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TKR Kakalele’s recovery

kalakeke

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Hi there. I have been reading the threads on here for weeks trying to get the best understanding of this whole TKR thing. Today is day two post op on a left TKR. I can’t do any heel slides and I don’t want to cause more problems for myself later. I have been reading that this may be normal.
 
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kalakeke

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I am icing, but hard to do at night when the ice melts so often. I made the recommended water/alcohol concoction and it leaked over night. I’m elevating, as well.
 

Celle

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Hello @kalakeke - and :welome:

Please will you tell us the full date of your knee replacement, so we can make a signature for you? Thank you.:flwrysmile:

Yes, it's normal to not be able to do heel slides at this early stage. Your knee is swollen and it wont want to bend much at all.

Here is the recovery reading we give to everyone - lots of helpful and useful information there:

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
5. At week 4 and after you should follow this
6. Access to these pages on the website

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 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.
 

kneeper

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I had the same problem with the home made ice packs. Nothing like waking up in wet PJs from a melted ice pack. :oyvey: I wound up buying a couple of gel packs at the pharmacy.
 
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zab

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Hey @kalakeke I feel you just need to chill a bit sorry I know its difficult read the links @Celle put up.
 

FCBayern

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My ice machine is my savior, it runs all night and really helps me sleep.
 
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kalakeke

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So I’m 5 weeks out today from my TKR with the surgery date of April 2, 2019. I have had a difficult time, as some others on here may know about, with this surgery. I feel like I should be bending at 90 degrees and I’m shy of that, maybe 83. I had no idea going into this that it would be this hard. I’m trying to talk myself through it and know that the recovery process is a long road that takes time. I think the worst part is knowing I would have to do it again for the other knee in a year or two. Oh well! PT is twice a week and she’s great. I’m afraid I may need the MUA (manipulation under anesthesia). When does a OS decide that? Anyone know?
 

lovetocookandsew

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I'd skip the thoughts of an MUA altogether. You're only 5 weeks into an average 52 week recovery-and your bend sounds fine to me for 5 weeks. Just keep doing your activities of daily living, plus ice, elevate and rest as needed. Time is on your side and you'll find yourself doing better and better each week. Good luck and keep us posted!
 

DLR

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@kalakeke give yourself time. My first knee I could walk well but didn’t pass 90 degrees until about 8 weeks. I am now on my 2nd knee and can hardly walk any distance but have a 110 bend at 4 weeks. It takes time for swelling to decrease, ligaments and tendons to stretch and be happy. This is a rough recovery.
 

TimeBuster

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I started outpatient physical therapy at four weeks. My first extension measurement was at 75. Six weeks I hit an 88. On my seventh week which was this past Monday, I hit a 98 extension. Like you, I was afraid that I was going to get stuck at the lower numbers gradually with exercise, icing and elevating, which I'm doing right now as I write this. I saw improvement every week. My suggestion is to give time, time. As far as the manipulation under anesthesia and this is my humble opinion, I wouldn't even think about having an MUA at least until three months by then you'll know if you need one. And remember this, you're in charge of your knee, not your doctor.
 
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kalakeke

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Thank you all. I don’t want to think about MUA, but my PT brought it up week 4 began. I was like “what, no way?” Scared the blood out of me. I feel better now. Thank you.
 

Celle

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Thank you all. I don’t want to think about MUA, but my PT brought it up week 4 began. I was like “what, no way?” Scared the blood out of me. I feel better now.
Threatening people with the possibility of an MUA seems to be a much-used tactic of some PTs. It's done to try and make you work harder, so you get "good" numbers, which makes them look good in their reports.

However, I think it's indefensible, because it scares and worries their patients. And it's so unnecessary.
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

Almost no surgeons will do an MUA if your flexion is over 90 degrees and you are already close to that.
Even if your surgeon does recommend an MUA, you don't have to have it. It's your knee and you have the right to choose what happens to it. You can ask to be given more time before any decisions are made. You can also control the type of PT you have, such as telling your therapist "Hands off my knee, no pushing and no pulling, and no painful exercises."
Saying no to therapy - am I allowed to?
 
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kalakeke

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I agree Celle and that’s what I told my PT. My response was “No one is manipulating anything unless I agree and I don’t agree.” I will try and be more patient with myself. I went back to work part time on week three and week four I was back to full time. I think I may be pushing myself, but I’m confused sometimes and don’t know what’s right or wrong.
 

Celle

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Yes, you did go back to work rather early. But that's done now and as long as you continue to make steady progress, even if it seems slow, you're doing all right.
 
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kalakeke

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I am feeling so discouraged today...I know I’m not the only one and I hate that I invited myself and am attending my own pity party. I had PT this morning and my PT said I should have been going all the way around on the bike between week 4 and 6. I’m just at week 6. I’m disappointed in my recovery and my mental psyche is in the danger zone. I keep telling myself that my recovery is MY recovery and not everyone is the same. I get sad reading how well others are doing and how stinky I’m doing. Anyways, am I expecting too much of myself at week 6?
 
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kalakeke

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More specific question. Where should I be at week 6? Estimate? My doc wanted me to be at 90 degrees flex at week 2-3. That didn’t happen and still hasn’t. I’m still at about 85.
 

Horseymum

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I'm the same, flexion less than 90 and can't get anywhere near getting all the way round on the bike. This is my second knee to be done and the first knee would probably not be where the physio wants it ( 10 months old ) but it works for me. It causes no pain and I can do all i want with it so I'm just going to let the new knee carry on with its journey and I'm sure I'll be happy with where it ends
 

Bionic

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@kalakeke
I will be 11 weeks post op this Friday. I am only now at 90 degrees and that's on a good day. Actually it changes from hour to hour not just day to day.
I can't yet do a full rotation on the bike and it's bugging me but I can see other improvements. Until very recently the knee felt tight all round as if it had a tight bandage wrapped round it but in the last few days the tightness has gone from the back of the knee although it's still tight at the front.
I am sure when my stiffness has gone completely it will make a big difference.
FYI when I saw my OS at the 6 week mark he said 'you really don't want an MUA'
 

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