TKR Fall after day 1 of TKR

[mamasita5]

Had my left knee replaced due to severe stage 4 R/A. Was sent home at 11pm the same day. The next morning went to use bathroom and my knee buckled. The next 2 days it bled thru the dressing. Finally they called me back to hospital and changed dressing. Now I am 4 weeks post op. Still on pain meds and started physical therapy. The PT gave me a massage on the incision to break up scar tissue.( Pain level off the charts) she also had me do excercises for 30 minutes non stop. My ROM was 93. Ever since that session my pain level has been 8-9. The PT said she was impressed at my progress considering I had a setback with the fall, she scheduled me for knee excercise classes. Can I get feedback on the knee classes. I am thinking of not participating. I am so glad I found this forum.

 

[mamasita5]

sorry about posting such a graphic picture but it’s to warn you that the pain medication gives you a false sense of security. You DO NOT want a fall while recovering.

 

[Jockette]

Hi and Welcome!

Please tell us the date of your surgery and we’ll make a signature for you.

The PT gave me a massage on the incision to break up scar tissue.( Pain level off the charts) she also had me do excercises for 30 minutes non stop. My ROM was 93.

It is not necessary for a PT to massage the scar. Any scar tissue you have at this point is par for the course (without it your surgical wounds would not heal) and will get less and less over time.

30 non stop minutes of exercises at 4 weeks is way too much for many of us.

she scheduled me for knee excercise classes. Can I get feedback on the knee classes. I am thinking of not participating.

If it was me I would not join the class. It might be “one size fits all” and you might fall into a peer pressure mentality and end up doing more than your healing knee is ready for.

Here is an article from the Bonesmart Recovery Guidelines:

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

 

[Jockette]

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to 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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[mamasita5]

My surgery was Jan 16/2024

 

[mendogal]

Oh my goodness, a next day fall is NOT what any of us want on our post op planner. I can only imagine how scary that was!

In terms of healing, your incision and the tissues under it need time to actually heal.

As it happened, with both my knees I started developing some easy-to-feel areas quite a distance from my incision several weeks out - tense ropy areas and lumps. You better believe I massaged those! My ortho team assured me they would resolve and they mostly have. They totally don't interfere with my ROM.

Meanwhile, as a martial artist I and many of my peers learned the hard way that even a minor sprain or strain needs 6-8 weeks to heal. The surgery we have had is more like a serious accident than a minor strain! So we need to heal. Please don't let any PT push you to the point of pain.

 

[selketine]

I have to do PT with my HMO and they also seem to funnel both knee and hip replacement persons into group classes. I'm just curious if you have an HMO? They've scheduled me for a group class and I'm also considering not going. I'm a week ahead of you and also tripped and twisted my surgical knee early on and after that it would give out on me randomly. The physician's assistant thinks I've sprained a ligament (or tendon - I don't know which) and gave me a brace to wear for 4 weeks when I'm walking long distances. Your ROM is close to mine. I've been doing PT from the day after surgery but never had anyone hurt me like yours did - ouch!

 

[MSuki]

OMG my therapist never touched my incision other than showing me how to move my kneecap and this was way down the road from where you are. If something hurts like that it can’t be good. Please don’t let anyone hurt you like that. And if your pain level is that high you should call the doctor for better pain control.

 

[mamasita5]

I have to do PT with my HMO and they also seem to funnel both knee and hip replacement persons into group classes. I'm just curious if you have an HMO? They've scheduled me for a group class and I'm also considering not going. I'm a week ahead of you and also tripped and twisted my surgical knee early on and after that it would give out on me randomly. The physician's assistant thinks I've sprained a ligament (or tendon - I don't know which) and gave me a brace to wear for 4 weeks when I'm walking long distances. Your ROM is close to mine. I've been doing PT from the day after surgery but never had anyone hurt me like yours did - ouch!

I do have an HMO.

 

[selketine]

I do have an HMO.

I have Kaiser so maybe you do as well considering they are the only one I've seen who have group classes for knee and hip patients. I have resisted going to the group class and asked the PT for individual sessions. It's hard to get appointments for one-on-one. However considering how your pain was off the charts after seeing that PT - I wouldn't want to go back to them if you think the massage was the cause. I haven't been able to find anyone who has been to the Kaiser group class so I don't know what it's like.

With Kaiser they sent a PT to my house about 6 times after surgery for two weeks and then I started going into the center. Not sure if you started PT at 4 weeks and that was your first class...but I think it's definitely too soon for a group class. I do about 10 mins of exercises and scatter them out during the day. At PT I've told her I don't want to do 30 reps of each one over the half hour because it's too much at once.

If you go to the group class, I'd be interested in a report. Are you feeling any better?

 

[mamasita5]

I do have an HMO.

I have Kaiser so maybe you do as well considering they are the only one I've seen who have group classes for knee and hip patients. I have resisted going to the group class and asked the PT for individual sessions. It's hard to get appointments for one-on-one. However considering how your pain was off the charts after seeing that PT - I wouldn't want to go back to them if you think the massage was the cause. I haven't been able to find anyone who has been to the Kaiser group class so I don't know what it's like.

With Kaiser they sent a PT to my house about 6 times after surgery for two weeks and then I started going into the center. Not sure if you started PT at 4 weeks and that was your first class...but I think it's definitely too soon for a group class. I do about 10 mins of exercises and scatter them out during the day. At PT I've told her I don't want to do 30 reps of each one over the half hour because it's too much at once.

If you go to the group class, I'd be interested in a report. Are you feeling any better?

I do have Kaiser and have decided to wait on the knee classes. I am feeling better since I did not go back after that session. I have been doing the bending exercises and go at my own pace and listen to my body. PT scheduled me to come next week. I am excited to see how much progress I have made on my own.

 

[mendogal]

Oh I'm glad you decided to hold off on the group class.
Let us know how it goes at PT!

 

[Layla]

Happy Two Month Anniversary!
How are you doing, mamasita? Please let us know, we'd really like to hear from you. Hopefully you're enjoying steady progress and PT has been beneficial for you. Best wishes until next time!
@mamasita5