TKR Dee's sparkling new knee<'

[Deeann]

Will try not to compare hopefully it will be a faster recovery this time know what I am letting myself in for this time. ThNk you for all the advice

 

[Deeann]

Well left knee is one today. Still stiff and sore if I over do things. Better than pre surgery hopefully it will feel better once the right one is done on the 24th August 2016. Hope all the July sparklers 2015 are all well Julie.

 

[Deeann]

Right knee replaced on the 24th August can not believe how painful it is. My surgeon did tkr with patellaplasty. Have started physio although I can not do much yet just doing a few easy knee slides can not lift leg to do leg raises at the moment. Can not believe how emotional I have been with this one was not like it with the first.

 

[Celle]

I'm glad your second knee is done.
Do make sure your pain medication regime is adequate. Ask for it to be altered, if you are still in a lot of pain.

Here are the recovery articles again, just to remind you and so that you have them handy for reference:
First are the BoneSmart 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 (PT) - to do it to you. exercise only gently
- 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!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lie down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

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?

When you feel able, please will you alter yourSignature, to include your second TKR.
Hover over your username, top right of the page, and select Signature from the drop-down box. Enter your surgery details and then save. This article also explains how to do it:
How to create a signature
If you can’t do it, please let us know, so that we can do it for you. Thank you.

 

[zzevi]

@Deeann I haven't walked exactly in the shoes your currently walking in, but I think and I didn't realize the commitment a person gives to recovery after a TKR, it's months before you feel better, you have pain, swelling, difficultly getting around, lack of independence, have to count on others for assistance, it's a tough roll, think it's only normal to feel sad and blue from time to time. I've had days like that also, seems like if I am tired or been pushing my self there's more of a chance of the blue feelings. You've made it through one, and I am sure all that you went through is still fresh in your memory, allow yourself some sadness and then move forward. Your going to do great, your a pro you know what and didn't work from last time, cut yourself some slack. Take care.

 

[skippyhak]

I'm 75 days out with my 2nd TKR. It is a struggle without complications. My heartfelt sympathy for all of those that have complications, infections etc. I've just had the "normal" recovery. My 1st TKR I pushed to hard and thought I could exercise, over work to improve my recovery. It got me no where other than a bunch of mini setbacks from doing too much. But resting and elevating, icing etc. requires patience and time, where I want to force a recovery solution. Anyway....I'm 80% and starting to get back some of my activities such as golf and hiking. Golf right now is just putting, chipping and hitting some short shots and hiking is just getting out and walking a mile or so. My pain levels are now intermittent but when it flares up I still use prescription meds to knock it back. Advil, Aleve are not effective when it flares up. I would average 1 or 2 5-325 Oxy over a day when it flares up. For me, the unrelenting pain is a recipe for depression.
Good luck to you and it will be behind you before you know it. Do not let the PT's scare you and push too hard. I'm still puzzled why so many get so aggressive with treating the TKR's? I'm wondering if there's some liability concern that blows back to them if someone does not recover?
Good luck and have a successful recovery!

 

[greatlakes]

Oh dear, sorry this one is so painful. Meds and ice! Hope things improve soon for you.

 

[Deeann]

Thanks for the support it will be three weeks tomorrow ice is my best friend. I am finding it very difficult to get comfortable at night and am still taking oxynorm and tramadol in the day but pain flare ups are rubbish. Have done a few sessions of sports therapy with the same guy as last time he is very good and pretty gentle with the knee he is also giving the left knee support to as it is still painful from time to time. I have my boss asking when I think I will be back to work keep saying when the knee feels upto it. Sorry to rant need to keep my chin up and be happy .

 

[sheliac]

I'm at 3 weeks today, too. And ice is my best friend, too. I'm glad you told your boss what you did. It's way too soon to even consider going back to work -- thank goodness I've learned that here


Shelia
RTKR - 8/23/16
LTKR - 9/20/2016

 

[Deeann]

Wow @sheliac you are going to have the other one done quick after 1st one. I think I went into this one blind thinking that it would be so much easier than the 1st boy did I get that wrong surgeon did do more work on this one by doing a patellaplasty as well.

 

[Deeann]

Hi feel like I am struggling with the right knee I am five weeks out tomorrow still having problems with straighting the leg bend is about 60/70. Knee feels hot to the touch most of the time but swelling is reduced. Hopefully my surgeon will be happy next week with how I am doing. It band is very tight having ultrasound to that area and massage for scar build up.

 

[Deeann]

Left TKR done July 2015. Is very sore around the patella joint and has some crepitus when straightening. Could it all be to do with the right TKR being only nine weeks old?

