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[TKR] Fell on knee

Discussion in 'Knee Replacement Recovery Area' started by Dancersoon, Jul 27, 2019.

  1. Dancersoon

    Dancersoon junior member
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    I’m 10 days PO. 3 days ago I slipped and knee hit the wooden floor.I heard 3 pops than pain! I managed to get up (don’t ask me how.) It was night time so I got into bed, iced knee and then tried to sleep. In the morning I called my surgeons nurse. She told me to continue to ice and elevate knee. By that time it was swollen quite a bit, quite sore and bruised .

    My home healthcare nurse was coming out the same day so she asked me to have him give her a call. He looked at my knee and said he was pretty sure it was just soft tissue damage and he called the nurse who agreed. No one suggested a doctor visit or xray. My knee is so tight and sore it’s impossible to do heel slides.

    The home healthcare nurse who is also a physical therapist wants me to continue pushing the heel slides to the point of pain. He of course thinks I will lose the ROM I have and won’t get “where I’m suppose to be by a certain date.” Tonight I pushed my leg as hard as I could doing a heel slide. Now one of the staples is slightly bleeding!

    So I’m just going to ice and elevate the rest of the weekend and do gentle heel slides and extension exercises. Staples come out wed and I start outpatient PT Friday.

    Any one else injure their knee early on? Have a staple problem?

    I’m trying not to get upset but I’m really scared. Any advice is welcome!
     

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    Last edited: Jul 27, 2019
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart!

    I’m so sorry you fell. That is something we all fear. Most times it is “just” soft tissue damage, the implants are pretty sturdy and well secured.

    However, those soft tissues can really throw a fit, especially so soon after the surgical assault they just recently suffered. Resting, icing and elevating is exactly what you should be doing.

    Anyone who tells you there is a window of opportunity is wrong. Very wrong, and I am proof. My ROM has not only increased after my first year anniversary, it has also increased after my second year anniversary.

    Therefore, there is no need to push to anywhere close to pain. Just move your knee gently to give it mobility. Pushing to pain only keeps the knee painful and swelled. And, don’t ever allow your therapist to push your knee to a further bend, or to push down on it to straighten it. The therapists who do that only do so because it is their opinion that it’s necessary. It is not necessary. Your ROM will come along fine if your knee is treated gently.

    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.

    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
    6. Access to these pages on the website

    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.
     
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    Last edited: Jul 27, 2019
  3. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Dancersoon Welcome to BoneSmart! So sorry you had a fall - everyone's nightmare. I would stop all the heel slides and ice as much as you can. You need to get that swelling under control. And you may want to skip PT on Friday.
    If you have done any reading here you know this is rubbish. You won't lose ROM but if you push through you will just increase the swelling. Ice, elevate and take your meds around the clock as prescribed. I hope all this eases soon.
     
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  4. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Pay attention to Jaycey - she knows what she's talking about!
     
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  5. Ladyala

    Ladyala member

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    I'm so sorry you've started out so rough. Praying you get past this setback!
     
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  6. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I agree that you need to let your knee settle down and get over this last 'attack' against it. All you need to do is get that swelling down. You do that by icing and elevating, not doing heel slides. Cancel PT until your swelling goes way down and your pain is better. PT will just aggravate an already traumatized knee and cause more pain and swelling. You do not have to push through the pain. That's counter productive.

    Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control. This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

    All you have to do is use it in your daily living. Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new. You have to be patient, though, it doesn't happen quickly. ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there:yes:.
     
  7. Dancersoon

    Dancersoon junior member
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    Thank for all the great info!
    I decided last nite no more pt until the swelling bruising and pain go away.
    I am alittle concerned because someone told me last nite they broke their kneecap falling!!!!!
    I thought our knee caps were replaced during surgery????
    I do know I had a lot of arthritis Under the patella.
    One of my staples started draining a tiny bit (should I be worried???) after I tried pushing knee in a knee slide last nite. NO MORE! Stupid PT Guy!!!!!
    I’ll contact doc and home healthcare nurse Monday. Staples come out wed.
    Well I had coffee and breakfast so I’m off to start icing and elevating for the day
     
  8. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    Good girl! I think that's a very smart move.
     
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  9. Dancersoon

    Dancersoon junior member
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    When you say “move your knee gently” what exactly Should I be doing?
    It’s super tight from the swelling and very sore. I hope I didn’t break my knee cap !
     
