TKR Knee pain

[sistersinhim]

Three times a day 1000 mg at a time , 8 hours apart.

You can take 1000mg every 6 hours as long as nothing else you are taking has Tylenol in it. Do not go over 4,000 in 24 hours.

 

[Winston0915]

Thank you!

 

[Winston0915]

Hi! I am looking for advice. I have had outer knee pain, where my knee bends, sharp stabbing pain since my surgery on August 5th. When I saw my surgeon on the two week mark he said it was my IT Band. I have been going to PT at the hospital 1x per week for two weeks after finishing in home PT, next week I start twice a week. I called my surgeon today on the advice of PT because of this pain. I still do all my therapy but it is painful in that one spot. I also use a crutch to get around. This pain keeps me up most of the night and I sleep about three or four hours per day because of this pain. I went back on Tramadol 50mg twice per day and I take Tylenol 1000 mg three times per day. I also walk up and down my driveway which is pretty long 3x per day and my exercises 2x per day. Ice religiously and elevate often. My stretch is at zero completely flat and depending on the day my flex is 97 to 110, it depends on that stabbing pain. Today my surgeon saw me to X-ray the area, he said it was fine, but would do an ultrasound next week to ensure he didn’t miss anything. He bent my knee because it was only at 90 (due to that stabbing pain in the outer side), and he rub over the scar (it burnt), he told me it was scar tissue and he was disappointed in me because I wasn’t working hard enough. He said I cannot use any walking devices, I need to get my knee to 120, and I have to massage the scar and use a anti inflammatory cream for the next two weeks. He said if there was no improvement I would need another surgery to manipulate my knee. I was stunned. I went home and cried, asked my family if they thought I was being a baby and not working hard enough? They were mad at my surgeon. I literally don’t sleep because of this stabbing pain. Has anyone vet had this stabbing pain in one spot on the outerside of their knee? Do I have to do a second surgery to fix this? I am beside myself.

 

[newlybionic]

You might be working too hard with some of the exercises you are doing. Your ROM is good for only a little more than a month post op. You might want to try stopping your exercises and just do your daily walks practicing walking heel to toe on both legs. I know your OS is telling you to work harder but the newer thinking is to let your knee heal first.

With your ROM most OS would not do a manipulation of your knee. That procedure is not a surgery. They put you under and then manually force your knee to bend. It will put you back to where you were immediately after your TKR surgery. Please try the Bonesmart way and rest your knee.

 

[Winston0915]

Ok thank you, he also said I should have returned to work by now.

 

[newlybionic]

He’s wrong. We recommend a phased in return to work starting at 12 weeks. This OS, for whatever the reason, is just not up to date with his thinking. Would anyone think that if you had a broken leg you would be back at work already? In this surgery two bones are cut. Metal pieces are attached to each bone. There is soft tissue that has been moved and pushed aside. I’m sure when you think about it you’ll see it’s not a failure on your part to achieve what your OS is demanding.

 

[Peaches0000]

Your Dr sounds pretty harsh with you, I am at 14 weeks and
just got to 0 extension & ROM is 110 & my Dr just told me to keep working on it.
I resent that I had to go back to full-time work at 6 weeks.It really hurt my recovery, so stay off work as long as you possibly can. hope you feel better soon!

 

[kneeper]

Ok thank you, he also said I should have returned to work by now.

Your bend is good for your time in recovery. I'm thinking you're overdoing.

When you say you do your exercises twice a day, how many exercises are you doing at a time? Usually they give you this long sheet which imho is way too many. My PT for the second knee gave me the advice that I didn't need to do the whole sheet every day. I'd do a few repetitions (no more than 10 at a time) maybe twice a day. Or 5 three times a day--kind of as I felt up to. I'd also do a little walking--increasing as tolerated.

 

[Winston0915]

Hi,
I was doing three sheets of exercises, some five at a time and some 10 at a time. Then I was flexing my knee and walking almost every hour 9:00 am to 6:00 pm. Then I walk up/down driveway. Today I went for a CAT Scan and surgeon will call me over the weekend. I just did my walking today to try and get myself off of the assisted device.

 

[Celle]

He bent my knee because it was only at 90 (due to that stabbing pain in the outer side), and he rub over the scar (it burnt), he told me it was scar tissue and he was disappointed in me because I wasn’t working hard enough. He said I cannot use any walking devices, I need to get my knee to 120, and I have to massage the scar and use a anti inflammatory cream for the next two weeks. He said if there was no improvement I would need another surgery to manipulate my knee. I was stunned. I went home and cried, asked my family if they thought I was being a baby and not working hard enough? They were mad at my surgeon.

I'm mad at your surgeon, too.

He has absolutely no right to blame you for what he sees as lack of progress. He has unrealistic expectations.

You don't have to please him. You have to please your knee and do what feels right for it.

It's only just over a month since you had major surgery and your knee is still upset from that trauma.
Forcing it to bend and overdoing exercises will only upset it still more and that will slow down any progress with flexion.

If you feel you still need to use a walking device, keep on using it. It's much better to do that than it is to risk having a fall.

I'm going to recommend that you stop doing all those exercises and just let your normal activities of daily life (ADLs) be your exercise. Your knee will get all the exercise it needs in this early stage of recovery if you do that.

Instead of exercising madly, spend more time resting, icing and elevating your knee, to help it calm down and heal.

In spite of what your surgeon told you, 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 .

In any case, 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 knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase.

This is your knee, not your surgeon's knee, and you are the only one with the right to say what happens to it. Your surgeon can advise, but you have the right to choose whether or not to accept his advice. He cannot dictate what you do with your knee and he cannot perform any surgery or manipulation without your consent,

You are in charge of your knee, not your surgeon. You have the right to stop PT at any time:
Saying no to therapy - am I allowed to?

