TKR Freedom works on recovery<<

[referee54]

Would the surgeon do the second knee if you can't go down stairs properly with the first one?

I had a BTKR, and some have sequential TKR's---you just learn the phrase, "Up with the good, down with the bad."

many use the CPM (and how does that work when your OS doesn't believe in it?).

The jury is out on the CPM's. Many Os's feel that it does not help at all. After my BTKR, my OS did not have me in one at all. My father's OS, after his TKR's, had him use it in the hospital only. The important point is that it is passive motion. Some people swear by them; some swear at them (my dad), and I did fine without one.

Don't run away with the idea that you have to work at a recovery, though. You let recovery happen, by giving your knee the best conditions in which to heal itself.

Yes---there are things that you can do that may help, but, for the most part, recovery just happens.

 

[Freedom]

Thank you referee54. I think I did not explain my queries very well.

If I can't go down stairs with the left foot first, and then I have the right knee done, it is possible that for a few days / weeks / months I won't be able to go down right foot first either! Then what do I do? I haven't developed my wings lol.

As for the cpm, I was asking specifically in terms of the MUA. I've not seen* anyone go through that and NOT use one. But I know my surgeon does not believe in the cpm for the TKR. Does that mean he may for an MUA? At this point, I don't know if I want it or not! Initially I DID want it as I develop keloids and felt it would help limit scar tissue build up. My OS convinced me that the cpm would not help. Then, considering all the pain I had, a cpm just would have increased my pain. So it is a good thing I did not have it. Now I am trying to sort out if it would be used for an MUA.

*I am on the Facebook support pages, lots of folks on those pages have the MUA. Each and every one of them used the cpm following that adjustment. In fact it amazes me how many on there have an MUA - some as early as 3 weeks post op, most about 7 weeks, and all before 3 months post op.

At my last OS visit, I sat crying most of the time. I am trying to gain some knowledge in advance of my April 29 appointment, so that I can try and be a 'big girl' this time around.

 

[referee54]

If I can't go down stairs with the left foot first, and then I have the right knee done, it is possible that for a few days / weeks / months I won't be able to go down right foot first either! Then what do I do? I haven't developed my wings lol.

When I had my BTKR, I did not have a "good" leg at all. They taught me to go up the stairs and to use my crutches and railings----I would use my "good" knee to go up and my "bad" knee (mind you---both were pretty much stiff) to go down. In looking back, I used my left knee as the good knee---it tended to be more of the "angel" throughout the recovery, and my right knee was the "Problem child"---so I went down the steps---ever so slowly and gently---with that knee first. One leg slowly at a time. It took me months and months and months to go down the stairs the "right way."

I would not worry at all right now about an MUA---you have quite a ways to go yet.

 

[Freedom]

I haven't been able to walk up or down stairs like a'big girl' for several years so that is not a necessity for a TKR.

Um, and you consider this acceptable? I don't. I thought the whole point of the TKR was to be able to do things again. Like go up and down stairs properly.

 

[referee54]

"Going up the steps" happened before the "going down the steps" for me. In actuality, going down the steps was on of the last way-points that I achieved. It took me time to get all of the muscles strengthened (Think how many are involved), to work on my gait, my balance, and my proprioception.

It happened one day---I just did it. When I got to the bottom of the steps in the basement, it struck me---"WOW!" I think it took me about six months before I could do it slowly---and eight months before it became more or less routine.

 

[referee54]

Ironically---combating gravity---going up the steps---is easier for us and comes first than using gravity---going down the steps. It takes more coordination and effort to control our muscles correctly while going down...

 

[Freedom]

Correct! Going DOWN requires much more ROM and involved many more tendons ligaments and muscles!

If I remember right, going up requires 90 degrees of bend / flexion. Going down requires 132!!

 

[newlybionic]

I had my TKR so I could go up and down correctly. Unfortunately I'm back to the beginning again because I needed to have it re-done since the original OS did a poor job. You are correct that is a goal I plan to reach. I was just letting you know that it wasn't necessary to be able to do stairs correctly before you had the second TKR. Sorry if I confused you.