  10. ElanorG

    ElanorG post-grad

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    I still have both my kneecaps (originals, real ones!). Maybe under certain circumstances they replace them but I know mine were not. When I had my first knee done, I accidentally twisted it getting out of a chair as I slipped on some liquid. I was convinced I had damaged it as it swelled and hurt. I know I also bumped it a couple of times (hard) and it swelled and hurt. Your knee is in such a bad state after surgery anyway, as all the tissues are so abused, that it does not take much to hurt them again. But typically most of these things are soft tissue hurts and will improve with rest, ice and elevation. So like everyone has said, take a step back and take it easier. These things happen sometimes when we aren't very steady on our feet. But you will get there!
     
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  11. ElanorG

    ElanorG post-grad

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    Walking to the bathroom and back is a way of moving your knee gently. You can try heel slides but at your own pace, don't push your leg so far back that you feel pain. When there is a lot of fluid in the knee, a bit of gentle motion, just the opening and closing of the knee joint, can help move that fluid around and break it up. A lot of this depends upon what motions are comfortable for you. When my knee was grossly swollen I found the heel slides didn't work, but I could sit on the edge of the bed with my foot dangling in the air and just move my foot up and down in a short arc for a small range of motion in the knee. Ankle pumps will also push fluid in and out of the knee although they don't move the knee directly. As the swelling subsides, you will find your range of motion will improve.
     
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  12. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I agree with @ElanorG , those are gentle bending movements.

    Your knee cap does not get replaced, as there is no such prosthesis for the patella. When a person has arthritis of the knee cap, there is a cleanup process for the underside of the patella before the button is placed. As the arthritis degenerative process progresses, it leaves the surface of the bone rough and often with places where the cartilage is completely gone. The surgeon will smooth the surface so that the button seats properly. Scraping is usually the means used to smooth the surface of the patella. The plastic button allows the knee cap to slide freely when you bend and straighten your knee and it adds stability to your patella that is now somewhat thinner after the scraping and cleanup process.

    I have a plastic button on mine.
     
    Last edited by a moderator: Aug 1, 2019
  13. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    As others have said your baby knee is banged up but likely the joint is fine. Keep on with the tlc of icing and elevation and the gentle movement as ElanorG described so well.

    If it helps any, I've fallen on my replaced right knee twice over the years with no ill effects to the prosthetic or kneecap. But I sure got a brilliant bruise. :wink:
     
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  14. Dancersoon

    Dancersoon junior member
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    My incision is now bleeding a tiny bit between two of the staples. Probably because the home health care nurse insisted I push hard when doing heel slides because “you will lose your rom”!
    GRRRRR. It hurt like hell!
    I noticed the bleeding after he had left. Staples come out on Wed. Should I be concerned about infection?
     
  15. Celle

    Celle FORUM ADVISOR Forum Advisor

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    No need to worry about infection.

    But you do need to know that you are in charge of what happens to your knee. It's your knee and you are the only one with the right to say what happens to it.

    You don't have to obey the health care nurse. He sounds like a bully anyway, and he's completely wrong about ROM.
    Saying no to therapy - am I allowed to?
    CONSENT: what it means and how it can be used

    Remember this, from the recovery reading we gave you:
    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.


    About ROM: There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR

    It's not exercising that gets you your ROM anyway - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, and it will gradually increase as your knee heals.

    Your poor knee is recovering from major surgery and it's had some more trauma from your fall. It doesn't need painful exercise. It needs rest, and just a little, gentle movement.
     
  16. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Next time you need to insist that you will not do that. As Celle said, it is not necessary. The healing of your incision has now had a set back, due to poor “advice” from a medical professional that you trusted.

    You really need to keep your guard up as many PTs feel the same way.

    What was the date of your surgery?
     
  17. Dancersoon

    Dancersoon junior member
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  18. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Thank you for your surgery date, we’ll put it in a signature for you. It helps us advise you appropriately.
     
  19. Dancersoon

    Dancersoon junior member
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    I’m seriously thinking about going into the doctor Monday. My upper thigh and inside the thigh are so sore. I don’t know if it’s from the fall or if it’s bruised from the Tourniquet during surgery. I just know it hurts Terribly!
     
  20. Benay

    Benay graduate

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    For me it's the "not being sure" that always worries me. Once I'm reassured I can cope, regardless of the discomfort. Watching for your update.
     

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