TKR Knee replacement post op issues

[Pnwgal]

Hello @Pnwgal - and

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.

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

Hi...sure.
April 22, 2009-right knee arthroscopy, meniscus debridement
November 19, 2010-left knee arthroscopy, meniscus debridement
November 18, 2011-right knee open-wedge high tibial osteotomy, cartilage restoration
November 2, 2012-Plate removal following right knee osteotomy
April 10, 2013-left knee arthroscopy, meniscus debridement
December 4, 2014-bilateral knee arthroscopies, meniscus debridement
May 13, 2020-total left knee replacement

Thank you!

 

[Pnwgal]

Another question-they told me I had to wear the compression stockings for 2 weeks. With all of my other surgeries including the osteotomy, I wore them for maybe a few days. They’re so tight and it’s painful to wear them. Are they really necessary still?

 

[Celle]

I think you'll have to ask your surgeon his/her policy about wearing the compression stockings. They shouldn't be too tight. If they are, you need to ask for a larger size.

There is some evidence that these stocking do little to prevent blood clots, but most surgeons still seem to prefer you to use them.

Once I was up and about I took mine off. My surgeon didn't say anything about that when I saw him to have my sutures removed.

 

[Pnwgal]

I think you'll have to ask your surgeon his/her policy about wearing the compression stockings. They shouldn't be too tight. If they are, you need to ask for a larger size.

There is some evidence that these stocking do little to prevent blood clots, but most surgeons still seem to prefer you to use them.

Once I was up and about I took mine off. My surgeon didn't say anything about that when I saw him to have my sutures removed.

Okay, thanks...will do.

 

[JennyLynne]

I am one day ahead of you! I can’t lift my leg at all either. I use a strap to lift my leg in and out of bed. From past surgeries, it’s taken my leg about 2 weeks to “wake up” and start being able to raise without much help.

I had a rough go with pain starting about 24 hours post op for 2 days, and my doctor changed my meds. That has controller the pain but made me so woozy.

It’s a tough balance but it gets better!!! The first 2 weeks are rough and then you will start to turn the corner. I’ve had another TKR and bilateral hips, and never hesitated to do this one. It’s so worth it! I’m 46 and happy to have the last surgery behind

(That doesn’t mean I have shed plenty of tears and told my husband that it’s NEVER felt like this- only for him to remind me that I say this every time, haha)

good luck to you... I’ll be here.. let’s cheer each other on!

 

[Pnwgal]

I am one day ahead of you! I can’t lift my leg at all either. I use a strap to lift my leg in and out of bed. From past surgeries, it’s taken my leg about 2 weeks to “wake up” and start being able to raise without much help.

I had a rough go with pain starting about 24 hours post op for 2 days, and my doctor changed my meds. That has controller the pain but made me so woozy.

It’s a tough balance but it gets better!!! The first 2 weeks are rough and then you will start to turn the corner. I’ve had another TKR and bilateral hips, and never hesitated to do this one. It’s so worth it! I’m 46 and happy to have the last surgery behind

(That doesn’t mean I have shed plenty of tears and told my husband that it’s NEVER felt like this- only for him to remind me that I say this every time, haha)

good luck to you... I’ll be here.. let’s cheer each other on!

Thank you! So glad to hear I’m not alone! Good luck to you too and yes, let’s cheer each other on for sure!

 

[Golfer1]

I will be 13 weeks post-op on a right TKR tomorrow. Oh how I remember those first weeks with a very stiff and swollen leg and having to use a strap to move it in and out of the bed! To do my heel slides I used a dry erase board that I would lay on the bed and then move my heel up and down it. It worked great. At first, the heel slides were very difficult and at times I would think that my knee was never going to bend right again. But after a time they actually began to feel kinda good (after the first few of a set that felt like breaking ice on a pond). I would actually do a set in the middle of the night (heck I wasn’t sleeping much anyway), in addition to a couple of sets during the day. My perseverance paid off with a flexion of 114° at nine days postop and 128° at five weeks.

You mentioned in your initial post that they told you that you should be able to get up and down the stairs after you got home with “no problem”. Why on earth would you be told that? I am just now beginning to go up the stairs foot over foot, but pulling some on the handrail. I am not the least bit confident trying it yet coming down the stairs. Personally, I believe you are WEEKS away from needing to be concerned with that.

I have found that this has been so far a real roller coaster of a recovery. There are more and more good days, but my knee still gets really cranky and swells on me if I overdo it... which is quite often. I still ice and elevate for 45 minutes twice a day.

This website has been a real godsend for me. I have received some very good advice and reassurance from caring people who have been there and found out that I was NOT alone in my struggles. I promise you it gets better. I encourage you to check in regularly and share any concerns you might have.

