.
 
I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Saw my PT today who says I've made good progress in the last week. My ROM is now 110 (90 last week).
Yes I'm happy to answer your questions.
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
1. Pain is a 4. Concentrated always on the scar.

2. Meds prescribed are tramadol 50mg max 8 in 24 hours. Paracetamol 500mg max 8 in 24 hours. I take 2 paracetamol and 1 tramadol before bed as my knee becomes restless.

3. Swelling is moderate now.

4. Flexion is 110. Extension is 5.

5. I'm icing every 2 hours in the day time.

6. Elevating every 2 hours.

7. Walking unaided indoors, have a stick for outdoors . Managing fine with light household chores, washing dishes, doing laundry, vacuumimg, dusting. Can walk around the supermarket.

8. Heel slides x 10, 4 times a day. Leg extensions x 10, 4 times a day. Leg lifts x 10, 4 times a day. Pt practiced stairs going up with bad leg but finding that one difficult without swinging my leg a little to the side.
 
Wow your only 2 days behind me and you are unaided inside, thats fantastic!!!
I am still one 1 crutch inside and feel like i will never get to ditch it .
I am sure your pain and meds will reduce over the next few weeks. Such a long frustrating journey....overall all your doing great :wow:
 
Sorry, you have missed out quite a bit of essential information
2. Meds prescribed are tramadol 50mg max 8 in 24 hours. Paracetamol 500mg max 8 in 24 hours. I take 2 paracetamol and 1 tramadol before bed as my knee becomes restless.
The question was "how much are you taking (in mg please) and how often?"
Extension is 5.
Extension is usually in a plus + or minus - state. Plus means you can't get your leg totally flat
5. I'm icing every 2 hours in the day time.
The question was "for how long?"
6. Elevating every 2 hours.
The question was "for how long?"
8. Heel slides x 10, 4 times a day. Leg extensions x 10, 4 times a day. Leg lifts x 10, 4 times a day. Pt practiced stairs going up with bad leg but finding that one difficult without swinging my leg a little to the side.
And with this I asked "This is the most crucial question so please help me by using the format I have left as an example (which means please make a list and not an essay!)"
 
@Kiwigirl62 thank you :flwrysmile: You'll get there. It takes me a while to get going as when I stand the first few steps are painful. You're right it's a frustrating journey, baby steps about sums it up. Looking back on the progress I've made in the last 3 weeks helps me alot as 2 weeks ago I'd never have believed I could do what I can now. That said I've along long way to go. All the best with your recovery
:loveshwr:
 
@Clairebear , thanks, just got back from PT, I'm happy with ROM, finally making gains with extension.
Made the break through as they had me practice walking un aided - between the rails. Was a big mental leap in my head.....once i conquered that was no problem and no pain. Will practice this week. Yes I agree, if i think about each weeks progression, it is happening - just cautious as i sooooo do not want any set backs......not that i can really control :praying:
 
Hi Josephine,
Sorry I did but it was in the early hours when I was struggling to sleep. Would you mind changing the name of my thread please, to Claires TKR journey. Thank you. I'll answer the questions below. I've changed my meds and my pt gave me more exercises so have revised my answers.

Meds, Tramadol 50mg x 6 daily
Paracetamol 100mg 4 x daily

My extension is +5

I'm icing now 4 x daily for 30 minutes

Elevating 4 x daily for 1 hour

Exercise

Knee slides 10 reps, 6 x daily
Straight leg lifts 10 reps, 6 x daily
Calf lifts 10 reps, 6 x daily
Step extensions 10 reps, 4 x daily
Squats, 10 reps, 4 x daily
Lunge calf stretch 10 x 4 x daily



@Kiwigirl62, that's great. Well done on the walking unaided. On my first session with my PT (1 week post op) I was a mess. I was so frightened of the new knee and the pain. I know now it was because the PT who came the day after my op was quite brutal! She told me to swing my legs off the bed, on doing so she didn't support my bad leg. I felt the sensation of the new joint as it bent and the pain was horrendous. The sensation of the new knee felt so alien.
My new PT explained to me that I couldn't damage the new joint as it was cemented in and it would take something drastic to cause any damage.
Sorry for the long winded essay! My point being that we need to be more confident and trusting of the new knee:flwrysmile:
 
Would you mind changing the name of my thread please, to Claires TKR journey.
Tis done! Though I did change it to "Claire's recovery journey" as there's already a TKR in your thread title.

I'll deal with the questions and answers tomorrow as it's just gone midnight here and I need my bed!
 
1. Pain is a 4. Concentrated always on the scar.
That's pretty good for 4 weeks out!
2. Meds prescribed are Tramadol 50mg max 8 in 24 hours. Paracetamol 500mg max 8 in 24 hours. Tramadol 50mg x 6 daily, paracetamol 100mg 4 x daily
Okay
3. Swelling is moderate now.
Good
4. Flexion is 110. Extension is +5.
Wow! Not bad!
I'm icing now 4 x daily for 30 minutes
You accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and more than 4 times a day.
Elevating 4 x daily for 1 hour
Elevate when you ice - always
7. Walking unaided indoors, have a stick for outdoors . Managing fine with light household chores, washing dishes, doing laundry, vacuuming, dusting. Can walk around the supermarket.
Very good!
Knee slides 10 reps, 6 x daily
Straight leg lifts 10 reps, 6 x daily
Calf lifts 10 reps, 6 x daily
Step extensions 10 reps, 4 x daily
Squats, 10 reps, 4 x daily
Lunge calf stretch 10 x 4 x daily
Given your excellent progress, you really don't need to do any of these! And you are quite active enough not to need them as well. That's why they are crossed out!
 
@Josephine , thank you! I'll up the ice and elevation. Thanks for all your advice, it's really appreciated.
 
And the exercising too? That's your biggest problem.
 

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