TKR Lolli’s RTKR

Lolli

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12/29/2022 was my big day after two postponements by my surgeon’s office. 3 countdowns later and surgery went well. I have spent my entire adult life with swelling, stiff, painful knees. Began in late teens. I haven’t been able to squat down since then. I have always wanted to know why what was the cause for such early onset of “arthritis” but there’s never been an answer. My own research had lead me to think possibly psoriatic arthritis. By the time I sought care (2017) I was 53 yrs old and was completely bone on bone in both knees. I was terrified of this surgery and recovery. But by age 58 I was ready for the plunge. I think if it had discovered BoneSmart prior to this surgery I might have gone for bilateral to get it all over with! Once you learn the BoneSmart way there’s almost no reason not to. However after my first at home PT experience(mostly ok except him wanting me to use my newly sliced quad muscle) I dove into research about recovery and found you and had my instincts confirmed: why in the world would anyone expect you to do leg lifts w a muscle that had just been medically injured??? That is insanity to me. My OB didn’t require crunches 4 days after my c-section! So we had a little talk on his second visit and I told him I’ll do nothing that makes me cry in pain. lol and it’s all been ok since then. I did 4 weeks of at home pt and have been going to outpatient for 3 weeks now. Again I informed the outpatient I won’t be doing anything that causes severe pain and they’ve also been accommodating. Thank you thank you BoneSmart!!
As of Monday my flexion is 117 (prior to surgery I was probably literally at 75/80) so I’m already thrilled with my results! My extension is another matter of course. *QUESTION*: what happens in surgery to disturb the muscles at the back of your knee? That is definitely the hardest part of recovery for me. I do the gentle stretches using gravity a few times a day but not usually for more than a few minutes because of the dull but very hard type pain it causes. I believe my extension is at a 5 as of Monday. The therapist didn’t tell me the actual number.
The biggest challenge I’ve had is the hypersensitive skin on the side of my knee and all done the front of my calf. Very painful like a severe sunburn. It has dissipated with time but I do still have it in a smaller area. Hopefully it will continue shrinking.
So that’s where I’ve been and where I’m at! Thank you so very much for all the great information and confirmation that pain is absolutely zero gain when it comes to tkr! Also thanks for sharing how important elevation is in recovery - it changed everything for me with swelling. I was not told that at all by anyone that cared for me!
 

Layla

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Welcome!
I will leave our Recovery Guidelines even though you are almost two months post op as some info will still apply. I will type more in a post below.

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.
 

Layla

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Again...Welcome Lolli!
Such a lovely post. It is nice to (virtually) meet you and read your story. I am sorry you suffered in discomfort and pain for so many years! Thankfully you came to the conclusion of what you needed to do to lose the pain and recapture life. I am happy for you! I like your analogy about the C Section and push-ups, made me chuckle, and so true. It's great to read how well you're doing and wonderful that you made some decisions about how you would recover based on what you read here. I'm glad you came out of the shadows to join us and hope you enjoy the camaraderie, support and encouragement you'll find here.
Have a wonderful Wednesday and rest of the week!
@Lolli
 
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Lolli

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I’d really like to find out if I could from anyone recovered from TKR if they remember experiencing a tightness across the knee cap and for how long. I feel it walking and I’ve just wondered if it’s normal after 10 and a half weeks post-op.
 

Jockette

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Yes, that tightness can linger for months. As you heal, it gets better!

Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue has been disturbed and is healing...and full healing takes a full year or more.
 

benne68

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I experienced tightness across the knee for months -- I noticed it walking and climbing stairs, and also when getting up after I'd been sitting for an extended period.

It did eventually disappear, although I can't tell you precisely when because I had it for so long that I had started to ignore it. One day, I suddenly realized that it wasn't there any more.

Be patient. It's normal and it does get better with time! :console2:
 

beachy

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I think most of us had/have that tightness. It will go away as time goes on. When the tightness goes away then you will get the clunking LOL
That goes away, too.
The comparison of crunches after c section is perfect. I've always said the same thing, but post hysterectomy.
My extension lagged for several months after first tkr, then it gradually went flat. Yours will, too.
I just developed back of the knee pain recently... I'm 8 1/2 weeks post op. Had it with first tkr, too. That will also go away.
Sounds like you're doing well with recovery.
It DOES get better!
 

