TKR My TKR Journey

Scanne

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Hello all. What a fantastic and informative Forum! I had my RTKR on 2nd Sept, and I must admit I had a totally different perception of what recovery looked like. On discharge day the PT assessed me with a short walk on crutches, a simulated stair climb and a range of exercises that I was to continue once I was home. I was also required to bend my knee to 90 degrees (in order to be discharged), 85 degrees wasn't good enough so I had to have another go. Got there but OMG it caused such immense pain just above the top of my knee.
Sent home with some pain meds and then the fun began, sleepless nights, restless days, tears, frustration and a feeling of failure. My exercise caused me so much grief to do and my knee got stiffer and sorer each passing day, but each time I reflected back to what the discharged nurse kindly reminded me, being that if I didn't do the exercises I would be back in hospital, that they would cut my knee back open and do manipulation to break up the scar tissue and I would be back to the start, so with that in mind I pushed through my exercises, tears streaming down my face.
However, since stumbling upon this forum on day 7 of my recovery I no longer feel alone and I have come to realise that intense exercise sessions are not the answer.
Although my knee is still very stiff and painful, it buckles now and then, I have a tearing feeling across the top of the kneecap, the occasional stabbing through the inside of my knee joint, aching when I stand for too long, have only 1 position I can sleep in for short periods and my lower back and right hip are copping the brunt of it and causing me some significant pain, still have bouts of depression, feeling of failure and tears, I can now see that this is not uncommon for most that have had a TKR and that there is a light at the end of what will probably be a very long tunnel. Since day 7 I changed my routine to now consist of pain meds, rolling my leg back and forth on a skate board, some rocking and semi rotations of a mini exercise pedal, ice and elevation 4 to 5 times a day and NONE of the painful exercises provided by the PT. Last night for the first time I was able to sleep on my right side for about 2 hours, another step in the right direction and a massive milestone in my eyes.
Thank you for this amazing site you have created and to all those who have shared their trials and tributes.
 
Hello and welcome!
So sorry you've been through he** and back with the threats regarding manipulation so early in your recovery.
You are in the right place. I am going through a similar journey. I've had setbacks including an allergic reaction to Dermabond which had me in the ER. Despite that and orders of one week of "tissue rest" the surgeon, PT and my husband expect me over 90-100 degrees flexion by the 22 or I'll be threatened with Manipulation Under Anesthesia. They can all threaten all they want and convince my husband he'll be married to a crippled person, I'm not having it! I'm progressing just fine, and it's my knee!
I pray you continue to find the strength to advocate for yourself, because the powers that be are using a "one size fits all" approach. It's not fair and you'll find you'll reach milestones as well as setbacks, but you will most likely make a full, wonderful recovery! Even though I'm nowhere near that stage, I have seen some progress, and with the support found here, I have the strength and courage to move forward on MY terms.
Looking forward to your positive progress as well :)
 
@Scanne Welcome to BoneSmart and the other side of surgery. The BoneSmart slow and steady approach to recovery is tried and tested - and it works every time. No need to force that knee. All that results in is pain, swelling and frustration. I'm shocked and saddened that they forced your knee before you left the hospital. Shame on them!

Here are your recovery guidelines:
Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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 Activity progression for TKRs

6. Access 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 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.
 
Scanne, :welome: to BoneSmart and this very interesting, mostly challenging, often frustrating roller coaster recovery ride! There is so much good informative here and tons of support. Take things slow, be gentle with yourself. We are all here to support you.
Gingerbread, great report! Keep up the good work!
 
Welcome @Scanne - so glad you found us! The information and the "tried and true" recovery approaches are spot on. And you are hearing it from those who have literally walked in your shoes, whereas your OS, PT, nurses, and even the hubs have not had to recover from this surgery. Forcing a brand new baby knee to 90 degrees while swollen as your ticket to freedom was stupid and cruel. You have had so much construction done in the narrow area pushing it like that may be why you are feeling the pain on top of the knee now. Everything must be allowed to heal before we start pushing it or we risk stressing what was just done.
I hope you continue to find the articles Jaycey referred you to and all your cheerleaders on here to be helpful and supportive in your journey to a painfree knee!
 
