TKR Fall during exercise session

[FraidyCat]

I think you'll be fine not doing any PT. Don't be surprised if your knee complains about not be used as much as it's used to, but since you are not non-weight-bearing, you might not have any knee problems at all.

Thank you for sharing your partially similar experience and for the encouraging words. I'm still in the process of trying to acclimate mentally since this mishap occurred 1.5 weeks ago. My knee definitely isn't happy: noticeably more stiffness/swelling.

 

[FraidyCat]

Oh goodness, FraidyCat, I am so sorry. How frightening it must of felt to lose your grip and feel yourself tumbling.
Thankfully you didn't fall further and do more damage. I'm glad you reached out here. It's understandable that the foot fracture feels like a huge setback. Feeling despair or anxiety is normal, but please know this will not ruin your recovery. Your knee has already gone through months of healing and strengthening. You won't lose that foundation. It is important to protect your foot right now, and its only temporary. Once the fracture heals you can resume rehabbing your knee safely, and likely with minimal work only you'll be back on track. You can keep your knee mobile with quad sets, or straight leg raises or other seated exercises, if it will make you feel as though you're still proactive in your TKR recovery. View this as a "pause" that's all. I'm also sorry you were disappointed by the physician you dealt with. You deserved kindness, patience and encouragement at a time when you were hurting physically and emotionally. Please lean on us when you feel the need, we are here for support always and we do care. Wishing you a peaceful Sunday.
@FraidyCat

Thanks for the kind words and for the encouragement. Since posting here, I emailed the foot doctor and he replied both in writing and with a phone call yesterday, so I now have a somewhat better understanding of why he gave me the Velcro-strap shoe vs. a boot, and a couple of other things. Unfortunately, both he and my PCP have seized on this incident as a launching pad for a lecture about osteoporosis--with the not-so-subtle implication that I now should reconsider taking medication. I do not believe that osteoporosis caused this accident; I simply didn't have as robust of a railing/grab-bar situation at the top of the stairs as I should have (but as of last week I do). It's not as though my foot/ankle has a habit of turning as I go about my daily life; the top of the stairs is the only location that it's happened. And though the foot doctor says that people with higher bone density might not have had a fracture, I think that, given the mechanics of the uncontrolled fall, it could have happened to just about anyone.

 

[Layla]

I do agree. We have the right to weigh all options in regard to our personal health journey. For many that includes non-pharmacological paths in favor of choosing what aligns will your, body, your values and long term well being.
A good description I read recently is that medical doctors are trained within a system that prioritizes diagnosis and pharmacological treatment because that's the model they're taught. It's the framework of western allopathic medicine. Identifying symptoms, matching them to conditions and prescribing treatments, often in the form of medications. Ultimately, its our choice whether we take prescriptions, ask about alternatives, or seek them out ourself through personal research.
Wishing you the best, FraidyCat!
@FraidyCat

 

[JWS]

I am five months post-LTKR and still can't navigate stairs, one foot over another, without pain/discomfort. Going up, the L leg makes a slight swing outward. Worse is going down: unless I've just finished five minutes using my rotating floor pedals, leading with the "good" leg is usually painful. I try to use the pedals twice/day, and I do knee-bend exercises, lying on the bed, once/day. My ROM isn't great; it's ranged from 95 to 105, which my PT thinks is good enough for most activities of daily living and the surgeon seemed OK”

Ok here is my thoughts and some may agree and others may disagree. PT usually is making you move beyond your comfort level which in turn cause more damage and or swelling which will slow down healing. I am just a few days past one year and I have had no PT since about my second month. I am 78 Years old and at 3 month post surgery I build my wife a good size green house climbing up and down ladders etc. Before stopping PT I was in pain a lot. Everyone is going to heal differently but that is my story.

 

[Layla]

Hi FraidyCat,
We haven't heard from you in a while. Wondering how you're doing after the fall?
Let us know when you have the time, we'd love to hear from you. Until then...all the best!
@FraidyCat

 

[FraidyCat]

Hi FraidyCat,
We haven't heard from you in a while. Wondering how you're doing after the fall?
Let us know when you have the time, we'd love to hear from you. Until then...all the best!
@FraidyCat

@Layla, thank you for thinking of me. It was a long, discouraging month-plus of inactivity due to restrictions advised by the foot doctor. A week and a half ago, a new x-ray showed the metatarsal fractures to be more or less healed, so I was told I could return to driving, health club, etc., and could resume outpatient PT for the knee. I've been working with an in-home PT for the last few weeks; she's given me some basic "homework" exercises, which I try to motivate myself to do. The private PT thinks my main problem is weakness of the quad and hamstring muscles. I'm so tired of hearing about/thinking about physical deficits! Hoping I can improve my gait so I can spend some time outside taking photographs (my retirement pastime) now that summer is about to begin. Hope all is well with you.

