Bilateral TKR Debs 2 new knees<

[msehphdjd]

I, too, am using no canes in the house, generally. I overdid it yesterday and am using it today just to lighten the load. But, I can't imagine walking outside without one, not for more than a few steps. I see my OS on Wednesday and will post an update after that. No issues with DVT except for occasional discomfort in my calf. Fortunately I am sleeping well so I'm glad for that. Hang in there!!

 

[Celle]

If you feel more secure using a cane, keep on using it. There are no prizes for giving it up early and it's much better to use it than to risk having a fall.

Even when I no longer needed a cane, I would still take it with me when walking in crowds, or when the ground was wet or uneven.

A cane can be a useful warning sign and it helps to ward off rushing people and dogs.

 

[DebM]

Woohoo! In my first two weeks of twice weekly hydro/pt plus stretches and gentle range of movement exercises daily at home I have gained 15 degrees ROM in each knee. Now 85 and 95. I think my OS will be happy at my six week check next week.

 

[DebM]

I am now 7weeks post BTKR and coming along slowly but surely. I am finding that I can only flex my right knee to a certain point then I get a grabbing pain at the back of my knee toward the outer aspect ( on @Josephine pain chart it's DRB1 ).
Wondering if anyone else has experienced this or has any ideas. My OS wasn't too concerned at my post op appointment. My PT said it could be scar tissue, bone bruising or many other things. It's annoying as it is somewhat restricting my bend.

 

[Roy Gardiner]

I wouldn't worry about it. I had aches and pains come and go for ages as the body adapted.

 

[Celle]

Have you tried icing the back of your knee, @DebM ? It could be that your knee is still swollen at the back.

In terms of this year-long recovery, it is still very early days. You have plenty of time for everything to settle down and there's no need to rush to get ROM - ROM can continue to improve for a year or more after a TKR.

 

[DebM]

Thanks @Celle I will try icing the back of my knee. I know I am early days and there is no rush but I think I would walk better if I could get a little more bend in that knee. I am not yet brave enough to walk around the street but can manage short walks at the mall - perhaps it's the shopping incentive ;)

 

[Celle]

The other thing that you might need to check, Deb, is that you aren't trying to do too much at this early stage. Make your visit to the mall quite short.

Read this article again and check how your daily activity compares to it:
Activity progression for TKRs

 

[Josephine]

on @Josephine pain chart it's DRB1

To me that's indicative of a Baker's cyst.

My PT said it could be scar tissue, bone bruising or many other things

Shows what a lot your PT knows!

At 7 weeks it could be some things I'm thinking about but before I opine, I'd very much like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

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 have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

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

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[DebM]

Certainly @Josephine


1. 2-3
2.Tapentadol 100mg @7.30am and 7.30pm. Pregabalin 50mg @ 7.30am and 7.30pm. Paracetamol 1000mg every 5 hours (4000mg/day). Oxycodone 5mg at bedtime. (11pm).
3.between slight and moderate.
4.last measured 2 weeks ago was 90 and 100.extension 2
5. Icing at least 4 times a day for an hour +
6. Elevating for at least 2 out of every 3 hours.
7. Put on a load of washing. Fold washing. Simple baking(because it keeps me sane) I Putting some dishes in dishwasher. Wiping benches. Nothing that has me on my feet for long. Have just started driving but just short trips to shop to get newspaper.
8.Three times a day I do
Heel slides x 15
Stretching my knee into flexion using a towel gently (no pain) 2-3 mins.
Stretching to extension by sitting with my heel on a stool for 5 mins
Calf raises x 20
Lunge/knee stretch on step x 3 times
Calf and hamstring stretches.
Up and down 15 stairs at home 3-4 times a day
9. See PT once a week who just checks my ROM and changes exercises as needed.
Looking to start going to hydro pool just to walk in water 3 times a week next week.

 

[Josephine]

Thank you for your excellent replies! Such a treat to get them all neatly laid out like that!

1. 2-3

Not too bad for 7 weeks out but does that include the grabbing pain at the back of your knee?

