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TKR Knee replacement post op issues

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Pnwgal

Pnwgal

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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/
Oh, that makes me feel better! Thank you.
 

Jockette

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This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 
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Pnwgal

Pnwgal

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This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
Oh great, thank you!
 

Jockette

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Can I ask what “MUA” is?
Here’s an article from the Bonesmart library about it:


Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/
 

erichknipp

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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.
I heard the same scar tissue concern from my surgeon. I think that this is pretty common guidance. While I think it is a good idea to bend it at least a little bit, but you don't need to be hyper-aggressive about it. Figure out the difference between discomfort and pain. When you're doing your heel slides, or for that matter any other exercise, find your maximum discomfort and don't push past that. I liken it to how intense a really good stretch feels when you're cooling down after a workout. Some people "enjoy" the stretch but I never have - it is an intense feeling and now I know that for me, it is discomfort. That's the kind of feeling you're looking for in your ROM exercises. If you go beyond that into pain, you're doing too much. And this early in your recovery, you may be surprised by just how little you have to do, to be doing too much! I know I was, and I am only one week ahead of you.

On the drugs front. Like you, the Oxy made me nauseous. Zofran helped a little but what was the ultimate help was never ever taking the Oxy without a reasonable amount of food. The least amount I would take with it would be an apple and a package of almonds (about 100 calories worth). This made a big, big difference in my level of nausea.

Good luck. It is hard but you will get through it.
 

Wolvesfan

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I had the same nausea with oxy, and Zofran didn’t help. My surgeon prescribed compazine and I finally got some relief. I hope you’re feeling better soon!
 
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Pnwgal

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Can I ask what “MUA” is?
Here’s an article from the Bonesmart library about it:


Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/
Thank you!
 
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Pnwgal

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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.
I heard the same scar tissue concern from my surgeon. I think that this is pretty common guidance. While I think it is a good idea to bend it at least a little bit, but you don't need to be hyper-aggressive about it. Figure out the difference between discomfort and pain. When you're doing your heel slides, or for that matter any other exercise, find your maximum discomfort and don't push past that. I liken it to how intense a really good stretch feels when you're cooling down after a workout. Some people "enjoy" the stretch but I never have - it is an intense feeling and now I know that for me, it is discomfort. That's the kind of feeling you're looking for in your ROM exercises. If you go beyond that into pain, you're doing too much. And this early in your recovery, you may be surprised by just how little you have to do, to be doing too much! I know I was, and I am only one week ahead of you.

On the drugs front. Like you, the Oxy made me nauseous. Zofran helped a little but what was the ultimate help was never ever taking the Oxy without a reasonable amount of food. The least amount I would take with it would be an apple and a package of almonds (about 100 calories worth). This made a big, big difference in my level of nausea.

Good luck. It is hard but you will get through it.
This makes a lot of sense. I’m finding that too with the Oxy and food. Food is a must. Thanks!
 
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Pnwgal

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Update-I was able to get in and out of the car for my first PT appointment and it went fine. I really like my therapist. She‘s super laidback and gentle. She just did ROM measurements (65) and had me try to wake my quads up a little, then massaged and iced my knee. She gave me a strap and that is a huge help in moving my leg! She told me to actually not get up and do a lot of walking in these early days because walking a ton will cause swelling and swelling can cause scar tissue. I feel a lot more positive about everything!
 

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Having a great therapist makes all the difference! I am so happy that mine returns from furlough next week. Being able to trust them and just relax helps a lot!
 
