TKR Incision opened when staples removed<

[fours2many]

While your knee is tight and swollen, cut right back on all your activities, especially any exercising, including walking in the poo

My leg is never NOT tight or swollen. I sit with my leg up on the recliner with 2 pillow on it and ice at least 6 times a day and ice through the night in bed.
I see my pcp tomorrow. My op appointment is at the end of the month.

I have several neighbors that had tkr and none of them had tightness, swelling, redness or warmth at 4 months. They all say they had an easy recovery. I also live in sw Florida. Shorts are a must. 86 and humid right now.

 

[Jockette]

People can forget the details of their recovery, amazinging as that sounds. I might forget when a particular thing occurred but I will never forget how difficult this recovery has been.

3 or 4 months into my recovery I had someone ask me if I’d done pool therapy. I said yes, but that it didn’t go well. She looked at me like there was something wrong with me.

One of the hardest things about recovery for me was the comments, opinions and expectations other people had for me. Most were people I barely knew. I live in a 55+ community so I often run into people I hardly know. It made me so mad that they were so vocal about it.

4 months is still very early. There is lots of time for improvement.

 

[Celle]

Your incision had a hard time at first, so it is going to take longer than the TKRs of people who had an uncomplicated recovery. If people comment when they see your knee, just tell them that it had a set back at the start, and your doctor has it all under control. You don't have to discuss it any further with them.

It's not a good idea to compare knees, because no two are ever exactly alike. None were in the same condition as yours before surgery, none had exactly the same amount of work done on them during surgery, and none of them had your complications after surgery.

It's easy after the fact to say that you had an uncomplicated recovery but, like childbirth, you do tend to forget the bad parts afterwards.
It's actually quite common to have a knee that is still swollen at 4 months and, even at 12 months a knee can swell after an unusual amount of activity.

As for the tightness, people do have that feeling, sometimes for much longer than 4 months. It's a pretty common complaint on BoneSmart and that tight feeling does fade gradually, but can longer for as long as 9 months.

I'm not sure, but the shininess and some of the discoloration seem to cover an area where you would have had the wound dressings. It could be something to do with that.

When I look at the photo of both your legs, your left leg does look swollen, but it's not a lot bigger than your right leg.
Thank you for posting the photos, by the way. It will be a help to Josephine.

 

[fours2many]

Yes, I totally agree. I get stopped all the time by people saying that they didn’t have trouble and they would sue the dr... blah, blah, blah. I came home last night and cried and was up all night looking at infected tkr on google. I sat at a dinner for a few hours last night with my leg down and it swelled, sent my husband for some ice packs, people just kept commenting. They all had me so scared.

 

[Jockette]

People just don’t think. I’m so sorry they said so much to upset you. It’s very hard to ignore those comments. And it’s also hard to “hide the evidence” that you had a knee replacement.

For what it’s worth, my knee is still not comfortable sitting at a table with my feet on the floor for the length of a restaurant dinner. It still prefers to be up on an ottoman.

I do remember when I was 4 months post op I was still propping my foot up on my cane when I went to a restaurant. Even that little bit of elevation helped, and it enabled me to have only a slight bend to my knee, not the 90 degree bend.

 

[Jamie]

I'm so sorry these armchair orthos are making your life miserable. Please don't give them that power over you. You KNOW you've done the right things with your knee and your surgeon does have things under control. Your knee actually looks pretty good to me, especially given all you've been through.

The shiny skin can be a factor when there is swelling. It's nothing sinister. Slight redness and heat are all normal parts of the healing process. And redness also can linger after cellulitis. If your surgeon is happy and you have none of the normal symptoms of infection, you should stop worrying about it. You've made tremendous progress from that point where your incision opened up. I'd say you're well on your way down recovery road!!

 

[Josephine]

Well turns out it wasn’t the Percocet causing the withdrawal symptoms. I was given Ativan to calm me after my incision opened and to help me sleep. I just stopped taking them the other day. Now I’m a limping, a drug addict, nervous wreck.

I agree with Celle - you are NOT an addict. You're a long, long way from that. But a) Ativan should never be given for that purpose. It's far too pernicious for that. And b) it is one of THE most addictive drugs going.

I had a relative (no surgery involved) had a period of rather intense depression and her GP put her on it. This was years before the internet and I'd never heard of it so I was no help! But after a while, she didn't like the side effects of it so spoke with her GP who told her to just stop it!

Still, it was a shock when her son called and said he'd had to call an ambulance the previous night because she was crouched up a corner in the lounge, screaming that the house was falling down around her and she was going to be killed! It was almost literally a 'men in white coats' scenario and she ended up being in a psychiatric hospital for 4 months.

For months thereafter she was confused and puzzled as to what had happened, convinced that it meant she was going insane. But I had a friend in the hospital where I worked who was a pharmacist and asked his advice. He explained how this was all due to the Ativan. Once I explained this to my relative, and she finally understood, she rapidly came to terms with it, realised and accepted that it was actually the GP's fault for telling her to stop just like that and more, for putting her on it in the first place!

