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TKR Knee Wobble Question

HokieGCC

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I am new here so if I violated any protocol please let me know and I will correct accordingly. I had a TKR on July 2, 2021. My (15 day) recovery has gone super fast except for two things. Although very stiff I have 0/105 flex and I ditched my cane 3 days ago. The first item is that with certain movements I generate a stabbing pain in the back of my knee. Generally speaking with my leg loaded and bent I have to be very careful with movement. Putting on or taking off socks in particular will set this pain (like a 10) off. Turning over in bed can also set this off as well. I only sleep on my back because of this. Once "set off" the back of my knee has a dull ache until I get up and walk around. Secondly, I am having a worsening feeling that there is a tourniquet wrapped around my leg just above the knee. That sensation comes when I walk and relieves when I rest elevated. I do have a lot of swelling there still.

If anyone has experienced these or has any advice please let me know. I plan on setting up an appointment with my Surgeon to discuss.
 

smokey1

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At 15 days out I was still in quite a bit of pain. Your 0/105 is very good . Do you have a lot of swelling? I still do at 9 weeks out. Turning in bed and putting on socks was quite painful at 2 weeks. They did a lot of work just above the knee. I still get pain there from time to time, I thinkyou will find a lot of people at 2 weeks are experiencing what you are. It will get better, don’t worry.
 
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HokieGCC

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Bless you for your quick and reassuring reply.

The 105 took a lot of work.

Not sure how it compares to others but it looks like I have a football for a knee.
 

Celle

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Hello @HokieGCC - and :welome:

I have moved your posts from smokey1's thread and his response to you, to start a recovery thread for you.

Here on BoneSmart, each person has their own recovery thread, where they talk about recovery and receive advice, if necessary.

So please post any updates or questions about your recovery in this, your own thread. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Just in case you couldn't find your thread, here are the instructions on finding it,
How can I find my threads and posts .

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle
 

Celle

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It sounds as if you're making a fast recovery, @HokieGCC, but it won't continue at that speed. You've just had one of the most major surgeries possible and it's not something that you can bounce back from in just a few weeks.

While you've rapidly gained good knee flexion, it's been at the expense of swelling and pain.

Complete recovery of all your tissues from a knee replacement takes a full year and there's nothing you can do that will speed that up. While you'll be able to do most things by about 3 months, you will still be healing and any over-activity will result in increased pain or swelling, or both. If you think of it in terms of a race, it's more like a marathon than a sprint, so you need to pace yourself.

You say that getting your knee flexion to 105 degrees took a lot of work. I'm sure that achieving those number so early did take work, and it was probably painful, too.
Usually, it's not exercising that gets you your Range of Motion (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 increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.

In spite of what your PT no doubt 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

I suggest that now you ease off the exercising and let your knee have a chance to heal, without making it work so hard. Spend as much time as you can resting, elevating and icing your knee, to try to help it calm down and decrease some of its pain and swelling. it's been through a hard time, so treat it gently.

There are articles about icing and elevation in the recovery guidelines, which I will give you in my next post.
 

Celle

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Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, but YOU are the final judge as to the recovery approach you choose.

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.
 
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HokieGCC

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@Celle I can't thank you enough. I believe you are right ... I locked in on the numbers and likely over did it. My PT told me the same and asked me to take this weekend really easy which I have done so far. I have an awesome recliner that we moved into place for me to use to rest more and elevate more. I also put on a full length compression sock to help the swelling during the day. I have hope because tourniquet sensation goes away when I elevate and it takes a few steps to come back when I walk. That suggests to me that the tourniquet feeling is swelling related. Since it goes away even for a little it shouldn't be nerve damage or anything like that. This means swelling should be my focus for a while. Still gonna talk to the Doc though.

I have read that swelling takes 2-3 weeks or up to 3 to 6 months to resolve. My Doc told me 6 weeks. But reading the forum I see people discussing swelling well past the 6 month milestone. I assume for the people that swelling does resolve in a couple weeks probably don't seek out forum's while for people that have stubborn swelling probably seek out info from forums such as this.
 

Celle

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I'm glad your PT also told you it was time to take things easy. Your knee will appreciate it.

The tight feeling around your knee sometimes lass for months, but it should decrease gradually.

