BoneSmart® Hip / Knee Replacement Forum
Joint Replacement Patient Advocacy
and Online Community
  1. Announcing BoneSmart's NEW Joint Surgeon Locator tool

    We are pleased to now offer a tool to help you find just the right surgeon for your needs. If your surgeon is not listed, please let us know and we'll get them added.

    Read more about this in this announcement:

    Dismiss Notice

[TKR] evonovitch's recovery thread<

Discussion in 'Knee Replacement Recovery Area' started by evonovitch, Jan 15, 2019.

  1. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    I have the usual tightness around my knee, but I have another pain that bothers me more: an aching from the outside of my knee down my leg and into my ankle on the outside between the bone and the heel. My foot has always been achy, but this particular pain started about 7 weeks post-op. Has anyone else had this? When I mentioned it to my OS, he said that I was knock kneed before surgery, and since they straightened out my leg perhaps this led to ankle pain. I’m wondering about some kind of tendinitis. I’m no longer doing PT but doing some stationary biking (20 minutes yesterday really ended up hurting) as well as extension and ROM exercises. I ice and elevate several times a day and am alternating Tylenol and Advil for pain.Any advice is greatly appreciated.
     
  2. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

    Member Since:
    Jul 23, 2011
    Age:
    67
    Messages:
    6,140
    Gender:
    Male
    Location:
    Essex and London
    Country:
    United Kingdom United Kingdom
    Hi, welcome to BoneSmart

    Yes, your gait will be different and your body will take ages to adjust - but adjust it will.
    Too much. That's training, not ROM stretching.

    Using a bike to gain ROM is pretty simple:
    • Set the bike to zero resistance
    • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
    • Gently turn the pedals, through discomfort but without pain.
    • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
    • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
    • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
    • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
    Here is a bit more chat and some pix and how 'healing' and 'training' are different


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


    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.
     
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

    Member Since:
    Nov 19, 2011
    Age:
    77
    Messages:
    33,450
    Gender:
    Female
    Location:
    New Zealand
    Country:
    New Zealand New Zealand
    Hello @evonovitch - and :welome:

    Please will you tell us the full date of your knee replacement (was it a total or a partial?) and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:
     
    • Informative Informative x 1
  4. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    Has anyone had a problem with stitch abscesses? I am 13 weeks post op. About 6 weeks ago I developed the first one at the top of my incision, which was finally getting better after weeks of drainage, and I suddenly developed another one last weekend. For the first I took an antibiotic. Waiting to hear from my doctor about what to do now.
     
  5. Jaycey

    Jaycey SUPER MODERATOR Moderator

    Member Since:
    Jan 27, 2010
    Messages:
    28,630
    Gender:
    Female
    Location:
    Yorkshire
    Country:
    United Kingdom United Kingdom
    @evonovitch you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

    This is for three reasons:
    1. if you keep starting new threads, you miss the posts others have left you in the old threads
    2. it often ends up that information is unnecessarily repeated
    3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

    Please keep all your questions and updates on this thread. If you would like a new thread title just give a shout.
     
  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    77
    Messages:
    84,910
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    They are actually quite common, so don't worry about it. Mostly they are caused by synthetic sutures that are not dissolving properly. Read this Closing surgical wounds

    The stitches will probably surface eventually and then either they can be pulled out by the surgeon or they will come out on their own. In the meantime, they can make a small pocket of pus which is generated by the dissolving suture material. But this is NOT an abscess as such. Just a pocket of debris. Neither is it a danger to your knee.
     
  7. gia2cats

    gia2cats junior member

    Member Since:
    Feb 4, 2019
    Age:
    69
    Messages:
    73
    Gender:
    Female
    Location:
    Maryland
    Country:
    United States United States
    I also have had issues with non dissolving sutures. I am currently 9 weeks post RTKR and I first noticed it at about 4 weeks. Sent a picture to the surgeon’s PA and since it was a little red and “juicy” looking, she put me on antibiotics for 5 days. Dried up beautifully but still have a non draining scab on my incision line. It’s like the suture wants to pop up and can’t.
    I did make a trip in to see the surgeon at 6 weeks for reassurance. He told me to just leave it alone and let him know if anything changes.
    The worry about infection is so grea. But between my surgeon and Josephine, I feel better about it.
     
  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    77
    Messages:
    84,910
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Jolly good! These things are often more apparent than real.
     
  9. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    My surgery for a total knee replacement was November 5, 2018 (so 13 1/2 weeks post-op). I’m still finding it very challenging with a lot of pain and discomfort, both down the side of my leg (very tight IT band and muscles) and in the knee itself. My extension is -1 and my flexion is 120, so that’s not bad. For exercise I walk about 15-20 minutes and do the same for biking (one or the other several times a week). I continue to stretch. I elevate and ice about 3 times a day. About 30 years ago I had an ACL reconstruction, and I’m wondering if that has had an impact on my recovery. Feeling discouraged.
     
