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TKR Greatday6's recovery thread<

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Greatday6

Greatday6

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Thank you, I wished I would have known about Bonesmart earlier, but I’m glad that I’m here today.
 
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Josephine

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1. Level of pain 3-4
3. Moderate swelling
Moderate swelling adds about 4 points to your pain score, since it is also a manifestation of pain. Thus I rate your pain as 8 which is high.
2.Pain medication prescribed :
Celebrex 100 mg 1 daily end 5/24/19
Oxycodone HCL 5 MG tablet take 1 to 2 tablets every for hours as needed moderate to severe pain.
I only take 1 tablet of Oxycodone ½ hour before Physical Therapy. That's usually when I have the most pain.
Tylenol Extra Strength 500mg 2 tablets 2x a day
Oxycodone 'as needed'? How often is that?
Celebrex is an NSAID and a pretty poor painkiller. Really no point in taking it.
Tylenol: take 1,000mg 3-4 times a day at 6hrly intervals. I know the FDA has ruled that 3,000mg acetaminophen is a safe maximum but that would be assuming that the patient is taking another medication that also contained it and thereby inadvertently take an overdose. Assuming that this is not the case, the maximum safe dosage per 24hrs 4,000mgs.
4. ROM Flexion- 90 Extension- +10
That's okay for 7 weeks out.
5. Ice knee for 20 min 3 times a day.
You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
6. Elevate knee 20 min 3 to 4 times a day
Same as icing - elevate when you ice.
7. Activity level- fold laundry, load dishwasher and unload, feed the dog and prepare dinner.
Okay

Exercises at home 3 times a day
Seated static chair scoot 10 x3 set - same as heels slides but your ROM is good so you don't need them
Seated gastroc stretch 15 x1 set - same here
Long sitting quad set on couch 15 x1 set - and here
Standing bilateral calf raises 15 x1 set - and here
Supine straight leg raise 15 x1 set - tip: once you can do these you don't need to do them any more
Supine ankle pumps 10 x1 set - these are only required for the first day or so after surgery. You certainly don't need them now!
Hook lying glute sets 10 x1 set - these are not necessary either
Side lying hip abduction 20 x1 set - this is a hip exercise so you don't need it

PT 3 times a week
Stationary bike 10 min - okay provided there is no resistance
Stretching hamstring - 5 x3 sets - not necessary
Stretching calf- 5 x3 sets - not necessary
Strengthening quadriceps sets 10 x3 sets - not necessary
Knee slides 5 x3 sets - not necessary
Straight leg raises 10 x2 sets - not necessary
Step board 2 x10 - not necessary
Slant board standing in place 30 sec - not necessary
Leg press 45lbs 30 x1 set - most definitely NO weights!
Leg curl 45lbs 30 x1 set - most definitely NO weights!
Hip abduction and adduction 45lbs 30x1 set - most definitely NO weights!

In summary:
1. adjust your pain meds
2. adjust your routine of icing/elevating
3. stop ALL your exercises. They are all of a wrong type anyway and all responsible for your pain and lack of progress. Read this BoneSmart philosophy for sensible post op therapy. Remember that you don't need exercises (or PT) to rehab from your knee surgery. There are many on this forum who recovered from their surgery but did NO exercises or PT whatsoever. However, they did their normal ADLs and it served them well. I was one of them. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?
 
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Greatday6

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@Josephine Thank you, I am definitely going to follow your recommendations. I can't wait to make these changes, especially after seeing that some of the exercises that I was doing are not necessary.

Thank you,
 
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sistersinhim

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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:.
 
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Greatday6

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Just checking in, I’m 15 wks post op TKR, I return to work at 8 wks post op, my employer would not allow the 12 wks recommended by my surgeon, however I was allow to work a 4 day work week for one month. At 8 wks post op my surgeon scheduled me for MUA since my rom has shown very little improvement. Pending on the time of day I was able to bend my knee between range of 88- 90 degrees. MUA was fine on 6/21. I was advised by my surgeon that he was able to reach 110 degrees after the procedure and that I will need to go to physical therapy for the next 5 days. I Went all five days because I was hoping MUA would really make a difference.
Day 1. My knee was pushed, cranked, and forced to bend, my rom measured 99 degrees

Day 2. More stretching etc, 103 degrees.

