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TKR Complications

Micky010925

new member
Joined
Jan 19, 2025
Messages
6
Age
52
Gender
Female
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United States United States
Hello all. My right tkr was on 1/9/25. In the hospital, I had extreme pain at the back of my knee. They had done a spinal with nerve blocks as my anesthesia. The surgery itself seemed to go well. When I said something about the pain at the back of my knee while in hospital, I remember them saying that I had a nerve block there and it must’ve not worked. Anyway, the next day I get a little PT and OT. I’m able to do my slight walk with a little step on the right side using my walker. Very painful but that’s what one should expect after surgery. I learn to use crutches to get up the stairs with that slight right side step and go home. Get into my house okay and everything seems normal 1/10-1/12.
My surgery was a Thursday. On the Sunday, I noticed that my foot was extremely swollen and slightly blue.

So I left a message for my doc to see if this was normal. They initially made me an appt for Monday afternoon but then called me and said the swelling and change in color is normal and to see how things progress as I was to start PT on Wednesday. So Monday night I notice some really odd sores on my leg and that the whole leg is swelling up and turning darker. I send a message with pics Tuesday morning and I’m told to see a doc when I go in for my PT on Wednesday. On Wednesday, I am no longer able to put any weight on my right leg at all. My calf is about 3x its normal size and beyond painful. I go to PT and they immediately get me a wheelchair, because I need to hop on my good foot using the walker. The PT guy immediately then goes to talk to my surgeon. The surgeon comes in about an hour later due to his other patients, looks at my leg, and immediately sends me to X-ray and to get a Doppler ultrasound to make sure I don’t have a DVT. The X-ray shows the new hardware is beautiful in my leg. The ultrasound shows no evidence of a DVT. I’m sent home to await next steps.

Speaking of steps, due to the fact that I cannot now use my right foot at all, it takes over 30 mins to figure out how to get up the three steps outside my home with no railing. I receive a call that the doc wants me to come in first thing on Friday.

Luckily my mom is caring for me due to my inability to do anything since I am now entirely non weight bearing on the right side.

We head into the doc office on Friday (8 days postop). He says he’s honestly never seen a swollen reaction like mine. He decides I should go on a prednisone z-pack for the next several days and see if we can reduce the swelling. He also orders a wheelchair, ramp, and home health aid 4 hrs/day, for my house. It’s a Friday and a holiday weekend so nothing is provided for me and won’t be available until next week. Since my mom needs to fly back home, a good friend comes to stay with me because I’m still 100% dependent due to being non weight baring on right side and no wheelchair.

Start prednisone zpack high dosage on Friday. Swelling of foot and leg has decreased substantially. However I am still unable to put any weight on my right leg. Pain is primarily in my calf, but a little up the leg as well.

I think the prednisone is doing the job it’s created to do which is reduce swelling. That’s good. However, the underlying issue that caused the swelling isn’t known. I am posting here to see if anyone has any ideas? I’m not wanting to fully go on leave and I’m trying to work remotely through all of this. I need to find answers as I travel a lot for work as well. Anyone have something like this and have any ideas?

Currently, I’m leaning toward the idea that the nerve block maybe hit the wrong thing and that’s causing the pain and issues. That’s just from my own reading though. I hope folks on this forum may have ideas. I want to start PT before it’s too late and I am unable to get full use of my right knee.

I tried to put a bunch of pics on here but they were too large. Just a couple from the early symptoms are provided.

Thanks!!
 

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Welcome to BoneSmart. Before answering specifics, here are some general guidelines:

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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 these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 
@Micky010925 Hi and Welcome!

I’m sorry you’ve had such a rough start, and I’m sorry your medical team is not sure what’s going on.

I want to start PT before it’s too late and I am unable to get full use of my right knee.
Please don’t worry about this delay of starting PT. Your body will heal in its own timeframe, with or without PT. Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
Hello and Welcome to BoneSmart and recovery, Micky!

Sorry you were off to a rough start. I am sure it was unnerving not understanding the reason for the extreme swelling. Thankfully it's resolved substantially. :thumb:

In addition to the prednisone and icing, please understand the importance in elevation also.
It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

Thanks for joining us. I look forward to following your healing journey. :wave:
@Micky010925
 
Hello and Welcome to BoneSmart and recovery, Micky!

Sorry you were off to a rough start. I am sure it was unnerving not understanding the reason for the extreme swelling. Thankfully it's resolved substantially. :thumb:

In addition to the prednisone and icing, please understand the importance in elevation also.
It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

Thanks for joining us. I look forward to following your healing journey. :wave:
@Micky010925
Thank you. I have my leg elevated whenever I am not hopping my way to/from restroom. I am icing 75% of the day. Not just ice machine for top of knee, but I added ice packs for my calf since it’s so painful.
 
I have my leg elevated whenever I am not hopping my way to/from restroom.
That's good!

Just to clarify: proper elevation means "toes above nose." This article gives some clear examples of the right (and wrong) ways to elevate.

 
Hi all. Could what I’m experiencing be “drop foot?” I haven’t seen anything about the extreme swelling connection, but now that I’m on prednisone, and the swelling has gone down a lot, I see the issue may be that I can’t point my toes in or my calf is on fire.
 
Can you not wiggle your toes or flex your ankle at all?
I had this for about 18 hours after my PKR. But thankfully in my case it was just due to a lot of local anaesthetic that the surgeon had used and it wore off gradually the next day.
You need to check in with your surgeon to exclude nerve damage causing foot drop.
Some people here have had this. But your problem might just be the swelling is still making movement difficult. Good luck. Keep us posted.
 
Thank you. I can wiggle my toes and my ankle moves a little but I can’t get all forward flexion and no weight at all on the foot. I’m now 11 days postop. I could put some weight on it for the first 3 days. Then the swelling and then the inability to use the leg. Now swelling is down due high dose of steroids. Still can’t flex all the way up and no weight.
 
Hi Mickey

With my 2nd tkr I had extreme calf swelling and a painful calf. I like you had a sono . No dvt

It will go down and so will the pain
Don't overdo the PT or exercise.

You will get there
Elevate ice and rest
 
Don’t really have anything substantial to add other than as much as it’s been a difficult start for you you’ll get great advice here. Really hope things start to improve for you.
 
Happy One Month Anniversary!
I hope you've enjoyed some progress over the past three weeks.
One month under your belt already. Sending best wishes for a continued recovery.
A great week to you, Micky! :)
@Micky010925
 

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