TKR Left TKR Oct. 2013, this is really bad

I NOPEd her again, said I’m doing fine going up 2-3 degrees a day and that was that.

Nope, your knee will be the decider of how much motion you get and how fast, and I doubt if it will be 2-3 degrees a day. Especially the last 10 degrees!

so why on earth do they insist 5-10 degrees a day on that CPM? It’s insanity. Can anyone do that?

I will say my pt's didn't ever tell me they expected a certain amount of gain. I really do think the most important thing early on is to reduce the swelling. I'm 10 weeks in and mine still has some swelling but I can see it is better than it was last week.
 
I NOPEd her again, said I’m doing fine going up 2-3 degrees a day and that was that.

Nope, your knee will be the decider of how much motion you get and how fast, and I doubt if it will be 2-3 degrees a day. Especially the last 10 degrees!

so why on earth do they insist 5-10 degrees a day on that CPM? It’s insanity. Can anyone do that?

Heck if I know. It’s lunacy. My swelling didn’t start going down until I stopped everything but 60-degree CPM, regular walking, and ADL. It seems reckless and dangerous to me to tell people to push it that hard.
 
Question: I had my staples out Tuesday, two weeks after replacement of the right knee.

The incision was covered with Steri-Strips and, as the PA suggested, I added a regular bandage over that.

There was initially a little bit of drainage and a few spots of blood, which I’m guessing came from the staple removal process.

Just today I noticed there was a nickel sized spot of blood on the Steri-Strips.

Is this something I should be concerned about 2 1/2 weeks out of surgery? It’s in the the one spot that is most stressed by bending the knee. I am on cephalexin until Tuesday. That is mostly because I am anxious about infection. The doctor was pretty confident the incision was not infected, but there was some warmth and redness he attributed to the heavy bruising and healing process.

This is not blood from the staples. It’s definitely from the incision. I just don’t know how unusual that is so Long out of surgery.

Thanks for any help!
 
Last edited by a moderator:
I think it's normal to have a little bleeding where the incision is stressed by bending. I suggest you don't bend as far until that bleeding stops. If it doesn't stop in a few days or gets worse, call your doctor.
 
Question: I had my staples out Tuesday, two weeks after replacement of the right knee.

The incision was covered with Steri-Strips and, as the PA suggested, I added a regular bandage over that.

There was initially a little bit of drainage and a few spots of blood, which I’m guessing came from the staple removal process.

Just today I noticed there was a nickel sized spot of blood on the Steri-Strips.

Is this something I should be concerned about 2 1/2 weeks out of surgery? It’s in the the onI had my staples out Tuesday, two weeks after replacement of the right knee.

The incision was covered with Steri-Strips and, as the PA suggested, I added a regular bandage over that.

There was initially a little bit of drainage and a few spots of blood, which I’m guessing came from the staple removal process.

Just today I noticed there was a nickel sized spot of blood on the Steri-Strips.

Is this something I should be concerned about 2 1/2 weeks out of surgery? It’s in the the one spot that is most stressed by bending the knee. I am on cephalexin until Tuesday. That is mostly because I am anxious about infection. The doctor was pretty confident the incision was not infected, but there was some warmth and redness he attributed to the heavy bruising and healing process.

This is not blood from the staples. It’s definitely from the incision. I just don’t know how unusual that is so Long out of surgery.

Thanks for any help!
My staples were taken out 9 days post op. They had been covered by a waterproof dressing which allowed me to shower. Once the staples came out, I had a few small spots on each knee/leg that had not scabbed over yet, and they bled a bit. The dr cleaned my incisions, put on a huge bandage and told me I couldn’t shower for at least a week until everything was scabbed over. To tell the truth, I was terrified to take the bandages off. I think I waited a week and a half at least. But everything was perfectly healed when I finally took them off. I hope the same happens for you.
 
