TKR Confused and unsure........

[Pjmc]

I echo your words as well as Probertson . I have slowest recovery , disappoint , pain like crazy and my surgey was Sept. 5 th . I am angry upset and just plain tired of all this . My incision has not closed ........ Seems one thing after another . I can not wait til we are all healed and pain free.

 

[Jamie]

@toffeymen23.....would you be so kind as to create a signature that contains your surgery date? That helps when reading your posts. To do that, you mouse hover over your username and select the link from the drop down menu to create a signature.

I think you may have misinterpreted your surgeon's advice a bit. When he told you to rest and let your knee heal, I doubt that he meant for you to be immobile for weeks on end. You do need to do gentle stretches and bends each day several times during the day to keep the joint moving. I suggest you start this now. Here is a thread from our BoneSmart Library with some exercises for you.

Riding the bicycle is good, but you do want to be sure that you don't overdo it. Rather than clock distance, you need to be pedaling by time right now. I suggest you start at 5 or 10 minutes with no resistance.....do that for a couple of days once a day. Then add 2 minutes every couple of days until you are up to 15 or 20 minutes. This is assuming you don't get any pain from it. If you do, scale back on the time until you can do it with no pain other than a mild discomfort.

If you find yourself with any pain at all, make sure you ice your knee a LOT. You may have swelling and just not see it, as the knee compartment is very compact. It doesn't take much swelling to cause pain.

I believe as you progress with some gentle exercises, you may see improvements in the pain on the side of your knee that you're feeling.

Also....please read these links from our Library. They describe the healing process. Even though you are a ways into it now, there still should be some helpful information for you there.

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

Next is a FAQ (Frequently Asked Questions) thread.

And then the articles in order of importance .
Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

 

[rjrober23]

Hi Dom,

There is a big difference between the UK and US as far as post surgery PT goes, at least to my observation. The exercises I have done at PT are mostly stuff you can do at home. It is good to have someone with expertise observe your form, analyze where your difficulties are and figure out what works well for you. At least that's what the good ones do. The "others" seem to have an arbitrary checklist of activity and results, if you're four weeks, you should be doing "x".

When I had home PT, they would have me doing quite a bit of warming up the joint before the exercises. Measuring ROM was always the last thing before stopping and putting the ice on at the end of the session. That said, as soon as you rest the knee for awhile, the ROM decrease a bit again, probably due to swelling. The knee feels tight, like it has a band around it. Elevation and ice helps that sensation lessen.

I have noticed that if I lay off or "rest" the knee too much, it gets much stiffer and even more painful. There's a balance of rest vs movement that is best for that knee on a given day. So some walking around the house, stretching and bending all help. If you're an active person, you know what a good stretch or use of a muscle is, there's the bit of discomfort that means the muscles are back in use and it feels good to use them. And then there's the push way too hard that so many therapists here seem to go for.

The pain of bending or straightening the leg after a little time in one position is still there in my right knee which is 8 months on. I don't know when THAT goes away.

(I have found that I can increase ROM more easily by working at the stairs. After my muscles are warmed up and flexing is easy, I go to the stairs and place my foot on the first step and keeping hold of the banister, lean into a bend at the knee GENTLY. I sort of rock slowly in and out of the bend without bouncing. Then I move up a stair and repeat it. You can push too hard, so having a rail or something to hold without putting too much pressure forward on the knee is important. This is probably the best and least painful way I've found for working on that knee flexion.)

 

[icep707]

Toffeyman. Im sorry to hear you are not having the results you expected. I know you thought being a younger healthy male that you would have healed quickly. I guess thats not the case. Im pre op but have been blessed with finding bonesmart the day I got my surgery date. Ive been on everyday since. STUDYING. Im a healthy big strong man ( night club security) part time. Indestructible! But im resolved into surrendering to my knee. Also a former basketball player with brothers ( extremely competitive) . Being in the states and having already attended a JOINT CLASS. IM aware the they do encourage and provide PT. My job to make sure that I have a gentle therapist and not a gorilla therapist. I can honestly say you are in the right forum. Hopefully things take a upward turn ! Im wondering if perhaps scar tissue has developed !!! Also you need to ice even if you dont see swelling and proper elevation. See group b mantras! Also see your primary physician for pain management !! Best of luck

 

[jimmy1956]

Hi, new to the forum. I'm 57 and had a TRKR on October 9th 2013, and am having a TLKR on Jan 22. I went to physical therapy for five weeks after my first surgery and was discharged by the therapist. I could flex my to 135 without assistance when I left. My knee is still tight but not really swollen. I only take any over the counter meds maybe once a week when I really over do it. And really thats for my left knee as well as it is quite painfull right now before the surgery. No issues really right now with the right knee at all other than the occasional tweak because of a wierd bending angle.

