TKR Hey Jude knee replacement

Samsrf

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Hope you don’t mind me asking, but how was your wound treated when the incision split open? And how long did it take to heal? Could you bend your knee while it was healing?
it split from bending. It was about 5 cm on the top of my incision (which is 18cm long -I had a medial incision to use a couple of old scars I had from previous surgeries). I actually felt it “release”. After consulting with the PA and sending pictures they told me to take 4 days off of PT. After that it was “bending as tolerated” so I would bend- and watch the incision. If it started to pull I stopped. It took about 11 days to close again. I monitored for infection but was told just to leave it be. I also was still wearing compression tights so that made it feel protected. I kept it clean by chainring tights 2x day. I washed sight with Hibiclens (surgical soap) and dried well when I showered. I didn’t have staples had internal stitches and glue on the outside. Below is the first pic at 4 days after it split when it started “gluing” back together. It was like a flap. 2nd picture is just right now of the same spot (texture on my skin is from compression on ice machine) After that spot was weird and puffy so I did some research and started using “Forces of Nature” scar which is a FDA registered (I’m in the US) homeopathic scar medicine. That spot actually looks better than below where they incorporated my old 3.5 “ scar
 

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Samsrf

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@Hey Jude P.S. I was super worried about my ROM and bending… I made more progress during that time than I had in a prior week. That’s when I realized taking it easy and not having gnarly PT was conducive to my bending and I just did stretches and bends that felt right. It was only a week or two after this that I “quit” formal PT. I am headed to week 16 of healing and feeling great. The bonesmart way worked once I realized I can be active and keep improving without torture and tears.
 
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Hope you don’t mind me asking, but how was your wound treated when the incision split open? And how long did it take to heal? Could you bend your knee while it was healing?
it split from bending. It was about 5 cm on the top of my incision (which is 18cm long -I had a medial incision to use a couple of old scars I had from previous surgeries). I actually felt it “release”. After consulting with the PA and sending pictures they told me to take 4 days off of PT. After that it was “bending as tolerated” so I would bend- and watch the incision. If it started to pull I stopped. It took about 11 days to close again. I monitored for infection but was told just to leave it be. I also was still wearing compression tights so that made it feel protected. I kept it clean by chainring tights 2x day. I washed sight with Hibiclens (surgical soap) and dried well when I showered. I didn’t have staples had internal stitches and glue on the outside. Below is the first pic at 4 days after it split when it started “gluing” back together. It was like a flap. 2nd picture is just right now of the same spot (texture on my skin is from compression on ice machine) After that spot was weird and puffy so I did some research and started using “Forces of Nature” scar which is a FDA registered (I’m in the US) homeopathic scar medicine. That spot actually looks better than below where they incorporated my old 3.5 “ scar
Thank you for sharing your experiences. Sorry you went through the trauma of a split wound, but glad that you have made such a good recovery.

I managed to get my wound looked at and now have steri-strips on it. Been instructed to keep it covered for a couple of days before I check to see how it is. Was told it should heal in 7 days - but I reckon it might take longer, as yours did, especially as my whole leg is still so swollen.

I am going to have a break from the bending exercises aimed at improving my range of motion (which actually isn’t bad already at 5 degrees to 105 degrees, after 2 weeks) to give it a better chance of healing.
 
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Should I cover it? Should I go back and request steri-strips?
For my two previous knee surgeries, they put glue on the incision after staples were removed.
That sounds sensible. But I haven’t been given that option - hopefully the steri-strips will now hold it together. Thanks for taking the time to comment.
 

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I had steri-strips in several places when I had my staples removed. Nothing opened up. They told me they'd fall off naturally after several days.
 
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Day 19. Beginning to feel a bit more normal at last! Thought I’d take stock of my various issues so far (largely for my own reference):

Knee Pain - originally taking codeine and paracetamol but continued to have dreadful 24 hour pain which wouldn’t go away however much I rested, iced or elevated. Trip to A&E advised as so painful, hot and swollen in case it was DVT (which it wasn’t). Added Gabapentin to meds which seemed to help a little but affected my vision. Pain now at last seems under control after changing meds on Day 17 to Tramadol and Naproxen. Had a little dizziness and nausea with new meds but well worth it to be without so much knee pain

Sciatic pain - had been from my buttock down to the arch of my foot. Now only infrequent ache in foot. Presumably because inflammation is going down and reducing the pressure on the nerve

Calf pain - virtually gone after lots of stretching exercises for calf muscle. Am sure this arose from overstretching during surgery in (successfully) getting my poor old bent knee straight

Eyesight - blurry vision gone after stopping Gabapentin a few days ago

Bruising - had been very extensive and painful in calf and thigh. Now all gone apart from a couple of little bruises on foot

Swelling - whole leg had been terribly swollen after surgery and the skin tight and sensitive. Gained 8lbs weight while in hospital due to the swelling. Removed ill-fitting compression socks the day after I got home because cutting into skin. Knee and thigh now still swollen but not as bad and calf is much more normal. Only weigh 2lbs more than prior to surgery now. Do get intense itchiness in my lower thigh weirdly. Reluctant to take antihistamine as I’ve researched it can reduce the antI-inflammatory properties of Naproxen

Wound - staples removed on Day 14, four steri-strips applied on Day 15 because wound hadn’t completely healed on the knee bend. Knee has felt warm to the touch ever since surgery. Still holding off having my first shower until I’m convinced it has fully healed.

