Progress report For anyone interested:
It will be 3 weeks since my TKR on Wednesday. I have been going to PT 3x per week and taking it easy in between, other than going around the house and out a bit. I started driving last week, and successfully ran a few errands and was tired afterwards but it was fine. I started with the cane last week and now have ditched that and go without it except when I go out or need to poke the cat. I named the cane “Mjoljir” after Thor’s hammer because I am a dork.
Pain: not much. A bit sore still where my MCL is. I suspect it got strained during the surgery with all the tugging about they do. Twinges at the top of my kneecap and here and there, but not bad. I have some pain in the medial side where I assume the replacement meets the bone, it comes and goes. My doctor said he had to cut a lot of bone there, and that my surgery was the hardest he has done, it took nearly 2 hours, so I assume these little pains are from all the bone cutting he had to do to get the thing in there. The pain and grinding I used to have throughout the contact points in my knee is totally gone. I feel nothing there, so that’s good. The aching at night is improving but I still sleep intermittently. I take a little Tylenol. I ice and elevate for at least an hour a day.
Function: I can walk pretty well. I try to walk with a normal gait. At PT on Friday I did 10 minutes on the bike and some step up drills. The 2 times before I struggled with the step ups but now I could do it. Yesterday I tried just a few at home successfully. This morning I tried going up the stairs foot over foot and did 10 steps! Held on just to be careful. It wasn’t that hard. I can’t go down that way at all yet and when I have to do steps in the regular course I don’t try any of this. I am very careful.
The main problem I have is the knocking, on basically every step. It is less when I walk with intention, concentrating on controlling my gait and engaging my muscles. The knee feels loose like when I had a torn ACL/MCL but not as bad and without the pain. It also moves a bit side to side. But it also feels like though there is movement, it won’t go all the way to shifting out of joint and giving way like my ligament damaged knees did. I am told this will improve over the year as the swelling goes away and the tendons/muscles tighten around the new knee configuration. So I am not really worried but I am a little bothered and hope it does in fact tighten up. Frankly it it didn’t I could live with it. Once the swelling is less I can tell it will be better than the old knee even if it were wonky and a little unstable. I suspect that people like me who have had TKR after ligament damage might adapt a bit better because we have felt knee instability before and have had to live with some shiftiness in the knee. What I could not live with was thedegenerated bone locked up with arthritis and that is gone now.
Activity: I am doing the PT, I know that is a point of contention, but they haven’t really pushed me beyond what I could do and I feel ahead of the game by quite a bit. I have full extension and I don’t know the ROM number but good enough for the bike. In between PT days I am a lazy bum basically. I go about the house but I do almost know PT exercises at home other than a few straight leg lifts, bending a bit and the stairs like I mentioned. I try maybe one thing a day. I find a PT day on/lazy day off is working for me. On my PT day I also drive to the bank, cleaned the kitchen, a couple bathrooms and pushed the sweeper just a bit because I couldn’t stand it anymore, but on my off days I watched Netflix, read a book, and played guitar (horribly).
Mental: yes, I am completely mental. I go up and down. To misquote Alice in Wonderland I am mad as a hatter but all the best people are, aren’t we? I think it comes from a deep animal fear of having a damaged leg and not being able to keep up with the pack and defend myself. An animal with a busted bone in he knee does not survive. So I suspect the depression is existential at that level and comes from a deep place. I had the same depression with the ACL surgeries when I was 18 and 32. It was unavoidable but I did not understand it. Family did not understand it either, they think of this as “just a sports injury” that will “get back to normal”. The ACL reconstructions were never normal again and I had to adjust my life and my mind. Things just progressed slowly worse for basically my whole life until I needed TKR. What I tell myself daily now is, “this is not that.” This TKR is progressing slowly better now, for the rest of my life. But the mind plays tricks. The animal wants to run with the pack and survive. But not today. Soon enough. Fortunately my pack is 3 lazy house cats who run very little and prefer lazy off-days with Netflix and bad guitar.
I hope this info helps somebody who is going to have a TKR. FWIW....