TKR Hello Everyone - First time knee replacement patient here : )

[Jamie]

One of our BoneSmart surgeons, Dr. Raj Sinha, tells his patients to focus on getting your extension as soon as possible for the best recovery. You’ve done that!

Swelling is much more likely to impact your flexion than extension and that will improve with time and some tender loving care. You are much better off doing only gentle bends and stretches to keep your knee loose while you’re awaiting that reduction in swelling. It will come if you don’t overdo things too much; drink plenty of fluids; rest, ice, and elevate; and try not to push yourself with exercises or activity. Overdoing it can heat up your knee and that is never a good thing.

Try not to worry about an MUA. Although your surgeon or even your physical therapist might threaten that, you’re way too early to say whether you’d ever need that procedure or not. Please don’t do any exercises to the point of serious pain. You should move just to the point of discomfort and if you find yourself having pain or swelling the next day, that’s the sign your body is not ready for that level of activity yet.

 

[Jockette]

His exact words were "You are very, very behind the 8 ball. This needs to improve asap".

I’m so sorry that this is your surgeon’s opinion. Not all surgeons agree with this. 19 days (not quite 3 weeks) is so very early in a recovery that takes an average of 52 weeks/one year.

I am experiencing a great deal of worry right now...terrified that an MUA could be recommended and that great gobs of scar tissue are forming as I type this.

It always makes me feel so bad, as well as a bit angry, that this is how some medical teams make their patients feel. We are struggling to recover from a major surgery that causes a lot of trauma to the area. We feel vulnerable and most likely, more emotional than normal, at this time. Please try to relax, you’re going to be fine.

Keep in mind the following:

People are all different (as are surgeons and PTs) and so are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

 

[Margot]

Thank you for your replies. I really appreciate them. xx

 

[sistersinhim]

I agree that it's way too early to be worrying about your bend. As you heal and your swelling goes down, your bend will naturally increase. If you do too much too soon, your knee will stay inflamed, and that leads to swelling. Swelling decreases your bend. Your aim should be to get that swelling down, not worry about your bend. Bending a swollen knee well is impossible. There is nowhere for all that fluid to go! Flushing out that fluid through resting, icing, and elevating will help to improve your bend.

Many of us never did any exercises, just used our knees as they were intended to be used. We did our normal daily activities, as our knees allowed without pain, and our ROM recovered just fine.

 

[IndigoKnee]

Just to second what others are saying about bend and threats. I'm mainly on here now following hip replacement but when I had my knee done in January 2023 I was also frightened by physios telling me how far behind I was and must push through pain. Thankfully I found this site where I was reassured. My knee recovery was a little slow but I did eventually get a good ROM and was back to walking several miles a day over uneven and undulating ground so please don’t worry.
My surgeon also said "of course you don’t yet have full ROM there is too much swelling there, but it will come" As will yours I am sure.

 

[Margot]

All of your posts are incredibly reassuring. Thank you! Thank you! Thank you!

I have another physio appt tomorrow and my therapist said with the staples out she can do some tissue massage. I've also started using some heat on the underside of my knee and still lots of icing and elevating for the top parts of my legs.

I'll update after my appt. tomorrow. Best wishes to everyone and thank you again : )

 

[mendogal]

Please don't heat the back side of your knee yet! It may not seem like it, but there IS inflammation and swelling. There's so little "spare room" back there we can't see or feel the swelling, but icing is what it needs.

 

[Margot]

Thank you for your advice re: not applying heat to the back of my knee. I will heed your advice : )

 

[Layla]

Hi Margot,
I do agree with, mendogal, on the heat. At two weeks post op your knee is still "calming down". Ice is your best friend right now because it keeps swelling under control. Heat increases blood flow which can worsen any swelling and make pain and stiffness worse. There will come a time when there aren't risks involved in applying heat...but not yet. Glad to read you'll heed the warning.
I hope you have a peaceful weekend.
@Margot

 

[Jockette]

my therapist said with the staples out she can do some tissue massage.

