PKR Is all ok?

[2labcrew]

hello, I had PKR of my right knee last Fri 7/20. I am 9 days out and have very little ROM. I am yet unable to do any of the home exercises given to me as I cannot lift my leg or let it down without holding it for support at the foot...currently I lift and lower by grabbing my sock

I had issues on the inner part of my knee and now my pain far exceeds what I had prior to surgery.

I do feel the stiffness I read so many others talk about...it feels as if they implanted a cement bar across my knee. Reading everything did give me comfort that at least that part is common. I also realized I am elevating incorrectly ...not above my hip, just up flush on an ottoman, and probably not as often as I should be.

In order to try a “stretch” my ROM I was trying to sit with my leg as close to normal as I could, which as you can imagine wasn’t very close at all.

I also found comfort in reading that 1 day you seem to progress and the next you seem worse.

After all that being said, my main anxiety-fear-terror thought is why I cannot lift my leg from the floor to an elevated position,and why I cannot drop it from an elevated position to the floor. I am talking vomit inducing pain, screams the likes I never thought I had in me when I have tried to do both.

Is it fear of the pain or is there physically something wrong? I spoke to my surgeon Mon 7/23, and his NP on thurs afternoon 7/26. On Mon he didn’t have concern, but on Thurs, she did.

Has anyone else experienced this, or that their pain was worse than before surgery? I feel,that I wasn’t fully made aware of what to expect after surgery.

Thank you for your time

 

[lovetocookandsew]

Welcome and congrats on your new knee! As I understand it, your quads kind of go to sleep with this surgery, and one day they just magically awaken. Mine did the same thing. One morning I couldn't lift my leg without the leg lifter, a couple of hours later, I lifted it to get out of bed and it actually lifted. My quads had decided to wake up again.
Someone will be along with some reading which will really help you if you read them. But for now, basically what you're experiencing is all within the "normal" range for this recovery. At this early in the year long recovery, you shouldn't be thinking at all about ROM, just about resting, icing and elevating properly, going to the restroom, and walking around your house a little every hour or two. Your recovery articles, which a moderator will soon be along to give you, will explain all this. Good luck and keep us posted!

 

[Celle]

Hello @2labcrew and

First, stop worrying that you can't yet lift your leg. This happens to a lot of us. It will gradually improve.
Second, don't worry that you can't do the exercises. All the exercise your knee needs right now is walking to and from the bathroom and kitchen, and doing ankle pumps to prevent blood clots. The rest will come later, as your knee gets over the trauma of the surgery.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Your job now is to rest, elevate and ice your knee and take your pain medications on a strict schedule.

Here is some reading to help you:
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. Here is a week-by-week guide for Activity progression for TKRs


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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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 a 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 history before providing advice.

 

[katchmo]

My quad was asleep for awhile. The PA didn't believe me and let go of my leg a few inches above the table and was treated to a scream as you described. I got a strap like this and it made my life much easier. It was a couple of months before I could lift my leg in and out of cars, tub, and bed on my own muscle power.

Also, the PA panicked and ordered a nerve conductivity test because he was concerned about nerve damage from the tourniquet. I cut the test short because it was like something out of a medieval torture chamber. Coming to Bonesmart, I found out a sleepy quad is very normal and the test was completely unnecessary.

 

[Roy Gardiner]

Hi, welcome to BoneSmart.

my pain far exceeds what I had prior to surgery.

Yes, so soon after surgery that's perfectly possible. Pre-surgery pain would only get worse, would never get better. This pain is pretty much as bad now as it'll get, will only get better and will eventually be gone.

 

[Jockette]

I couldn’t lift my leg either, for a couple of weeks, and even after I could it was still hard to get it up on my ottoman when I was sitting on the couch. My husband was usually nearby to help.

I had a partial also. Mine is a Patellofemoral. Which partial did you have?

Things will get better in time. Try to relax and go with the flow. Most of us were unprepared for this recovery!

 

[2labcrew]

Thank you all so much for your replies! It adds comfort, but is still scary to me. I will look into the strap as now I am grabbing my sock. Lol

Celle, thank you for reposting that info...I actually read it yesterday in a reply you left for someone else too...it’s where I learned I was elevating incorrectly!

I will continue to read through the forum...the more you read that others are experiencing the same things, the more comfort you get.

Thank you all again!

 

[SusieShoes]

You don’t necessarily have to buy a strap (unless you really want to). Many people use a belt, dog leash, bathrobe sash or any other handy household object. You won’t need the lifter forever, so use whatever is easiest for you.

The pain you describe is normal. I had a great recovery, and the first week it was pure agony whenever the person helping me lower my legs off the bed just dropped them (why do they do that?) That’s bad pain. As you recover and get better at controlling (lowering and raising) your leg, you will encounter less pain. It will hurt to stand or walk for a while yet, but that pain will get better and better as time passes.

 

[2labcrew]

Yes you are right Susie! I am using my sock or a towel now...no need to change. I am currently running on oxy brain...

Is it just me or did others not get an accurate picture of how post surgery would be??

