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TKR Knee replacement post op issues

Pnwgal

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Hi! I’m a new member; literally just joined 5 minutes ago. I’m 5 days post-op a left total knee replacement. I’ve had multiple knee surgeries, including a knee osteotomy and cartilage restoration, and this recovery has been one of the hardest for me. I’m still in a lot of pain and I can’t bend my leg. My husband has to hold my leg and keep it straight when I go to sit up and then slowly lower it to the floor, and hold it and keep it straight when I sit back down. Is this normal? I couldn’t even go to my first PT appointment on Friday because of the pain. My second appointment is today and I’m scared I won’t be able to get into the car. I’ve called my doctor’s office a few times since Friday and he’s out of the office until tomorrow. I would have expected the on call doc to call me back but no one has. I can’t get up the stairs either because of the pain, which I was told I’d be able to do with no problem. I had my surgery at an outpatient surgery center and was discharged the same day. Just kind of feeling like I was thrown to the wolves. ☹ Tell me it gets better?
 

Jaycey

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@Pnwgal Welcome to BoneSmart! Sorry you have had a rough start with this recovery. Sounds like you are under medicated. Are you taking anything for your pain control?

Try icing and elevating that op leg for at least 45-60 minutes several times per day. Ice will reduce the swelling that is causing your pain.

And please don't worry about any PT. You are in recovery now - not in training. Many surgeons are not sending patients to PT until weeks after surgery.

Here are your recovery guidelines:
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. At week 4 and after you should follow this Activity progression for TKRs

6. Access 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.
 

Tykey

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After only 5 days, you should be on the maximum level of pain killers, what are you taking. Maximum icing should also be your aim.
 

erichknipp

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Hi! I’m a new member; literally just joined 5 minutes ago. I’m 5 days post-op a left total knee replacement. I’ve had multiple knee surgeries, including a knee osteotomy and cartilage restoration, and this recovery has been one of the hardest for me. I’m still in a lot of pain and I can’t bend my leg. My husband has to hold my leg and keep it straight when I go to sit up and then slowly lower it to the floor, and hold it and keep it straight when I sit back down. Is this normal? I couldn’t even go to my first PT appointment on Friday because of the pain. My second appointment is today and I’m scared I won’t be able to get into the car. I’ve called my doctor’s office a few times since Friday and he’s out of the office until tomorrow. I would have expected the on call doc to call me back but no one has. I can’t get up the stairs either because of the pain, which I was told I’d be able to do with no problem. I had my surgery at an outpatient surgery center and was discharged the same day. Just kind of feeling like I was thrown to the wolves. ☹ Tell me it gets better?
welcome to the board and to recovery. I am just slightly ahead of you as I had right TKR on May 7. Short answer is you’re probably right where you should be. Your husband is right about keeping the leg straight to get in and out of bed. Try using your good leg to support the weight. For the first week I had to tuck my left foot under my right ankle anytime I wanted to move the leg. Getting in and out of the passenger seat was excruciating. The swelling limits movement and the whole area is enflamed. Make sure you’re staying on schedule with your pain meds. If you wait until your pain is level 6-8 you’ll regret getting behind the pain. Ice and elevate as much as you can and trust that it will get better.
 
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Pnwgal

Pnwgal

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Hi there; thank you both for your response. I’ve been icing a ton but I don‘t think I’m elevating correctly. They told me to only put a pillow under my heel so my leg stays straight but that has been super painful for me as it stretches the muscles behind my knee. They have me on Mobic anti-inflammatory twice a day, Tylenol 1000mg 3 times a day, and Oxycodone 10mg every 4-6 hours. And they insisted I start PT right away.
 

Summer2020

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oh how I remember that first week! Some of the worst pain I have ever felt in my life. and I was taking oxycodone every 4 hours.

My first PT appointment was cancelled by them due to bad weather, and I ended up cancelling my second one because like you I didn't think I would be able to get in and out of my car.

All I can say is it takes time, lots of time. I had one of those polar ice machines (circulates water through a bucket full of ice, and feeds the cold water up to a big pad I put around my knee). I used that constantly. I only left my recliner to go to the bathroom, which actually was a lot because I was trying to drink a lot of water.

When you say you can't bend your knee. Are you saying it will not bend even if you try, or you can't bend it because of the pain it causes? If it's pain then I agree you need to figure out a way to manage your pain better. If you just can't get it to bend at all, that doesn't surprise me, mine didn't want to bend for me either. Thus the recliner with my foot up on pillows.

Each day I would lay in bed and attempt to do knee slides. I laid on my back and I put my foot on a cookie sheet pan, and slid it back to my butt as much as I could. The first week or so was hardly anything but each day it improved.

It's very hard to find that balance of rest and needing to move it. If you don't move it, its soooo stiff, and if you do move it too much it swells and hurts.