Numbness - large patch of skin to the outside of the wound has been completely numb since surgery (photo attached)

Constipation - was bad when came out of hospital but have since managed by taking Laxido daily

Exercising - had been attempting all the prescribed exercises (bending, stretching and muscle strengthening) but currently being extra gentle to ensure the unstapled wound does not re-open. No aggressive physio undertaken at all. Apart from physio checking I could walk up and downstairs before leaving hospital, I’ve just had one physio appointment on Day 15 where she checked what I could/couldn’t do, gave me a few extra exercises to do at home, and encouraged me to do more walking with the crutches.

Range of motion - had a “log leg” until day 9 where I couldn’t lift it off the bed at all. Swelling impeded movement. Now have 5 degrees to 105 degrees. Knee much straighter than it has been for years, which makes walking feel so much more upright and comfortable. Does feel like my operated leg is an inch longer which worries me - but hoping that is because for years my hips have been crooked to cope with the previously bent knee and now it just “feels” different.

Sleep - last night had my first decent night’s sleep since the operation - no doubt because the constant pain was at last under control and the post-surgery swelling is starting to come down. Makes such a difference to how I feel in myself. Hurrah!

Thought this might be useful for people going through the uncertain tough times in the fortnight or so after surgery. I know we are all different but I’ve found Bonesmart incredibly helpful when trying to find out if my issues should be a cause for concern.
 

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Jaycey

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@Hey Jude Thanks for the update. Sounds like you are doing really well! Glad you are taking the slow and steady approach to recovery - it works every time.
 
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Day 27. Another update for my benefit and for anyone else who likes to compare notes.

Pain - Continue to wake each morning with a constant ache in my knee. Also aches after any walking or sitting without my leg raised. But immeasurably better compared with a fortnight ago. Have reduced painkillers to 3 Tramadol per day (from 8) and 3 Naproxen per day (from 4) and intend to wean myself off prescription meds over the next couple of weeks. Lovely husband bringing me breakfast in bed so feeling very spoilt! Do spend a lot of time lying on my bed still but cleaned the bathroom yesterday and intend to gradually do more each day.

Wound - scar healing well but one little scab remains so not risking a shower yet. But looking forward to having a shower very soon! Knee remains swollen, I have the ‘tight band’ feeling and there is some redness/warmth at times - but it doesn’t feel ‘angry’ so am assuming it is not a sign of infection.

Range of Movement - achieved 121 degrees flex today (from around 90 degrees after the op). Am really pleased with the progress. I find the prescribed heel slides uncomfortable and prefer bending my knee while lying on my back on the bed - photo attached. I just let gravity very, very slowly increase the bend to stretch the various ligaments and tendons. Seems to be working. Do feel like something catches behind my knee when I straighten my leg….but hoping that is temporary given other people’s experiences (a big thank you Bonesmart for being such a great source of reference).

Sleep - have abandoned trying to sleep with my leg raised on pillows. Now sleeping on my side again which is more normal for me so I’m getting much more sleep.

Overall, I can’t believe how much better I feel compared with a fortnight ago when I was seriously regretting having surgery. No doubt there will be setbacks along the way but am feeling very encouraged for now.
 

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Susie-Q

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You are doing very well! I also preferred bending my knee while on my back, letting gravity do some work rather than heel slides. I still do it once in awhile when I first get up if I remember. So glad you are feeling better and sleeping better! I also hated sleeping on my back and when I could finally sleep on my side I got much better rest.

Keep on keeping on! Slow and steady wins this race. :flwrysmile:
 
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Day 34

Good news - feel like I’ve made a lot of progress in the last week. Must be feeling better as I’m noticing how the windows need cleaning, the garden needs weeding etc, whereas before I was oblivious to it all! Have started to do a few household chores, have stopped taking prescription meds apart from one Tramadol at bedtime, and am sleeping well. Husband took me for a drive on Saturday so I could have my first short scenic walk (just one third of a mile and with crutches), and had my first (gentle) knee exercise class this morning which went okay. All good so far. :) :-) (:

Bad news - ever since the knee replacement I have felt like my operated leg is longer than my other leg. Walking causes hip and back pain. Today the physio took a formal measurement and advised it is around 1cm longer. After years of hobbling with a permanently bent knee, I had so hoped that surgery would enable me to go hiking once again. I’m very disappointed that it has given me uneven leg lengths. :cry: I’m trying to be practical and have sent off for a full length shoe insert but I’m dubious there will be enough room in my shoes. Has anyone else had this leg length differential problem?
 

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Lots of people are born with leg length differences. Back when I was a runner (main source of my knee problems) we found my left leg was almost a half inch shorter than my right (more than 1 cm) and so I had at first a heel lift and then later, custom orthotics that corrected for the length differences. It took a few weeks to get used to but then it felt fine.
 
