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Revision TKR helga’s right knee revision

aquamarine117

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Hello to all, haven’t been on since before surgery. Finally out of the hospital after five days, yikes! Knee is coming along fine but couldn’t empty my bladder. I was given extra time but no success was sent home with a catheter.
My knee was doing so well, and I was up walking several times daily in hospital as well as sitting up for meals with my knee bent. Funny but so new after this surgery my titanium knee feels strong and stable.

I’ve been doing well with the exercises that pt sent me home with.
Fast forward to my first at home pt visit. I did all exercises to my best and she brought out a measurement dial to check my rom. It was 110 on its own and she urged the knee to 128 ouch!

I had a miserable night with so much more pain and swelling and today it hurts just to bend it some. I cancelled today’s appointment and mentioned bonesmart philosophy of healing . She kind of scared me and said because it’s a revision i will develop scar tissue and need to push through the pain.

I’m on strong pain med dilaudid and feel like I’m eating it as though it were candy, every 4 hours. What do you all think?

I had a partial right knee 1 and 1/2 year ago, a tough recovery that never had gotten well enough to accept. I am desperate that the outcome of this revision is an excellent one, having gone to a surgeon who specializes in revisions.

I am new at this but it feels good to be able to share my experience. I have been reading many other posts . We feel each other’s pain
 

LynetteCly

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I’m so sorry the PT pushed you. I hope rest and just normal activity will reduce swelling and pain so you can get back to your earlier excellent results. Take care of you.
 

Pumpkln

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@aquamarine117
Welcome to the otherside! :welome:

110 degrees this early out of your revision is fantastic, no need to push your ROM, it will continue to improve with out any "help". Glad you cancelled your PT, suggest you call the home health agency and ask for another PT who is up to date.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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 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 a 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 history before providing advice.
 

Celle

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Hello Helga, @aquamarine117 , and :welome: to recovery.

It sounds as if your knee is doing well. Please don't let that home PT therapist get you worried or upset. She is wrong. your first ROM (flexion) measurement was remarkably good for so soon after surgery. 110 degrees on its own is way better than what's expected.

Your therapist should not have forced your knee to bend further. She's upset it and caused you pain and stiffness. Don't let her do that again. In fact, tell her you don't want her to touch your knee at all.

It's your knee and you are the only one who has the right to say what happens to it. Your knee, your rules. You are in charge, not your therapist. Establish from now on that you do not want anyone forcing your knee, and you will not do any exercises that take you beyond discomfort into pain. Your therapist has to respect your wishes.
Saying no to therapy - am I allowed to?

She kind of scared me and said because it’s a revision i will develop scar tissue and need to push through the pain.
She's wrong there, too. Don't allow anyone to make you push through the pain. "No pain, no gain" is the wrong policy for this recovery. "No pain, more gain" is the rule for TKR recovery.
Myth busting: no pain, no gain

Of course you'll develop scar tissue - that's what holds your wound together. Without scar tissue, you'd continue to have an open wound. What your PT is talking about is bad scar tissue, more properly known as adhesions.

And adhesions aren't just sitting there, waiting to pounce if you don't exercise enough. In fact, over-exercising can actually encourage the development of adhesions. That's because exercising too much causes your wounded tissues to become hot and inflamed. Hot tissues become dryer than normal tissues, and dry tissues tend to stick together more easily, forming adhesions.
MUA (Manipulation under Anaesthetic) and Adhesions

Your new knee just needs to be kept moving gently, which you do every time you walk around your house. It needs lots of rest, together with icing and elevation, to help it heal and bring down its swelling. It's the swelling that stops your knee from bending, not a lack of exercise.
 

NightQuilter

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It sounds like you have really embraced your new knee and the brighter future it will provide you. I am so sorry that pt pushed your knee and caused it ... and you... such needless discomfort. What Celle said - all the way. 110 so soon after surgery is something we all longed for. Ice and elevate it and allow the inflammation her pushing caused settle down. You'll soon be back on the way to a good recovery. And stay on schedule with the meds, even if it feels like eating candy. If you get behind schedule and the pain flares up, it will take longer for the dose to do its job.

Good luck!
 

sistersinhim

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110 at 5 days out is outstanding! Most OSs expect 90 at 6 weeks. You are way ahead of that. Your PT had no right to push your knee like that. It was totally uncalled for, plus has caused you extra pain and swelling. Don't let anyone ever push your leg or push down on your knee. Please read all the articles that were left for you. You will find wonderful information to help you have a less painful recovery.
 
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aquamarine117

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Does the knee swell a lot during the first week after leaving the hospital? I won’t let pt force the bend again. The other exercises I seemed to be able to do with some discomfort after ten repeats but not pain like the forced rom. Thanks for your encouraging and sane advice
 
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aquamarine117

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110 at 5 days out is outstanding! Most OSs expect 90 at 6 weeks. You are way ahead of that. Your PT had no right to push your knee like that. It was totally uncalled for, plus has caused you extra pain and swelling. Don't let anyone ever push your leg or push down on your knee. Please read all the articles that were left for you. You will find wonderful information to help you have a less painful recovery.
Not going to let her force the knee to bend more. She is not in pain and sleepless whimpering at night like I was. Thanks for your support
 
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Pumpkln

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aquamarine117,
No need to quote a message to respond, just scoot down to the box at the below of the last post next to your avatar, and start typing.
Here is an article about how to use the quote feature.
How to use the quote feature
 

NightQuilter

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I hope the pain from the PT pushing so hard has relieved itself some and you are feeling more comfortable.
 
