TKR Left TKR December 7, 2023

[ProgressAtLast]

Had my successful operation on 7 December so one week post surgery. Had my first physio appointment at the hospital on Wednesday this week and my flexibility with my second knee is better than at this point with my first knee. Bending and straightening seems to be coming on well but the strength exercises are not as successful and do feel painful so I have started to use something to help with that. Using the ice pack regularly and so far seen to be having okay sleep. Staples are due out on 22 December.

 

[Jockette]

Bending and straightening seems to be coming on well but the strength exercises are not as successful and do feel painful so I have started to use something to help with that.

At only one week post op it is early to be doing strength exercises, especially if they cause pain. All you need at this very early stage are gentle bends and short walks, to give your knee mobility. The surgery causes a lot of trauma and and by being gentle, you will have less pain, than if you try to push the exercises. Plenty of time for them after you’ve healed a bit.

When you say you “have started to use something to help with that” does that mean you are taking pain meds before doing PT and exercises? If so, Bonesmart recommends not to do that. While it may make you feel better while doing an exercise, the medication can block an important pain signal that is telling you that you are doing more than your body is healed to do.

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.​

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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.​

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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

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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.

 

[Jockette]

I‘ve moved your post above out of the Monthly team thread as we reserve that thread for surgery date information, and so members can see who else has surgery the same month. We prefer all other comments and discussion to take place in a pre op or recovery thread, such as this one. Enjoy interacting with others who are on the same journey, here in this thread.

If you would like a different title just let us know and we’ll change it for you.

 

[ProgressAtLast]

When I say "using something to help with that" I don't mean medication I mean putting a dressing gown tie under the leg to take the strain of the lifting up of the leg. My physio did say that the strengthening was not the key thing at this time but to try the leg raises if I could buy mainly to focus on bending and straightening. I never do any exercises that cause me pain but obviously when I did the leg raises it gave me some pain so I stopped them or used something to help sort the leg.

 

[mendogal]

Hi there!
My entire ortho team was unified in telling me that in the early days "less is more."
Leg raises, regardless of the "intent" behind them, are really hard for many people in the early days and there is a much easier way to start activating the quads with less knee stress: the humble quad sets.
I found doing just a dozen at random times during the day incredibly valuable. It also helps (when activating any muscle) to lightly touch it with your fingers while doing them.

 

[ProgressAtLast]

Hi there!
My entire ortho team was unified in telling me that in the early days "less is more."
Leg raises, regardless of the "intent" behind them, are really hard for many people in the early days and there is a much easier way to start activating the quads with less knee stress: the humble quad sets.
I found doing just a dozen at random times during the day incredibly valuable. It also helps (when activating any muscle) to lightly touch it with your fingers while doing them.

Thank you. As this is my second TKR I have to say I am more relaxed about my physio this time and not as regimented and hard on myself as last time. I am just remaining a bit more active with more gentle walking and when I move around just doing 'a few' stretches and bends.

 

[sistersinhim]

It sounds like this is working well for you. Walking is a very good exercise for a new knee unless you walk too much. Be careful about that in your very early days. It is so easy to overdo and anger an infant knee!

 

[AnnYo]

@mendogal --totally agree about the leg raises! My in-home PT person was great, but the only thing that was so sad and painful were the leg raises! My leg just laid there on the bed like it wasn't even connected to the rest of me. He kept saying, "Ma'am use your core!"A couple of weeks later I could raise my leg so easily and I realized that it was TIME that had done th trick, not practice. Also agree that putting my hand on my thigh when I do quad sets is invaluable for me doing them correctly, even now at 5 weeks out.

 

[benne68]

my second TKR I have to say I am more relaxed about my physio this time and not as regimented and hard on myself as last time.

All the knowledge we gain the first time around really helps, doesn't it?

I just had my second TKR Friday, so I'm only 3 days post op. But I'm feeling so much less anxiety about the swelling and stiffness that I did with #1. It makes such a different knowingthis is temporary and that we will improve with time!