2.Tapentadol 100mg @7.30am and 7.30pm.
Pregabalin 50mg @ 7.30am and 7.30pm.
Paracetamol 1000mg every 5 hours (4000mg/day).
Oxycodone 5mg at bedtime. (11pm).

That looks fair.

3.between slight and moderate.

Okay

4.last measured 2 weeks ago was 90 and 100.extension 2

Not bad

5. Icing at least 4 times a day for an hour +
6. Elevating for at least 2 out of every 3 hours.

Perfect!

7. Put on a load of washing. Fold washing. Simple baking (because it keeps me sane) Putting some dishes in dishwasher. Wiping benches. Nothing that has me on my feet for long. Have just started driving but just short trips to shop to get newspaper.

Jolly good!

My comments in bold
Three times a day I do - you'd be much better doing these just once a day and none at all at the weekend
Stretching to extension by sitting with my heel on a stool for 5 mins - I never recommend doing things like this to increase extension.
Calf raises x 20 - got a tip for you, once you can do leg raises okay you don't need to do them any more!
Calf and hamstring stretches - these are the only things that get the okay from me! BUT, it seems your hamstring pain is not hamstring pain at all but being caused by a Baker's cyst. So I'd suggest you give these a miss for a while and see if things settle down. If they don't, then I'm wrong!

Heel slides x 15 - heel slides are really easy to do badly and 15 reps x3 daily is bad! Read this Heel slides and how to do them properly.
Stretching my knee into flexion using a towel gently (no pain) 2-3 mins - never use assistance to flex your knee. It just increases the swelling which blocks the ROM.
Lunge/knee stretch on step x 3 times a day - another flexion exercise. You really only need one
Up and down 15 stairs at home 3-4 times a day - and again, a flexion exercise.
You don't need to do any flexion exercises as a) you have excellent flexion anyway and b) see below!

9. See PT once a week who just checks my ROM and changes exercises as needed. - good!
Looking to start going to hydro pool just to walk in water 3 times a week next week - that's okay but do keep it minimal for the first few visits as it's awfully easy to overdo it and then you get consequences!

I leave you with this bit of information:
It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all 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. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.

 

[Grayson04]

@DebM There aren't many of us BTKR's here on this site. Wondering how you are doing?
I'm 5 weeks out tomorrow.

 

[DebM]

Hi @Grayson04 . No there's not a lot but interestingly when I was in hospital and rehab there were more bilateral than single in all age groups so it may becoming more common, at least over here.
OS and everyone tell me I am doing well, I can be a bit hard on myself. I am pretty mobile and only use a cane when out and about. I manage the 15 stairs at home quite well. I do basic cooking, cleaning etc but find if Iam on my feet for too long my knees get tight so I generally elevate and/or ice between tasks. My swelling is generally slight on the outside but probably more on the inside which I can feel withknee tightness. I got the ok to drive last week which is a godsend because I like my independence.
Sleeping is my biggest issue but I managed 5 hours in bed last night only waking once which is fabulous - the best I've done is 3.
I have found 6 weeks was the turning point for me and I am starting to feel glad I had them done and certainly very glad I had both at once.
How is your journey going? It is quite a process.

 

[Josephine]

There aren't many of us BTKR's here on this site.

I beg to differ! There are at least 25 this year and many more in recent preceding months.
450 in the life of this forum!

 

[Celle]

It is probably more common to have bilaterals in a rehab unit, because people with single TKRs usually go straight home from hospital.

If you click on the green "Bilateral TKR" prefix at the start of your thread, a list will come up of all the Bilaterals - there are lots of you.

 

[Josephine]

That's where I got those numbers from!

 

[DebM]

Actually the hospital I was in rehabs both single and bilateral. Singles are in for a week, bilateral for 2 weeks.

 

[DebM]

I am 8½ weeks. I don't have obvious swelling but know I have swelling inside as my knees feel tight and stiff when I have been on my feet or sitting with my legs down for a time.

 

[Josephine]

@DebM you will notice that I post into your recovery thread as we prefer that members post their issues there.
You were in another member's thread and had anyone responded to you, it would have risked derailing that member's thread.

 

[DebM]

@Josephine I was simply commenting on the thread about my experience with the length of swelling (as others have) which was the subject of the thread.