TKR Less swelling more knee buckling

[SoCal]

I am approaching 5 weeks LTKR post-op. I have been using a cane and walking has been good. Still on Norco 5/325 (2 every 6 hrs) for the pain/swelling. Started outpatient PT last week (3xwk) and have been getting great movement. I have been focused on rest, elevate and ice faithfully and doing my exercises 2-3 times per day. Today the swelling seems to have gone down and I am able to get more movement in the knee/bending. But, along with these steps forward I have had my knee buckle on me 6-7 times. I have tried walking slower, but nothing seems to help. It is so frustrating because I felt that my walking was going very well. I was praying for the swelling to start going down and now that it seems to be doing that I am fearful of walking due to the buckling.

Has anyone else had this happen? What did you do to stop it from happening? Specific exercises? I have the fear that something is wrong with the implant or ??

 

[Campervan]

Hi, does your knee still feel strong when it buckles? I had something similar and its all down to weak quad muscles. I had it from around week 2 and it still does it occasionally at 10 months but I have quad lag (which means I can't get my leg straight) and so expect weak quads.

 

[SoCal]

I am sure my quad muscles are not as strong as they should be. I am at 105 flexion and my leg is almost straight and this is what concerns me. When the knee buckled a few times over the first 4.5 weeks I just chocked it up to muscle weakness. Yesterday's multiple times buckling is what freaked me out a wee bit. I wish you continued success in straightening that leg. Hope at 10 months you have made great progress. Thanks for responding.

 

[Celle]

Hi SoCal,
I wonder if the swelling had been supporting your knee a little bit, and now that it's gone, the support is all up to your muscles? Perhaps you need to talk to your OS about it.

Meanwhile, as a safety measure, would you consider going back to walking with two sticks or two crutches? i know that sounds like a backward move, but it will give you more security until things settle down.

I wish you all the best.
Celle

 

[SoCal]

Celle - II used a walker upon departure from the hospital and for the first 3 weeks. Your suggestion may be what I should do, return to using the walker until my muscles are stronger. I do think the swelling was supporting the knee. I hoped for less swelling since I had been doing so well with the cane and now I feel like two steps backward. The walker would certainly give me more security and falling is a very big fear.

Thanks!

 

[Josephine]

Well, don't panic about it, SoCal. It will remedy itself in time. And Celle didn't suggest a walker but crutches or walking sticks. And I agree with her. If you lack confidence, you need an "assistive device" until your confidence improves. With time it will do just that.

But whatever you do, don't start thinking that because your quads are weak or out of condition the answer is to embark on some strength training. Some simple exercises may be all you need and you can find them hereSome suggestions for home physio (PT) and activity progress. Remember that your quads are out of condition because they have been injured so go easy on them for several weeks - remember that 5 weeks out is still in the very, very early stages of recovery.

 

[SoCal]

Josephine - thanks for the information/advice and the link to exercises. I have been doing all of those exercises in the past 3 weeks and I will continue doing them, increasing my reps over time. I will continue to move forward to build my confidence with walking. I really appreciate the response. I have learned so much from reading the threads on BoneSmart. Everyone has a similar yet different journey.

Again, thank you!

 

[Josephine]

 

[1ELISEA]

Hi SoCal
Hope you are continuing to improve. Sometimes it does take time to gain that confidence in walking. I found I had some bad walking habits from so many years of favoring one knee (i.e. limping, bad gait).

I literally had to repeat in my head when I walked post op, the mantra given to me by PT, describing where on my foot to step down first, keep head up, stomach and glut muscles tightened, etc.

It took awhile to learn new walking habits and make them second nature for my new walk.

 

[skigirl]

Great, you are on the right path---buckling is frequently caused by weak quads and hamstrings.