As for swelling, it's a very individual thing. Some find it goes away relatively early, while others still experience it for months.
No two recoveries are alike, so there are no set milestones in this recovery.

You're right. We do get a disproportionate number of people on BoneSmart who have problems. Many more people have an uncomplicated recovery and have no need to look for help. They recover and go back to leading their normal lives.

We're here to help anyone who needs help. All of the staff have had at least one joint replaced, so we've been through recovery and we understand what it can be like.
(I've had 3 knee replacements and one shoulder replacement.)
 
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HokieGCC

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Thank you so much for your help. I am glad to hear that the tightness will eventually go away. It is pretty intense at the moment. If it weren't for the tightness I could go on longer walks pretty comfortably. As it is I just cover a couple tenths each day hoping I can go for longer walks over time.
 

BBCG

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Hi HokieGCC, and welcome to Bonesmart! Yes, many of us found this forum in desperation! This time I came back anyway (TKR right, April 29, 2021), since my two very different experiences might help others. TKR #1 was a pre-Bonesmart resetting my brain experience and this time was a Bonesmart under the belt experience!

That tourniquet above the knee feeling does last for months, in come cases. In my knee $#1 (2016) it lasted for a good 6 months. But, I've had more knee scar release massage this time, so there are still new little twinges in the hinges, but my recovery is well in hand. I'm at 12 weeks this week, and able to walk a good pace for about 1.5 miles, though afterwards I ice and elevate for sure! And, that tourniquet feeling left around week 9 I guess... but, during TKR #1 it took me many months to get back to walking well again.

This time I've had alot of tension and restriction in the upper inner thigh radiating out to the hip toward the top of my leg, following the sartorius muscle, so my ortho massage person has worked on that twice now, and after her last treatment, it pretty much was better. Not everyone has these sorts of folks nearby, though, I know. Some PTs do manual therapy, too which is similar to a degree.
 

Sisterpat

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Welcome, Hokie! My Sister had both her knees replaced (months apart) and it took a full year for her swelling to go down! Don’t be anxious for “longer walks” quite yet! The tightness will also remain for quite a while. You need to be patient. Celle told you everything you need to know - it is time, not working through pain that will win the day. Hang in there.
 
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HokieGCC

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Thank you @Sisterpat and @BBCG.

This experience is indeed testing my patience and your experience and wisdom is helping me deal with it.
 
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HokieGCC

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So here is some proof Bonesmart knows what they are talking about.

On Friday at PT I hit 105 degrees with pressure and with much agony and work in the days leading up to PT. As folks noted in the thread I was overdoing it.

I was advised to take the weekend very easy. I hardly did any stretches and no PT. Well, today (Monday) they tested me again and I was doing 105 w/o assistance and hit 118 with applied pressure. I gained over 10 degrees through rest and swelling control.
 
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Sisterpat

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See, it does work to follow BoneSmart guidelines. And WHY are you allowing them to apply that pressure? That’s a no-no! It will set you back. Just say NO!
 

BBCG

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Agree with Jockette! Now you need your poor baby knee to re-heal from that assault on it by the PT pushing it!

None of the PTs like to be told no, so what I’ve learned to do is set up ground rules, AND I have learned to remind them at each visit! They grumble, but I heal faster!
 

sistersinhim

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The 105 took a lot of work.
Work isn't what gets you the good consistent numbers. Getting rid of the swelling is what lets that bend get better.
Well, today (Monday) they tested me again and I was doing 105 w/o assistance and hit 118 with applied pressure. I gained over 10 degrees through rest and swelling control.
You should never let anyone push on your leg to get better numbers. That pushing will just cause more inflammation which causes swelling. I bet you have more pain and swelling now since you had that added assistance. Numbers really don't mean a thing, it's what you can do that matters. Letting the pain and swelling go down will only improve your knee's function.
 
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HokieGCC

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Thank you @sistersinhim.

I can sure see that. It is my swelling that is limiting my leg 100%.

BTW - When I used the term "assistance" what I meant was me bending it not someone else. By without assistance I meant how much I could get by only using my leg's own power.
 
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HokieGCC

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@Sisterpat

I see I confused folks with my verbiage. By "assistance" I mean me bending it. By unassisted I mean only my leg all by itself under it's own power.
 

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