It is within the range of normal to have a bit of blood on the bandage following staple removal. When they are removed it's possible that not all the areas of your incision were completely closed. That should begin to scab over shortly and heal just fine. The thing to watch for would be any pus or cloudy drainage. Or should you see a significant amount of drainage (meaning that you need to change bandages because of it)....then you should contact your surgeon. But from what you describe, I'd say you're just fine.
 
I’m wondering about flying post-TKR. I can’t take NSAIDs. My flight is two hours nonstop and I’ll be right at six weeks out.

Wondering if I should ask for the blood thinner I used post-surgery for prevention of clots?

In other blood news, still nickel-sized bleeding in one spot under the steristrips. Surgery three weeks ago. (Sorry for the yucky picture.)
 

Attachments

  • D97BAA3C-46CA-4F27-BDA0-E35379ECFE85.jpeg
    D97BAA3C-46CA-4F27-BDA0-E35379ECFE85.jpeg
    166 KB · Views: 243
Here’s an article from the Bonesmart Library about flying:


Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/
 
Tomorrow will be four weeks since my right TKR. I am amazed by the lack of pain in the knee itself. Still pain in the leg but improving rapidly.

I’ve been splitting my 10 mg norco into 5 mg pieces. Alternating with Tylenol 650 works pretty well with most days only needing 1 or 2 doses of norco.

I way overdid yesterday and ended up taking 20 mg total but I did A LOT and I’m fine this morning.
That foot elevation pillow that’s recommended here is AMAZING. It really really helps with the achiness that seems to start up later in the day.

And speaking of starting up, what my old doc called “start up pain,” that feeling almost like my muscles were shattering when I’d stand up after sitting for a while — it’s gone in the right leg. HALLELUJAH!

I’m at 100 degrees and going up a degree or two most days. This board with the recommendation to be gentle has been a godsend. So grateful.
So that’s that. When I get these frozen peas off my knee, on to the day.
 
Seven weeks out from right TKR and I’m ecstatic with my new knee. Wound finally healed, home PT signed off and I transferred to regular PT at a clinic nearby.

Following the excellent advice received here, I started by making him commit to no forcing. I had to say it twice and remind him later, but got through without that particular agony.

It was pretty intense for me. Much more than home PT. But it also felt great. I used to love LOVE working out, lifting weights, etc. — haven’t been able to do it in ten years. Then, OUCH. The pain hit early evening.

Still, I kept it up at home for two days. All of the exercises, sets of 10-15, three reps. And I was in so much pain. Could barely walk. Hobbling like I used to before surgery.

They are great exercises, but I’ve been essentially sitting or lying down for years and years, using crutches for the last eight.

i think It’s just too much too fast and I’m thinking I don’t really need it. I have access to a gym, start back at my pool tomorrow (running in water, my primary source of exercise over the last decade), and I can do all of the routines he showed me and more on my own, as I progress, but at a gentler pace.

Am I making excuses? Or would daily gentle exercise with an eye toward improving by adding reps, sets, or additional weight work? Right now, I have about 110 degrees on the bend — this on a knee that was 60-70 for years before surgery.

I’m not a wimp, I get that I’m way out of shape and need to improve, but going back to all day crippling pain doesn’t seem like the best plan.

Thoughts very much appreciated.
 
@LynetteCly. Your experience sounds much like mine. I am 5 weeks out from right TKR today. I also have arthritis in my left knee, both hips & shoulders.
I was on crutches 8 months before my surgery & I have some atrophied muscles now. Can't imagine years.
I am taking a 2 week break from PT right now. I had what I thought was a great session last week but it knocked me out for 4 days where, like your experience, I could barely walk. My PT is not happy with that but I think its best. I do my easier exercises on my own. My last PT session my flex was measured at 94 with him pushing a little. Last night I moved my leg back, with no help or pain, to what appeared to be 100°+ because my leg was not on a 90° angle it was bent slightly under the chair I was sitting in. Once again proof that the Bonesmart way works.
I look forward to reading about your continued progress. This site has amazing support, information & inspiration. I'm glad you found it
 
Wow, thank you so much for sharing your experience. It means a lot to me. I canceled today’s appointment because I’m just beginning to feel normal again. I think I’ll cancel Friday too and see how I can do with a more gentle approach.

