TKR Almost one year later

Montana

new member
Joined
Oct 11, 2019
Messages
12
Age
74
Country
United States United States
Hi, I would have posted earlier but could not figure out how! New to online communities. Having visited this site multiple times and learning very valuable information I decided I had to get online and share some of my journey. The revelation that I didn’t have to put up with an approach to physical therapy that didn’t work for me encouraged me to look outside my HMO. I was discouraged and intimidated by the Physical Therapist in the “knee group” with an aggressive one size fits all approach to rehab. Subsequently after calling private clinics and interviewing several physical therapists I found a person who works with me one on one. I felt that I needed to work with a therapist and I feel lucky to have found the support and approach that works. There are good physical therapists out there who don’t bully patients to get results.
 
@Montana
:welome: to BoneSmart, glad you joined us.

Happy to hear the information on BoneSmart was helpful to you in your search for the right PT.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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
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

6. Access these pages on the website


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.
 
I have added your surgery date to your signature, an added you to the September Sapphires recovery group, where you will be able to see your surgery buddies.
 
Last edited:
There are good physical therapists out there who don’t bully patients to get results.
You are so right. A person just has to search for them. The good therapists can be a huge help to recovering joint replacement patients. But, the bad ones can stall or even set their recovery back.
 
Today was my first visit with the surgeon-two months after my replacement. He said my X-ray looked good however my ROM is poor for being this far along. Last week my PT measured my knee and said I was at 90. I try not to be focused on the numbers but it is hard considering ROM numbers are stressed so much. The surgeon said that he wanted to do a manipulation under anesthesia and that I only had a short window in which to do it. It all seems very confusing to me. I’ve read BoneSmart’s articles on recovery of ROM and I wish I had a surgeon who subscribed to the long range view. I hate to be cynical but I couldn’t help but wonder if the rush to do the MUA is a reimbursement issue.
 
We do believe that ROM can come slowly and be fine in the end.

MUAs can be done at any time, so if you want to wait to see what your knee will do, then wait. Your surgeon can’t do it without your consent.

Here is what one of our other members reported about her ROM:
At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!) :egypdance:
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" :yes:
 
Thank you for the encouragement to accept that my knee will gain ROM slower than the average. The prospect of undergoing a procedure that requires general anesthesia and could result in a broken bone or ruptured tendon is unacceptable to me. I see positive changes in my mobility and strength that have occurred naturally over the past 8 weeks. I thought I would never give up my walker but I now walk with a cane or hiking stick(s). Slow changes and I am focusing on those positive signs that healing is happening.
 
12 weeks out from surgery date with limited (to me) ROM. I am impatient to get enough flexion to ride a stationary bike. My physical therapist encourages back and forth for 10 minutes on the bike. I’m also wanting to build my leg muscles back up. I would like to add strength training for both my legs because I feel that I have lost so much muscle strength. I basically stopped all exercise for a year year and a half before my surgery in the hopes of not exacerbating my arthritic knee. What is the BoneSmart philosophy on strength training this far out from surgery?
 
We recommend waiting at least 3-4 months before strength training. But, since you don't have your bend enough to do a bike rotation, I assume you are still pretty swollen. If you are, you still have inflammation in your knee and doing strength exercises will just aggravate an already aggravated knee. I'd suggest you get that swelling down, then concentrate on your strength building.
 
Today I walked in my neighborhood six blocks using two walking sticks. I still feel awkward and unsteady when walking but the sticks help. This was as far as I walked before my tkr. I’m hoping my balance will improve as my leg muscles become stronger. I feel I’m unusual on this forum because I am still taking Norco 5 pretty much every 6 hours. When I try to stretch the interval to 8 my knee and entire leg complain. I tolerate the norco without any side effects and it keeps me comfortable enough to live my life with this knee. I also elevate and ice daily because my knee and lower leg swell very quickly when I’m up and about. By the way, I had never used narcotics before this surgery.
 
