TKR LTKR July 5th 2023

[Razorback 1983]

Well I made it. The surgeon said my knee was very bad and my bones were very large but all went well. When I awoke in recovery the pain was pretty bad but after they gave me pain meds and got me to my room it eased down. The therapist came and got me up to walk and do some exercises. During this my incision started bleeding pretty bad. They were going to let me go on home but when the ultrasound was being done it started bleeding again so the doctor wanted to keep me overnight. The pain isn’t to bad but the nerve block is still working. Will see how it is tomorrow.

 

[Jockette]

Welcome to the Recover side!

Be careful doing the exercises, especially since they increase your bleeding. Some PTs give us more to do in the way of exercises than our brand new knee is ready for. There will be plenty of time for those later, after you’ve healed more. All your knee needs right now are gentle bends and short walks, to give it all the mobility it needs to help with healing. Don’t be afraid to tell them no, to any exercise you don't feel is good for you, you know your body better than they do.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Razorback 1983]

Thanks. He didn’t have me doing much. The doctor used an old scar from 42 years ago and just made it a little longer. He thinks that is why I am having some of the problems with bleeding.

 

[sistersinhim]

Many OSs don't prescribe PT for at least two weeks to give the knee's incision more time to heal. These patients recover just as well, if not better, than those that start PT right after surgery.

 

[Razorback 1983]

After the 2 hour ride home from the hospital I am extremely swollen in my thigh and severe pain. I am trying to elevate and ice but the ice increases the pain so I can only do it in short intervals. The hydrocodone want touch the pain and the oxy only lasts for a short time.

 

[Misspastor2]

The first few days are rough. I think I cursed my decision at that point but it really does get better. Listen to your body and allow it to heal. Hoping the pain and swelling get better soon!

 

[Razorback 1983]

I can handle it I just want to get to the point where the ice doesn’t cause more pain. I go to therapy this morning at 10. Maybe they can give me some pointers about the icing. Thanks for the encouragement.

 

[Flashlight]

Hi, I had to change my pain medicine from oxy to Hydromorphone on the 2nd day. Called your OS and let them know you aren't getting good relief from the Vicodin. I was also on Tylenol ES but your pain med has tylenol in it. My thigh also was very sore so I used a heating pad on my thigh area and ice on my knee. Do you have a good barrier between your skin and the ice pad? i don't know what I would have done without the ice 24/7. Don't worry about moving around too much the first couple of weeks. The most important part is getting some of that swelling down and recover from the surgery.

 

[benne68]

the ice increases the pain so I can only do it in short intervals.

If icing causes pain, you may need to use a thicker towel between your leg and the ice. As a reminder, here are BoneSmart's guidelines for the proper way to ice: Ice to control pain and swelling

 

[Razorback 1983]

Well I had my first therapy session this morning and it went well. My ROM wasn’t to good but she said we would get there to just work on getting the swelling down for now. I am icing what I can. Resting and elevating in the recliner and the swelling has came down some. I am actually sleeping a lot when the pain isn’t too bad. I am actually doing better than I thought I would at this point.

 

[Finallydone]

If you expect the worst, things will generally seem better!!! The ice is best. The better you treat your knee now, the quicker it will improve in the long run, and I find this a long run. It seems all goes smoother if I pay attention to my knees’ needs rather than my head’s wants (does that make sense?). Blessings

 

[trinket]

I can handle it I just want to get to the point where the ice doesn’t cause more pain. I go to therapy this morning at 10. Maybe they can give me some pointers about the icing. Thanks for the encouragement.

I also had problems with the icing. It didn't feel that it was helping at all and felt like it made the pain worse. Consequently, I didn't ice as much as I should have and that was probably not good in the long run. Finally, at the suggestion of the great folks here, I started to let my ice "warm up" before I used it. I let it sit about fifteen minutes before I put it on the knee. I also found that different gel packs worked differently ... some didn't seem as cold as others.

At seven months in, I'm doing great but still elevating and icing. I had a lot of swelling and just in the last couple weeks am I seeing significant improvement.

 

[Razorback 1983]

Thanks for all the advice it is greatly appreciated. I have been able to increase the time I am icing and keeping it elevated when setting. Things seem to be progressing nicely at this point. I know I will have good and bad days but I am content with the progress. So far I guess I have been blessed because I have had no problems with sleep and the pain hasn’t been terrible.

 

[benne68]

My ROM wasn’t to good but she said we would get there to just work on getting the swelling down for now.

So good to read this! Sounds like you have a therapist who understands that it is inflammation that restricts the ability to bend you knee.

Way too early to worry about ROM. Keep icing and elevating. As the swelling comes down, your ROM will naturally improve.

 

[Razorback 1983]

So far not counting the day I came home I have had very little pain and I can’t seem to keep my eyes open. I could sleep all day I think. The problem I seem to have is that I sweat profusely when just doing small things. I haven’t taken any pain pills today but still sweat. The only medicine I don’t normally take is the blood thinner but I don’t know if that will cause the sweating or not.

 

[mendogal]

So far not counting the day I came home I have had very little pain and I can’t seem to keep my eyes open. I could sleep all day I think. The problem I seem to have is that I sweat profusely when just doing small things. I haven’t taken any pain pills today but still sweat. The only medicine I don’t normally take is the blood thinner but I don’t know if that will cause the sweating or not.

Fatigue, sleepiness.... Heck yeah!!!!
Blood thinners shouldn't cause sweating. It may be an idiosyncratic reaction to the stress of surgery. My internal temperature regulation is definitely off kilter.

 

[Razorback 1983]

Besides having an excessive bleeding issue the day of surgery things haven’t been bad. Of course I have a lot of swelling but it is only causing pain when I first get up to walk and do my therapy. Things could be a whole lot worse and I am sure I will have bad days but just being 3 days since surgery I am happy.

 

[Razorback 1983]

I am having some pain and swelling in my calf today that hasn’t been there before. I am sure it is from doing the therapy or things just waking back up. It feels like the muscle is real sore or the tendons are just stretched.

 

[Layla]

Hello Razorback,
I am sorry you’re experiencing some pain. I hope you’re feeling better today.
There is swelling involved in the area after major surgery like TKR, especially in the early days / weeks of recovery. If you can trace it to a particular exercise, back off from that until you’re feeling better. Try icing and elevating the area and see if that helps.

I am only sharing this information for your awareness because you mentioned calf pain - If you experience any sudden chest pain, shortness of breath, painful breathing, chest tightness, new cough, red or discolored skin, veins that stick out, unusual pain or tenderness that is unrelated to your incision, reach out to your surgeon’s care team.

Stay adequately hydrated also. Hopefully you’re doing better today. Please let us know as time allows.
@Razorback 1983

 

[Tentcamper]

@Razorback 1983 I have major swelling and a ROM of 45. Yeah, ugly but after six weeks I am able to get around on my own. I just wanted to say take it easy. It doesn't take much to inflame everything and then you get to spend more time icing and relaxing again. Best of luck in your recovery.