TKR DaveJH's Knee Recovery Thread

[DaveJH]

Right TKR 24 March 64 years old
Recovery seems to be going well. I feel for all of the folks I see having troubles and feel fortunate for a (so far) much easier path. Off of hydromorphone at 4 days and using paracetamol (acetaminophen) and naproxen Na. OS said he doesn't need to see me again unless I have problems and I am at PT twice per week. I love the Game Ready machine that is my "reward" for finishing my PT course each time. I feel that my PT therapist is on a team with me and always asks about how I feel about any specific exercise before starting it with me.

Swelling is, of course, still an issue, but hopefully will begin to improve soon. My ROM is 0-145 and my OS has the same implant that I do, Though his is a Journey I and mine is a Journey II. I mentioned sleep problems to him at my last final visit and he told me that he had to take valium for a couple of months when his knee was done. In addition he recommended diclofenac cream and said it should help with swelling also (skeptical, but OK). My state has medical marijuana, so I have a permit, though I don't really feel that I have gained too much relief from the gummies. The valium has improved my sleep and that truly makes a world of difference.

I wish the fastest possible recovery for all of the folks struggling.

 

[sistersinhim]

@DaveJH, I‘ve moved your post above out of the Monthly team thread. That thread is reserved for surgery date information. Having this monthly team thread allows members to see who else has surgery in the same month as they did. All other comments and discussions should take place in a pre-op or recovery thread, such as this one. Enjoy interacting with and learning from others who are on the same journey as you are, here in this thread. If you would like a different title for your thread, just let us know.

 

[sistersinhim]

Even though you had your surgery about 6 weeks ago, I'll leave you your very own Recovery Guidelines.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

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.

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

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

6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep

 

[Layla]

I mentioned sleep problems to him at my last final visit and he told me that he had to take valium for a couple of months when his knee was done.

Another option to consider -

Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

Welcome to the forum, thanks for joining us! It seems you're doing well. I wish you all the best and hope you'll continue to share your journey with us.

 

[DaveJH]

Trying the "Calm" magnesium citrate and ditched the Valium last night. So far I'm encouraged. Longer to fall asleep, but good deep sleep and fewer times awake.

 

[Layla]

Wonderful news, Dave!
Just a FYI...Magnesium Citrate and Magnesium Glycinate are the most easily digestible forms of Magnesium.
People often use magnesium glycinate instead of other magnesium supplements, as the body finds it easier to absorb magnesium in this form. It is also one of the gentlest supplements on the stomach. Unlike other forms of magnesium, it might not cause as many side effects, such as an upset stomach or loose stools.

As long as you don't have an issue with Magnesium Citrate, stick with it, but know there is another option if it begins to affect your digestive system. Best of luck to you!
@DaveJH

 

[Layla]

Happy Two Month Anniversary!
Hope you’re doing well and sleep continues to improve.
Enjoy the rest of the week and have a great Memorial weekend!
@DaveJH

 

[DaveJH]

Thank you. I went camping and probably overdid it a bit, but am taking it easy for a few days. Sleeping has improved, though my biggest concern right now is swelling. It just always feels tight. But I guess that is about normal for this time. I was not prepared for the length of the recovery, and will be travelling to Austria for a conference in about 2 weeks. Time to break the TED hose out again.

 

[sistersinhim]

Easy does it and get lots of ice, elevation, and rest!

 

[DaveJH]

After reading about many of the journeys of my fellow TNR recipients, I wonder about individual PT and specific routines. I decided I would put my routine down:

1: Heat and soft tissue massage with ultrasound (skeptical about the ultrasound...but)
2: Foot pedal machine 5 minutes
3: Bicycle 5 minutes
4: The Bender: 15 minutes. The Bender attaches my ankle to the moving bar and puts a strap over my thigh. I have a hand crank that allows me to crank my leg to extension and then hold 30 seconds then crank to whatever flexion I want to hold 30 seconds. The machine tell me my knee angle in degrees and counts the 30 seconds for me. I usually get 10 cycles in during the 15 minutes.
5: Total Gym 5 minutes. The total gym is just a sled set on an angle that I use to push up and lower with my legs. Usually the PT measures my max flexion on the total gym after my 5 minutes.
6: universal gym curls. I sit in a chair with my ankle hooked to the gym. I set whatever weight I am comfortable with and pull my ankle to myself in the chair lifting the weight. 20 times.
7: Mini-squats 20 times. I place a large inflated ball against my back and lean against a wall; lower myself down as far as is comfortable and raise back up.
8: Step-ups and Step-downs. 20 times. I step up with the injured leg and then down with the good leg. The step is about half the height of a regular stair step.
9: Side steps and forward steps. An elastic band is placed around my ankles and I side step across the floor about 13 steps leading with the injured leg. 4 times. Then with knees slight bent I walk forward the same distance again 4 times.
10: leg raises. I lay on a padded bench and but a small object under my knee. I raise my foot to straighten my knee 20 times. Then I raise my entire leg as high above me as I can 20 times. (Lately I have put a small weight around my ankle during this routine)
11: The PT gently stretches my legs and back muscles for about 5 minutes.
12: Balance heel to toe walking same distance as the side steps.
13 Game Ready and STIM. 15 Minutes. The muscle stimulation pads are placed under the Game Ready Sleeve and then the I control the level of electrical stimulation. The Game Ready provides compression and recirculates ice water through the sleeve.
14: Soft tissue massage and Icy/Hot cream. about 15 minutes