Please don't struggle to achieve 120 degrees of flexion to meet your surgeon's unrealistic degree. You won't make it, no matter what you do and he'll only abuse you again.

Take a support person with you to the appointment and try to calmly tell your surgeon that you believe your knee will achieve good ROM, given time. Tell him you do not want to have a manipulation, but would like more time.

If you get upset, your support person should speak up on your behalf - ask them beforehand to do this and tell them what you'd like them to say.

If your surgeon gets annoyed, that's his problem, not yours. He's an adult, not a two-year-old having a tantrum. He'll have to get over it. He has no legal right to force you to do anything.

 

[Jockette]

I agree with everything Celle said.

 

[Winston0915]

Celle, Thank you, I will take all your advise as I have spent my day crying with pain since he manipulated my knee yesterday. I went for a CAT Scan today to ensure knee joint is healing properly. Going forward I am not letting him or anyone else manipulate my knee, this has been done to me three times since my surgery, twice by the surgeon and once by PT. Each time it has set me back in my recovery. I also tried to stop my crutches but almost fell a few times today so I will continue to use them until I can walk safely without them. I will back off on my exercises and just do my ADL’s and continue to rest, ice and elevate. I will take my mother with me my next visit to advocate on my behalf, as she is helping me through this and sees how he sets me back each time he manipulates my knee. She told me to get another opinion. I am so happy I found this forum, I literally have spent the last 24 hours crying and beating myself up for not being further along, thinking I wasn’t doing enough, so I thank everyone for helping me get through this.

 

[Jockette]

I am so sorry your medical team is not more supportive.

My team never said to me the things yours has told you, but they did force my knee to bend more than it was ready to, causing me a great deal of pain.

My PT betrayed my trust when I was one week post op, he just slowly continued to push until I thought my knee would burst. I was holding on to the table that I was lying on so tightly that it actually caused great pain in my shoulder, and an exam of my shoulder less than a week later said it was acute tendinitis. (as if my knee didn’t hurt enough!) The dilaudid I was taking did not touch the shoulder pain.

Later that same week I was sitting on the exam table, feet on the floor and my PT surprised me by lowering the table, forcing my knee to bend more by default.

My surgeon also hurt me by bending my knee to get the highest measurement he could at every check up until I finally refused him at my seventh month checkup.

If I ever have another replacement, I now know that I can and will handle things very differently.

 

[sistersinhim]

. My stretch is at zero completely flat and depending on the day my flex is 97 to 110, it depends on that stabbing pain. Today my surgeon saw me to X-ray the area, he said it was fine, but would do an ultrasound next week to ensure he didn’t miss anything. He bent my knee because it was only at 90 (due to that stabbing pain in the outer side), and he rub over the scar (it burnt), he told me it was scar tissue and he was disappointed in me because I wasn’t working hard enough. He said I cannot use any walking devices, I need to get my knee to 120, and I have to massage the scar and use a anti inflammatory cream for the next two weeks. He said if there was no improvement I would need another surgery to manipulate my knee. I was stunned. I went home and cried, asked my family if they thought I was being a baby and not working hard enough? They were mad at my surgeon. I literally don’t sleep because of this stabbing pain. Has anyone vet had this stabbing pain in one spot on the outerside of their knee? Do I have to do a second surgery to fix this? I am beside myself.

Your ROM is really good for only 6 weeks out. Most surgeons expect 90 degrees at 6 weeks and you have surpased that already. You do have scar tissue. That's what is closing your 6 layers of incisions.
Closing stitches. But, with a bend and extension like you have already, it's very doubtful that you have adhesions, which is what your doctor is referring to. Adhesions are very, very rare, but so many doctors and PTs will blame scar tissue, (adhesions), on poor ROM when it's nothing more that swelling that is causing it.

Many of us never took formal PT or did any exercises. I am one of them. I had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing. I used my knee as it was intended to be used by walking around to take care of my daily needs. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do.

 

[Winston0915]

Thank you! I have been in severe pain the last few days, I will be taking all the advice given to me. My sciatica is acting up again and I had that under control. I will listen to everything said to me and let my knee dictate what I am able to do. I actually am going to cancel my apposition my surgeon in two and reschedule for one month instead. That will give me the time I need to figure this out. Again I really appreciate all the support, I look forward to day that I am pain free and not crying.

 

[Winston0915]

My appointment with surgeon in two werks

 

[Winston0915]

Hi, I am looking to see if any one has advice on lower back pain. I started pool therapy two weeks ago, 1 time per week. I went on Friday and my lower back has been excruciatingly painful. I can’t walk I am in so much pain. My back has been given me issues since my knee replacement on August 5th, it cramps up when I walk. But now I am struggling to walk because of the pain. Has anyone else experienced this? If so is there anything I can do to treat it?

 

[Winston0915]

Hi
I had surgery August 5th, the road has been very long and hard. I still have a lot of pain especially on the outer side of my knee, but the last few weeks, my knee has been locking. I called my surgeon he said this was normal, has anyone else experienced this?

 

[Abbylayla]

My right TKR was also August 5th. The outside of my knee does not hurt but its numb. My knee does feel like it locks a little. Mostly it gets stiff & doesn't take much for it to swell. There are days when the swelling is down & it moves pretty good. Easy to get flex over 100. Other times its swollen & everything is a challenge. Still not pain free walking on it either.
What happens when it locks? Does it freeze up all together? Painful? Is there anything in particular your doing when that happens & how do you get it moving again?

 

[Winston0915]

Hi! It happens when I am walking all of a sudden it will lick then it feels like I am going to fall, then it lets go. I am also having a lot of clicking. How are you doing at night?