  10. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

    Member Since:
    Dec 5, 2010
    Age:
    67
    Messages:
    3,631
    Gender:
    Female
    Location:
    Maine
    Country:
    United States United States
    Hi there. It's frustrating to get a "new knee" and have pain that is hard to explain. Roy had some feedback that is key. For example, you report stationary biking where you ended up "really hurting." That's cause and effect. Because of some hype surrounding physical therapy, I witness people I know and people here on the forum suffering from what is basically self-induced pain from trying to exercise away pain. I hope you'll consider following our advice to ease up on your activity, maybe even give it a total rest for, say, a week and see that brings improvement. If your theory is correct that it's related to straightening out your leg, excess activity will make that adjustment even harder. Your body needs time to adjust to the new alignment of your leg, and the new knee.
     
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    77
    Messages:
    84,910
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  12. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    Yes, I would.
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    77
    Messages:
    84,910
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Here y'go then!

    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. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    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?
    ai63.tinypic.com_eta39s.jpg

    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.
     
  14. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    I am now at 4 months and still experiencing the aching pain from my knee to my ankle. It kept me from sleeping last night and is bothersome all day. Every step hurts as I walk and bend my knee. I have a very tight IT band, but since that goes from the hip to the knee, I don’t think that is causing the pain down my lateral leg??
    1. My pain ranges from 2-4.
    2. I am only taking Tylenol now with an occasional Tramadol. I cannot take NSAIDs because of gastrointestinal problems.
    3. Swelling between moderate and slight.
    4. Extension is 0 and flexion is 120.
    5. I ice my knee about 3 times a day for about 45 minutes.
    6. I elevate when I ice.
    7. I am doing all activities (currently living in a small condo), like cleaning, cooking, shopping.
    8. Exercises at home: foot on chair, left, center and right—lean in and hold for 15 seconds 3 times, do this 2-3 times a day. Use a strap to slide my leg toward me, hold for 5 seconds, do 15 times. Use a strap to stretch my hamstring. Do these 2-3 times a day. Stand on a stair and stretch calf for 30 seconds, 2 x a day. Three times a week I either ride my bike or exercise in a pool for a half hour.
    Still going to PT but planning to switch to massage.
    30 years ago I had an ACL reconstruction, and I’m wondering if that has complicated my recovery.
     
    Last edited: Mar 2, 2019
  15. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    77
    Messages:
    84,910
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Some detail I need
    The question was how much are you taking (in mg please) and how often?

    The question here was 'please make a list and not an essay' and 'how many sessions you do each day' and 'enter exercise by name then number of repetitions of each'
     
  16. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    1000 mg. of Tylenol twice a day.
    Exercises at home 2-3 x a day
    1. Extension: foot on chair, lean in, hold 15 sec 3 x.
    2.flexion: strap on foot, slide foot toward me 15 x
    3. Stretch hamstring and calves.
    4. Biking and water exercise for strengthening.
     
  17. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    I am 4 months post left TKR. I still have a lot of stiffness and aching pain, particularly on the lateral side of my knee and down my leg to my ankle. Can anyone else relate to that?
     
  18. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

    Member Since:
    Dec 4, 2015
    Messages:
    17,788
    Gender:
    Female
    Location:
    Virginia
    Country:
    United States United States
    At 4 months you still aren't healed and have at least 8 more healing months to go through. New aches and pains popping up are completely normal. One day it's here and the next day it's somewhere else. Have you increased your activities lately. That could account for your pain. Being stiff is a sign that you are swollen, even if you can't see it. The inside of the knee has a very small area and any amount of fluid would cause it to be stiff. I suggest you ice and elevate as much as you can and cut back on some activities.
     
  19. evonovitch

    evonovitch new member
    Thread Starter

    Member Since:
    Jan 15, 2019
    Age:
    73
    Messages:
    9
    Gender:
    Female
    Country:
    United States United States
    I am 6 months post TKR (November 4, 2018), and I continue to have aching pain that runs from the side of my knee down to my ankle. I continue to do stretching, ride a stationary bike for 30 minutes, and do deep water aerobics, so I’m not overdoing it. I also ice and elevate a couple of times a day—but still that aching, which is pretty much constant. My xrays look good, and my doctor says the pain is probably because he straightened out my leg and also removed some screws from a previous surgery. Has anyone else experienced aching down the lateral leg? If so, what did you do about it and how long did it last?
    Thanks for any input.
     
  20. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

    Member Since:
    Jul 23, 2011
    Age:
    67
    Messages:
    6,140
    Gender:
    Male
    Location:
    Essex and London
    Country:
    United Kingdom United Kingdom
    My guess is that because your leg is a different shape now (straightened, as the doc said) then some ligaments/tendons need to stretch to be a bit longer. This just takes time. As I say, only my guess.
     

Share This Page