Knee Infection* Infection TKR

[Ddole]

I had my LTKR surgery Tuesday, so today I’ll be five days PO. Maybe I’m being a baby, but my pain today and yesterday is worse than immediately after surgery.
I assume this is normal? Any suggestions how to decrease this pain?

 

[Jockette]

Hi, Welcome to Recovery!

Read through each article of our Recovery Guidelines for answers to reducing/managing pain. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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.

 

[Rockgirl4]

I am one week ahead of you and just saw the initial pain drop around Day 8-9. Days 1-3 were not bad for me, but Day 4-7 were brutal when the local analgesia inside my knee (from surgery) had worn off. I really did not know if I was going to be able to cope, as the pain meds barely helped. Days 8-9 were a little bit better. By Day 10, I knew I had turned a corner.

Don't get me wrong---the pain is still all encompassing. I still need my 2 oxy-5's every 5-6 hrs, plus there are some nights with little to no sleep. I 'll take the baby steps though and hope you turn a corner soon too.

As for how to lessen the pain---Elevation and ice helped, but my ice machine came with a leg pad that just IS NOT comfortable. I've been using a lot of gel packs. It's all helped my swelling come down, but I don't feel immediate pain relief like I had hoped.

Best of luck to you in this painful, emotional recovery.

 

[lovetocookandsew]

Because every knee is different, and every person reacts to pain differently, there's no hard and fast date to say when your pain will subside. It will fade and eventually be gone, but no one can tell you whether that's two days, two weeks or two months after the surgery. But, the likely reason it hurts more now than in the first day or two after surgery is your doctor probably put in a block during surgery and that block wore off, so now you feel the pain. My advice to you is to make sure to stay ahead of the pain by taking your prescribed meds on time, before the pain hits. If you're prescribed a pain med on a four hour rotation for instance, take the pill right at four hours, so the pain doesn't hit you like a brick, and then you have to work try to get it under control.

There will come a day when you can go longer and longer between doses; first as you find yourself forgetting to take them once in a while, to where you realize you haven't been in any significant pain and don't need pain relief around the clock any longer. It's similar to the question of when you don't need a particular walking aid; when you find yourself forgetting, for instance, a cane, and when you think about it have to go hunt it down where you last left it, that's a good clue that your dependence on it is lessening, and are on the way to not needing it at all.

I also suggest you spend a lot of time icing and elevating as that really does help with pain. I took no pain meds at all this last time around as I am unable to take any at all, so ice and elevation was the best, and only, way to help with any pain I had. Read the articles Jockette left you, especially the activity progression one. I read that one every single day during the first weeks and months of my recovery so as to remind me not to do too much, or too little, at any given point in my recovery.

I promise you, this will get better; but it is a roller coaster recovery and you will have days when you feel on top of the world, and days when you want to crawl into a hole and pull it in after you. But taking your life back is the end goal, and in order to reach that goal we have to go through a time of frustration, pain, lack of the ability to do the things we want to do, tears, pain, and oh, did I mention this recovery hurts a lot at first? This forum is here to help you with any questions and listen when you need to vent, as every one of us has gone through the surgery and understands what those who have never gone through a TKR recovery can't understand. Good luck and keep us posted on how you do!

 

[jeffjob]

For me the worst pain is the first week.

The second week was less, with some going back to the first week pain.

My meds kept it under control, it just gets tiresome to deal with it.

I went thru my first on April 11 and during that first week, I thought it would never end. Now I barely remember it.

Stay positive, keep your meds up, know that it will pass and that it is a healing pain!

 

[9 of 11]

Yes, those are some wicked days and nights but it does improve and you will get periods where you can enjoy life. Your new vocabulary will now be meds, ice, elevate and let’s not forget nap. Slowly you will add other things to fill your day but you are truly just beginning the walk on this path ( literally and figuratively!)

 

[Josephine]

For me, with my first knee, the worst pain was the first SIX weeks. Just read the recovery articles and follow the advice within.

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?