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aquamarine117

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Hi everyone, I’m wiped out! On tuesday will be three weeks since surgery. My knee hurts more and am wondering if it is because am now using a cane and not the walker . Could it be because I am putting more weight on the right knee when walking? It is confounding that every day is different. Today really keeping up with the pain meds and resting. I was out in the supermarket briefly two days ago and picked up a few items. It felt good to be part of the everyday stream of living. Maybe overdid it? Is exhaustion and bouts of crying part of this recovery, or am I being a wimp? My knee does feel strong but does hurt a lot especially the inner aspect of my knee , still swollen.
 

Jockette

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Yes, unfortunately it sounds like you overdid it. I know how hard it is to take things slowly, and we don’t know how much is too much until we do it.

Maybe go back on the walker for a while and see how you feel.

Crying is par fir this course, also.
 

leejaa

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Definitely sounds like you overdid. I stayed on the walker for quite a while since it provided more stability as I relearned to walk correctly and not limp. After I went to a cane I would use the walker early in the morning and late in the evening when I was extra tired for a week or so.

There is always a desire to get out there and be part of the world again but maybe next time start with smaller trip with less walking and then give yourself a couple of days to see how your knee and body feel about it. Small incremental increases work much better than trying to do too much too fast. Slow and steady recovery will get you to a good outcome with fewer set backs. You did not mention if you were icing after your outing. Icing and elevation are so helpful to get the inflammation down and helps with pain control. I lived with ice for months whenever I was sitting or elevating.

I hope your night is peaceful.
 
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aquamarine117

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Hi @ leejaa and Jackette, thanks for helping me decipher what’s going on. There was probably too much walking while in the store, those aisles are long! I tend to be an overdoer and so love moving about! Need to remind myself to be a little slower and not to get emotionally distraught. Had a bought of crying just because. I will keep my walker handy as a backup when I am tired.
I mentioned while answering someone’s post about metal allergy that I had a partial knee replacement one and a half year ago because the OS suggested it. After several years of cortisone shots, gel shots, 3 arthroscopic procedures for torn meniscus and cleaning out loose cartilage in the knee it sounded like a good option and a fairly easy recovery. Fast forward the outcome was horrible, always in pain , limping and needed to have the knee drained several times. I realized my right knee was not getting any better and remembered all of the family events especially our daughters wedding that I had to tough it out and power through without having full enjoyment.
In spring of this year I went to a specialist in knee revisions and had the surgery on July 29th revision from patellofemoral knee replacement to total right knee replacement. I am coming up on three weeks soon. My surgeon suggested I get a titanium implant due to a nickel sensitivity. When I was a teenager couldn’t wear cheap fashion earrings because my ears would really flare up and get quite infected. My partial had nickel components and seemed like my body was reacting to it. It has been a long haul having two major surgeries in such a short time. The new knee really feels strong although It is tight and swollen still. Getting better each week though and am glad it is behind me. Even this early on there seems to be less inflammation than my previous surgery and somewhat less painful. I would like to suggest to all that are approaching a knee replacement to be certain about the type of implant that will become their knee. The dr.s don’t bring up the materials used and it is awful to have a failed implant because of a metal allergy. Thanks for all of your kind supportive comments and helpful advice.
 

leejaa

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I am glad we could help in explaining things. Now, the hard part is on you to listen to your body and your knee and give it plenty of rest with icing and elevation. Swelling hurts and is so uncomfortable making everything more difficult. Have a wise restful day. :flwrysmile::ice:
 
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aquamarine117

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three weeks post surgery and knee hurts more than ever, WHAT HAPPENED? I've been using the cane but have been out of the house thanks to a ride from my son , grocery store to pick up a few items along with another couple of stops. Maybe was too much for my new right knee. I looked at the bonesmart timeline for activities in my stage of healing and will be mindful of the advice. I was feeling so good and probably over did it. More swelling and pain, not so swell. So glad of this forum
 
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aquamarine117

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Kelleytoons; hi and welcome. I just had my 2nd tkr on 30 July. I had my 1st one on February 13th. I am 6months. out and tight feeling is almost gone. It seems to go away in most people around the 6 to 7 months time frame; but remember this is a year long recovery and everyone heals different. Hang in there it will get better; Doodlebug
hi @doodlebug60, my surgery revision to rt tkr after partial knee replacement was on july 29 th. How is your knee feeling? Mine was doing so much better a week ago. It seems I overdid it walking with cane in supermarket and doing a few errands, thanks to being chauferred by my son. So good to get out of the house and feeling some independence. Back to icing and resting. What is your activiy level? This is my first total knee replacement. Love this forum and feel like part of a big family
 
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leejaa

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You are an overachiever regarding activities which causes the swelling and pain. You realize it after you do it so that is progress but now to work on managing the activities in smaller increments. You know they say that the world was not made in one day and our knees do not heal in one day either. Stagger your activities over days and rest/ice and elevate in between. This is not a race but a marathon and your knee knows that so it is making its feelings known. I hope your evening is peaceful and your pain decreases.
 

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@aquamarine117 This surgery doesn't allow you to get over confident with activities. It ALWAYS let's you know when you have overdone it!!
 

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