TKR Hinged knee replacement after broken tibia plateau with all lateral ligaments torn

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
In a few hours, I will be having my right knee surgery for a total hinged knee replacement.
Will update on my recovery going foward.
 
Last edited:

Jockette

Staff member since March 18, 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
31,951
Age
66
Location
Delaware
Gender
Female
Country
United States United States
Best Wishes!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as 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.

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 to 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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Jockette

Staff member since March 18, 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
31,951
Age
66
Location
Delaware
Gender
Female
Country
United States United States
The orthopedic trauma surgeon tried his best to put the tibia back together… had two metal plates with 15 screws along with loads of bone cement in there. After about 9 months, I had all the metal hardware removed in preparation for liagments reconstruction surgery.
Can you give us the dates for these two surgeries please? We’ll add them to your signature. Thanks!
 
Joined
Aug 14, 2008
Messages
149
Age
71
Gender
Female
Country
United States United States
In a few hours, I will be having my right knee surgery for a total hinged knee replacement.
Will updates on my recovery going foward.
Good Luck to you. Will look forward to hearing about a great outcome!
 
Joined
Aug 14, 2008
Messages
149
Age
71
Gender
Female
Country
United States United States
Interested to hear about your ligament reconstruction surgery when you have recovered enough and feel like writing about it.
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
@Flowerfloosey69 Thanks.
I did not and will not do the ligaments reconstruction. This is the reason I am getting a Hinge Knee Replacement. Ligaments aren’t need with the hinge knee replacement, in fact my OS said they usually cut the ligaments when putting in a hinge knee.
 

Cjackso21

member
Joined
Jun 10, 2018
Messages
212
Age
59
Location
Arizona
Gender
Female
Country
United States United States
Hello, I am really interested in how your hinged TKR goes. I had that option as my ligaments stretched due to all of my revisions. My new doctor, after I moved, said there were limitations and he thought he could fix them without the hinge. So I had a TKR revision where he balanced the ligaments using the soft tissue model and robotics. My ligaments stretched again after 6 mos., thus another revision last year. They have stretched again so I am now in a brace, possibly permanently. They are now sending me to a physical therapist that specializes in other techniques to recover atrophied muscle, which they believe is the cause of the stretching. Then another revision likely to increase thickness of the poly. Looking back I feel I should have done the hinge. I don’t think I have enough bone left for that now, but not sure. So, please let me know how it goes! Good luck!
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
They have stretched again so I am now in a brace, possibly permanently.
This is exactly what multiple OS said will happen over time in my case. (My primary OS sent my case to multiple colleagues around the US to get their opinion). My primary OS used to work for NFL teams in NY, so he has some good connections for sport injuries. Most of them came to the conclusion, with the extreme varus in my repaired leg that my ligaments will stretch out over time (couldn’t say, 3 months, 6 months, maybe a year). In fact, my OS was very honest and told me, one of his colleague told him “don’t try to be a hero with ligament reconstruction, this patient needs a hinge knee replacement to continue living a comfortable life”.
Good luck with everything. My suggestion is to get as many opinions from other OS to make the best decision for you.
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
Today was my big day for my total hinged knee replacement. I’ll start by saying, this is what I experienced so far. Please don’t take what I am going to say, as the same thing you will or may experience with a hinged knee replacement surgery. Use it as a data point in your research for this type of surgery. Everyone is different and will have different tolerant to pain, medication, etc.
Now on with it… everything was going really well in pre-surgery preparations until they had to put in the IV needle. Started with the left arm, needle pushed in, then nurse started to move it around it there and couldn’t find a vein. Moved to the right arm, got it working but the needle got bent 90 degrees after I push down on the operating table as I was going onto it. Had to reposition a new one.
After that bad start with IV, I got a nerve block on my thigh above the knee and was “knock out cold”.
Two & a half hours later, woke up to massive pain in the knee. I complained to recovery room nurse who gave me an IV shot of Dilaudid. After about 30 mins, pain was still high, I got another shot of dilaudid. 30 mins later…WOW. Boy, I was ready to jump out of bed and start running. Pain was down to a tolerable level, it’s not even funny. Recovery nurse told me that’s some high level narcotics, to which I reply, can I get some of that prescribed for home lol.
Since I was feeling so good and recovery nurse saw the change in my demeanor, how much I could move the leg, doing strong heel pumps, wiggling of toes, he had me try walking with a walker. He was impressed how well I did. He said I can go home today but he will have to get clearance from my OS (OS had me down for overnight stay). He called the doctor and relay how good I am doing and that I walked really well with the walker, OS suggested a physical & occupational therapist evaluate me. If they gave the okay, then I can go home. I demonstrated walking with a walker, a cane, up/down stairs, as well as getting on & off the toilet. They gave the okay and I was on my way home. At home, pain is tolerable because I took my pain meds about an hour before I needed them.
P.S I should also mentioned, I have a pretty high tolerance for pain. In fact, when I first injured the knee when I fell (crushed tibia plateau, all lateral ligaments completely torn and a dislocated knee cap), I didn’t go to ER until 12 hours later after I pass out from the pain. (Hindsight, not a smart decision)
 