 

[Pnwgal]

I will be 13 weeks post-op on a right TKR tomorrow. Oh how I remember those first weeks with a very stiff and swollen leg and having to use a strap to move it in and out of the bed! To do my heel slides I used a dry erase board that I would lay on the bed and then move my heel up and down it. It worked great. At first, the heel slides were very difficult and at times I would think that my knee was never going to bend right again. But after a time they actually began to feel kinda good (after the first few of a set that felt like breaking ice on a pond). I would actually do a set in the middle of the night (heck I wasn’t sleeping much anyway), in addition to a couple of sets during the day. My perseverance paid off with a flexion of 114° at nine days postop and 128° at five weeks.

You mentioned in your initial post that they told you that you should be able to get up and down the stairs after you got home with “no problem”. Why on earth would you be told that? I am just now beginning to go up the stairs foot over foot, but pulling some on the handrail. I am not the least bit confident trying it yet coming down the stairs. Personally, I believe you are WEEKS away from needing to be concerned with that.

I have found that this has been so far a real roller coaster of a recovery. There are more and more good days, but my knee still gets really cranky and swells on me if I overdo it... which is quite often. I still ice and elevate for 45 minutes twice a day.

This website has been a real godsend for me. I have received some very good advice and reassurance from caring people who have been there and found out that I was NOT alone in my struggles. I promise you it gets better. I encourage you to check in regularly and share any concerns you might have.

Thank you so much! Yeah, I’m not sure why I was told that. But I’m discouraged because my bedroom is upstairs and so is my shower so I’ve been sleeping in my recliner downstairs and washing up in the bathroom downstairs, no shower. I miss my bed and I want a shower! :(

 

[Sara61]

Depending on the surgeon and medical history it is common for the use of compression stockings ( I had, had varicose veins issues previously) so I was told to wear compression stockings for 4 weeks, as I live in a warm climate our compression stockings have the toe part left open ( so that you can wear with flip flops) actually these are the easiest to get on as you can slip a plastic bag on your foot then pull stocking over then remove the bag ..IMPORTANTLY get the right size your leg needs to be measured correctly. Fortunately I had my surgery in the Winter so they were comfortable, I now only use them on long journeys or flying.
How many stairs are there to your bedroom ?
Can your husband not help you up them so at least you can take a shower ?
In Portugal one of our criteria on leaving hospital ( there are no TKR out patients surgeries here ) we have to prove we can manage alone with the use of arm crutches/handrail a flight of 16 steps up and down, one foot at a time. The pattern to follow is: “Up with the good leg, Down with the bad (operated)”.
It really helps if you have elbow crutches/hand rail as walkers don't usually fit on the stairs.
A shower should only be taken once your stitches/staples have been removed unless your have a secure waterproof bandage/plaster.

 

[Sara61]

Useful article and video

Stairs: how to cope with them after surgery

Do NOT worry about stairs! You'll not be allowed out of hospital till you can do them and it's really not that difficult. This video is suitable for both hips and knees On arrival home, I was on my own for a few hours till the cavalry arrived and in that time I made it up and down twice...

bonesmart.org

 

[aperture]

I agree to not being overly concerned about PT. Usually in our area (cleveland) they come to your house for a few weeks to make sure nothing is too swollen or too stiff and have you do gentle knee slides and walking a bit. you shouldn’t have to get in the car and an office so early on. I am 3 1/2 months out from my PKR and after a few weeks of in-home gentle exercises with my in home therapist (Medicare will pay for a certain number of the in home) I stopped the exercises totally and still do no PT exercises. I did my normal household activities slowly and a bit at a time. I did as much walking as my knee would put up with. Three months later I am hiking over three miles a day and only have occasional discomfort, mostly after doing back and forth or turning sideways movements. The first weeks are really tough and you will look back soon and see how far you have come. Everyone here was so supportive and helpful.

 

[partialfixFeb]

@Pnwgal I HATED the compression stockings and was so excited to be done at 2 weeks UNTIL at my 10 day post-op appointment I was told 4 weeks even though I could swear it was supposed to be only for 2 weeks. Luckily, it was February/March so not hot outside yet. I did purchase some socks at Amazon that my PT suggested to replace the hospital ones that I liked a little bit better but they were tight and a pain to deal with also...just not as ugly. (BTW, she mentioned wearing them when I fly from here on out but she's conservative that way.) My OS had me wear the ones that come below the knee...others have stockings that cover the knee...

Interestingly, my PT had me do heel slides on my back with my feet against the wall (with your tush not too close to the wall.) I used a bed without a headboard (wasn't ready to get on the floor yet). My PT felt it was better that way because I was elevating my swollen knee while I gently did the slides--assisted with a strap. I remember how little I could slide down the wall at first but my bend would improve by the end of the set only to go back to square 1 the next day with so little bend for the longest time - but as swelling subsided, more range of motion came. It just takes time.

