TKR L. TKR on 1/16/2025

[Prof_Mama]

Howdy Everyone!

Tomorrow is the big day. I am feeling a bit nervous, but am excited to begin the healing process and get back to an active lifestyle free of daily bone on bone pain.

I will try my best to provide regular updates during my recovery since there are not very many 32 year olds receiving joint replacement.

Hearing and reading about all of your experiences gave me such peace of mind going into surgery. I hope my recovery journey can do the same for someone else!

 

[eaglemom]

Good luck, you've got this and we're here to help you.

Take a deep breath and it will be fine. Remember ice / elevation / medication on time is your mantra for the next few days.

 

[EalingGran]

Good luck!

 

[Jockette]

Best Wishes!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Layla]

I will try my best to provide regular updates during my recovery since there are not very many 32 year olds receiving joint replacement.

Thank you for being so thoughtful. Please know that we're here for YOU, in support of your recovery and celebrating each victory with you no matter how small. I look forward to following your journey.
Wishing you only the best!

 

[Prof_Mama]

Day 1: On my way home from the hospital now. Surgeon said everything went very smoothly and that my knee was one of the worst he has ever seen, which was validating in a way, and confirms that I made the right decision for total replacement.

I had a Mako robotic assisted replacement and the Persona IQ implant. The pain is pretty intense and I am not looking forward to the next 4-5 days as those are going to be the most painful.

If you all have any tips or suggestions for me, I’m all ears! Thanks again for all of the support and info.

 

[mendogal]

Welcome home!
Tips:
Take pain meds on a schedule. If the rx is written "every ... hours as needed." Just put them on that schedule and take them, to keep the blood levels therapeutic.

Ice near constantly, or at least 45 minutes at a time, while elevating. The standard 10 - 20 minute icing session won't really address either swelling or pain.
Personally, I iced except for my prescribed short walk every hour while awake and if up for personal hygiene.

Activity: my ortho team kept telling me, in the initial weeks, Less is Better.

Sleep whenever the urge hits - don't worry about a sleep schedule for a while. Your body energy is going into repairing itself and needs rest.

 

[Jockette]

Another tip, you don’t need to do a list of exercises at this point. Doing so could increase your pain and swelling. However, you do need mobility, which just means very gentle bends, and short walks every hour or two that you are awake, like to the bathroom, or to the kitchen to get an item (not to make a meal )
This will help you have a less painful recovery, especially in the beginning.

 

[sistersinhim]

I suggest you read the articles that Jockette left for you. These are short but extremely helpful in. Doing too much too soon will cause setbacks in your healing process. Never let anyone push or pull your leg, not even you! In the next few months, PT should be gentle and concentrating on reducing swelling and pain, not creating it!

 

[Layla]

Hello and Welcome to recovery!

If you read nothing else, and I say this because it was difficult for me to concentrate long enough to absorb the articles early on, keep in mind that rest, icing and elevation are most important and following is a suggestion of what to aim for in the first and second weeks post op -

Week 1
Walks around your home - trips to the bathroom and kitchen count
Be up on your feet several times a day, without getting obsessive about it
A 5-6 minute walk every 3-4 hours is plenty and this can normally be accomplished with a trip to the bathroom or to the kitchen for a snack / drink.
Spend most of your time resting, icing and elevating

Week 2 - add this to previous instructions in Week 1
Walks around your home 3-4 times a day for about 5 minutes without getting into pain, or too fatigued.

Best Wishes for an uneventful and smooth recovery. I look forward to following your healing journey.
@Prof_Mama

 

[ouchie!]

Hope all went well. I can only reiterate what everyone has said - rest, rest and rest, elevate and ice. Walk a bit but don’t go crazy. Take your pain meds regularly. You can do the odd bit of simple PT if you feel up to it, but don’t fret about it. Wishing you well.

