TKR Leg Extension Concerns After 2 Months

[Charlierun]

Thanks, I really appreciate your answers, they are reassuring. I do have a question about the icing. When I do ice, I become extremely tight and inflexible in my knees and area above. I wonder if this is because I have maybe some form of Rauynauds in my hands and feet ? When I hike in the northern mountains here in Canada I have to wear heated socks ,heated mits , heated, vest, etc. in the fall. My hands are always colder , same with my feet than anyone else’s. So my question is if a person has traditionally problems with cold extremities, does the icing help or not help? I keep icing and hoping for a different outcome. I do get so cold that I have to cover numerous heavy blankets on me in order to cope with the icing. Does anyone else have this experience?

 

[EalingGran]

By the end of the day it feels like both knees above the kneecap are a lot stiffer. I know it has been explained to me that this is normal but I worry that I might be building up a lot of scar tissue

Agree with @mendogal that stiffness that builds up as the day wears on is entirely normal and not due to scar tissue building up.
That unpleasant sense of stiffness and tightness is due to the knee being a relatively small joint and even tiny amounts of fluid/ swelling making it feel tight and stiff.
I had this for months ( probably at least 7-8 months before it went completely).
It used to worry me as well despite lots of reassurance here. I have no restriction on movement now ( 150+ flexion and 0 extension) and no sign of any " scar tissue" beyond a fine white scar of the incision.

 

[EalingGran]

When I do ice, I become extremely tight and inflexible in my knees and area above. I wonder if this is because I have maybe some form of Rauynauds in my hands and feet ? When I hike in the northern mountains here in Canada I have to wear heated socks ,heated mits , heated, vest, etc. in the fall. My hands are always colder , same with my feet than anyone else’s. So my question is if a person has traditionally problems with cold extremities, does the icing help or not help

I have poor circulation probably due to mild Raynauds ( my daughter has full clinical Raynauds).
I used an Aircast Cryocuff with a cool jacket. It was cold but not like putting ice packs on my knee. I found it very soothing. I am not sure if I could have tolerated ice packs- particularly in the Winter months when my extremities do get very cold.
I think it is about finding what suits your body. You might need to balance cooling on the knee with a hot water bottle on the feet. I used to use a hot water bottle for my bad back and cold feet sometimes whilst cooling/ elevating my knee!

 

[Jockette]

If the icing bothers you that much then try stopping it for a while and see how you do without it. We’ve had at least 2 members here whose surgeons told them not to ice at all, and they recovered fine. There are no absolutes, just lots of individual recoveries.

I never liked icing. It didn’t make me feel super cold, but my leg felt so stiff afterward. Back then I hadn’t heard of any doctors who said not to ice, so I kept doing it. I may change that if I ever have to do this again.

Here’s one member’s thread:

TKR - Second Knee Replacement Done

I did well yesterday. Was at the hospital at 5:30 and went back to get the spinal at 7:27. I don’t remember anything else, don’t remember the doctor finishing the epidural. Next thing I remember, I was in recovery. I was there for about 2 hours and then to my room, My husband and...

bonesmart.org

 

[mendogal]

Just to chime in.... It's entirely possible to be very cold-sensitive OR to have chronically cold hands and feet - one without the other isn't uncommon! - without having clinical Raynaud's, which is a specific vascular disorder diagnosed based on specific pain and color changes (pale, pain, cold, tingly, numb)... I have normal temperature hands and feet that are quite cold-intolerant, while my husband's hands feel cold all the time but don't bother him at all!

I agree with my colleagues that it's worth your while experimenting with elevation + no ice and with elevation + varying degrees of cooling. Bodies are so very highly individual!!!

 

[Layla]

Happy Two Month Anniversary, Righty!
I hope you’re having a nice week so far, with blue skies and lots of Summer sunshine. A great rest of the week to you!
@Charlierun

 

[Layla]

Happy Two Month Anniversary, Lefty!
I hope those two new knees are serving you well so far.
The best is yet to come!
@Charlierun

 

[Charlierun]

Hi, I feel I am slowly making progress with my staged knee replacements( 2 weeks apart) My right knee which is 10 weeks is doing great, no issues with flexion and extension. My left ( 8 weeks) is not flexing as well, but I can walk down stairs without any problem and bike on recumbent bike. I have only been to physio twice and will go back for an appointment in another month to assess my progress. When I went to my last physio appointment a month ago my physio encouraged me to use bands for knee exercises plus bridges with knee bands. I tried them once at home and the exercises caused increased swelling behind my knee so I am not planning to do those exercise for another month.
My only swelling I have had since a month post op has been behind my knees where I have baker’s cysts. My surgeon said that will eventually go down and it is decreasing now.
My tight band feeling I have been complaining about is around each knee cap and not around the leg . The tightness is predominantly on both sides of each knee cap. The stiffness is worse in the morning , improves with movement during the day. When will that go away?
I have been walking approximately 3-4 miles 5 days a week since mid July. I am also using the stationary bike now for the last three weeks and I try to cycle around 40 minutes a time at very low resistance.
I hope it is realistic to hike 6 miles in another month with 660 feet elevation gain. Prior to TNR surgeries starting April 17 th I had been hiking for months so kept up my fitness. I used bilateral knee braces on each knee plus I had developed significant varus which was corrected by the surgery.
What would be a realistic goal in terms of hiking in September at 3 months post op?

