TKR Just wondering on my progress?

[thebullockpen]

please help.im 13 days post op.I take 200mg ibuprofen 3 times a day and co codamol 30/500 every 4 hrs.I rest elivate etc most of the day.why is it I get niggley nerve pain at around 7pm. Is my medication strong enough? I felt fantastic this morning cant possibly be overdoing things can I ?.this getting me down and im begining to regret my surgery.

 

[sjm1027]

You may think I am crazy but My doctor and my PT told me it was ok to do everything I mentioned as long as I use good judgement. Because I can drive as of 4/1 and my last PT was 4/2 I will not have PT for 3 weeks. Outpatient PT starts 4/22. I was told to keep my range and have my wife help bend the knee a little more than what I could do alone.

 

[Gentle Giant]

sjm1027

I can relate to the clicking in your knee. I am approximately 4.5 months out on my left knee and 2.5 months out on my right knee. I have clicking in my left knee, but no pain. It just feels a little weird, but I figure that this is due to the muscles needing to be strengthened. I had a lot of swelling with the left knee, but virtually no pain. The swelling lasted about 2 months, then was gone one day. I have no swelling now or since. After 2 months, I was able to have a ROM of 115 and was riding a stationary bike and walking quite a bit. I have no problems with the stairs on my left leg, only the right. The clicking in the knee has been of very little concern to me, especially since there is no pain. It is starting to diminish as the leg becomes stronger. I also believe that part of the feeling I may be having is the type of joint they used. They put a flex joint (I hope I am saying that right) in to give me greater ROM. The left leg is doing very well at this point, now if I can get the right to behave I would be a happy camper. Keep your chin up and keep making progress. Hope everything goes well for you in the future.

 

[sjm1027]

Thanks for the info on the clicking. Yes it drives me nuts right now. Today is only 5 weeks from my surgery but it seems like the clicking is worse today tun it was 2 weeks ago. I did hear it was muscles from my PT as well. Then she also mentioned I may have to live with it if it's not just muscle. I hear that sometimes doctors give you a looser fitting knee to give you a better ROM. I am getting about 110 to 119 depending on the day and on how I want to push myself... or maybe I should say others push me. I still have a lot of swelling and I believe once the swelling goes down I will be better. Good to hear you say it took 2 months for the swelling to go away. I can only hope the swelling goes down next week or I am wearing sweats to work on 4/21. Your right the clicking doesn't hurt, just drives me crazy. Not sure what I had for a new knee, I will be getting my records next time I visit the doctor's office. Good luck to you and thanks for making me feel a little better tonight.

 

[Gentle Giant]

sjm1027

I am glad that I can make you feel a little better. You should feel good about your progress. ROM to 119 after only 5 weeks is awesome. Just be careful not to do too much too soon. Keep up the great work and good luck with your return to work. Hope you continue to feel better.

 

[kneeper]

I think I had that clicking feeling for the first couple of months.

 

[sjm1027]

I guess it's just something that may go away in time. Thanks for letting us know. The more we share the better we understand. I feel better because this seems to be more common in the beginning than not.

 

[kneeper]

BTW--I like your icon.

 

[sjm1027]

As I continue on week 5, my surgery date was 3/6/14. I still have clicking, looseness in my knee - on stationary bike, walking, walking in a downward slope, specially when I do my bed exercises, scissor leg from side to side. Some days better than others.

Question, today when walking I noticed I was walking towards the outside of my foot. I tend to do that anyway. Does the doctor want patients to have orthotics to make sure we strike our foot on the ground flat and not to one side. I had less clicking feeling when I forced a flat strike?

And does anyone know when you can stop worrying about blood clots?

 

[maryo52]

I see you have a nice collection of worries. What have you been taking for clot prevention (Lovenox or warfarin), and are you done? Generally it's earlier on after surgery when these occur. The clicking is normal. I think it's related to joint effusion. As time goes along you'll have less but it will occur from time to time. The main thing is getting used to it. I remember how wrong it felt.

Maybe you could be more specific what you mean by "looseness." When do you notice it, and what happens?

I hear that sometimes doctors give you a looser fitting knee to give you a better ROM.

I do not believe this is true. A TKR is not as simple as replacing the eroded ends of our femur and tibia. The knee has to be "balanced." There are ligaments on several sides that factor into it. The knee has to be tight but not too tight when straight, bent, and in between. They do not purposely put in loose knees because this causes a host of problems including recurrent synovitis (which I have) and even dislocation.

 

[sjm1027]

Yes, I tend to worry a lot. Sort of easy when your home along for the 4th week.
I was only taking 350 mg Aspirin for clotting. I am now back to my usual 81 mg.
Looseness only means the clicking or a feeling of when I move my leg I feel this little thud or something like that.
Can't hear it but you can feel it in the joint. When I ride a bike, walk, doing leg lifts, scissors leg moves.
I can feel the difference between heights from one leg to another. Feels like I have a stilt on one leg. or a lift of 1/8 inch. Still lots of swelling at 5+ weeks.