 

[Ddole]

Sure. Thanks

 

[Woodpusher]

This is how my first 2 weeks have gone. One mistake I made so far is to let the pain get out of hand before reaching for pain relief. Worked a little too hard one day figuring I'd take the max pain med prescribed and have it taken care of. Didn't work that way.

 

[winemama]

For me the pain is a horror show weeks 1-4. Keep under the pain, don’t try and be a hero Nothing else matters except ice, meds, & sleep

 

[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.

 

[Ddole]

I’m hoping this is normal. I’m almost five weeks po. My pain might be a bit better for a couple days, then gets worse for a few days. I’m in the middle of a difficult pain period now. (Not always associated with PT.) And the location(s) of my pain can change day to day, or may be a new type of pain in a same location on knee/leg. Worse in the evening, but during day as well. I feel like asking, “What will today’s surprise be?” I know recovery is not linear, but this is crazy.

 

[Celle]

Hello again @Ddole

You'll notice that I have merged your newest post with your original recovery thread. Did you lose your original thread?

Please read back now through the thread - you'll see that Josephine has posted her questions that you asked for. Answer those, and she'll be able to advise you about your pain.

For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on. Please do that.

 

[Rockgirl4]

I would say between weeks 4 and 5 post-op, pain went from a constant to a mystery of "how much" and "when" for me. I didn't need the Percoset (oxycodone) as often, but when I did need it, a lower dose would NOT help!! Pain was also still pretty bad at night too, so I stayed up late until I couldn't keep my eyes open. Otherwise I lay there unable to sleep for the aching.

I remember a lot of people saying here that weeks 4-6 were when most felt better enough to try more normal activity....but then pain increased because they began doing too much instead of easing into things. I made a point to ease back into life, as my swelling was still significant and impeding my range of motion. My surgeon also gave me an anti-inflammatory at the 4 wk mark,as he allows none the first 4 wks. It has made a HUGE difference too. I also had to back off of some PT activities that were aggravating things.

Overall, it's been a lot of trial and error, but weeks 5 and 6 have been wonderful for me, so I hope you notice the same. I didn't think it was even possible to get this much better, this quickly, considering how bad my first 2 wks were.

 

[robert johnson]

When I went in for my 2 week PO checkup and to have my stitches removed, I started to tell my doctor about a pain I had in the back of my knee at the top of my fibula. He looked at me with a glint in his eye, a smile on his face, and sort of shrugged as if to say, "Ya think?".

There are a lot of pains associated with this operation. They come and go for months on end. That's why I always want pain medicine for as long as they'll give it to me. Eventually you don't need it any more.

Don't get me wrong. There are times, even now at close to 4 months post op, that I get a little worried about some pain that wakes me up at night, but what I do is sit up and look at my leg. If it looks like it did yesterday, I try not to worry about it too much.

 

[winemama]

I’m at 8 weeks, and pain creeps in and out, every once in awhile I’ll need to take a pain med. I’m like you, sleep is hard. One day at a time

 

[Benay]

Tonight I'm trying trying 2 Tylenol PM. No Tramadol. Let's see.

 

[Atlas_aus]

@Ddole

Hi, we have the same op date, but I got 2 for the price of 1 deal

I think the first lot of real pain comes after all the anesthesia and other drugs form the surgery wear off. I have been truly blessed to date and so glad I have gone through this.

There is still a long way to go but I am happy with my progress, each day seems to throw a new pain or woken up some muscles I have not been able to use for a long time !

Hope you sort the pain side of things soon.

 

[Josephine]

I know recovery is not linear, but this is crazy.

I think the 'not linear' is more so than you think!

But actually, if you would answer my questions (in post #11) I'll do all I can to help you.

 

[Ddole]

Happy new year everybody. I’m seven months from left TKR. Coming along fine, not super fast, but fine. I had a bakers cyst before surgery which doctor said would be gone after. However, I’m pretty sure it’s back. I’ve got pain behind knee and fullness exactly like before surgery.
I have an appointment in a little over a week with OS.
Has anybody else experienced this? If so, what happened? Can they drain and give cortisone injection as before TKR? I’m trying not to panic and assume I’ll need a revision! Just hoping this is a small bump in road!