BoneSmart® Hip / Knee Replacement Forum
Joint Replacement Patient Advocacy
and Online Community

[PARTIAL KR] HelloMako’s patellofemoral recovery

Discussion in 'Knee Replacement Recovery Area' started by HelloMako, Mar 9, 2019.

  1. HelloMako

    HelloMako new member
    Thread Starter

    Member Since:
    Feb 18, 2019
    Age:
    54
    Messages:
    14
    Gender:
    Female
    Location:
    Michigan
    Country:
    United States United States
    Hello all, I had right patellofemoral replacement March 7, one night in the hospital. I haven’t had as much pain as I expected, and today almost none. I’m walking well with a cane and stairs are fine.

    I’m renting a vascutech machine which cools without ice and also provides compression, keeping my leg elevated on a 45 degree wedge pillow. I’m icing/elevating almost all of the time, but even so, my swelling keeps increasing. In appearance it’s only moderate, but it’s beginning to feel almost like my leg is in a cast.

    First time up on day of surgery I could straighten my leg completely and flexion was probably 110 (guessing). By next day PT measured extension 0, flexion 98. Today extension is still 0, but flexion is probably half what it was. I’ve given up the heel slides for now. I was given a few exercises to do at home, but no PT until after my two week check up. I’m wondering if there’s such a thing as over icing? I was told I didn’t have to limit icing time with this unit because it stays at 43 degrees. I ice over a pair of lightweight sweatpants. Could too much icing be causing this stiffness?

    I would love to hear how some of my fellow March surgeries are doing in these early days!
     
  2. JV15

    JV15 new member

    Member Since:
    Feb 18, 2019
    Age:
    45
    Messages:
    8
    Gender:
    Female
    Country:
    United States United States
    @HelloMako I had a patellofemoral on the 6th and my experience has been fairly similar to yours. Flexibility was great in the hospital but since then it continues to get worse. Today the knee feels so stiff I don't know if I'm even going to make it close to 90 degrees. The pain hit me pretty hard yesterday and through the night but has been totally fine today.

    PT in the hospital told me that I would need to allow my knee to warm up sometimes to allow it to clean things out. I keep mine elevated most of the day and rotate icing with the cryocuff and gel packs.
     
    • Like Like x 1
  3. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

    Member Since:
    Dec 4, 2015
    Messages:
    16,613
    Gender:
    Female
    Location:
    Virginia
    Country:
    United States United States
    Welcome to Bonesmart. The following are our basic guidelines and should help get you started. As you read more on other members recovery threads, you’ll get a better perspective of what to expect and what not to do, especially regarding PT.

    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. Here is a week-by-week guide for Activity progression for TKRs


    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.
     
  4. HelloMako

    HelloMako new member
    Thread Starter

    Member Since:
    Feb 18, 2019
    Age:
    54
    Messages:
    14
    Gender:
    Female
    Location:
    Michigan
    Country:
    United States United States
    Thanks for the quick replies. This forum is such a wealth of information and inspiration. I know I’d be feeling much more anxious if I didn’t have the opportunity to read about other people’s experiences.

    @JV15, thanks for passing along the advice from your PT. I’m going to allow for some warmup time going forward.
     
  5. Jockette

    Jockette FORUM ADVISOR Forum Advisor

    Member Since:
    Aug 29, 2017
    Messages:
    9,513
    Gender:
    Female
    Location:
    Delaware
    Country:
    United States United States
    What does that mean? Clean what things out?
     
    • Agree Agree x 1
  6. JV15

    JV15 new member

    Member Since:
    Feb 18, 2019
    Age:
    45
    Messages:
    8
    Gender:
    Female
    Country:
    United States United States
    @Jockette allowing increased blood flow can better tissue perfusion allowing more nutrients to get to the tissues as well as decrease edema.
     
  7. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

    Member Since:
    Apr 20, 2018
    Age:
    59
    Messages:
    976
    Gender:
    Male
    Location:
    Michigan
    Country:
    United States United States
    @HelloMako, welcome from a fellow Michigander. I had a lateral Makoplasty PKR about 11 months ago. While our procedures are slightly different, the recovery is pretty much the same. The swelling will go down over time. Continue what you are doing. Thinking back, I believe there was some initial increase in swelling as the impact of the surgical trauma settles in and the soft tissues react.

    I also used a similar cryo machine that both cooled and provided compression. This was extremely helpful, especially at night, as it helped to minimize potential for DVT and also acted to massage the leg and knee.

    One word of advice, don’t get over anxious to start PT and do not let any therapist push to pain.
     