 

[Layla]

Thanks for your response, Fraidycat! I am sorry you had a long discouraging month, but the good news is that your foot fracture has healed. Big step in the right direction!

I'll bet you're happy to get behind the wheel again and regain the independence that goes along with driving. I hope you venture slowly back into the health club since you've been away for a time.
Good to read that you're working with an in-home PT and she's given you some exercises. I also know it can be difficult to motivate yourself to do the exercises daily...because it's boring. Try to view it as protecting your investment (knee) keeping it strong and ensuring it lasts for your lifetime. It's not to late to make progress as many notice improvements into their second and even third years post op. Just a few minutes a day as you watch tv or listen to music should help it feel more manageable. I found setting aside a time made it easier than waiting until I "feel like it". It's one of those things that we may dread, but feel so good once we've accomplished what we set out to do.

I hope you're able to get back into your photography soon and have a fantastic Summer 2025.
@FraidyCat

 

[FraidyCat]

My concern is now shifting back to my R knee--not the knee that was replaced, which was the L knee, but the so-called "good R knee." Unfortunately the "good knee" has bone-on-bone osteoarthritis--the surgeon described it as "done" as viewed on x-rays a few months ago--it experienced two episodes of locking with severe pain last Fall, upon getting out of bed during the night. Those episodes then inexplicably stopped. But over the last day I've noticed a sudden stiffening--not painful (yet)--of that knee. I'm wondering if that's a typical sign of osteoarthritis progression or if it's just "one of those things" that could come and go. And wondering why it's happening when it hasn't before. I very much do not want a second knee replacement a mere year after the first TKR--I don't feel physically or emotionally capable of having yet one more recovery pile onto the still-ongoing rehab of the L knee and the R foot. I think that each new recovery is creating a setback from whatever recovery was already in progress.

 

[Jamie]

No one can predict with certainty how your “good” knee will progress. We can just say that it will….arthritis is a progressive disease that does not get better. If you’ve had a respite in symptoms, that’s a good thing. The fact that your right knee has stopped locking could be related to your changed alignment as a result of your left TKR. But your knee is still bone on bone.

I know you aren’t wanting another surgery just yet, but you need to be aware of a couple of reasons to consider it as soon as you feel you can.

• Your right knee will not improve. Although no one can predict the speed of its deterioration, it will get worse. Sometimes this can happen quite suddenly and cause extreme pain.
• When you have a bad knee, it will impact your gait, which can lead to problems with other joints. You really want to try and avoid that as much as possible since it means you have to spend even more time dealing with getting your body back in balance again.
• The sooner you replace your right knee, the better your chances are for an easier surgery and recovery. The longer a surgeon must be in surgery with a joint, the more likely it will be that you have tissue trauma that can lead to more pain as you recover.

Since you still feel overwhelmed by trying to recover from both your left TKR and your foot injury, I suggest you just continue with that for a couple of months and try not to overtax your right knee with a lot of exercise or activity. Of course you’ll want to continue movement and your activities of daily living to keep all your joints lubricated and working. But just be mindful that you do have a “done” right knee that can worsen. Then, assuming you haven’t had any serious issue with pain, schedule an appointment with your surgeon in the fall just to talk about where you are at this point. Remember that it can take months to get a surgery date and you could consider setting something up just in case the right knee starts getting worse suddenly. Perhaps by then you’ll be in a better frame of mind to get your right knee corrected so you can actually get on with your life. The bad thing about trying to wait is that it’s very stressful to be constantly concerned about potential problems with your right knee. Sometimes that worry or “waiting for something to happen” is worse than just getting it done and moving on to recovery. It is true that your fall impacted your current recovery. But once your foot heals, you should find that your new knee functions just fine.

Don’t hesitate to post about any concerns you have going forward. We’ll be here for you.

 

[Layla]

Hi FraidyCat,
We haven't heard from you in a while and we're curious about your progress. Also, wondering how your right knee is doing and whether you've made any decisions regarding a Right TKR? I want to remind you that we're available for support if you need it. If you ever want to share thoughts, be encouraged, or just vent, please know that we're here for you. Hope you're having a good week.
@FraidyCat

 

[sistersinhim]

@FraidyCat, how are you doing? We miss hearing from you. Would you stop by and give us an update when you have a chance?