PKR Ian's Recovery Thread - Early days, but OUCH!

[IanOS]

Hi,

I am new to this site, having had a right partial knee replacement last Friday, 7th Aug. So, very early days yet.

I am no newcomer to invasive surgery, having had 12 operations on my lower spine and neck (fused C3-C7 and L3-S1). Having said that, I had not expected so much discomfort from this knee surgery - Wowsers, it hurts!

I had the surgery done as at 55, with a young family, I want to remain active and able to cycle and climb hills for many years to come. After all the work regaining fitness following spinal surgery, I do not want worn out knees to stop us!

Following the surgery, I have reasonable movement at this point - 90⁰ and can straighten also. The swelling is the issue - Am having to work on keeping it raised/iced to control that. Am also taking ibuprofen and cocodamol regularly.

Sleep is a challenge, but I guess will improve as the swelling and bruising reduce.

I had advised my employer that I'd return to work (desk/computer) after 2 weeks. I am now realising this is probably far too soon... Maybe 4-6 weeks, maybe even 6-8? Any thoughts on this please?

Great to have found this site and forum to discuss with other people in similar situations

 

[Celle]

Hello @IanOS - and
It sounds as if you're doing well. You're doing the right thing in keeping your knee elevated and iced. That will help to reduce its swelling. It's swelling that prevents yur nee from bending more, but more flexion will come gradually.

I think you were pretty optimistic in expecting to be back at work in just a few weeks. Even though you'v only had a partial knee replacement, it's a major surgery, from which complete recovery takes a full year. You'll be able to do most things long before that year is up, but we do recommend that you take about 12 weeks off work, and then do a Phased return to work , if possible.

I'm afraid sleep disturbance is a familiar part of this recovery. There's an article about it in the recovery guidelines, which I'll give you in my next post.

 

[Celle]

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Sara61]

@IanOS Congregulations on your partial knee replacement.
Sleeping is very difficult in the beginning, namely as we are all advised to sleep on our backs, with our legs straight. I was always a side sleeper and for the 1st week or so, I hardly got any sleep at all, until I discovered it was ok to sleep on my side with a large pillow between my legs, usually I had my operated leg on top and my knee slightly bent.
I would suggest only return to work when you feel you are fully able to, usually it's recommended to work part-time to begin with, between the 11th and 12th week.
I have family living in Salisbury it is a beautiful town.
All the best with your recovery

 

[leejaa]

Congratulations on your new knee. Icing and elevation are vital at this point to keep the swelling down. I iced pretty much non stop unless I was walking and even than I had a ice pack wrap that I could leave on. You did not say how much PT or exercises you were doing. If you are doing a lot this would also add to your inflammation and swelling so consider doing fewer reps and spreading it out over the day in small increments.

I have to admit that I did return to work at 6wks but not full time hours. I had to return since I only had that much time off and I needed another knee done that year. I had a desk job and my own office so that helped as I could elevate my knee and brought ice packs with me. This was not easy on the leg but also the brain got tired and the rest of the body. I would come home and literally collapse with more ice and elevation for weeks and weeks. Poor husband had to cook or pick something up on the way home for dinner. If at all possible give your body time to recovery and build strength.

Ice and elevate and have a peaceful evening.

 

[pkraug2020]

I can totally relate! I had PKR left knee on August 6th. I started work about 1 week out but am fortunate to work from home and can elevate, ice and move frequently. I still tire easily and rest when necessary.

Sleep has been a challenge for me as well but is improving slowly since my pain has lessened greatly in the past few days. Only need to take Tylenol and/or Advil as needed now.

I'm a newbee to surgery and had done plenty of research etc prior, but this was definitely more painful than I had anticipated. I'm very active but I'm thinkng recovery is going to take much longer than I was hoping.

Sounds like you're on the path to recovery. Hang in there!

 

[IanOS]

I am quite concerned about my knee. I am now about 3 weeks Post surgery and the pain is different and worse. For the past 5 days, rather than improving, I am now in severe pain when I place weight on the knee. The pain seems to be in the joint interface with tibia. It is a very strong burning sensation, which also runs down my leg to my foot, in the form of pins and needles. Had anyone else experienced this please? I am nervous, as in previous surgeries to my lower spine and neck, I have had trouble with failed fusions and metalwork.

 

[Roy Gardiner]

I am now in severe pain when I place weight on the knee.

Avoid anything that causes pain. It's almost certainly not anything failing in the joint itself, but your body frantically adapting.

One's condition post-op is sometimes worse than pre-op for a few days or up to a MONTH later. One has to learn to roll with the punches, to relax, take medication, let the body do its thing and heal. It will do this all on its own. PT can be helpful with this process, but the key element is time.

But it will happen. Millions of TKRs are done every year; this wouldn't be so if it didn't work.

 

[IanOS]

Thank you all so much for the lovely encouraging and helpful messages. I am worried about the knee currently, as the pain is worsening - If I place any weight on it, the pain between the joint and lower leg is really severe - burning and also some feeling of pins and needles into my foot. The swelling is better than before though. I guess I should see how it goes over the next day or so.

 

[sistersinhim]

I had extreme pain in the same place. I think it's where the stem of the implant goes into the bone. Mine is still tender if I push on it. Also, it could be shin splints. Make sure when you walk you place your heel on the floor first then roll onto your foot and push off with your toes. This gain helped to relieve some of that shin pain.

Have you tried icing and elevating more?

 

[leejaa]

Have you called your OS office and asked what they advise or if they wish to see you and check things out with an x-ray. It never hurts to touch base with the surgeon when odd things pop up. In the meantime try to rest it and ice it as much as possible.

 

[DiannesNewKnee]

Hi. Just FYI, I’m 8 weeks out from a PKR, and I’m back to doing some things I used to do before. I still have pain, but only need to take pain medication at night. I can do large grocery store trips and some easy lawn work. I’m not working out like I did before but will get there.

When you said you were surprised by the pain, I could seriously relate to that. I couldn’t believe how painful this surgery was.

I hope you feel better very soon, and I’m sure you will.

 

[IanOS]

Thank you all so much for your helpful and encouraging comments. The pain is worsening with pain meds not touching it. Seems to run from top of tibia down to my foot. I'll call my doctor to make an appointment tomorrow (public holiday in UK today)

 

[sistersinhim]

Let us know what you find out.

 

[babycatcher]

I'll call my doctor to make an appointment tomorrow (public holiday in UK today)

I'd do that too as sounds like things are different from before. Hopefully all will be ok. I'm 5 days behind you and feel that progress is being made except for in my exhaustion! Hopefully they will see you soon. If you're really worried don't forget 111 or A&E. My GP Nurse said to go to A&E if worried about anything despite me feeling it wasn't really the place but at least you'd be seen by a surgeon. Take care.