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PKR Left PKR 9 July 2020 (Australia)

barrj46

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Underwent left PKR (referred to variously as Uni or Hemi compartment, or half knee replacement here in Australia) 9 July 2020.

Walking (shuffling) in frame on the afternoon of surgery, moved to crutches following day & some walking without crutches by day 2 post surgery. Discharged a day early on 11 July due to meeting various requirements for discharge.

Little pain other than during exercises whilst in Hospital. First night at home slept till 1:45 then off to recliner, 2nd night till 1:10 am & last night till 3pm. Last night pain level was worst to date, but perhaps only 6 from 10. Concerned however that pain levels have increased each day. Perhaps the decision to walk unaided by crutches the day prior has contributed?

After discovering this site, I today eased off the exercise & stretching & allowed time to rest, ice & recover. Pain & swelling levels allshowing improvement this afternoon. It will be interesting to see whether the reduced activity leads to lesser pain levels tomorrow.
 

Jockette

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Hi and Welcome!

I suggest you keep using a walking aid, crutches, or whatever else you like, your leg went through quite a lot of trauma during the surgery and really does need the support.

Lots of exercises are not necessary for this recovery, especially this early, even though most of us are told they are necessary.


Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.


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.

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

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.
 

Wolvesfan

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@barrj46 ... Welcome to recovery! I’m in the US, and my surgeon calls it a “uni,” too. I’m four months post op (right medial partial replacement) and doing very well; still a few random aches and some lingering stiffness, but making progress every day. Best wishes for a successful recovery!
 
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barrj46

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Thank you for the responses. I'm now one week post op & feeling a bit lost. Surgery & hospital stay was all very positive, as was the initial physical therapy in hospital. After returning home, I feel like things are going slowly backwards. My entire leg feels weaker & the effort to maintain flexion is painful (mentally as well as physically). Finding a comfortable position to sleep has become increasingly difficult & what was my saviour in the early nights home (a new recliner chair) is no longer proving comfortable.

Perhaps I'm expecting too much too soon, but as I said above, I'm feeling a bit lost as to why I seem to be going backwards & how best to proceed.
 

Sara61

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@barrj46 One week post op is such early days. You need to relax and rest and heal that poor knee.
I basically stayed lying down the 1st week, only getting up to go to the bathroom.
I did a few mandatory heel slides and whilst on the way to the bathroom a few knee bends. Also, once they remove that bandage, you will be able to bend and have better movement.
Lying down, especially as we are told to sleep on our backs, is jolly hard.
After great advice from fellow Bonesmarties, I lay gently on my side using big soft pillows as a prop and it helped enormously.
I never purchased a recliner so when I eventually moved from the bed to the sofa... I did the same.

Read the articles Jockette left for you, and try not to worry so much.
I had a total knee replacement in October last year and I am doing fine.
I did little PT... followed the advice here on BoneSmart and today I have total range of movement and a good new life and you will too.

Just try and be patient xxx
 
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barrj46

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Hello Sara, thank you for taking the time to respond & telling me of your recovery. I think part of my anxiety has been this possibly misinformed rush to obtain flexion within the first 6 weeks. It is very reassuring to hear that other peoples recoveries at lesser speeds have ended up with great flexion & range of movement.
 

Jockette

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I think part of my anxiety has been this possibly misinformed rush to obtain flexion within the first 6 weeks
There is no time limit to regaining our ROM. Mine continued to improve after my first year, and, after my second! If I’d had that confidence in the early months I wouldn’t have been so stressed. However, my surgeon and my PTs were always pushing ROM, both literally and figuratively.
 

Wolvesfan

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@barrj46 ... As others have said, don’t worry! But I know just how you feel. My surgery was only days before the quarantine in our state, so that meant no PT, a brief visit with my surgeon to get the staples out, and then lots of isolation. I was so worried about falling behind, and when I had a good day followed by two days of more pain, I was sure that something was wrong and I’d never feel fine again. I was finally able to start outpatient PT 10 weeks after my surgery. After just three gentle sessions, my ROM was 127 and extension was 0....all great....and all accomplished mostly through ADL around our house and yard, and gentle stretches/heel slides. Like Bonesmart says, as swelling goes down, ROM returns. Maybe that’s not true for everyone, but it sure happened for me. Get lots of rest, along with elevating and icing your new knee, and keep us posted on your progress!
 