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Lots of people are born with leg length differences. Back when I was a runner (main source of my knee problems) we found my left leg was almost a half inch shorter than my right (more than 1 cm) and so I had at first a heel lift and then later, custom orthotics that corrected for the length differences. It took a few weeks to get used to but then it felt fine.
Thank you for taking the trouble to respond. It’s very reassuring to know that others have overcome this problem.
 

benne68

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ever since the knee replacement I have felt like my operated leg is longer than my other leg.
This is quite common in knee replacement surgery. My operated leg is also marginally longer, because the surgeon needed to straighten my leg (which was badly bowed) during the replacement.

Interestingly though, the hip and back pain you describe may not be from the differential in leg length. I had a similar complaint during my first few months post-op and it turned it that the pain was my body getting used to being in proper alignment after so many years of being slightly twisted because I was favoring the bad knee.

In my case, the back and hip pain have completely disappeared. In fact, I spent my summer vacation hiking along fjords and up-and-down dirt paths without any difficulty.

You will be able to hike again! Just give your body time to adjust to its new posture.
 

benne68

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Almost forgot: here's an article that you might find helpful.

 
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ever since the knee replacement I have felt like my operated leg is longer than my other leg.
This is quite common in knee replacement surgery. My operated leg is also marginally longer, because the surgeon needed to straighten my leg (which was badly bowed) during the replacement.

Interestingly though, the hip and back pain you describe may not be from the differential in leg length. I had a similar complaint during my first few months post-op and it turned it that the pain was my body getting used to being in proper alignment after so many years of being slightly twisted because I was favoring the bad knee.

In my case, the back and hip pain have completely disappeared. In fact, I spent my summer vacation hiking along fjords and up-and-down dirt paths without any difficulty.

You will be able to hike again! Just give your body time to adjust to its new posture.
ever since the knee replacement I have felt like my operated leg is longer than my other leg.
This is quite common in knee replacement surgery. My operated leg is also marginally longer, because the surgeon needed to straighten my leg (which was badly bowed) during the replacement.

Interestingly though, the hip and back pain you describe may not be from the differential in leg length. I had a similar complaint during my first few months post-op and it turned it that the pain was my body getting used to being in proper alignment after so many years of being slightly twisted because I was favoring the bad knee.

In my case, the back and hip pain have completely disappeared. In fact, I spent my summer vacation hiking along fjords and up-and-down dirt paths without any difficulty.

You will be able to hike again! Just give your body time to adjust to its new posture.
Thank you. It is easy to get dispirited when there is a new hurdle to address. Your experience gives me hope that it can all turn out okay in the end.
 
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Update - 7 weeks since TKR

Had the post op review with my surgeon yesterday. He’s a very busy man but I managed to squeeze a lot into the ten minute consultation.

It was reassuring to get to see the post op x-ray and he is happy with my knee’s progress. He echoed everything I’ve read on this site ie:
- pain, clicks, clunks are all par for the course
- progress will be incremental
- Bio Oil can be helpful (thank you Amazon for delivering promptly today)
- patience is needed as it can take up to a year to recover.

The surgeon is confident my leg length differential is not due to the knee replacement and suggested getting x-rays of my other knee and hips to find out what is going on. I wouldn’t be surprised if everything is out of kilter given the way I’ve been hobbling for years. I’ve invested in a thick adjustable insole which is warding off the hip pain for the time being.

I’m still frustrated with my knee as it remains swollen and is very sore (particularly around the knee cap) apart from first thing in the morning. But I’m excited to be given the all clear to drive as I’ve hardly left the house in the last couple of months. Think I might postpone the housework yet again and have a short drive to the coast later today! Might even have an ice cream!
 

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Jaycey

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I wouldn’t be surprised if everything is out of kilter given the way I’ve been hobbling for years.
This is definitely true and why we always suggest our member not wait too long for joint replacement. Limping for years has a major impact on many areas.
Think I might postpone the housework yet again and have a short drive to the coast later today! Might even have an ice cream!
Best medicine in the world!
 

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I think the coast and ice cream are just what you need. Seriously. This recovery is difficult & changing it up with a change of scenery and a tasty treat sounds good.

One of the many aspects of recovery is when you begin to possibly start to have some energy it is so easy to over do it. That is where so many make a mistake and its a setback. The saying slow and steady comes to mind with recovery. Enjoy your day.
 
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I think the coast and ice cream are just what you need. Seriously. This recovery is difficult & changing it up with a change of scenery and a tasty treat sounds good.

One of the many aspects of recovery is when you begin to possibly start to have some energy it is so easy to over do it. That is where so many make a mistake and its a setback. The saying slow and steady comes to mind with recovery. Enjoy your day.
I agree. I didn’t make it to the coast yesterday, but had my first drive this evening….and this was my reward. Definitely good for the soul!
 

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sistersinhim

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Oh my goodness that is absolutely beautiful! You need to make a poster of that.
 

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