The first time I saw this surgeon was 9 weeks out from a trip of a lifetime to Italy. He wanted me to schedule the surgery prior to my trip as he made it out to be LESS of a recovery than my scope surgery where I was up and walking with little discomfort in 2 days. I think I have more anxiety bc I was NOT prepared for the reality of what this would entail.

 

[Jockette]

Very few of us were adequately prepared for this recovery. They keep it all hush hush, and then,

SURPRISE!!!

 

[Celle]

Recovery from a knee replacement is a marathon, not a sprint.

It's true that most surgeons don't warn you what a long drag this recovery is going to be. Either they simply don't know (because they only see you infrequently after the surgery) or they're afraid that telling you would put you off having the much-needed surgery.

Whichever, it is a rude awakening for lots of people.

The consolation is that the pain you have now is going to get better, while the pre-op pain you had would have continued to get worse.

 

[2labcrew]

Well, for whatever the reason they keep it from us, at least I’m in good company at the party!

 

[Xmasknee56]

Yes I used a scarf to lift my first ltkr for weeks. This time with rtkr I’m like a spring chicken. No dead leg and sleepy quads at all. All knees are different. And I can sleep on my side cause I’m not beached like a whale in my bed.

The pain is overwhelming at times. My comment is to be on top of medications and take on schedule. No pain breaking through to 7 8 or 9 if possible.

Ice is pain relief also.

I think I could write a paper on pain. Of course I have the qualification. Lol. It’s the oxy writing. I have several different kinds of pain in several different places. All at different times and stages. There’s a kinda of surprising pain dance that goes on for a while. Pain from the implant that is right in the knee. Pain at the wound sight. Pain from the tourniquet. Pain from the meat and muscles being torn open and sewn back. Pain from my leg being stretched in all 360 degrees during surgery. Pain from electric zingers when nerves are healing. Swelling pain. Hot pain. Cold pain. Pain from bio mechanical changes now that I have straight legs. Pain when I go to the ODIC part of the our world. Pain from too many opioids . Pain in my toe nails that I can’t reach to cut. I am probably a pain in the butt of my OH and children too. My youngest granddaughter stands by me and asks which knee she can sit on for a cuddle.

Sorry to give you a head pain reading this. It does get better

There is no way I could do Italy. I asked my surgeon he said to allow 6-12 months.
In my opinion stick it out with people who have been there done that on Bonesmart. I know they know what pain is.

Take good care
Kathryn.

Oops forgot the pain of TEDs. To get off and on. And strangulation of the leg pain.

 

[mlwreader]

I can't believe he was going to send you off to Italy AFTER surgery. That would have definitely ruined the trip of a lifetime. How irresponsible of him. I will say that my OS never led me down the garden path on the time for recovery. In fact almost the first words out of his PA's mouth was that this is one of the most painful surgeries out there. I didn't like her much that day, but I respect what she told me now when I think back on it, that's for sure.

 

[KitKat64]

The consolation is that the pain you have now is going to get better, while the pre-op pain you had would have continued to get worse.

I so agree with this!! During the early parts of my recoveries from both TKRs, there were times the pain practically drove me to tears!! I would question whether I'd made the right decision to have the surgery. Then, a little later on, I would recall the words of friends who had been through TKRs--this pain is only temporary, and will eventually subside; unlike the pain before my surgery, which was constant, and agonizing!! Hang in there, it will get better!!

 

[katchmo]

Many people use a belt, dog leash, bathrobe sash or any other handy household object.

I used my pants leg, towel, used my sock until it pulled off my foot and I dropped my leg, ouch! I liked the strap because it was longer and I could move my upper half more easily while still controlling my leg. I felt like I had more control overall. Also, it has a wire in it so you can bend it and it will securely stay over a walker frame or your arm etc. Just my pov on why I think the strap is worth the money.

 

[2labcrew]

In my opinion stick it out with people who have been there done that on Bonesmart. I know they know what pain is.

I am certainly getting emotional relief her the more I read....AND, what a difference today after elevating correctly since I read Celle’s info yesterday!

 

[chicklet]

I bought a leg lifter like the one pictured in katchmo’s post and I loved it! It’s rigid but bendable. I used it a LOT the first few weeks. Sometimes, though, I’d get to bed and realize I left it in the living room, or vice versa, so I would improvise and use the hook of my cane. I would put the hook across the bottom of my foot and lift my leg that way. Worked great!

 

[pacosmom]

I was definitely not prepared for what the recovery would be like my OS always said (before surgery) “it’s just a partial”. Obviously he’s not had one done to him lol I feel so bad hearing about the awful pain when lifting your leg. My daughter had an ACL, MCL, meniscus repair last year when she was 18. The screams of pain if we lifted or lowered her leg too quickly still haunt me. She lived on the couch for 2 weeks. When she had to go to the bathroom, she’d use her arms (while we held her leg) to lower herself into a blanket & we pulled her to the bathroom I was so, so thankful she had good arm strength. It was like having a 130 lb newborn lol I can’t imagine how my hubby would have handled it if I had the problem!

Hang in there, it does get better!

 

[Spex10]

For the first few days while I couldn't lift my leg the PT showed me how to hook the handle of my stick round my foot and simply swing my leg up or down by using that. It worked really well. No need to buy any other gadgets as you're going to need a stick anyway.