Just take one day at a time, keep on the pain meds on a regular schedule, even if the pain isn't too bad still take them on a schedule you don't want to have to play catch up to the pain. My SO and my son took turns even waking me up at night every four hours to take my pain meds with some water, and some saltine crackers.

When you are ready for PT, then go. It is hard to get in and out of the car, but you will work at it and figure out a way that causes the least pain.

This is a MAJOR surgery. Take you time. time is what heals.
 
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Pnwgal

Pnwgal

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oh how I remember that first week! Some of the worst pain I have ever felt in my life. and I was taking oxycodone every 4 hours.

My first PT appointment was cancelled by them due to bad weather, and I ended up cancelling my second one because like you I didn't think I would be able to get in and out of my car.

All I can say is it takes time, lots of time. I had one of those polar ice machines (circulates water through a bucket full of ice, and feeds the cold water up to a big pad I put around my knee). I used that constantly. I only left my recliner to go to the bathroom, which actually was a lot because I was trying to drink a lot of water.

When you say you can't bend your knee. Are you saying it will not bend even if you try, or you can't bend it because of the pain it causes? If it's pain then I agree you need to figure out a way to manage your pain better. If you just can't get it to bend at all, that doesn't surprise me, mine didn't want to bend for me either. Thus the recliner with my foot up on pillows.

Each day I would lay in bed and attempt to do knee slides. I laid on my back and I put my foot on a cookie sheet pan, and slid it back to my butt as much as I could. The first week or so was hardly anything but each day it improved.

It's very hard to find that balance of rest and needing to move it. If you don't move it, its soooo stiff, and if you do move it too much it swells and hurts.

Just take one day at a time, keep on the pain meds on a regular schedule, even if the pain isn't too bad still take them on a schedule you don't want to have to play catch up to the pain. My SO and my son took turns even waking me up at night every four hours to take my pain meds with some water, and some saltine crackers.

When you are ready for PT, then go. It is hard to get in and out of the car, but you will work at it and figure out a way that causes the least pain.

This is a MAJOR surgery. Take you time. time is what heals.
Hi,
I can’t bend it due to pain. Sounds like you went through exactly what I’m experiencing! Thanks for the tips!
 

Summer2020

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yup it sounds like it. There is a post on here somewhere that is pinned that talks about the best way to elevate it, I was looking for it but couldn't find it. It even has a picture to show you how to put the pillows. I will keep searching. maybe some of the oldies but goodies on here know where its at and can point you to it?!

I went through a lot of ups and downs during my recovery. Mentally and physically. It's one of the hardest things I have had to do. The pain was excruciating at times, but I just kept plugging away. I am now at week 18 I think, and now I deal with stiffness. But that deep deep pain isn't there anymore.

This is a great forum to be at. Lots of great advice, people's responses on my posts kept me going, and continuing to try my best to make it through. They also validated a lot of my feelings.
 

Summer2020

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@Pnwgal I found it. It's up above in Jaycey's response in your post. "Elevation is the key". The three stack pillow I used a LOT when I moved out of my recliner to the couch later on. When I was in my recliner, I did the same with two pillows. The first one was just below my knee, but supporting my calf, and the next one up was right around my ankle. I was told to only put a pillow under my ankle too, but it created that same pain behind my knee. BUT if you bend that knee at rest too much, I feel that was part of my issue when trying to get my extension to zero at PT. That and for years before my surgery I walked with a limp with my knee slightly bent so that is what it was use to.

So I do understand that just under the ankle makes the back of your knee hurt, so maybe move the pillow up a little bit, But DO NOT put the pillow under your knee, and let your feet go down the other side. That is a big no no. Does that make sense?
 

Jaycey

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And they insisted I start PT right away.
And who is in charge? You are and you don't need to start PT immediately. Wait until you get this swelling under control. Then find a PT who is not aggressive. At this point PT will be totally counter productive.
 
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Pnwgal

Pnwgal

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@Pnwgal I found it. It's up above in Jaycey's response in your post. "Elevation is the key". The three stack pillow I used a LOT when I moved out of my recliner to the couch later on. When I was in my recliner, I did the same with two pillows. The first one was just below my knee, but supporting my calf, and the next one up was right around my ankle. I was told to only put a pillow under my ankle too, but it created that same pain behind my knee. BUT if you bend that knee at rest too much, I feel that was part of my issue when trying to get my extension to zero at PT. That and for years before my surgery I walked with a limp with my knee slightly bent so that is what it was use to.

So I do understand that just under the ankle makes the back of your knee hurt, so maybe move the pillow up a little bit, But DO NOT put the pillow under your knee, and let your feet go down the other side. That is a big no no. Does that make sense?
Yep, makes sense! I did the stacked pillows just now and it feels much better! Thanks!
 