 

[Layla]

You're brave going back for more at only two weeks post op, but one recovery rolling into the other that quickly is basically ONE recovery! Get er'done all at once!

Thankfully you're listening to your body and when you have pain or an unfavorable reaction to activity, you take it to heart.

Fluid accumulation around the surgery site is what's causing the stiffness. Per my OS, swelling can last up to a full year for some, normally easing over time. Too much strain on your healing knee can cause swelling and the resulting stiffness. Your activity feels rather ambitious. I'd be curious to see if you try cycling at a low resistance for only 30 minutes on the days you're not walking 3-4 miles if you notice a difference in the stiffness. Wondering what your surgeon has to say about hiking 6 miles with a 660 ft elevation when you're three months post op?

Best wishes as you continue the journey.
Happy Wednesday, Charlierun!
@Charlierun

 

[Jockette]

When I went to my last physio appointment a month ago my physio encouraged me to use bands for knee exercises plus bridges with knee bands. I tried them once at home and the exercises caused increased swelling behind my knee so I am not planning to do those exercise for another month.

Check out this article about rehab:

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

My tight band feeling I have been complaining about is around each knee cap and not around the leg . The tightness is predominantly on both sides of each knee cap. The stiffness is worse in the morning , improves with movement during the day. When will that go away?

Tightness is very common and can/will last for months. Overdoing the rehab can prolong it.

I have been walking approximately 3-4 miles 5 days a week since mid July. I am also using the stationary bike now for the last three weeks and I try to cycle around 40 minutes a time at very low resistance.

This is a lot for only about 2 months post op.

 

[Charlierun]

Hi , I read the BoneSmart Philosophy and am avoiding all those exercises. Some were recommended by my physio but I will not be doing them until my stiffness improves around my knee caps.
I am concerned now about my extension in my left knee which was replaced on May 31. While my flexion is good on both knees it feels like my left knee is not extending as fully as it did a few weeks ago. I am starting to worry about this even though I can walk comfortably and go up and down stairs, plus use my recumbent bike. I never measured my extension before surgery as I had no limitations in my movement ( but increasing pain) . My MRI showed advanced osteoarthritis, bone on bone, affecting all compartments. I have bakers cysts behind both knees and the left knee is the larger of the two. This continues to be where any swelling occurs but that had decreased the last two weeks.
Why would my extension worsen after two months? What exercise is best to improve this?
Also could my heading of my post be changed to : Leg extension concerns after 2 months post staged bilateral knee replacement?

 

[Jockette]

Two months, give or take a week or so, is still very early in this year long recovery. Progress is not always a straight line forward. We call this recovery a roller coaster, with lots of ups and downs.

Swelling plays a big part in the ROM number. Swelling varies from day to day, so likewise, the ROM number will also vary. This is normal. Add in baker cysts, and that is another factor.

I can walk comfortably and go up and down stairs, plus use my recumbent bike.

These are excellent milestones so early in recovery.

Try not to worry about your extension. Where you are now is not where you will end up.

Also could my heading of my post be changed to : Leg extension concerns after 2 months post staged bilateral knee replacement?

How about we just use Leg Extension Concerns After 2 Months, to keep it shorter?

 

[Layla]

The ups and downs of recovery.

Hang in there, Charlierun. You're recovering from two major surgeries only two weeks apart. I say you're a brave woman, doing very well. Happy Three Month Anniversary, Righty!
Have a great Sunday.
@Charlierun

 

[Layla]

Happy Three Months, Lefty!
I hope you're having a good week. Enjoy the weekend!
@Charlierun

 

[Charlierun]

Hi , I thought I would send an update on my progress at 5 months post op staged bilateral knee replacement. I have made excellent progress after steadily increasing my activity level after three months. I am able to bike on my stationary bike for an hour and having increased the effort slowly. I’m excited to be back hiking as I can go approximately 7 miles with up to 1312 feet elevation comfortably now. I am pain-free while I exercise now, but I do feel stiffness and some soreness at bedtime. My ROM has also really improved with no longer any concern about my leg extension on my left leg. I make a point to exercise every day which is what I was accustomed to prior to my knees becoming really arthritic. I’ve had to give up running because I had total knee replacements instead of partials, but I’m OK with that. I had met two other ladies having surgery on the same day with the same surgeon as myself and they are doing just as well as I am. I attribute are successful outcomes to the Mako robotic system and the excellent post op rehab exercises we were given.

 

[EalingGran]

Great report- glad to hear your update!

 

[Layla]

Thanks for stopping by to share such a positive and inspirational update. I can't imagine the challenge of recovering from two TKR's that took place within only two weeks. You're a brave one! May it only get better.
Enjoy the weekend and the remainder of the Autumn season.
@Charlierun