Personally, I would not consent to any massage right on the knee, and especially not the incision. For me it would be too early for this. A lot of this recovery involves just letting the knee “be” so it can heal. We don’t always have to have something done to it, to enhance that.

And especially, don’t let them bend your knee for you, at all. Been there, done that, because I didn’t know any better, and it didn’t go well for me.

 

[EalingGran]

You are still very early to be worrying about bend.
I honestly don't know what my bend was at your stage but I have full bend now (150 degrees). I had glue so I didn't see my surgeon until 6 weeks and he didn't measure me then- just watched me walk and asked me how I was feeling.
I didn't do any formal physio. I just followed the exercise book I was given and paid for some private pilates after about 4 weeks.
I never pushed myself to pain. If something hurt I stopped. My ROM definitely came back over months and I gained the final 10- 20 degrees from about 6-12 months as the last of the swelling and stiffness eased.

 

[IndigoKnee]

I would agree with @Jockette about the massage that it is too early. I did a little very gentle massage on my own knee (I am a therapist) at about 4 weeks but I would have been very reluctant to let anyone else massage it, especially not around the incision.

 

[Margot]

I am grateful for the insight shared - it is so helpful! Thank you : )

 

[mendogal]

The only body work/massage I would indulge in during the first couple of months was being carefully positioned sidelying on my non-op side. My surgical leg was fully supported, extended forward on a large bolster so that hip-to-toes it was parallel to the massage table, knee comfortably flexed.
My therapist didn't touch the leg at all. She did hip, pelvis, low back releases that made a HUGE difference!

 

[Margot]

Hello everyone : )

My physio yesterday went well...no massage of any kind...she just did some light stroking on either side of the incision (but not on the incision) all the way down my calf to the top of my foot. She used the laser on my ankle and top of the foot as she felt it might help with some of the swelling there. We did 8 knee bends with me on my back - holding each for 5 seconds - with each bend just at the line before deep discomfort becomes pain. This was very difficult, but I made it - she measured me at 50 degrees flexion which is 10 degrees more than my surgeon said I had on Wednesday, so I felt relief at that. For myself - my goal is to simply see improvement each week...even if it is very slow. We also did some quad and ankle strengthening exercises and that was it. I was super sore after and immediately went home to ice and elevate. The elevation is definitely making a difference in terms of the ankle/foot swelling.

I will see her again next week on Wed. and Friday.

Hope you're all doing well!

 

[Jamie]

Great report, @Margot. You have the right approach to the recovery process. Slow and steady. It will pay off for you. I’m glad you have what sounds like a great therapist.

 

[Layla]

Your outlook on recovery is thoughtful. You're giving yourself exactly what you need by focusing on steady progress week by week. That type of mindset takes away any pressure to meet unrealistic goals or timelines. Hopefully keeps your spirts up also. This is the best attitude to have on your recovery journey, Margot.

The extra care you're taking by elevating after PT is paying off with less swelling in your ankle and foot. Keep celebrating the small wins, you're doing all the right things and it's nice to read about your progress.
Thanks for sharing an update and enjoy the rest of the weekend!
@Margot

 

[sistersinhim]

Yay, for your bend improvement!

my goal is to simply see improvement each week...even if it is very slow.

As you heal and can do more, don't be surprised if your bend goes down a little. This is because of swelling from increased activity, and completely normal. Fluctuations in our ROM are something we all see in our recovery. More swelling = less ROM. Ice and elevation will help to flush this increased fluid out!

 

[Margot]

Hi there...I'm currently 26 days post op...in your opinion, does my incision look pretty typical for this amount of days post-surgery? The fluidish stuff is Polysporin that I put on a couple of hours ago.

 

[mendogal]

Yep, looking good.
Did your team recommend Polysporin? Did they have a concern? It's not routinely used as far as I'm aware.