I’ve had people tell me it looks infected, my skin is also shiny on that knee. I don’t know... I read here that some people have redness warmth and swelling for a while. I have no fever, but the tightness is irritating, but not painful.

Honey, with excessive swelling comes all those things. It doesn't mean there is any infection.

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[SusieShoes]

People can be incredibly thoughtless, even if they are “trying to help.” They’re not helping, though, if they are making you anxious and scared. My knees were still swollen at four months. They were still swollen, less so, at six months. They’re not swollen now but I’m nearly a year after surgery. So don’t let the swelling get you down.

Oh, and the stiffness! That’s one of the last things to go away. If you have swelling, you are going to have stiffness. It just means that your knee is still healing, and that’s going to be the case at four months.

I love the answer Celle gave you to use on busybodies: “My knee had a setback at the start, but my surgeon has it under control and I’m doing really well now!”

 

[fours2many]

@Josephine
Yes, I’ll answer all your questions.

I’m sorry about your relative. Thank God we have the internet now. I figured out what was happening, got to the dr and now am tapering off valium. I was on Ativan for only a month, but tapering will take months and months I don’t ever want to take another pill once I’m off this.

Anyway, ask and I will answer.

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[fours2many]

@Josephine

1. Pain level 3-4 swelling and stiffness

2. Off pain meds, just tapering valium 4 mg (dr said that helps relieve muscle pain...) liver damage from levaquin so no meds allowed.

3. The middle picture for sure

4. 120-0. That was a month or so ago. About the same. Maybe 120-2? Doesn’t straighten as well now.

5. Yes I ice all the time. 5 times a day/1hours. Also, All night long or I can’t sleep.

6. Yes I elevate when I ice 5 times a day and when I sit to watch tv at night.

7. Minimal Housework, minus vacuuming. My husband does that. Easy meals and dishwasher. Husband helps with it all.

8. I try and stretch in the pool at least 4 times a week. Also if I am up to it ride the recumbent bike with zero resistance for 15 minutes. Still have trouble walking so pool helps with that.

Good news. Gp said knee doesn’t look infected. He is still running blood work just to make sure, but doesn’t feel there is an issue.

 

[Josephine]

1. Pain level 3-4 swelling and stiffness

Okay

2. Off pain meds, just tapering valium 4 mg (dr said that helps relieve muscle pain...) liver damage from levaquin so no meds allowed.

Oh dear!

3. The middle picture for sure

So moderate?

4. 120-0. That was a month or so ago. About the same. Maybe 120-2? Doesn’t straighten as well now.

is that a + or a - number?

5. Yes I ice all the time. 5 times a day/1hours. Also, All night long or I can’t sleep.

Good

6. Yes I elevate when I ice 5 times a day and when I sit to watch tv at night.

Excellent

7. Minimal Housework, minus vacuuming. My husband does that. Easy meals and dishwasher. Husband helps with it all.

Oh good ol' hubby!

8. I try and stretch in the pool at least 4 times a week. Also if I am up to it ride the recumbent bike with zero resistance for 15 minutes. Still have trouble walking so pool helps with that.

Is that all? That's good.

Nothing more for me to add then.

 

[fours2many]

@Josephine

#3 yes moderate

#4 that is a plus +.

Sorry for the confusion

#8 yes that is all the exercise I do I walk in the pool to take stress off my tendons and joints.

Is there anything you can recommend? Today I went to the grocery store with my husband. I wasn’t there long. The pain after was 5-6. I had to go right home and ice and elevate. At 4 months is there more I should be doing? I didn’t go to the pool for 3 days because I had appointments, but still felt the swelling and pain. Is it normal to have swelling, redness, warmth, tightness?

 

[Josephine]

I didn’t go to the pool for 3 days because I had appointments, but still felt the swelling and pain.

Yes, but this kind of pain can persist for quite some time if it is chronic.

At 4 months is there more I should be doing?

Never consider that the answer to pain is to do more of anything. Though perhaps a visit to a chiropractor for some remedial massage might help. That's what I do when I have these persistent pains.

 

[fours2many]

Wondering if anyone could recommend an os for my knee in Naples, Florida. I need a second opinion. I have called so many surgeons and they say they won’t look at my knee. There has got to be a different surgeon that will give me an honest opinion on my replacement.

Thanks.

 

[Celle]

Your knee is still only 4 months old and it still has plenty of time for improvement.

The thing is that most surgeons won't give a second opinion on your knee until a year post-op. That's for a couple of reasons. The first is that complete recovery can take a full year, or even longer. Until the year is up, your knee hasn't finished healing. It's still a work in progress, not the finished product. There's no point in suggesting treatments, when just time itself can effect a cure.

Second, it's a matter of professional courtesy. It's not fair to the first surgeon to judge his/her work until the knee has finished healing. It could seem like trying to steal the first surgeon's patient.

 

[Josephine]

Celle is right. You have to allow more time for a provable outcome.