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Pnwgal

Pnwgal

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And they insisted I start PT right away.
And who is in charge? You are and you don't need to start PT immediately. Wait until you get this swelling under control. Then find a PT who is not aggressive. At this point PT will be totally counter productive.
Makes sense! Thank you.
 
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Tykey

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Jaycey is absolutely 100% right about the physio.. If all they did was a bit of GENTLE manipulation with oodles of encouragement, that would be OK. I'd stay at home!
Sadly, we see so many new friends on here who are brutally manipulated and bullied by physios. They do more damage whilst your knee is wanting to heal.
So just try to get your elevation sorted, keep icing, and review your medication
It's tough at the beginning, but it does get better - honestly
 

pamsknees

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@Pnwgal - so sorry that you’re in pain. Be sure to ice & elevate. To be honest, I would cancel the PT. I had my knee replacements (bilateral) on Mar 16, the day before everything shut down. I had been reading this forum for months & was concerned about PT as I’d read so many horror stories, so I was kind of relieved it was shot down. I did what I felt able to, on my own, following the guidelines on here. At 6 weeks I went to my post op & was told I was way ahead of where most people are & no need for PT at all. I’m now 9 weeks today, walking around 1.5 miles/ day, riding exercise bike & having no pain. In my opinion, icing & elevating is the big key.
 

eaglemom

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You will always get good advice here. You might look at a Lounge Doctor for your elevation. I ordered mine from Amazon - well worth the money. I use it daily. With it your thigh and calf are supported, as is your knee. Just a thought for you.

As for PT your in charge. I'm wondering why you don't have home health? Its far far far to soon to be getting in and out of a car. Goodness, that would be awful. You can choose to wait for PT, later on down the healing road. Or request home health. Or........do it on your own. If you follow the Bonesmart ways I think you'll do just fine.

What you should be doing is icing & elevating. Constantly, with the exception of a hobble to the restroom and around the house. Your knee is mad, furious you did this to it, and you need to listen to it. Also make certain to get on a time schedule with your pain meds - around the clock. If the pain gets out of hand you'll have a rougher time getting it back under control. Make sure to have something in your stomach with taking pain meds.
 
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Pnwgal

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Jaycey is absolutely 100% right about the physio.. If all they did was a bit of GENTLE manipulation with oodles of encouragement, that would be OK. I'd stay at home!
Sadly, we see so many new friends on here who are brutally manipulated and bullied by physios. They do more damage whilst your knee is wanting to heal.
So just try to get your elevation sorted, keep icing, and review your medication
It's tough at the beginning, but it does get better - honestly
Glad to know. Thanks!
 
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Pnwgal

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@Pnwgal - so sorry that you’re in pain. Be sure to ice & elevate. To be honest, I would cancel the PT. I had my knee replacements (bilateral) on Mar 16, the day before everything shut down. I had been reading this forum for months & was concerned about PT as I’d read so many horror stories, so I was kind of relieved it was shot down. I did what I felt able to, on my own, following the guidelines on here. At 6 weeks I went to my post op & was told I was way ahead of where most people are & no need for PT at all. I’m now 9 weeks today, walking around 1.5 miles/ day, riding exercise bike & having no pain. In my opinion, icing & elevating is the big key.
That’s encouraging!
 
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Pnwgal

Pnwgal

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You will always get good advice here. You might look at a Lounge Doctor for your elevation. I ordered mine from Amazon - well worth the money. I use it daily. With it your thigh and calf are supported, as is your knee. Just a thought for you.

As for PT your in charge. I'm wondering why you don't have home health? Its far far far to soon to be getting in and out of a car. Goodness, that would be awful. You can choose to wait for PT, later on down the healing road. Or request home health. Or........do it on your own. If you follow the Bonesmart ways I think you'll do just fine.

What you should be doing is icing & elevating. Constantly, with the exception of a hobble to the restroom and around the house. Your knee is mad, furious you did this to it, and you need to listen to it.
I have Medicare and I don’t think they pay for home health....that would be a dream if they did though! I’ll order the Lounge Doctor now; thanks!
 

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Hello @Pnwgal - and :welome:

Please will you tell us the full dates of all your knee surgeries, what they were, and which knee it is, so we can make a signature for you? Knowing the exact dates will help us to advise you appropriately.
Thank you.:flwrysmile:

As the others have said, you are in charge of your knee and what happens to it, and you don't have to go to PT until you can do it without excessive pain. Saying no to therapy - am I allowed to?
Stay home, and rest, ice and elevate your leg.

The articles about icing and elevating are in the recovery guidelines you were given earlier, but here thy are again:
Ice to control pain and swelling
Elevation: the do's and dont's
 

Flpickleballer

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Please do not obsess about PT. I did the same thing. When and if I do my next knee I will skip PT. You will be fine on your own. This will get better soon. Listen to the advise on this site.
 

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