TKR Kenello's TKR recovery

[Kenello]

My left TKR was outpatient 1/17 and am mostly out of pain unless I push the PT. I have really valued the advice on this forum to take it easy! I had my first PT on day 4, and the doc's expectation is 45 min. 4 times a day flexing, stretching and strengthening, plus an hour a day walking. Whew!
I don't think all that is necessary, but am actually doing about 1/2 that and icing/elevating after. Heel slides and letting the knee hang with my fingers laced behind it for2min at a stretch get me to about 110 degrees. I have been walking in the house and on the deck comfortably without the walker or cane. Minimal swelling, keeping compression socks on 24/7

Very grateful and Cautiously relieved.

 

[SusieShoes]

Hi @Kenello and to the Recovery side! Sounds like you're already finding your way to a sensible and sane recovery.

It's quite liberating to know you can manage your own recovery by taking the surgeon's guidelines as just that: guidelines. My surgeon wanted me to walk a LOT further than I could do at first, but I did walk every day as much as I thought good, and eventually I was doing what he wanted. Doing what the knee says it's up to doing will get you to your goal.

Here's some recovery reading for you. You might have seen these articles before, but now you have your own set! And of course you can always raise any questions or concerns. We're here to help!

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​

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.

 

[Celle]

the doc's expectation is 45 min. 4 times a day flexing, stretching and strengthening, plus an hour a day walking. Whew!

Whew indeed! Please don't cause yourself pain by pushing the PT. That's not good for your knee.

Your poor knee has been through major surgery. It needs rest and gentle treatment, so it can start to heal.

It's wounded, not lazy or unfit. All the exercise it needs right now is a gentle walk around the house every hour or so. Later, when it's had more time to heal, you can increase your exercises.

Different surgeons have differing opinions and protocols for recovery.
My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good Range of Motion (ROM), as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

Just in case you've been told different, there's no need to rush to get ROM, 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

 

[sistersinhim]

Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control! This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new! You have to be patient, though, it doesn't happen quickly! ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there!

 

[maryo52]

@Kenello Where did you have your surgery? It sounds like you're doing fabulous. I'm 14 days out and have been babying myself. My ROM is slow and was slow the first time. You're already at 110 and "mostly out of pain." That's pretty darned good. My observation is that the doc's expectations don't seem to be in line with accepted practice. I was given a very minor PT routine to do 3x day and was told if it resulted in greater pain or swelling to back off and ice & elevate.

 

[Kenello]

Dr. James Van Horne a Paragon Orthopedics in Grants Pass, Oregon. He also requires patients to do the same exercises prior to surgery, and he's got quite the program going. Today is my day 7. I am only exercising to the point of discomfort, and hope to start walking out in the yard today, and practicing on our indoor stairs which have 2 railings. Today was the first day my leg wasn't totally stiff when I woke up.

 

[Kenello]

Hi All,
I am now 6 weeks postop, and have been on this forum almost daily! It is soooo helpful to read others' experiences and the moderators' expertise, especially if I'm frustrated or bummed about perceived lack of progress. Overall I'm doing really well most days and can walk at least around the mall or to do my daily errands, etc. but it is still very tiring. I have not had as much practice walking on natural surfaces outside due to weather, and hopefully will be able to do an easy 1 mile hike within a month. I am sleeping better, and can even sometimes sleep on my left TKR side! What is bothering me when I do that is a dead spot on the side of the knee that my surgeon warned me would be there, but could diminish over time. The only time it bothers me is when I try to lay on it. Also my left hip is also ready to be replaced, and that pain also inhibits my walking and sleeping as well.
My left hip replacement will be on April 25, so I should probably move over to the pre-op hip.
Thanks to everyone for their continued input!

 

[Lilli215]

Hi @Kenello, am interested to read that you’re scheduled for hip replacement in April. I had LTKR on Feb 10th so am just three weeks in but have an appointment to see hip surgeon in middle of March re right hip replacement. At present I no more feel like having to undergo more surgery than fly in the air but my hip is really painful soneeds must. Is it worrying you to have to go through more surgery within four months of your previous??

 

[Kenello]

Hi @Lilli215
I am tired of regularly being in some kind of pain, but my left hip is very painful, and I am looking forward to getting it replaced. I am banking on it being an easier
recovery than the kneeand I also have to replace the right knee. That will wait a bit longer I hope! I am concerned about having 2 done on the same side though.

 

[Lilli215]

@Kenello, can completely understand the tired of being in pain. My hip is on opposite side from knee but isn’t half taking a hit at the moment taking the strain off of the tkr. Goodness knows what will happen to the tkr down the line if I get hip op in next few months and the new knee will have to take the strain- it’s just a nightmare at times

 

[Kenello]

I am now about 3 mos. out from my left total knee, and am feeling much more comfortable doing my daily activities, and feel I am getting my stamina back. The knee is still somewhat stiff with increased activities, so I still elevate and ice when I think I've overdone a bit. Just got back from vacation and was able to do easy hikes of about a mile, and snorkel or shop for an hour or so. I do have slight pain because I have an adhesion, and I've been stretching the skin around it to loosen it up with some results. I usually do not need anything for pain, and if I do, it seems like its more from my hip, which I am scheduled to have replaced April 25. Today I stood for 5 hours (with a 15 min. break) and was just slightly stiff! Thanks to everyone for your posts and information. It has made a huge difference for me!

 

[Lindylee]

You're just a few days in front of me and seem to be on a similar recovery. Most of my aches and pains are in back and hip rather than knee now. Good luck with your hip replacement. I hope you have a successful recovery from both your surgeries.

 

[maryo52]

You're doing very well for 3 months. Just imagine how good you'll feel at 6 months!

Yesterday I did some field work, uneven ground, lots of walking. Yes, the knee swelled some but didn't hurt. Not bad.