TKR Days of Recovery (TKR 1/4)

[LD of Michigan]

Woo-hoo! I had my left knee TKR this Wednesday LONG day but no complications.

Outpatient - which was not preferred, yet went very well per the excellent staff that did not over-rush me in the context of the same-day release construct. I took well to the first steps, short walking and mini-stair stuff you must do in order to be released. Second day pain in some ways less this time and different - more at the back of the leg then the front so far. I have the nerve block stint pump still in so true pain not fully known. Yet overall I feel I am having not having as much pain in flexing (which is of course required here and there) as before.

Appetite is pretty good (it wasn't pre-surgery), but tired and bit 'loopy'from my meds of course, so signing off now to binge movie watch some. Thanks for your support. I'll write more this weekend.

 

[Jaycey]

@LD of Michigan Welcome to the other side! Sounds like you are off to a good start. You know the drill - rest, ice, elevate, meds, repeat!

Here are your recovery guidelines in case you need a refresher:

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​

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. Here is a very general week-by-week guide. Activity progression for TKRs

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[InkedMarie]

Glad all went well, @LD of Michigan ! My second TKR was outpatient but I was there almost twelve hours. There was no rushing, stay til you feel up to leaving. In fact, I could have spent the night but I was fine.

Hope your weekend goes well!
Marie

 

[LD of Michigan]

@InkedMarie

The pressure was on for me to leave my outpatient center as they close early. I would have had to be transported by ambulance to the main hospital had a problem arose. As it went I did stay until they all but pulled down the shades and turned out the lights. I refused to be over-rushed.

My first TKR was at the main hospital - but not an option now unless you have existing problems warranting it. I am RESISTANT to ice this time around. Can't stand the feeling of it against my skin on any level but I know it does the new joint and surrounding area well so I do it. And it does reduce pain.

My walker does not fit in tiny bathroom but I have one of those four-legged canes so I manage. I seem to be more adaptable to the pain and know the positions that increase it. Recalled the technique of shoving the non-surgical leg under the TKR one to reposition leg in bed as needed.

PT came to house already along with a nurse. So far so good!

 

[beachy]

Sounds like you're doing great!

 

[FCBayern]

I am RESISTANT to ice this time around. Can't stand the feeling of it against my skin on any level but I know it does the new joint and surrounding area well so I do it. And it does reduce pain.

Icing really is important for the reduction of swelling and pain relief. Have you considered an ice machine? One that you have a pad instead of ice on your knee and it pumps ice water through the pad. Mine was a big part of my recovery.

 

[InkedMarie]

@LD of Michigan i was lucky, I think. I had my surgery at the hospital, not the surgery center. Maybe that’s why I wasn’t rushed.

Marie

 

[sistersinhim]

I also had an ice machine that circulated cold water. I loved it! It was a great pain and swelling reducer.

 

[JusticeRider]

I concur on the ice machine! It’s a much gentler kind of cold than the gel packs in my opinion. And the one I have (Ossur Cold Rush) has adjustable settings, so you can have it more or less cold depending on where you set the dial. Also, once you Velcro it on you can forget about it for a while. I find fussing with the gel packs trying to move and reposition them to be kind of irritating.

 

[EalingGran]

concur on the ice machine! It’s a much gentler kind of cold than the gel packs in my opinion.

I really think you should try an ice machine. If you want to try one there are much cheaper alternatives to the motorised versions. I just have an Aircast Cryocuff that you fill with ice and then the water jacket a little later when the ice has melted a little. The water stays cool in the thermos like main container for ages if you put plenty in. The water jacket stays nice and cool for the length of a 20 minute session. I was given my machine by the hospital. I found it better for pain relief than the dihydrocodeine I was sent home with- as I couldn't tolerate the side effects. I am 10/11 weeks out from a PKR and I absolutely love my ice machine. I still ice at least a couple of times in the day and rest the cool jacket on my knee at night ( changing it when I wake). The first 8 weeks would have been intolerable without it. If I was doing this again I might be tempted to splash out on a motorised version. It might be possible to rent one- my friend was offered this by her hospital.