Thanks
Steve

 

[maryo52]

I think people's worry levels relates to some pre-programmed wiring so I guess you just ride the waves, huh? Who did your op and where? You're right about unevenness in legs needing attention. Hopefully you are generous with the icing and elevating.

 

[sjm1027]

Dr. Van Flandern at New England Baptist Hosp.
Lots of Ice and elevation!

 

[Josephine]

I am getting about 110 to 119 depending on the day and on how I want to push myself... or maybe I should say others push me

No-one should EVER push on your leg to get better flexion. It might get a couple more degrees but it's an even more efficient way to get more swelling and more pain!

I still have a lot of swelling and I believe once the swelling goes down I will be better

As I said above! And yes, you will.

Good to hear you say it took 2 months for the swelling to go away

I think I said at least 2 months! Mine took about 4 months!

scissor leg from side to side

What's that exercise for? Never heard of that being useful for knees! I'd stop it anyway!

Does the doctor want patients to have orthotics to make sure we strike our foot on the ground flat

Certainly not! Worst thing you can do, especially at this early stage.

does anyone know when you can stop worrying about blood clots?

Actually everybody is at risk of clots all the time. It's a question of degree. I'd say that you will be down to 'normal' around 8 weeks or so.

I am getting about 110 to 119 depending on the day and on how I want to push myself

May I refer you to my first comment in this post!

 

[sjm1027]

Was wondering how others are feeling at 8 weeks out.

I am feeling pretty good today, still focused on my knee. Wondering if others are focused on almost every step they make. I seem to do that.
I have this thumping when I walk at times. Especially the day after PT. It's like something is loose or a tendon twang... not sure how to explain. I have told the doctor and PT and they don't seem as concerned as I am so I guess I have to trust the experts.
Seems when I have PT the next day I go backwards for 1 day. I can flex my knee alone 110 degrees and with PT help we get to 120. I am riding the stationary bike for 40 minutes per day, 20 in AM and 20 in PM. I went for a walk today and only felt comfortable walking approx. 3/4 of a mile to a mile. Still get swelling but it is 90% better now.
I am not looking to compare because we are all different but I am concerned on the thumping or what I think is movement. They say it's the muscles not strong enough and it creates this feeling.I have iced and elevated today after my walk for a very long time. 8 weeks is a long time, longer than I thought it would take me. In my head I just thought I would be doing better than this.
I still have a problem with stairs, I have to hold on to the railing to walk up and down.
When I go from the gas pedal to break I have a clicking in my knee. I still have pain in my knee and take 2 Advil, 2 times per day. I am afraid to stop the Advil at this time but not sure I am just afraid to stop the medication. My guess is I still need it. Are you all still taking medication 8 weeks out?
Thanks,
Steve

 

[DogLady]

Hi Steve

Sounds to me you are doing well for 8 weeks out. This is not a quick thing to fix. It just calls for lots of patience. I also had funny noises and clicks that were new and a bit concerning. All turned out to be nothing. As you said we are all different, but sounds to me that what you are experiencing is perhaps on the better end of the spectrum. Keep up the good work.

 

[sjm1027]

Thanks for responding. I appreciate you taking the time. Will be great to hear from others as well. Good to hear you also experienced the same funny noises and clicks, thumps... Gives me some hope. Some days I get very depressed at how things feel but I tend to always think I should be doing better than I am, story of my life
Yes I agree, the surgery was much more than I thought it was going to be. BUT when you look at the X-ray after surgery you realize just how much work they had to do.
Thanks

 

[maryo52]

The clicking and clunking seem to happen when there's a little extra joint fluid, which would be normal for you at this stage.

Seems when I have PT the next day I go backwards for 1 day.

I suggest you make sure PT remains moderate and also cut down your cycling to 10 minutes twice a day until month 3 or 4. Is anything in PT causing pain? Nothing in PT should be more than uncomfortable. If PT sets you back, that's a clue too much is being done, and doing more will not speed up recovery or give you any advantage whatsoever. You will actually have a faster recovery if you slow down. Trust me, I've been through it and have witnessed scores of others get better results when they did less and rested more. It's not your bones/joint that recovery is all about, it's the soft tissues that were injured during surgery, and PT does nothing to heal those injuries.

 

[speccybecky]

My knee still 'clunks' now and then. I remember at about your stage when out walking it felt like my knee was going to give way, it never did, just felt a wobble. When my muscles strengthened it went away. I was still taking painkillers. I was still having trouble on stairs for a good while yet. BUT I got there and so will you. It is still early although we all appreciate it doesn't feel like it. You're doing great...honest injun!

 

[Josephine]

@sjm1027 I merged your threads as per this request One thread for your recovery please? Please don't start new threads about your recovery.

One reason why not is that I spent a lot of time writing answers to your queries in your first thread (now post #74 in here) and you obviously never read them as you never responded.
I think that shows a lacks of courtesy.