PKR EdiePA’s RPKR Recovery

EdiePA

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Surgery (October 23rd) went pretty much as expected. My ortho doc did the arthroscopy first and then the partial medial replacement. Half of my medial compartment had profound arthritic damage — probably due to my previous medial meniscus repair.

I came home yesterday. The pain is bearable, the nausea not so much. I was hoping that with a spinal anesthetic, instead of general, that I’d skip the nausea, but no such luck. Resting today after home physical therapy.

Thanks for all of the suggestions and helpful tips!

Edie
 
@EdiePA ,
Welcome to The Other Side!!!
Glad to hear you are home and doing well, hope the nausea settles down soon.

Here is your copy of the recovery guidelines, the articles are short and will not take long to read.

Knee Recovery: The 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
5. At week 4 and after you should follow this

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.
 
Are you taking meds for the nausea? They can prescribe something that will help a lot. The pain meds are probably causing it. Be sure and eat something with protein before taking your meds. The protein takes longer to digest and protects from that nausea better. Also, I found that motion-sickness pills helped me a lot with mine.
 
Welcome to Recovery! Best wishes!
 
I was prescribed meds for the nausea, and those really did help. Something else that helped me a bit was to suck on a peppermint. Wife had these tiny peppermint lozenges that I'd tuck up under my tongue, and this really did seem to help with the queasy feelings I was getting.
 
Yesterday was Day 3 post-op and it went to well, I was feeling pretty smug. (I had heard that Day 3 was the worst as far as pain.). Well, I woke up at 3:30 AM and had to get back to the Oxy. I did call the doctor’s office yesterday and he gave me a prescription for nausea. It has helped. So, today is a quiet day and I see lots of ice and elevation in my future. Flexion is almost 90 degrees, even with the swelling.

(If a moderator reads this, could you add to my signature:
L. Hip Arthroscopy — Synovectomy, gluteus medius tendon repair, bursectomy, lengthen IT band. 1/2011
R shoulder -- rotator cuff repair, subacromial decompression, labral debridement -- 4/2016)
 
We will add that for you!
 
Now day 16 post op and doing pretty well. Had my first outpatient PT yesterday, which went well. Even able to fully ride a bike, slowly but for 5 minutes. The therapist and I talked for a longtime prior to surgery and he’s onboard with taking it slow and easy — maybe some discomfort, but no forcing things to pain.

My question today is, I’m having nerve type “zaps”over the area where the arthroscopy opening was. After the “zap”, my whole leg jumps. Is this just normal healing or could something be wrong? Also, today when I stand up it feel like something is “catching” and hurting within my joint.

Thanks for any help!
Edie
 
Edie, your knee is a newborn infant. It will have all kind of crazy pains shooting all through and around it. This is normal. The zaps are what we call zingers and are nerves reattaching. They will continue for months.

Fantastic news that your PT is on board with your wishes. Your recovery should go well!
 
Last edited:
Another vote for normal healing so far. The zingers can be quite surprising. I got one just the other day, a hearty zap. And the catching and hurting new sensation could be any of several, utterly normal, expressions of your healing soft tissues. It was a few weeks into my recovery that my left knee developed a "catch." A pain. Turned out to be an unhappy bursa. It took a while to settle down, but it did, and I no longer feel that pain at all. As your knee heals, be prepared for surprises. Most are good. :ok:
 
Just met with my surgeon today for my first post-op check (nearly 5 weeks). He was pleased with my flexion and extension — and especially happy that even though I have surgical pain, the pre-surgery, stabbing “ice pick” pain is completely gone.

He’s leaving it up to me as to when I will return to work. Any thoughts? I’m a hospital pharmacist and on my feet for a good part of they day. Right now standing in place is extremely painful for any length of time. Plus, the pharmacy is on the 15th floor and if there is an emergency and we can’t use the elevators, it would be extremely slow-going because I’m not able to go step over step down.

Tylenol keeps me at a low pain level during the day. But with exertion, I still may need an oxycodone 5mg and take 5mg at bedtime. I’m also still going to physical therapy twice weekly.

Thanks for your help. My supervisor keeps asking for a date that I’ll be able to return.

Edie
 
@EdiePA, I went back to work at the start of week 5 but I was able to work from home at a desk, not on my feet! Week 6 saw me alternate between home and my office location, but still at a desk. There is no way I would have been able to tolerate on my feet all day until at least week 10, maybe even 12!
 
We recommend 12 weeks before returning to work and then only half days for the first week or so. Your knee and your body's energy level should be your guide.
 
Help!!
I’m six weeks post-op today and feel like I’ve taken a really huge leap (or maybe several steps) backward. Last Friday at Physical Therapy, we tried a new exercise to work on my hamstrings and it felt like my kneecap was clicking or sliding out of place. I told my therapist and we modified the exercise. Woke up on Saturday and I was in PAIN, which lasted all weekend.
Yesterday, I went back to therapy and explained what was going on to the therapist. He gently felt my joint and moved it thru ROM. His feeling was that my quad tendon was inflamed. We went easy on my exercises and I came home and iced and elevated.
Today, it burns under the kneecap. So badly that I can no longer go up the stairs leg over leg, back to being a toddler again. Plus, I had to take 5 mg of oxy just to get comfortable. (Haven’t needed narcs in a week, but Tylenol just wasn’t cutting it.)
So, do I cancel therapy tomorrow? My therapist has been great — doesn’t believe in the “no pain, no gain” philosophy. He tells me to listen to my knee and then he listens to me. I just don’t want to be doing damage to my new joint.
Thanks,
Edie
 
If it was me I’d stay home until I had a lot of improvement.

Keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for 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 in the early weeks does more harm than good. Normal activity is the key to success.
 
Last Friday at Physical Therapy, we tried a new exercise to work on my hamstrings and it felt like my kneecap was clicking or sliding out of place. I told my therapist and we modified the exercise. Woke up on Saturday and I was in PAIN, which lasted all weekend.
Yesterday, I went back to therapy and explained what was going on to the therapist. He gently felt my joint and moved it thru ROM. His feeling was that my quad tendon was inflamed. We went easy on my exercises and I came home and iced and elevated.
That exercise was definitely too much for your new knee.
Don't do it again for a couple of months.
So, do I cancel therapy tomorrow? My therapist has been great — doesn’t believe in the “no pain, no gain” philosophy. He tells me to listen to my knee and then he listens to me. I just don’t want to be doing damage to my new joint.
I'd cancel therapy until your leg has settled down completely. Rest, ice and elevate as much as you can.

Good as he sounds, I think your therapist is trying to rush your recovery. Was he trying to help increase extension?
Extension often takes longer than flexion, because those large muscles and tendons at the back of your leg need to be stretched slowly and gently. You can't rush that, but it will happen.
 
Good as he sounds, I think your therapist is trying to rush your recovery. Was he trying to help increase extension.

No, I don’t think so. My extension is good — 0 to -4. I just think I’ve been progressing so well that we pushed the strengthening too fast. I’ve cancelled tomorrow’s appointment and spent today icing and elevating. I just wish this recovery was a little more straightforward!
 
It is way too early to be working on strengthening exercises. You knee is not no where knee ready for that. Strengthening shouldn't be done until your knee is about 4 months or older.
 
Seven weeks post op R knee arthroscopy and medial partial replacement. “Graduated” from Physical Therapy today. Pre op: Flex 105 degrees, extension 0 degrees. Today: Flex 128 and Ext. -10 deg. (hyperextension). Good knee: Flex:135 and Ext -10. Minimal pain and finally feeling like this was all worth it!


Thanks for all of the help and encouragement along the way!
 
Sounds like you are doing really well!
 

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