 

[LD of Michigan]

One week later folks! Thank you for all of your feedback especially re. ice.

I had a bit of a scare, visually more than anything. Day six yesterday I noted a bit of swelling BELOW my knee to the outer left and discoloration. Got out a mirror and to my shock I had dark, mottled bruising and pain to the touch in that lower area and a bit of bruising at the inner bend area of knee.

I'd heard talk of bruising post surgery but did not have it with my RTKR. So I was worried......

Called hospital -- they assured me that so long as I was staying on my aspirin daily, elevation and icing this was ok and should get better if I iced more. Home PT visit reviewed that bruising was not dangerous. Well - confession time: I'd not been icing much.

I don't like how ice feels against my skin - especially in the winter. But it is a healer - my new knee LIKES IT!

I find the sandwich wrap-packs cumbersome and very binding (especially at the back of the knee) so I was going hours not icing. Further, not put my knee up as frequently as advised. This got the bruising to start to some extent I feel.

COURSE CORRECTION required me to get on the ice and more elevation. So, I got out my giant wedge, in creasing elevation and icing. The bruising and pain to the touch in those areas lessened.

PERHAPS, I would have benefited from an ice machine, over the sandwich-style ice pack wraps. Though I did not want another item to plug in.

 

[LD of Michigan]

@JusticeRider

Yes JR. I found/ find the ice 'repositioning' and binding difficult too. I have a larger ice pack personally-purchased which contours better than the hospital packs. The velcro wrap straps really bind back of knee but I am using what I have the most (hospital packs) as I can rotate them in freezer.

And I know I will be done with them for the most part long term. Timing the icing is great too. I cannot sleep with the wraps on. So I time the use to make sure I get it in while awake in bed/ couch.

 

[LD of Michigan]

@InkedMarie

Yes, I protested to be in the hospital two-days as with my 2019 RTKR. But my doctor is out-patient oriented. That seems to be the way of it more than ever. I did not get much rest for the twenty-four hours because reflexively when I got home I was over-doing it and NOT resting as I would have in the hospital.

On the other hand, you DO need to get out the bed relatively fast - using the bionic new knee; understanding that the replacement joint is made for fast weight-bearing. I did feel that the med staff effectively ensured that I was able to do core basics (some steps, balance and walking) so as be eligible for release. I would not have faked that -- as I could have been taken to the hospital nearby by ambulance had I felt too weak, etc.

 

[LD of Michigan]

@FCBayern

Yes, for sure I will try an ice machine in the future. The surrounding coolness sounds preferable over compressed, hard edged ice wraps.

 

[JusticeRider]

And I know I will be done with them for the most part long term

For your sake, I hope you are right!!
I have gotten WAY more mileage out of my ice machine than I ever expected or wanted to! Now I’m afraid to get rid of it lest I jinx myself (kind of like how if you leave the umbrella home it’s sure to rain). But I wish YOU a future with no need for icing!!

 

[LD of Michigan]

Right-oh. You never know what you need in the future. Taking off my 'tunicate' ice-wrap now. Ick.

It would be nice to be able to nap while icing as the machine seems to allow.

 

[beachy]

@LD of Michigan
Can I suggest the large blue gel packs....
They are soft when frozen and cover a large area. They have a fabric instead of plastic cover. Use a light hand towel or dish towel between the gel pack and your skin. Put on on top of your knee and one under your knee.
I used an ice machine with the 2 gel packs all night last night. I also have an ace bandage around knee which acts a barrier. The knee stayed cool all night, but not the freezing feeling.
Hope you get some relief soon!

 

[WFD]

@beachy, do you have a brand name or link for these gel pads you like? Thanks.

 

[beachy]

@WFD
I got these on Amazon. Bought them awhile ago because they're good for any kind of swelling. I have 2.

 

[InkedMarie]

I use Chattanooga ColPak that I bought on Amazon.

Marie