Welcome, Scanne! I'm 4 days ahead of you on my second TKR. Listen to everyone here, they really know their business! I'm about to go to my first PT appt today.
 
Day 12 and the stitches come out today. Pain level has slightly decreased as I had my meds changed. Knee is quite stiff and ROM is about 75 (without being forced). I still cannot do a leg raise, it's like the message from my brain gets blocked before it gets to my knee, no matter how hard I try that leg just lays there. Is this normal for others?
 
Hi,
Just wanted to ease your mind a bit, I wasn’t able to lift my leg for 6 weeks.
Quads were just sleeping, I did try about 4 weeks and really agitated the area to the right of my knee, it took my wonderful PT person 2 sessions to make it begin to feel better.
 
My PT did this trick to wake my quads up. While I was sitting in my recliner with my legs straight out, he had me bend my good knee by pulling my heel to my butt. Then he lifted my bad leg straight up so my foot was facing the ceiling. He told me to hold it and I said I couldn’t. He said I could and let go, barely moving his hand away. I was able to hold it. Then he lowered his hands a few inches and told me to tap his hand 4 times with my foot. Which I was also able to do. Then he repeated that process, moving his hands down a few inches at a time. It was 100% non painful, although it took a lot of concentration. Afterwards I could lift my leg on my own, although not very high. Everyday since I’ve had more control and now can do it pretty easily.
 
Thank you both so much, that has certainly put my mind at ease.
SZone you look like you are only one day difference in surgery dates, do you have much pain above your knee cap when you do lift your leg? What is you ROM like, mine is fairly minimal?
 
Scanne, My pain is getting a little better everyday. Now, if I could just do something about this stiffness I would be very happy. I just did a test leg lift, with my leg perfectly straight. I had no pain while doing the lift, but immediately afterwards I had pain around the top of my knee cap that then went away pretty quickly. My swelling is fairly minimal, but I think there is swelling under the knee cap area that makes it hurt more.

As of today (day 12), I can get to 90 degrees without an assist by just lifting my foot up and sitting it down at that degree. I still feel some resistance while it is at that degree, so I will keep at it. I had been at 0 or negative for extension, but realized after I fell earlier today and was sitting on the floor that I am now at about 2. So I’ve lost some of my extension and I’m going to have to start working on that again. I feel like it’s one step forward and two steps back.
 
My PT did something interesting today to get a better quad flex out of my left thigh. She said tighten the right quad and then the left and that way the brain gets the message to the operated leg better.
 
I still cannot do a leg raise, it's like the message from my brain gets blocked before it gets to my knee, no matter how hard I try that leg just lays there. Is this normal for others?
This is very common and will get better as you heal. I did not do “work in this” and in time I could do it.
 
So I’ve lost some of my extension and I’m going to have to start working on that again.
You did not “lose” extension, your fall caused swelling, which has affected your extension. When the swelling reduces, your number will get better.
 
Milestone! I lifted my leg for the first time this morning, funny thing is I wasn't even trying i was just adjusting my leg relaxer and needed my leg off it in order to do so, before I knew it my leg was up off the relaxer by about 4 inches. The only reason I realised was because I felt alittle pain about the knee. I won't get too excited by doing a heap of leg lifts instead just continue to let everything progress naturally.
 
This is exactly how I realized I could finally lift my leg! It took me a couple of weeks.
 
3.5 weeks post op, sleeping fairly well, pain management pretty good with very little meds great extension at 0, unfortunately flexion not so good at (according to the PT) is 65. I have been having trouble from day 1 with extreme pain in the medial area but only when I try to bend too far, it just feels like it hits a block. My PT yesterday said she was pushing my knee as much as she could & it felt to her like it just blocks as well. Any ideas or advice greatly appreciated.
 
I was at about the same flexion at 3.5 weeks. I had some complications so my recovery has been slower than "most" but by Bonesmart standards I am coming along nicely!
You probably are swollen from too much PT. Rest, ice and elevate. Let yourself heal.
Having the PT push your knee won't make it better. I know because they did it to me too.
Time and going at my own pace has done it.
I'm at about 100 now. Many people on here wouldn't be happy with that but I am. It's forward progress and it gets better everyday, going at my pace.
 

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