 

[Probertson]

I echo your words as well as Probertson . I have slowest recovery , disappoint , pain like crazy and my surgey was Sept. 5 th . I am angry upset and just plain tired of all this . My incision has not closed ........ Seems one thing after another . I can not wait til we are all healed and pain free.

Your incision hasn't closed after 4 months? That doesn't seem right. Is your surgeon aware of this? My staples were removed after 6 weeks and actually my scar looks pretty good now.

I will eventually need my right knee replaced but I am not ready to do that yet. I'm hoping TKR is like child birth, you remember it was painful but forgot how painful : /

I'm just so frustrated with still being in pain and I think my family and friends are tired of hearing me moan and groan when I go from a sitting position to standing. I'm also bored with not being able to do all my housework without my knee screaming for attention by swelling and hurting, it's like dealing with a spoiled 2 yr old.

I'm just glad that all of us TKRers can relate. I'm expecting new grandbaby #6 in May so I've decided to crochet a baby blanket instead of watching tv and eating everything in the snack drawer.

Feel well

Feel well

 

[Josephine]

@Probertson @Pjmc @Celle ladies, please don't derail a new member's thread!

 

[Celle]

Sorry! I've deleted my post.

 

[bayfoxnw]

jeano, I was wondering the same thing: IT band, tendon,ligament. the snapping and feeling like it is going to let go. I had that in my left hip before surgery and it is gone now. That is what I love about this site is the fact someone always has been through what you are going through and that helps with the feeling down periods. I had THR and can not know what you are going through with your knees but I can relate to the feeling down and the frustration of the limitations a person goes through after TKR or THR. Hang in there and read some of the articles, they really help. this is the best site I have ever looked into. This too will pass believe me. When I slowed down and tried what some of these people through experience had told me to try I felt much better.Good luck and keep us informed of how you are doing. Again if you are not moving because it hurts to much I would think about taking your pain meds. Without knowing how much you were taking I do not know if maybe the dose was not high enough to help you. Some one here will go over that with you. Talk at you later!

 

[Josephine]

@toffeymen23 I think you are right, UK patients do tend to get left to their own devices BUT they usually have assessments every few weeks by a physio to see how they are doing. Clearly this got missed out for you.

Now 4 months on I can just barely achieve 90 degrees so I mentioned this to my surgeon on my visit and he said no, what you have now is what it is

Well that's not true for start. Many of our members have reported improvements in ROM up to one year later. So don't despair. We may be able to get you back on track if you will follow advice. The first thing I want to take you up on is this ...

I don't use any ice as not really got any swelling
I do not take any medication, I stopped using medication after about 6 weeks as seemed to make no difference if I took tablets or not.

Then you say ...

- pain I suffer from now is all on the outer left hand side of my knee
- any slight movement brings excruciating pain

- if I sit with my knee bent for too long, it's agony to straighten again and vise versa
- if I'm sat with leg straight to long its agony to bend it again.
Should this really be the case 4 months on??

So you are clearly experiencing pain. So why aren't you taking pain meds?
What were you prescribed originally?

The way I feel at the moment is that if I knew it would be like this then I would 100% turn back time and not even bother having it done and would have been able to carry on with my life as I was

No you wouldn't because you wouldn't have been able to carry on as you were. The knee would have got worse and worse and you'd have been begging for it to be done. We are all knee replacement patients on here and that much we know!

but for the last 4 weeks I have literally done nothing.

This may be where it started to go wrong. It appears to me that you took your surgeon's words a little too literally. They gave you a sheet of exercises - did a physio not go through them with you and show you how to do them, how many times and how often to do them?

We may advocate on here not doing too much but there is quite a difference between 'not doing too much' and 'doing nothing at all'.

But before I delve more into that, I have some questions to ask you:
1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications were you prescribed, how much were you taking in the first 4 weeks (in mg please) and how often?

3. how often did you ice your knee and for how long?

4. did you elevate your leg, how often and for how long?

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

6. what kind of exercises did you do? How much and how often? (and detailed details would be appreciated, please! reps, sets and session and all that)

I would also like you to indicate the exact point of your pain using this chart.
Each square needs a double reference like so BR1 - also say if it's front or back.