TKR Let the Recovery and Rehab begin

Semper

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I had my left knee replaced today and everything seemed to go well. The spinal was painless and I was surprised at how quickly I was awake after the surgery. I had to drink a lot of water and coffee to go to the bathroom so I could leave the surgical center; I'm sure that will catch up to me later tonight. The Dr. said everything went well and he fixed the alignment of my lower leg. He said getting my full extension will be the most difficult part (I haven't been better than 5-10 degrees in well over a decade). My hamstring and calf muscles will need a lot of stretching.
 
getting my full extension will be the most difficult part
Congrats, Semper, on being home the same day! (I was in for three days.) I had two bone on bone knees going in with terrible extension. Extension was the easist for me; almost immediately after surgery I was 100% (is that zero degrees?!). My flexion is very much a challenge. But we're all very different as I'm learning. My PT is now working on flexion in my new knee and extension in my old knee...it's crazy. I hope your recovery goes brilliantly!
 
Hi Semper :wave:
Welcome to recovery and congrats on your new knee! I'll leave the Recovery Guidelines along with best wishes for your comfort and a peaceful evening as you begin your healing journey. Stop back often to share your progress, we'll be here for support if you need us.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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

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 a 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 history before providing advice.
 
getting my full extension will be the most difficult part
Congrats, Semper, on being home the same day! (I was in for three days.)
Thank you! Yeah, I was in and out in under 5 hours...crazy! I'm very thankful for my arctic ice machine right about now; we'll see how sleep goes tonight.
I hope your recovery goes great too, Twocaledonias!
 
Last edited:
Welcome to the recovery side! Ice machines are great! Remember to stay elevated and take your pain meds regularly to stay ahead of the pain.
 
Well, it didn't take me long to over do it, and I paid for it last night. I think it was a combination of the nerve block wearing off and overdoing the exercises they recommend. I'm trying to stay on schedule with my pain meds, but last night I got behind the pain curve and won't make that mistake again. I haven't gotten much sleep yet, hoping that changes soon.

I'm icing a lot (probably about 40 minutes out of every hour) and will probably just do my short walks around the house today. The pain meds are going to be a pain...I was only given enough for 7 days at the lowest dose (and 3.5 days at the max dose).
 
I think it was a combination of the nerve block wearing off and overdoing the exercises they recommend.
You don't have to do all those recommended exercises. Your knee is an infant and should be treated with the same TLC that you would treat your newborn baby. Many surgeons don't prescribe PT until 3-4 weeks out. This allows the knee to begin its healing process. If you do too much too soon, it causes setbacks in your recovery. It's best for the first few weeks to just do your ADL, (activities of daily living), and your ankle pumps and very gentle foot slides. Never go to pain, just discomfort. If anything causes pain and/or swelling at the time or the next day or two, then your knee isn't ready for that activity. Back off of it until a few more weeks, then try it again. Your ROM will improve naturally as your knee heals and the swelling goes down. You can not force it to heal any quicker than it is going to heal, but you can set it back by doing too much too soon.
 
Simper, I am 8 days ahead of you, I too tried to cut back on the pain meds. Bad idea. I am in. PT 3 times a week but I tell them to stop when it hurts. Not being a baby but on Monday’s session I got carried away at PT and then walked a few hundred steps up and down my street. Not a good idea. Today I hurt. Take your time. This is a marathon not a sprint.
 
overdoing the exercises
Please stop exercising! You are only two days post op and you need to recover for the trauma of surgery first!

Yes, you should get up and walk around every hour or so for circulation, and doing gentle heel slides are appropriate -- but that's really all you should be doing at this early stage. Your body needs to heal -- and that takes time.

I found this chart really helpful in understanding why you can't rush this recovery:

1652123217285.png


Do keep icing and elevating. You will feel better with time.
 
Finally got some sleep last night; only 4.5 hours, but way better than the 1 hour the previous two nights. I found keeping the ice machine on all night (cool, not cold; 20 min on/10 min off)) helps with the comfort level. Finding a good position that lasts is tough. I was so tired, that my body would occasionally twitch when falling asleep, and of course that little jerk of the knee would not feel good.