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Excuse my pity party here. I’m on day 12 of TKR recovery and I’m going crazy. :gaah: I honestly thought I’d be further ahead by now. Still can’t walk without a walker, still unsteady on my feet and lose my balance easily, still in a lot of pain. Can’t make it up the stairs yet so I can’t sleep in my bed and can’t take a shower so I have to bathe standing up in the downstairs bathroom. Feeling bored and getting extremely frustrated that I have to depend on my husband for everything. My patience is at a zero. Looking around the house is making me have anxiety because it’s not cleaned up to my standards. I know the poor guy is trying but.....ugh. I went through this exact thing when I had my osteotomy in 2011 and it’s deja vu. But I really thought this time around would be easier. When does it get better? :sad:
 

sondrals

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You’re 12 days out. Give yourself a break. I honestly used my walker for a good month after my right tkr, I just recently had a revision on my left and was able to ditch the walker, except first thing in the mornings at two weeks. I still shower using a chair, my house drives me insane, and my patience is pretty limited too. Use the walker as long as you need it, the house will still be there when you’re ready and able to clean it. Try not to stress about it all (I know that’s hard, I’m a world class stresser).
 

JennyLynne

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Aw I’m sorry you are feeling so blue! With my other TKR, I started turning the corner at about 3 weeks. I’m hitting 2 weeks tomorrow and trying to remind myself that it’s a slow go.

I hate the stairs, but I have taken the opposite approach. I stay upstairs for the first couple of weeks and don’t come down! I stay in my bedroom. I’m so much more comfortable in bed, and easy to get to bathroom and shower. I walk the hallway every couple hours, which isn’t much. Granted, it makes it harder on my husband but it’s not for long.

I am downstairs now, for the first time since my PT eval. My hubs smoked ribs all day and was very excited for dinner, so I made the trip down. I can’t wait to get back to my nest! Shhh... don’t tell him!
 

Wolvesfan

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Pity parties are ok! It’s a really big surgery and some really big emotions can accompany it. I think I had some sort of mini meltdown every day for the first month or so, mostly because of sheer frustration with my limitations. I’m 10 weeks post op, and had a little crying jag just last night because I overdid it and my knee felt so stiff. But I promise you...it does get better! A friend told me that for the first three months, there will be times when you wonder why you did this to yourself. By six months, you’ll feel better about your decision, and by a year, you’ll be good friends with your new knee. Hang in there!
 
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Pnwgal

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You’re 12 days out. Give yourself a break. I honestly used my walker for a good month after my right tkr, I just recently had a revision on my left and was able to ditch the walker, except first thing in the mornings at two weeks. I still shower using a chair, my house drives me insane, and my patience is pretty limited too. Use the walker as long as you need it, the house will still be there when you’re ready and able to clean it. Try not to stress about it all (I know that’s hard, I’m a world class stresser).
Thanks. Makes me feel better!
 
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Pnwgal

Pnwgal

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Aw I’m sorry you are feeling so blue! With my other TKR, I started turning the corner at about 3 weeks. I’m hitting 2 weeks tomorrow and trying to remind myself that it’s a slow go.

I hate the stairs, but I have taken the opposite approach. I stay upstairs for the first couple of weeks and don’t come down! I stay in my bedroom. I’m so much more comfortable in bed, and easy to get to bathroom and shower. I walk the hallway every couple hours, which isn’t much. Granted, it makes it harder on my husband but it’s not for long.

I am downstairs now, for the first time since my PT eval. My hubs smoked ribs all day and was very excited for dinner, so I made the trip down. I can’t wait to get back to my nest! Shhh... don’t tell him!
I should’ve done that! Gone upstairs first, lol. My surgeon told me three weeks also....hoping that’s the case! Yum, smoked ribs sound so good! Enjoy!
 
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Pnwgal

Pnwgal

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Pity parties are ok! It’s a really big surgery and some really big emotions can accompany it. I think I had some sort of mini meltdown every day for the first month or so, mostly because of sheer frustration with my limitations. I’m 10 weeks post op, and had a little crying jag just last night because I overdid it and my knee felt so stiff. But I promise you...it does get better! A friend told me that for the first three months, there will be times when you wonder why you did this to yourself. By six months, you’ll feel better about your decision, and by a year, you’ll be good friends with your new knee. Hang in there!
Thank you!! Glad I’m not alone.
 

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