 

[ProgressAtLast]

Totally agree. I used the knowledge from the first operation to make me more relaxed about the procedure. When I had my first op and was back in bed I literally sat completely still all night scared to move so the next day when I got it off bed my knee was really painful and I was scared to put any weight on it. This time around I moved the leg when the spinal had wore off so it wasn't such a shock when I got our off bed. The main thing though is like I mentioned the physio - yes it is important and I need to sensibly bend, stretch and walk but I am in no way traumatised if I don't do it as many times or for how long I should and as long as I have iced, elevated and rested the leg I am happy. I am 11 days post op and have to have my staples out in 4 days and I feel I am ahead of the progress I made with the first knee at this point.

 

[Layla]

Happy One Month Anniversary, ProgressAtLast!
You're doing great! I will admit I chuckled when reading this -

When I had my first op and was back in bed I literally sat completely still all night scared to move so the next day when I got it off bed my knee was really painful and I was scared to put any weight on it.

I can relate! You do feel really apprehensive understanding the trauma involved in the process of joint replacement. Thankfully you felt more comfortable approaching surgery the second time around. It sounds like you're taking a relaxed slow, and easy approach and I believe it will take you far.
Best Wishes as you're healing. I hope 2024 is a great year for you and your new knees!

 

[ProgressAtLast]

Thanks for your message. Thought I was making good progress but had a bit of a backwards step the last few days. I haven't overdone exercise and the only thing that has changed is a reduction in my medication which has been gradual to ensure I don't get withdrawal symptoms.

I have no pain on bending and straightening of the knee joint itself but since yesterday on the outside of my left knee even I am in a straightened position and only in a certain angle I have a severe pain which lasts until I move the position of my knee and then it goes.

I don't think I have done anything to the knee joint itself but I am worried that I may have damaged something to the side of the knee causing the pain or was the pain always there but masked because I was on a higher dose of meds.

Has anyone else experienced this pain and is it normal or should get it checked out?

 

[Axx72]

I have experienced lateral knee pain. Do you remember a rotational movement you may have done? Standing and twisting or bending down to pick something up? A quick uncontrolled movement, fall or knee strike?

Weaning off heavy meds can, for sure, open your eyes to discomfort you did not realize was there previously. Think it was already mentioned but meds can give one the false impression that there is very little pain allowing us to do to much.

Torsional movement definitely takes longer to become comfortable and connective ligaments can become more easily strained as blood flow to them is lower and healing time is significantly longer. I found that sleeping in a static non-lineal leg position at night for a period of time can also laterally irritate my joint. Movement helps dissipate fluid buildup from sleeping too.

Everyone is going to react differently depending on pain threshold and patience. I would suggest that if your lateral knee pain is manageable treat it with (rest,ice,compression,elevation) If your pain is severe, getting a medical opinion is never a bad idea.

 

[ProgressAtLast]

Thank you for the reply.

I cannot recall any sudden twist or movement that may have caused the issue although that doesn't mean it didn't happen. The only thing that I started to do was sleeping on my side because that is so much more comfortable and I wonder, As you mentioned, that it may have put pressure on the side of the knee although I was careful to cushion the knee and I didn't put any weight on the joint either. I feel like I am clutching at straws and second guessing what it could be.

My thought is that it is the reduction in meds making me more sensitive to the pain and as it is not all the time when I am walking I am hoping it gets better. I am pretty good with pain and this pain is nowhere near as bad as I was in before he operation so I am hoping it reduces itself.

I have an appointment with the surgeon next Friday so if it still hurts then I will let him know.

Thanks again for your help

 

[sistersinhim]

You are very early in your recovery and just getting started. Having aches and pains in different places at different times is normal. While sleeping you could have moved your knee in a way that angered it. Cutting back on your pain meds could be a cause because the pain isn't masked anymore. Your OS might have had to do more work in that area, causing pain there. There could be so many reasons for that pain. Be sure to ice and elevate enough to help lower the pain. Ice is a wonderful pain reducer!

 

[MSuki]

I would give it a few days and see if it’s better. If not you might go ahead and call the surgeon and see if they can get you in early.