I am getting around with one crutch. I feel it gives me a better gait than the walker (which I only used for one day), but still very supportive. I'm taking it pretty easy, but still getting up every hour to walk around the kitchen and living room before heading back into the bedroom. I also started to incorporate some passive electrical nerve stimulation around the knee using a TENS unit.
 
The first week is ......interesting. My first week was a blur of finding a comfortable place, position, asking for stuff, pain meds, food that i could tolerate, constipation, painful walking, blah blah blah. You're in the thick of it now. You will gradually be more comfortable.
Constant ice, elevation, pain meds will be your friend. Take the meds regularly, set your alarm. You will stay ahead of the pain . And you will eventually forget the first week.
I'm having really good days lately and you will, too.
 
Sounds very familiar... I'm pretty sure I could be the co-founder and one of the foremost members of the ODIC(overdoitclub). One thing that helped me put it all into perspective was to go and watch a TKR video of a professional up on a table hammering a prosthetic into a femur. If that turns your stomach there are clips that are digital and less graphic. Think about it this way. A TKR is an extremely traumatic and violent surgery when you take into consideration what has been done. I for one, gained a very healthy respect for the procedure and why my knee was swollen to twice the normal size. If you are are previously a active person, sitting and doing nothing seems lazy and counter productive but you need to let your body recover from that trauma. Once PT starts and you figure out what exercises work for you there will be lots of time to run with the ODIC:)

Congrats on your new joint and I wish you all the best going forward. Welcome to a new opportunity:)
 
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Thanks, Beachy...I am very ready to be past the first week! I actually got pretty much a full night of sleep last night, although it pushed out my pain med schedule by a few hours and it took about 3 or 4 hours to get caught back up (the sleep was definitely worth it though).

Axx72...I actually watched a hip and knee replacement in the OR years ago (physiology undergrad). It was crazy how brutal it was. I definitely understand why the first few weeks after surgery are so painful. I've been lifting weights for over 35 years and spent 20+ years in the Marines...me and ODIC go way back, haha. I am trying to be smart and slow about things though; I want a highly functional leg when its all said and done, and I want to avoid the big steps back as much as possible.
 
We're also a Marine family.
Pain is weakness leaving the body. The person that coined that phrase never had a knee replacement.
It's not easy to slow your roll when you've been so active for so long. But slow and steady gets you to the goal with tkr.
Hang in there.
 
Hello and Happy One Month Anniversary!
I hope you're doing well. We'd love to read about your progress if you have the time to share an update.
Wishing you all the best as you continue healing. :wave:
@Semper
 
Thank you, Layla. Last Tuesday was my 4-week follow-up visit. Everything is coming along, but still lots of ups and downs depending on how much I do. Sleep is still tough to come by, but getting better. My flexion was 110 and my extension was 5; which is great considering my extension was 12 pre-surgery and hasn't been below 10 degrees in well over a decade. The OS was very pleased. I started PT at week two and go twice a week. I do a lot of extra stuff at home though. I had a lot of atrophy prior to surgery, so I have a lot of work to do on my whole leg.
 
I have to say that with my knee revision, I am letting nature do its thing and it is working. I declined Outpatient PT ( in the US that is frowned upon “No pain, no gain”) but everyday my flexion and extension get better on their own. I am letting my knee speak and for once, I am listening. I only do what I can and I rest a lot. It has helped. Good luck on your recovery and strengthening your entire leg.
 
You're welcome, Semper. Thanks for the update!
It sounds like you're doing really well for four weeks post op and getting a nod from the surgeon is always reassuring. Even though it's been a month, it's still early days and it will only get better.
Best wishes as you continue the journey!
@Semper
 
Happy Two Month Anniversary, Semper!
I hope you're doing well in your recovery. If you stop by the forum, please let us know how it's going.
Wishing you a lovely Spring!
@Semper
 

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