EalingGran

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I am 20 weeks post PKR and the tightness is much much less.
There are quite long periods in the daytime when it is gone completely. But I still get it in the evening together with slight soreness. I don't have much visible swelling but I suspect the tightness is probably due to some very slight swelling in the tissues at the end of a busy day.
 
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Lolli

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Thank you everyone for all the feedback!! I appreciate it so much! So next *question*!! Has anyone else experienced the hypersensitive skin issue like I have? It was really bad in the beginning. It felt like a really severe sunburn. Which did dissipate over the first two mos. But I still deal with the sensitivity. I am wondering if it’s going to happen when I have my LTKR?
 

FourCats

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The hypersensitive skin can be an issue because of all the messing with the nerves during the surgery. I had that on the inside of my first knee with numbness on the outside. Second was exactly the opposite. The sensitivity eventually went away but I still have the numbness.
 

Layla

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I am wondering if it’s going to happen when I have my LTKR?
I hope the skin sensitivity continues to ease for you. I am wodering if you have your Left TKR scheduled yet? If so, please leave the date and we'll add it to your signature.
Happy Three Month Anniversary!
 
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Lolli

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Up until a few days ago I had decided I’d go for the second tkr in September this year. However, I’ve had a pretty big setback. This past Sunday afternoon I began having extremely sharp pains happening at the top of my kneecap while walking. The kind that takes your breathe away. This is completely new and so unexpected. And I am just devastated. The one thing I did that day was helping my husband with moving our 450lb safe. All I did was try and help the dolly under it by pushing with my right foot (the new knee). I didn’t experience any pain while doing that but about 30 min later the sharp pains began. Only while walking but they are excruciating and stop me in my tracks. I’ve stayed off my feet since then in hopes it would calm down but it’s still happening.

I’m 3 months 6 days post op and fully expected to be feeling better and better. Instead, I’m more immobile than ever. I’ve canceled PT for this week and giving it some time before I call for a dr appt w my surgeon.
I’m desperate to know if anyone has experienced this type of situation. Up until this point, it’s been an ok experience and PT has been going very well. I had even begun checking into exercise classes to continue w strengthening my legs but now I can’t even walk more than 5-10 min without the sharp pains. There’s also been no outward of damage as in new swelling etc.

Any insight I would so greatly appreciate.
 

sistersinhim

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The one thing I did that day was help my husband with moving our 450lb safe. All I did was try and help the the dolly under it by pushing with my right foot (the new knee). I didn’t experience any pain while doing that but about 30 min later the sharp pains began.
Oh boy, this really angered your knee and it will take a while for it to settle back down. You are only 1/4 of the way healed inside and your knee can easily be inflamed and setback, which is has. You are doing the correct thing by canceling PT and resting more. You can also ice and elevate for hours at a time to help reduce some of that pain and inflammation.
 
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Lolli

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Such a dumb to do. My hubs is hating on himself right now. But it’s me that shoulda known better. Ok thank you so very much for your reply and advice - will definitely do that!
 

benne68

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Yikes! I hope resting, icing and elevating will have you feeling better soon, @Lolli. Let us know.
 
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Lolli

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Yes it helped tremendously! Doing ice hadnt occurred to me because there wasn’t any visible swelling but I thought must have been inflamed and ice helped to calm it. Thank you sistersinhim!!!
 

sistersinhim

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You are very welcome. I'm so glad I could help! Ice is a great pain reliever, not just a swelling reducer.
 

Layla

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Happy Four Month Anniversary!
I hope you have a great Spring and Summer 2023!
@Lolli
 

WillB

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Such a dumb to do. My hubs is hating on himself right now. But it’s me that shoulda known better. Ok thank you so very much for your reply and advice - will definitely do that!
I’m afraid as our knee feels better, stronger and less painful we tend to want to do more. Almost thinking we’ve got it made! And then we overdo it and our knee reminds us we’re not even halfway to fully healed. I did it two weeks ago myself at 3mos+…it will be back shortly!
 

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