    • Like Like x 1
  8. HelloMako

    HelloMako new member
    Thread Starter

    Member Since:
    Feb 18, 2019
    Age:
    54
    Messages:
    14
    Gender:
    Female
    Location:
    Michigan
    Country:
    United States United States
    Thanks @NavyGunns! I’ve not done much at all but ice and elevate, only doing ankle pumps and a few quad sets to keep blood flowing, gave up on the rest for now, just too stiff. I’ll check in with my surgeon tomorrow, just since I keep going backwards, but I’ll bet it’s just my individual response to the surgical trauma, as you suggested. Thanks, for the input, it helps
     
  9. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

    Member Since:
    Dec 4, 2015
    Messages:
    16,613
    Gender:
    Female
    Location:
    Virginia
    Country:
    United States United States
    I believe most of us go backwards shortly after getting back home from this surgery. The trauma of the surgery is really starting to hit then, plus the added stress on the infant knee by just taking care of your daily needs. Just worry about icing, elevating and getting the swelling down. Very gentle movements are the best thing for your knee for the next month or so. It has a lot of healing to go through.
     
    • Like Like x 1
    • Agree Agree x 1
  10. HelloMako

    HelloMako new member
    Thread Starter

    Member Since:
    Feb 18, 2019
    Age:
    54
    Messages:
    14
    Gender:
    Female
    Location:
    Michigan
    Country:
    United States United States
    Its one week today post op, slept decently last night, found that everything was feeling less stiff today, and I was walking better. Home PT came for my first session and she was onboard with letting me move the knee only as far as I was comfortable.

    Well...between her enthusiasm and me being too coachable, I must have pushed myself harder than I thought. I got to 110 degrees flexion, 0 extension, but I didn’t do myself any favors. I have the most pain and most swelling I’ve had since the surgery. Bruising too, and I hadn’t had any before. I can barely bend my leg to walk. So frustrated with this setback and with myself :banghead:
     
  11. Jockette

    Jockette FORUM ADVISOR Forum Advisor

    Member Since:
    Aug 29, 2017
    Messages:
    9,513
    Gender:
    Female
    Location:
    Delaware
    Country:
    United States United States
    I’m so sorry this happened. Sometimes it seems fine when we do something but then the pain and swelling shows up some time later.

    This is why we caution about PT. Too much too early does more harm than good.

    It was one week post op that my PT (outpatient) continued to bend my knee to an excruciating place. I didn’t find Bonesmart until several weeks later, so I thought this was necessary. I sure know better now!

    I’m sure you know the drill: rest, ice and elevate.

    I hope things settle down for you soon. :console2:
     
    • Friendly Friendly x 1
  12. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

    Member Since:
    Apr 20, 2018
    Age:
    59
    Messages:
    976
    Gender:
    Male
    Location:
    Michigan
    Country:
    United States United States
    @HelloMako, it amazes me how different OS approach PT. Mine didn’t even want to discuss PT until after my first follow up visit at just over 2 weeks post op. I didn’t even have home PT or home nurse care. By the time I got PT scheduled at a local therapy center, I was about 3 weeks post op. All I did at home on my own prior to that were basic heel slides, extension stretches, etc. I was able to achieve a rom of 0 - 100 completely on my own before PT by waiting. When I did go to PT, sessions mainly focused on getting quads to work again, that and massage and tens to further reduce swelling. Can’t think of a single session that resulted in increased swelling or pain. Some stiffness but minor.
     
  13. HelloMako

    HelloMako new member
    Thread Starter

    Member Since:
    Feb 18, 2019
    Age:
    54
    Messages:
    14
    Gender:
    Female
    Location:
    Michigan
    Country:
    United States United States
    @NavyGunns, after two week checkup was my surgeon’s plan as well. I contacted his office Monday regarding losing so much flexion since discharge and the feeling of tightness inside my knee. The PA suggested having PT come take a look to evaluate. Since I called on Monday but PT didn’t get here until today, I was feeling looser and one thing led to another.

    I asked the same question here about backsliding since discharge, and got reassuring answers. I should have cancelled but I was curious and bored so I didn’t. I had no intention of doing too much. The swelling and bruising from today is more than I had with the surgical trauma!
     
    • Agree Agree x 1
  14. HelloMako

    HelloMako new member
    Thread Starter

    Member Since:
    Feb 18, 2019
    Age:
    54
    Messages:
    14
    Gender:
    Female
    Location:
    Michigan
    Country:
    United States United States
    How can I make a tag for my thread that indicates that my surgery was PKR?
     
  15. Jockette

    Jockette FORUM ADVISOR Forum Advisor

    Member Since:
    Aug 29, 2017
    Messages:
    9,513
    Gender:
    Female
    Location:
    Delaware
    Country:
    United States United States
    We’ll set that for you.
     
  16. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

    Member Since:
    Apr 20, 2018
    Age:
    59
    Messages:
    976
    Gender:
    Male
    Location:
    Michigan
    Country:
    United States United States
    @HelloMako, sometimes we just have to learn the hard way. No problem doing so as long as we do, in fact, learn and do our best not to repeat. I don’t know how many times I “learned the hard way” during my recovery. Always for something different though, so at least that was a good thing.
     

Share This Page

Sponsors
Close X