 

[Celle]

If I remember right, going up requires 90 degrees of bend / flexion. Going down requires 132!!

I think it's less than 132 - many people don't get as far as 132, and yet they can manage stairs properly.

 

[kneeper]

I'm not at 132 and I go downstairs effortlessly. But it did take a few months to get there.

 

[Freedom]

Ha ha haaa, okay OK! I said I may not remember it right!!

 

[Freedom]

Should be a way to share this with everyone who is on Post Op!!!

 

[Freedom]

Today is 13.5 weeks post op. I see OS again on Friday. Hope he will say we can move on to the right knee. At least, I think I hope that.

 

[Freedom]

I've been getting nervous for the past 3 days, tomorrow morning is my OS appointment. I have no idea how this will work. I stopped PT April 8; I know I have more ROM than I did at that time, but I have no idea what my numbers are. I know the PT had to notify his office that I self discharged from PT. Typically, PT will notify the OS office of your numbers at the session you have right before the appointment.

 

[Celle]

You're a big girl now. You don't need anyone's permission to do what you feel is right for your knee.
Your surgeon can advise, but he can't make you do anything. It's your choice whether you accept his advice, or not.

Since your ROM has improved without going to PT, that supports your decision.

 

[Freedom]

Saw my OS this morning. Now, he went by visual, not a goniometer, but he says my extension is zero and my flexion is at least 110. YIPPEE!!!

I was calm for this visit, thanks for the supportive post @Celle, I really needed that.

Now, I think I have lost my mind: RTKR is now scheduled, June 1!!

Attached are photos from last visit - Mar 4 - showing my left implant, and xrays from today showing the Right.

 

[newlybionic]

Just think after this second surgery you're on your way to having pain free knees. I would do my other one sooner than later but I can't since I have to go back to work. It was easier for me with the revision surgery because I knew what to expect. You'll do fine. Congrats at 110!!

 

[Freedom]

Thank you! My left knee is just about pain free. Still some stiffness, but that is different. And now when I walk my dogs, it is only my right knee that makes me stop.

I am between jobs just now so have to get the 2d one done. Can't imagine going for a new job and then saying, Oh by the way, I need 12 weeks off for knee surgery - not going to get me a job is it?! LOL

I need to address pain management. For the left, I had 5 days of uncontrolled pain. I attempted to discuss this with the OS this morning. He insisted "it is a 2 way street, you have to push through the pain. When PT shows up and asks if you are ready to get up, if you say no you are in pain, they turn and leave. You have to say YES!" If my pain on a scale of 1 to 10 is a 15, and I am screaming and saying the top of my head is going to blow off, there is no way I can say yes to any sort of movement, PT or otherwise.

If anyone has thoughts on how to address this, I am open to ideas.

He also said I would do better if I could go home rather than inpatient rehab. Well, how do I manage that? I have a weak to nonexistent support network. I don't know what he thinks I am going to do to suddenly change that! I'm also not sure what to do about inpatient rehab PT, and then inhome PT once I get back here.

 

[newlybionic]

I actually did go for a job interview before my first surgery and told them ' by the way'. I got the job and they held it for me for three months. Then 5 months after I'm there I tell them I'm going to be out for 3 months! I even have been paid short term disability! I'm very lucky but it could happen for you too.

The main thing I asked my current OS was about pain management post op. I was very sick taking pain meds after my first surgery and the surgeon tried one other and then he just ignores me from that point out. My current OS promised me he would always listen to me and work with me to find a pain med and also give me an anti nausea med. I was told in the hospital by a PT that if I didn't work harder(the day after surgery) that I would need a MUA. Maybe it was the drugs but I laughed out loud! If you have appropriate pain meds you'll be able to start getting up. Having the pain med discussion beforehand is what is needed.

 

[Freedom]

Thank goodness for this forum. I can't believe PT on day 1 post op threatened you with an MUA! Geesh.