 

[EalingGran]

Agree with all the above.
I found my Aircast Cryocuff was a life saver. I hated opiates- made me constipated and sickly. So I gave them up fairly quickly- as I also didnt really find them as helpful as regular icing.The cool water jacket was sufficiently cold to give relief without being too icy. I used it almost all the time I wasn't walking or exercising.
I had a booklet from the hospital with exercises, which I did do ( but gently) three times/ day. I stopped if anything hurt though. I never had formal PT apart from a couple of sessions in hospital to learn how to do stairs with crutches. At about 4 weeks I got my pilates teacher to come and give me private pilates sessions once a week. She helped me to learn how to get on the floor again and get up. She absolutely never let me do anything painful and we worked together to get my knee moving freely.
I slept as much as I could and used sleep aids ( sedative antihistamine/ valerian) interspersed with some zopiclone from my GP.
I liked walking from fairly early on. I preferred it to sitting or standing. Standing was really hard for months.
If I sat I had my foot elevated on a rocking stool.
I wish now that I had recorded things more regularly and earlier. What was really hard was knowing what was normal in this recovery. There are a lot of things that are normal but don't get covered in the surgery information. Like the numb patch that everyone gets ( inevitable damage to a small sensory nerve during surgery)/ Zingers (sharp fiery pains that come when those nerve fibres regrow)/ the temperature difference between your surgical knee and the other one. This last one really freaked me out at times. I became convinced I had an infection at about 5 weeks and got my GP to do a blood test ( CRP).
This is where BoneSmart is really good. It helps you to get reassurance and separate out the signal from the noise.

 

[Prof_Mama]

Day 2: Last night was ROUGH! Woke up crying several times, but continued icing and briefly walking with my walker throughout the night.

The pain is pretty bad overall, but I am staying on top of my medications and icing/elevating as much as possible.

I don’t really have much of an appetite but have managed to get a protein shake and bowl of oatmeal down today.

As painful as everything is right now, I’m still happy that I made the decision for total replacement.

Thank you so much for all of your tips! So helpful right now.

 

[mendogal]

Sending a ((hug)) your way. It DOES get better!!!!

 

[Layla]

Aww, so sorry you were crying in pain. These early days can feel unbearable, but it won't last...that's a promise.
Hang in there and know that we're here for you.
@Prof_Mama

 

[Prof_Mama]

Day 3: Pain is becoming more manageable. I do fairly well during the day, but once 5-6pm comes around the pain becomes more acute.
I am trying to have a good balance of walking, elevating/icing and letting my leg lay flat.
Walking is much tougher than I thought. I have swelling from my hip all the way down to about mid-calf that makes it pretty tough to get around.

Still happy I went ahead with the surgery!

 

[benne68]

I do fairly well during the day, but once 5-6pm comes around the pain becomes more acute.

If your pain ramps up towards the end of the day, that's a signal that you are doing more than your new knee is ready to handle. You are still very, very early days in this recovery and there is no need to overdo the walking.

I've had both knees replaced and my surgical team was very clear that trying to do too much during the first few weeks of recovery is counter productive. In fact, my surgeon told me that my ONLY job for the first two weeks as to rest and recover.

Give yourself the grace to heal from all the trauma it's been through. There will be plenty of time to exercise once your body has begun to heal.

 

[Prof_Mama]

Thanks for the reminders

I’m really not doing much. The only walking I do is to use the restroom or to go from the living room to the bedroom, or if I’ve been laying down for more than 2 hours I do a quick little lap around my bedroom.

I am constantly icing, elevating, and letting my leg lightly lay straight on the bed. The only exercise I’ve been doing are ankle pumps.

I think the pain hitting me at that time has to do with the gap between my meds, but I will make sure to take it easy!

 

[benne68]

I think the pain hitting me at that time has to do with the gap between my meds,

That could definitely be the case! Be sure that you are taking the medication on a regular schedule. Don't wait for the pain to start because it's really hard to catch up when that happens. I found this pain chart really helpful in understanding why it's so important to stay on schedule:
The importance of managing pain after a TKR and the pain chart

 

[Prof_Mama]

Day 5: Still working on getting the swelling down and pain management. I do have some good periods throughout the day where the pain is tolerable, but as the swelling reduces it seems like I experience more bone/nerve pain.

The bruising is in full effect today! My goodness lol. Describing my leg as black and blue feels like an understatement.

Every day is a little bit better. Just have to keep on keepin’ on!