Day 3.” “ 99
Day 4. “ “ 94
Day5. “. “ Between 89 and 90.

At this point I’m not going to worry about my rom. I don’t believe the MUA helped me at all.

I reduced physical therapy to once a week, I schedule my appointment only with physical therapist that are gentle. I just started Aquatic physical therapy this week, I’m pleased so far.

I’m still experiencing some swelling and stiffness, so I continue to ice and elevate.

I’m thankful for Bone Smart. I was given good sound information and should have stuck to it. My knee needs more time to heal and there is no rush.
 

Jockette

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I’m sorry the MUA didn’t help you. They are great for people who have true adhesions, but they don’t really help people who “just have swelling.”

Swelling is a big deal and really limits ROM. Do what you can to get the swelling down and just treat your knee gently and try to be patient.

I had a very slow recovery, then had a major set back at 4 months, it took a month to improve and then I had another set back at 5 months and my ROM was shot. It took months but I have a good ROM now. I am more than 2 years post op and my leg in general feels better now than it did even a year ago when I was just over a year post op.

So don’t believe anyone who tells you there is a time limit to regain ROM. If mine cane back after my rough first year, yours can, too!:console2:
 

sistersinhim

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Day 1. My knee was pushed, cranked, and forced to bend, my rom measured 99 degrees

Day 2. More stretching etc, 103 degrees.

Day 3.” “ 99
Day 4. “ “ 94
Day5. “. “ Between 89 and 90.
Right here is the proof that aggressive PT is counter productive for a knee replacement recovery. Even now some days I bend easier than others. It all depends on how active I was the previous day. I assume it's internal swelling that causes my bend to change. It doesn't take much fluid to affect our knee's ROM.
 

Josephine

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I agree with sisterinhim 100%. I've heard this time and time and time again.
 
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Greatday6

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Hello everyone,

I had a follow-up visit yesterday with my surgeon, I’m approaching 5-month post-op and my ROM has improved from 90 to 96 degrees since quitting PT two weeks ago due to having to constantly remind the therapist to be gentle. I decided that I had enough, and made my decision not to return. I think the two weeks away from pt. made a difference the swelling went down considerably. I had mentioned in my last post that I had MUA in June to break up scar tissue and my surgeon was able to get my ROM to 110 degrees. I’m not going to worry about my Rom and stress myself out, I’ll continue with my normal ADL’s, I have access to a gym where I can use the pool and stationary bike. I’ll continue to ice and elevate and my next follow up visit with the surgeon is in four months.
 

ApricotPie

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@Greatday6,
Many surgeons seem to downplay recovery times, describe the op as routine, you might only be in hospital for a day, and do not stress to the patient prior to the op how much trauma will occur (maybe because people may not go ahead with such elective surgery at that point?).
Sadly, many people go into the surgery not realizing it is a brutal marjor surgery that requires many months, even over a year to fully recover form. Sometimes the surgeon does not mention it. Sometimes the patient doesn't bother to listen. But, IMHO, the real fault goes with those people in the medical profession (prosthetic makers and medical clinics) who advertise all sorts of phenomenal recoveries in a matter of weeks or months. One tennis player is back to playing doubles in 4 weeks. Another guy is snow boarding in three weeks. And old codger (like me!) is hiking to the top of Mt. Sipperyslope at 6 weeks. And an IronLady is running a half marathon at two months. It's sort of like saying "Hey, I just won the 20 million in the state lottery, so all you other people can do it too!"

What arrogance. What ignorance. What nonsense!!!!!!

I would like to take all these people outback to the woodshed for a 'reality adjustment'.:hissy::no-fin:

FWIW, I am at 6 weeks going on seven. My comfortable ROM is about 98 degrees. With some work warm-up and stretching on my part I can hit 105 degrees. If the therapist gives me a gentle push I can hit 110.
 
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