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

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Newbai

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Four days after surgery, I was able to move around more and put more weight on my leg. Swelling went down quite a bit. I am able to flex knee about 100 degrees and extension of about 5 degrees. I can do more but I am mindful of my pain level. Also, took a shower today, which felt great. Pain management is still my biggest issue. I am icing through out the night, ice machine has an on-off cycle, which is awesome. Kinda a bored stuck in my recliner.
 

Cjackso21

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Sounds like it is going fairy well, normal Revision/TKR stuff. What did they say is the limitations with the hinged TKR verses a normal revised TKR?
 
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Newbai

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What did they say is the limitations with the hinged TKR verses a normal revised TKR?
From what I have been told there aren’t any limitations to a hinge TKR. The don’t use it as primary TKR if your ligaments are strong and intact. The hinge prosthesis provide stability if you have weak and stretch out ligaments. In fact, they cut and remove the ligaments when using a hinge prosthesis. I was also told it’s less painful after the operation, since no ligament balancing or restrictions of the collaterals might cause any additional pain. FYI, it’s painful.
 
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Took off bandage today, relieved to see they didn’t use staples to close the cut like my previous surgeries. Cut seems to healing well. Did my daily flexing/extension but was a bit hesitant for fear the cut to open up.
 

sistersinhim

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There is no need to stress the knee by trying to increase your bend. It will come naturally as the swelling and pain decrease.
 
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Newbai

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Today, was a bit painful. I stop taking oxy yesterday, only taking Tylenol and tramadol for pain. I also noticed two small areas on my incision a bit wet (not heal/closed). Hoping in the next couple of days, those areas scab over. Don’t want to get an infection.
On a positive note, I hopped on my stationary bike (seat at a high setting) to see if I can do a complete pedal rotation. I was able to do it with a little bit of pain. Was just a test and got off after that.
 

sistersinhim

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Good night. It's way too early to be trying a bike. It's good that you can do it, but you shouldn't be doing it yet. Please be careful. Your knee is an infant and needs to be treated as such.
 
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Newbai

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@sistersinhim I know I know… I was walking pass the bike and thought I’ll give it a try… I am not doing that any time soon, just wanted to get a feel for it.
 
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Today was another positive day. Wet spots on incision seem to be drying out and started to scab over. Pain level was higher this morning, but after Tylenol kicked in, it was bearable. I also walked in my house un-aided (no cane/crutch) with full weight bearing for the first time in more than a year. Right knee felt stable. Still walking with a limp due to the large incision and swollen knee, but it felt great to be able to put full weight on my right leg and not having it buckle.
Still haven’t done any formal PT, except some light stretches/exercises I learned from my previous surgeries. Will decide after I see might OS next week if I’ll do any formal PT. ROM is about 100-105, extension is at 0.
 

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You are doing fantastic! It sounds like that hinged knee is working well for you. With that ROM I'd say you really don't need PT. You know what to do and what not to do.
 

Cjackso21

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Wow, that sounds very positive. I am like you, want to test the bike early. My last full TKR revision, I go on the bike at 2 weeks and had no pain! I think it was the precise robotic surgery. I used no resistance, just turned the knee with other leg. Felt great! Keep the posts coming please… great to hear you are doing well. Thanks.
 
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Newbai

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Doing great so far, walking more and more un-aided. Pain is down tremendously, just hitting my Tylenol pills at the 6 hours window and it’s working great with pain level. Swelling is down a good deal too, I guess icing the whole night and sometimes through the day is working well. My extension and ROM are getting better but I am not pushing it a lot… somewhere between 105-110 degrees. Incision looks better, all open/wet spots scab up.
My only issue is during walking my knee seems to clunk at the end of travel of my step (i.e. at full extension on the knee). It’s not painful, just that I can feel this clunk. Since I have a hinged knee prosthesis, I know there is a end of travel hard limit at extension (to prevent hyper extension of the knee). Not sure if I am hitting that end of travel limit. I’ll try to do some research to find out the extension limit or when I see my OS on Wednesday, ask about it. Hopefully Smith & Nephew website will have some details on the extension limit.
 

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Yesterday, I was finally able to do a walk around my lawn and tend to some of the weeds (kids did most of the hard work, I just supervised). Was able to prune some of my plants. Finally, went out to dinner with the family, wife drove but sitting in the car was kinda uncomfortable. Kids were happy after dinner, we sat outside the house and they were able to ride their bikes, scooter, etc and play on our dead end street. Wife was also happy as yesterday was our wedding anniversary and we were able to do family stuff and my injury/recovery now seems to heading in the right direction towards a life of normalcy (fingers crossed, no setbacks).
 

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Well done on getting out and about! Still very early days for you. Please continue the slow and steady approach to this recovery. Eye on the prize - a pain free life!
 
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Yesterday I had my first post op visit with my OS. He was impressed with my ROM (110 deg) and extension (0 deg). He said that my incision is healing well, and the swelling has gone down a lot. I was given the clearance to drive and use the stationary bike at zero resistance (I’ll hold off getting on the bike for now). I asked about clunking, he said it’s normal and it will eventually stop as the muscles around the knee tighten. I asked about golfing, he said only "putting" for now. I think he sensed I was asking about too many activities, so he was adamant for the next three months, I have to take it easy on the knee (said it multiple times). Follow up in three months.

I am walking pretty much unaided except in the night when I get up, I use the cane.
I also got a look at my baby for the first time from the x-ray yesterday (see attachment)
 

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Jockette

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It sounds like you have a very reasonable OS.
 
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Newbai

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It sounds like you have a very reasonable OS.
Yes, he specialized in joint (hip & knee) replacements, as well as revision surgeries. I told him I am doing my own PT at home, and he said continue doing what I am doing… never pushed for me to do formal PT. I had to ask for a PT prescription (if I decide to do formal).
 
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Newbai

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In the last few days, I have decreased Tylenol intake. I only take Tylenol in the morning when I wake up and when heading to bed (I don’t need it, but just taking it as a precaution).
ROM has steady improved to about 120 degrees. I am mostly walking without the cane (cane in the night for bathroom run). Because of increase ROM I able to walk up stairs normally with the hand rail. Continuing ice through the night and at home exercises/stretches.
I also drove for the first time since surgery.
 

Jockette

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You are doing very well!
 

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