It was SO discouraging to feel like I did before surgery, even in the new knee.

Four days of normalcy is a lot to lose. glad you’re taking time off.
 
Its kind of mind boggling that the accepted PT mentality is still no pain no gain. I can't tell you how many people have advised me of the importance of PT and "its hard but you have to push through it", and if you don't you will never be properly rehabilitated.
Maybe that is true for some surgeries or injuries, I don't know. But for me personally & apparently you as well, the easy dose it philosophy works better. I have so many other joint issues it really doesn't take much to set me back.
My PT is better than most. He won't automatically push me. He will ask me how i feel about trying a certain exercise & I will immediately say yes because I am so hell bent on trying to get back to life as i knew it. So i absolutely tend to be my own worst enemy.
 
Right now, I have about 110 degrees on the bend — this on a knee that was 60-70 for years before surgery.
Wow, that is a great improvement! You should be very pleased and not worried.
 
Your ROM is very good for so early in your recovery. It hasn’t even been 2 months, and this recovery takes an average of a year.

There is no reason to do painful exercises to have a good outcome.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 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: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 
Sorry admins, I couldn’t find my original thread. (Could you change my title to this?)

At six-seven weeks I was in heaven. Healing, getting active, pain vastly diminished. I took a short trip and came home in agony.

I tried to keep going with exercise and my own rehab and it was just awful. Not only my left knee was flaring, but my TKR right knee and my right hip, of all things. Never had hip pain. It was very discouraging.

It finally occurred to me that besides the increase in activity, I CHANGED MY SHOES when I flew to Kansas City.

I’d been wearing a flat on the new knee side and a 1” heel on the other before that trip. I was tired of wearing mismatched shoes and I figured it was okay.

I’m 1-1/4” taller on my right (new) knee than on the left. I adjusted to the difference wearing matching shoes but my body rebelled.

it’s early, but I’ve had a day and a half pain free. Even ran in the pool for most of an hour, then went shopping and stood without pain for over an hour.

I can hardly believe it, but wanted to share in case anyone else might be having the same problem. The pain was so bad I was thinking the implant was messed up. So happy with that.

NOT happy with some very hard quarter-sized knots at the top of my incision. They extend out about an inch on either side and are irregular and HARD. Any ideas what that could be?

thanks for reading!
 
Hi @LynetteCly
You'll notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

Here are the instructions on finding your thread, How can I find my threads and posts?

Many members bookmark their thread, so they can find it when they log on. Please will you do that?
 
It sounds to be as if your new knee has had too many changes within a short time frame - the change of PT therapy to more demanding exercises, the travel, and the change of shoes.

There is no need to do all those demanding exercises. It's not exercise that give you your ROM - it's time: Time to recover, time for swelling and pain to settle, and time to heal.
Your ROM will continue to increase as long as you keep your knee moving gently, Just your normal activities of daily living (ADLs) will do that, even without additional exercises.

Doing exercises that are too demanding, or repeated too often, will just upset your knee, keeping it swollen and painful, and slowing down your recovery.

I suggest that you stop all formal PT for a month and spend more time resting, icing and elevating your knee, to try and get it to calm down again.

AS for the lumps and bumps in your scar, those will go away, given time. Some of them are due to sutures beneath the skin surface still pulling some of your tissues tight. As those sutures dissolve, the
incision will flatten out gradually.
You don't have to do anything about it. Mother Nature has been healing wounds for a long time and she knows what she's doing.
You scar won't always look the way it does now. By the time a year has passed, it will have flattened out and turned a silvery-pink colour, much less noticeable than it is now.
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011
  • Roy Gardiner
    Staff member since February, 23, 2013

Members online

Forum statistics

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