I’m now three months and two weeks out from surgery. Today I came home from a several hour outing with a friend. My knee, calf, ankle and foot were swollen and my knee felt wrapped in a rubber tourniquet. I got the ice out and arranged the pillows to elevate all the while feeling so discouraged. Limited ROM, swelling and pain are my constant companions. I came here to vent and found two articles that seemed written for me. So grateful for this forum and the reminder that this recovery is a long one, very individual and the knee is in charge. Nevertheless, looking to the day when I have improved range of motion and mobility.
 
  • Agree
Reactions: Suz
I'm glad you know how to calm down your angry knee. This rollercoaster ride is so frustrating. But, knowing that it will get better and those dips will be higher and shorter lived as time and healing occurs!
rollercoasterexample-gif.74641
 
I’m sorry your knee is upset. When that happens after a busy time we call it joining the ODIC (Over Did It Club!) It happens to all of us.

I’m glad you found some information that helped, that’s what we’re here for.:flwrysmile:
 
I'm about 2 weeks ahead of you and even though my ROM is doing OK (based on the different activities I can accomplish) I too still have to elevate and ice regularly because my IT band and calves are slowly adjusting to the newly straight leg! I get out and walk, for about 30 minutes, but I had to take a 2 week break before the holidays, because of overdoing it!

This forum has been sooooo helpful to me also. I glad you are finding articles that help you! Be kind to yourself and take it easy. This will get better!

Have a peaceful New Year!
 
Also, I'm glad you found a great PT...I have had the best and they are very gentle and positive about everything! I started out good at the hospital and the first weeks they just did lymph massage....so I got excellent numbers with no pushing.

Then at around 8 weeks (when I returned to work full time) I just stalled. They absolutely supported me and pointed out the extra activities I was doing.... so I just have had to slow down my activity and even stopped the short walks at work to help my knee in this recovery.

I'm not real good at slowing myself down! I am just beginning to learn how to listen to my knee
:idea:
 
I saw my surgeon for a second time today. My complaint is continued pain, stiffness and limited range of motion at almost 4 months out. At my initial visit he suggested a MUA; this time he said a manipulation was off the table because at this point the risks were too great. A part of me was relieved and another part fearful that I will never achieve a good enough range of motion to do the activities I had anticipated doing with a new, good knee. He did say complete recovery takes”about a year”. He also said that one in five people don’t get the outcome they want and I may be one of those people. I feel sorry for myself now and doing the “if only” I had done this or “if only” I had done that differently my knee would be bending and I would be among the satisfied, happy 80%. Just needed to share with people who understand the physical and emotional complexities of this recovery.
 
Oh dear. I’m sure someone will post the link to all the stories of people who continued to improve, slowly but surely, month after month. You really needn’t see this as the door shutting on those things you had hoped to do with your new knee. You’ll see that there’s plenty of reason to expect better days.
 
You still have lots of healing to do. Your ROM will improve with time. Mine continued to improve after my one year check up and after my second year anniversary.

It’s way too early to think this is all you’ll get. Where you are now is not where you will end up.
 
My big fear is that I do have scar tissue in the knee. Has anyone heard of success with breaking up surgical adhesions arthroscopically? I have also been researching the Graston Technique but I dont know if it is used for internal scar tissue. A local sports chiropractor in my town uses this technique. Anybody heard of any deep tissue or myofascial or trigger point massage techniques that work to break up scar tissue?
 
I think the Graston technique is like the Chinese Gua Sha technique. It’s like scraping with the flat of a metal instrument without breaking the skin. I think it feels good, and I think it helped me gain some extension today. It could be too harsh, I guess, but it’s not supposed to be. My therapist used cupping on me today too, and it seemed helpful. Neither of these feel as bad to me as deep tissue massage. That makes my eyes water.
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011

Members online

Forum statistics

Threads
65,167
Messages
1,596,863
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom