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TKR Knee replacement 27th October 2019

Elizaman

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I had a total knee replacement 3 1/2 months ago. I am concerned that I am in pain when walking and climbing stairs. Not much discomfort at night and when sitting with my legs raised. In the morning when I first get up it takes about 10 minutes of being on my feet before the horrible pain starts, I cannot walk very far at all although my bend is good and I can straighten my knee. I am having hydrotherapy with a Physiotherapist twice a week and it is gentle exercise. I take panadol osteo and have just started Mobic but it is giving me a sore tummy. Hoping to see my Surgeon shortly, I feel I need some reassurance that nothing is wrong. Surgery was Mako. Any comments would be appreciated. Just to add my knee is still very swollen.
 
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Celle

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Hello @Elizaman - and :welome: to recovery.

Please will you confirm the date of your knee replacement? Earlier, you told us that it was going to be done on November 1, 2019. Was the date brought forward? If so, I'll remove your name from the November Nimbles surgery list and add you to the October Feisties instead.
Thank you.:flwrysmile:

It is normal to still have some pain when climbing stairs, but it's probably a good idea to see your surgeon for some reassurance.

This is a long recovery, taking a full year for complete recovery of all your tissues.

You didn't post to us earlier in your recovery, so you missed getting our recovery guidelines. I'll leave them for you now:
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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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. Try to 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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Celle

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PS: Since the Mobic is giving you a sore tummy, you should stop taking it. It is an anti-inflammatory and they have a tendency to cause stomach upset and possible bleeding. Let your doctor know.
 
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Elizaman

Elizaman

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Thank you for your comments, I will read the guidelines. Just to confirm my Surgery was brought forward at the last minute. I will not take any more anti-inflammatory's, the Surgeon seems to want everyone to take them. I was taking Lyrica for nerve pain at night and Palexia SR also but I have ceased these as they did not help much.
 

Jockette

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Hi and Welcome to Bonesmart!
I am having hydrotherapy with a Physiotherapist twice a week and it is gentle exercise.
How long is this session? It may seem gentle but it could be more than your particular knee is ready for at this stage, especially since you are still very swollen.

I did not have a good pool experience, but I was put in the pool at 4 weeks, and it was a 50 minute session, with countless bending exercises. It took me 3 days of additional pain to recover from my “ therapy” session.

Since you still have a lot of pain and swelling I suggest you take a break from PT and just go about the activities of your day, as you are able. Rest a lot between activities, elevate every time you are sitting or laying down, and read the article in the Recovery Guidelines about ice.

Your ROM is good, so at this point it’s more important to address your swelling (which is a form of pain) and let your knee heal. At 3 and a half months you are only about 25% healed in this year long recovery. You can always go back to pool exercises later if you want to.
 

sistersinhim

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I agree with Jockette. Your ROM is good and there's no reason to go to PT anymore. Your daily activities will continue to rehab your knee as you are healing. You need to address that swelling. It usually comes from inflammation, which comes from too much activity for the state of your knee's recovery. Stiffness is caused by swelling, too, along with pain. Get rid of the inflammation by cutting out PT and let your knee heal naturally. You will see a difference in a few weeks.

Be sure to ice and elevate as much as you can. That is a great swelling and pain reducer.
 
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Elizaman

Elizaman

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Jockette and Sistersinhim Thank you for your thoughts. My Hydrotherapy sessions are for 1 hour, I was wondering if this was the cause of the ongoing swelling and pain in my knee, time to give it a miss I think. I mentioned earlier that I was taking Lyrica for nerve pain which was helpful but someone told me that they could cause heart attacks, this frightened me and I stopped taking them...
I will be icing and elevating several times a day to reduce the swelling. Many thanks
 

sistersinhim

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I think an hour is probably twice as long as you should be doing. Is the water hot like a hot tub, so more like a swimming pool. Hot water will definitely cause you to swell, but so will too much activity. It seems our bodies feel really good in the water, but after we get out, that night and the next day we find out it was too much. Water adds resistance to your movements, so it's like using weights. I tried it once at 3 months for about 15 minutes and hurt afterwards for days. I waited another month before trying again in a month. It was much better then.

If I were you, I'd try it for about 15 minutes at a time for a few weeks. Then, see how you do. If the swelling is better, then you know what will work for you.
 
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Elizaman

Elizaman

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Thanks for your comments Jockette, the pool water is 36 degrees, in fact very warm. I have cancelled the classes for the next few weeks and I have an appointment with my Surgeon on Wednesday.
 

Jockette

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36 degrees, I guess you mean celsius (which is 96.8 Fahrenheit, I had to look that up! :heehee: )

Yes, that is nice and warm.
 

sistersinhim

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I believe water this warm is leading to more swelling. Remember that ice helps to reduce swelling. That means that heat does the opposite after this surgery. Heat feeds inflammation while ice starves it. I think you are doing right by cancelling the next few weeks. It will be a good test to see if your knee's swelling diminishes some. Be sure, though, to not increase your other activities at the same time. Then, you wouldn't be having a true test about the water because the added activities would probably cause swelling.

It's a touchy thing. Is this enough, is this too much! Just let your knee tell you by its reaction.
 
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Elizaman

Elizaman

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Seeing my Surgeon this Wednesday, hope he can help....
 

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