Last edited:
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
In addition, for this surgery I purchased a cold therapy machine for post surgery recovery. This thing is awesome! For the previous two surgeries, I survived with ice packs but they had limitations.
This cold therapy machine is a game changer for me. Highly recommended, if you can afford one!
RICE is my new best friend too. I also declined in home PT after surgery because I kinda know what I should/can do after knee surgery. I had two previous knee surgeries and for the first one, I followed all the OS advice for PT and did it religiously. Second one, no PT. I did my own stretches and exercises at home, minding the pain. I was able to get almost full flex in the knee, (heel touched the back of the quad) and about -5 deg extension without any formal PT. So, I am going to take it easy and do my own PT based on my pain level.
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
Forgot to add, I got the Smith & Nephew Hinged knee joint with a cone insert on the tibia side of the knee.
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
Can you give us the dates for these two surgeries please? We’ll add them to your signature. Thanks!
First surgery June 20th 2021
Hardware removal surgery April 5th 2022
Right Hinged TKR surgery July 12th 2022
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
Didn’t get a lot of sleep after TKR surgery, ~3 hrs max. I am a belly sleeper, so sleeping on my back with leg elevated wasn’t very comfortable. I knew sleep would be tough. For my surgery to repair my crush tibia I had to be in a straight brace, elevated and that was rough for sleeping but after few days I adjusted and got more sleep as the days went by.
Pain is higher today (IV pain meds worn off), but I am managing it with the pains meds I was prescribed. I am walking (weight bearing) with walker and one crutch, as much as I can tolerate. Not pushing my the knee too hard, mindful of the pain level. Started light stretch/bending and quad exercises again mindful of my pain level… nothing crazy, just little & slowly. Cold therapy machine is helping a lot with pain and swelling. Second day is going good.
 

Jockette

Staff member since March 18, 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
31,951
Age
66
Location
Delaware
Gender
Female
Country
United States United States
 

sistersinhim

Staff member since March 20, 2017
BoneSmart Staff
Joined
Dec 4, 2015
Messages
27,442
Location
Virginia
Gender
Female
Country
United States United States
Listening to your knee and treating it very sensibly is a smart way to recover. You know its reaction better than anyone else does. Experience has been your best teacher!
 
Joined
Aug 14, 2008
Messages
149
Age
71
Gender
Female
Country
United States United States
Hello, I am really interested in how your hinged TKR goes. I had that option as my ligaments stretched due to all of my revisions. My new doctor, after I moved, said there were limitations and he thought he could fix them without the hinge. So I had a TKR revision where he balanced the ligaments using the soft tissue model and robotics. My ligaments stretched again after 6 mos., thus another revision last year. They have stretched again so I am now in a brace, possibly permanently. They are now sending me to a physical therapist that specializes in other techniques to recover atrophied muscle, which they believe is the cause of the stretching. Then another revision likely to increase thickness of the poly. Looking back I feel I should have done the hinge. I don’t think I have enough bone left for that now, but not sure. So, please let me know how it goes! Good luck!
I'm so sorry to hear this I'm concerned about quality of bone too. Do you have other ligament issues in other parts of your body?
 
OP
OP
N

Newbai

junior member
Joined
Jun 27, 2022
Messages
42
Gender
Male
Country
United States United States
Today, I have to say, knee stiffness is no joke. I was able to bend my knee to about 90 degrees with bearable pain. Extension is a bit tougher, I am about 10 degrees. I am not a person who like meds, so I tried to cut back one dose… that wasn’t smart two days after surgery. Pain was crazy, so I am not going to do that any time soon again. Cold therapy ice machine is a life saver. I was able to sleep longer last nite and napped quite a bit today.
 

sistersinhim

Staff member since March 20, 2017
BoneSmart Staff
Joined
Dec 4, 2015
Messages
27,442
Location
Virginia
Gender
Female
Country
United States United States
I used my ice water circulating machine the whole time I was sitting or laying down for at least a couple of months. This helped so much with controlling my pain and swelling. You can't over ice as long as you have a cloth between your skin and the ice bag. Don't forget to elevate your toes above your nose.
 

BoneSmart #1 Best Blog

Staff online

  • Sara61
    Staff member since March 23, 2020

Members online

Forum statistics

Threads
61,185
Messages
1,528,484
BoneSmarties
37,209
Latest member
JerzPat
Recent bookmarks
0
Top Bottom