 

[skigirl]

Unfortunately the knees do not cooperate to being identical twins!! Each knee is different and heals at its own rate. So, it is hard to compare one to the other. It looks like you are about 8 weeks on the latest knee which is still quite early in recovery. When the knee causes extra pain, it is telling you that you are doing too much. Is your PT really strenuous? are you walking a lot?

 

[newlybionic]

Your older knee is probably doing more than it was before your second surgery. I think in time it will calm down as your new knee starts doing its fair share.

 

[Celle]

Have done a few sessions of sports therapy with the same guy as last time he is very good and pretty gentle with the knee he is also giving the left knee support to as it is still painful from time to time.

I don't think that sports therapy is appropriate for recovery from a knee replacement. The approach to recovery from a sporting injury is different from the approach to a TKR recovery.

Hi feel like I am struggling with the right knee I am five weeks out tomorrow still having problems with straighting the leg bend is about 60/70. Knee feels hot to the touch most of the time but swelling is reduced. Hopefully my surgeon will be happy next week with how I am doing. It band is very tight having ultrasound to that area and massage for scar build up.

I think you may be doing too much with both your knees and you would benefit from cutting back some of the PT.

I'm going to ask @Josephine to advise you. Please answer her questions as fully as you can, so that she can advise you appropriately.

 

[Deeann]

.Thank you for your replies. Yes I think I am possible doing too much physio twice a week and sports therapy once a week. Back to work only part time. Do about 6000 steps a day on average the last few weeks. Think I am just in a panic as left knee is playing up and had to go back to two crutches.

 

[Celle]

Yes, what you're doing is far too much. Cut back and be kinder to your knees and kinder to yourself.

 

[Josephine]

I'd 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. what kind of PT exercises and exercises at home are you doing? How much 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 each day)
enter exercise then enter number of reps and sets
etc., etc.

At PT (how many times a week)
enter exercise then enter number of reps and sets
etc., etc.

 

[Deeann]

Hi pain level 7-8
meds tramadol 50 mg 2tablets four times daily and oxynorm liquid 5mg/5ml if needed dicloflex 50 mg 1 tab 3 times daily.
Moderate
Flex is about 80/85 extension 10
Using cryo cuff four times daily for 25 minutes and ice pack at work
Elevated when at home watching TV should do more
Back to work part time vet nurse and walking dogs once a day
Doing straight leg raises 3 sets of 15 twice daily knee slides same exercise bike peddle to stretch
Knee bends 3 sets of 10 daily
Pt twice a week
Sports therapy once a week
Sports massage once a week
Hope I have answered the questions in a correct format x

 

[Josephine]

pain level 7-8

Gosh! That's high, especially at 10 weeks!

meds; Tramadol 50 mg 2tablets four times daily and oxynorm liquid 5mg/5ml if needed dicloflex 50 mg 1 tab 3 times daily.

You're still on oxynorm? That should really only be taken for a week or two. Has your GP not discussed that with you? You really shouldn't be taking it this long. It's extremely addictive and you will probably have to wean yourself off it now. Weaning off pain medication

And are you taking 2 paracetamol with each dose of Tramadol? You should because they compliment and enhance each other nicely and there is much less risk of dependency.

Moderate swelling

Swelling is a sign of untreated pain.

Flex is about 80/85 extension 10

That will mostly like be due to the swelling.

Using cryo cuff four times daily for 25 minutes and ice pack at work
Elevated when at home watching TV should do more

What you should do more of is icing!
You accomplish little or nothing in 25 minutes. Ice for at least 40-60mins and more than 4 times a day.

Back to work part time vet nurse and walking dogs once a day

When did you return to work how many hours/days do you work?

My comments in bold
straight leg raises 3 sets of 15 - a little tip, once you can do an SLR there is not longer any need to do them!
twice daily knee slides, knee bends 3 sets of 10 daily - what's the difference between knee slides and knee bends? I think they are both the same, pretty much and most likely the cause of your swelling and therefore your limited ROM. Doing 360 of these a day is punishing in anyone's view!
bike peddle to stretch - this is also a bit much

pt twice a week
Sports therapy and massage once a week - what is this???? Please explain!

With the amount of normal daily activity you are doing - work and walking the dogs, not to mention household stuff and shopping, I'll be bound! (you never told me about all that, did you?) you have more than enough activity for your knee without exercises. So I strongly suggest that you stop all exercising and physio and whatever that 'sports' stuff is and allow your poor knee to settle down and recover properly.

Thing is that 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.