 

[JennyLynne]

My bedroom and shower are upstairs- and that’s where I stay! I made the journey up when I got home and haven’t gone down in a week! I am supposed to have my outpatient PT eval tomorrow so I will have to deal with the stair. Nervous!!! I’ve never left my house before 2 weeks before.

 

[Wolvesfan]

I remember that first trip down the stairs! I did it the wrong way (went down with my good leg first) and was a sobbing mess by the time I made it to the foyer. Then I had to navigate a few outside steps to get to the car...and then do the hip swivel to get into the passenger seat. Fun times! You’ll get through it!

 

[Pnwgal]

My bedroom and shower are upstairs- and that’s where I stay! I made the journey up when I got home and haven’t gone down in a week! I am supposed to have my outpatient PT eval tomorrow so I will have to deal with the stair. Nervous!!! I’ve never left my house before 2 weeks before.

Guess I should’ve done that! Good luck today!

 

[Pnwgal]

@Pnwgal I HATED the compression stockings and was so excited to be done at 2 weeks UNTIL at my 10 day post-op appointment I was told 4 weeks even though I could swear it was supposed to be only for 2 weeks. Luckily, it was February/March so not hot outside yet. I did purchase some socks at Amazon that my PT suggested to replace the hospital ones that I liked a little bit better but they were tight and a pain to deal with also...just not as ugly. (BTW, she mentioned wearing them when I fly from here on out but she's conservative that way.) My OS had me wear the ones that come below the knee...others have stockings that cover the knee...

Interestingly, my PT had me do heel slides on my back with my feet against the wall (with your tush not too close to the wall.) I used a bed without a headboard (wasn't ready to get on the floor yet). My PT felt it was better that way because I was elevating my swollen knee while I gently did the slides--assisted with a strap. I remember how little I could slide down the wall at first but my bend would improve by the end of the set only to go back to square 1 the next day with so little bend for the longest time - but as swelling subsided, more range of motion came. It just takes time.

Guess I’ll have to suck it up and wear them for another week. Thanks!

 

[Pnwgal]

Useful article and video

Stairs: how to cope with them after surgery

Do NOT worry about stairs! You'll not be allowed out of hospital till you can do them and it's really not that difficult. This video is suitable for both hips and knees On arrival home, I was on my own for a few hours till the cavalry arrived and in that time I made it up and down twice...

bonesmart.org

Thanks!

 

[Pnwgal]

Depending on the surgeon and medical history it is common for the use of compression stockings ( I had, had varicose veins issues previously) so I was told to wear compression stockings for 4 weeks, as I live in a warm climate our compression stockings have the toe part left open ( so that you can wear with flip flops) actually these are the easiest to get on as you can slip a plastic bag on your foot then pull stocking over then remove the bag ..IMPORTANTLY get the right size your leg needs to be measured correctly. Fortunately I had my surgery in the Winter so they were comfortable, I now only use them on long journeys or flying.
How many stairs are there to your bedroom ?
Can your husband not help you up them so at least you can take a shower ?
In Portugal one of our criteria on leaving hospital ( there are no TKR out patients surgeries here ) we have to prove we can manage alone with the use of arm crutches/handrail a flight of 16 steps up and down, one foot at a time. The pattern to follow is: “Up with the good leg, Down with the bad (operated)”.
It really helps if you have elbow crutches/hand rail as walkers don't usually fit on the stairs.
A shower should only be taken once your stitches/staples have been removed unless your have a secure waterproof bandage/plaster.

He tried to help me but the pain was excruciating and I couldn’t get past the first step. There are 6 steps, then a landing, then another 8-9 steps. Thanks!

 

[Pnwgal]

So, today is my one week post-op. Today was slightly better but still having a LOT of intermittent pain. Getting up and stretching some and trying to ever so slightly bend my knee and then attempt to straighten again. I talked to my surgeon yesterday and he said he’s concerned with me not bending my knee at all that I could develop scar tissue and have a permanently stiff knee. :( They upped my pain meds dosage because the pain was so out of control and as a result, I was extremely nauseous yesterday, despite Zofran. So I’m back on 10 mg of Oxycodone every 4 hours and 7.5 mg of Mobic twice a day, along with Tylenol 3x a day. He said it’s mind over matter; said I have to push through the pain and try to move it. I thought compared to my knee osteotomy and cartilage restoration, knee replacement surgery was supposed to be a piece of cake. This is brutal.

 

[sistersinhim]

he said he’s concerned with me not bending my knee at all that I could develop scar tissue and have a permanently stiff knee.

This is not true. Your bend can continue to improve for a year or two. Each knee is different as is the time it takes to bend.
One of our members, Bertschb, kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

I'm 12 months out from my surgery and have some advice based on my experience:
Don't worry about your ROM Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple of months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have worried about ROM.

https://bonesmart.org/forum/threads/myth-busting-window-of-opportunity-in-tkr.6895/