The whole process takes about 2 hours. I have been going twice per week, but am about to change to once per week as I start water aerobics class.

 

[Layla]

Happy Three Month Anniversary, Dave!
Enjoy the Summer!
@DaveJH

 

[DaveJH]

Just returned from a two week trip to Austria for a conference. I had been warned that travelling before 3 months might cause discomfort, and I can say, that yes, they were correct. Lots of walking through airports and then some climbing and hiking without a good ice supply caused a lot of swelling.
Now back at home, I am trying to slow down a bit and doing water aerobics. Hopefully the swelling goes down some day.

 

[Layla]

I hope you're able to get some rest and icing in and feel better soon.
Never been to Austria, but pics are certainly beautiful! Can't help but envision, Julie Andrews, singing the Sound of Music, lol.
@DaveJH

 

[sistersinhim]

I think you need to back off of the water aerobics until your swelling goes down. Water has a resistance which is like using weights. This will cause increased inflammation, which in turn causes more swelling. It's a domino effect.

 

[DaveJH]

At 64, I am pretty much the youngest person at the water aerobics and the I wouldn't call the workout intense. Mainly it is stretching and some cardio like jumping jacks which I do slowly and they seem much easier in the water, but I could see how a strenuous workout in the water could stress the knee. I always take it slow and easy.

 

[Jockette]

Now back at home, I am trying to slow down a bit and doing water aerobics. Hopefully the swelling goes down some day.

A slower approach is appropriate right now since you have this swelling. A lot of rest, ice, and especially elevation, will help that swelling, more than water aerobics. There will be plenty of time to do such activities once your swelling reduces.

 

[DaveJH]

Just over 5 months since RTKR and I feel mostly there, Still some swelling, but I really don't have time to rest and elevate much, so it is what it is. My PT says the swelling will eventually go down and to give it time. I have good ROM with full extension and flexion to 149. My biggest complaint is really that my knee cap area is still numb. It is really weird to kneel when there is no surface feeling. Again, my OS assistants tell me that the feeling should eventually return, to some extent, but that I may always have some areas of numbness.
Overall, I feel much better than before the replacement and do not think that there is anything I can't do with the new knee. My OS has retired and that was a bit of a surprise, but I'm happy with the job he did and wish him the best in retirement. He has the same implant as me in one of his knees and is the same age as I am.
My wife and I are looking forward to seeing my eldest daughter, her husband and my two grand daughters in New Zealand starting in November for a few months. It was tramping over mountains with them in NZ that pushed my knee over the edge last January, so I anxious to see how the new knee handles it.
Wishing less pain and more ROM to all who are going through early recovery from joint replacements. If we lived a hundred years ago, it would just be bone on bone pain for the rest of our lives.

 

[EalingGran]

My biggest complaint is really that my knee cap area is still numb. It is really weird to kneel when there is no surface feeling. Again, my OS assistants tell me that the feeling should eventually return, to some extent, but that I may always have some areas of numbness

At 10 months I definitely have some sensation back all over my kneecap but it still feels "different". It can still be a bit unpleasant if I knock it accidentally or put too much pressure on one spot when kneeling. I know what you mean about it feeling really weird when you feel you are kneeling on nothing.
My slightly numbish area hasn't changed much in the last month. I hardly ever have zingers now either. Do you get those? They are a sign that the sensory nerves are regrowing- so I always felt very pleased when I had them.Even though they can be quite sharp and nasty.

 

[benne68]

It is really weird to kneel when there is no surface feeling. Again, my OS assistants tell me that the feeling should eventually return, to some extent, but that I may always have some areas of numbness.

I am almost two years out and still have a few small areas of numbness. However, most of the sensation has come back. I noticed that the numb area sort of "shrunk" over time.

As far as kneeling, I can tell you from two years out, that it still feels odd to kneel on the operated knee. That said, it's something you can get used to. I started practicing yoga again when I was about six months post-op. At the beginning, I needed a pillow under that knee; now I just use my yoga mat.

It sounds like you are doing extremely well in your recovery and I'm sure you will enjoy tramping in those NZ mountains again soon!