Sara61

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@barrj46 In fact, it was my surgeon whom insisted that I took it easy. On asking him on departure from the hospital when I should start PT he basically said - only if you want to after the 2nd week but your knee...once swelling has gone... will work fine.

Usually here in Portugal they only insist on PT for the very elderly as they know they don't move as much at home. This way it gets them out of their homes and moving. This surgery is very different to a sports injury.

Get yourself a good book and choose a feel good movie and use plenty of ice, and elevate as much as you can xx
 
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barrj46

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Thanks once again to Wolvesfan and Sara61 for your comments. Very reassuring and eases my concerns.

Like Sara61, my surgeon's parting words were "take it easy". I've gone back and read his handouts once again and he reiterates the message on not overdoing things in the early weeks/months. Feeling quite good today after my best night's sleep to date. I was able to use a pillow under my leg and had two sleep periods of 3 hours and 2 hours and awoke feeling quite good. I didn't have the weakness in my upper thigh on rising today, perhaps also due to the pillow under my leg supporting the muscles whilst I was sleeping.

My wife is back to work today for the first time since my return home, thus my dog and I are sharing the house together. Since returning from Hospital, I'm sure the dog has sensed my injury, as he hasn't come near my left leg and today was the first day he has jumped up on the bed in the morning to greet me, which he would routinely do any other day. Amazing what animals can sense.
 
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barrj46

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Time to remove the waterproof dressing & all looks well, 8 days post op. Clearly swollen & some minor bruising, but happy with the outcome so far.
 

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Sara61

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Happy to see you had a relatively
decent nights sleep, :sleeep: one feels so much better for it.
The knee is looking good, you'll find now without the bandage you'll have far more movement, are you using a walker or crutches ?
Dogs are very sensitive to our aches, pains & injuries I have two, the youngest being a daschund who stayed glued to my side my whole recovery but so very gentle with my left knee, they give us so much company, your dog sensed that your wife had to go to work so he is now "looking after you":puppysmooze:
 
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barrj46

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I'm currently walking with one crutch if I go outside the house for a short walk, inside the house I feel fine walking without crutch apart from when I wake in the middle of the night. The knee is hot and swollen and doesn't want to cooperate for a little while, so I use one crutch to go to the family room where I ice the knee and hopefully then back to sleep.

I have replaced the waterproof bandage today, but it is to be removed permanently on Sunday. I think I may have put the new bandage on too tight as it is pulling, however I seem to be able to flex to 90 degrees far easier than before. Strange.
 

Jockette

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It’s a bit early to walk without your crutch. Your knee needs the support at this very early stage.
 

Wolvesfan

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@barrj46 I smiled when I read about your dog looking after you. Our very energetic puppy was not yet a year old when I had my surgery. When I was elevating and icing my knee, his little face would often pop up between my feet (as in attached photo) to check on me. Pups are such good medicine!
 

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Time to remove the waterproof dressing & all looks well, 8 days post op. Clearly swollen & some minor bruising, but happy with the outcome so far.
Those look great, @barrj46! Do you know what the dressing was called? If I ever to this again want to be sure to try those and not the Aquacel Ag that @Rick951 and I had that led to the adhesive burns we experienced.

Sorry you felt you were regressing earlier. Has that gotten better? Good to hear about the sleep improving. I had similar experiences a few weeks back. The swelling really hit me almost a week after surgery and with it came more intense pain and reduced ROM but it's gotten better over time. The sleep is still a struggle.

All the best as we soldier on to full recovery!
 

Rick951

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@TKAA How are your dressing burns coming along? You are several weeks ahead of me. As for mine, the affected area no longer burns when I take a shower. The best relief I have found is icing. :ice:
Hope you are recovering well!
Rick
 
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barrj46

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@barrj46 I smiled when I read about your dog looking after you. Our very energetic puppy was not yet a year old when I had my surgery. When I was elevating and icing my knee, his little face would often pop up between my feet (as in attached photo) to check on me. Pups are such good medicine!

Our little dog is doing similar. He regularly appears beside my bed or below my recliner, looking to see what is going on. He has been very understanding until now, but last night when my wife went to work, come 5 PM he was expecting his nightly walk and just couldn't understand why dad wouldn't take him out.
 

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