TKR MAKO robotic TKR Surgery

[mendogal]

"Well by 3-6 months" is overstating most of our experiences.
The healing takes a year plus.
It's very common to start overdoing things at 4 - 6 months because we feel we *should* be healed; people then thing something is wrong. It's generally nothing a day of rest and ice won't fix.

 

[FleuveStone]

Good cautionary advice, @mendogal. Thanks from someone who often feels great at 2 months (until I don't!!!). I'll have to be mindful the coming months.

 

[mendogal]

@FleuveStone ... It's a "dangerous age" as I've learned from our many members... We are naturally challenging our evolving capabilities at the same time we mostly have slacked off on thinking "rest, elevate, ice"!

 

[benne68]

PT the day of my outpatient TKR OP ( standard these days )

Wondering where you are getting your information? Do you have a reference for this statement?

Because according to all the orthopedic resources I've searched, this approach is NOT "standard these days." In fact, it's the "old school" approach.

Recent research by the leading hospitals in orthopedic surgery (like Hospital for Special Surgery) is that for the best outcomes, the emphasis during the first two weeks should be nothing but icing and elevating, with some simple stretching and short walks around the house.

Additionally the American Physical Therapy Association's latest study concluded that PT sessions during the early days should be focused on "education, assessment and provision of equipment" rather than "traditional range of motion or strength exercise, which we're finding patients don't need."

You can certainly choose to rehab however you wish -- It's your body and your recovery. But please don't make misleading statements that will confuse/mislead others.

 

[mendogal]

Well technically I "had PT" in the Recovery Area because that's who watched me get up with my walker and walk independently to the bathroom, then up and down the hall, and "cleared me" for discharge.

 

[EalingGran]

The only physio I had was a couple of sessions before discharge. She gave me a book with exercises and just explained them. I was told not to push myself to pain and take it steady.
The main emphasis was on learning to use the crutches correctly and how to do a flight of stairs using the crutches. Good leg goes to heaven ( up first) and bad leg goes to Hell ( down first).

 

[eaglemom]

Each TKR, person, surgeon and circumstance is different. Therefore, different "guidelines" if you will, are given out. The one fact that will never change is that you can not do PT to hurry the healing processes. Healing, again varies person to person.

Just because your surgeon gives you a prescription for PT doesn't mean you have to complete it. Now, I would, however, have discussed it prior to the TKR with the surgeon. On my 3rd revision I discussed no formal PT and my surgeon was quite fine with it. He did say he would write the prescription for PT because that shows he offered it. He didn't want me doing anything except ADL's.

 

[namastebeach]

well, My rehab is normal for many surgeons these days .
PT is very much a part of daily life, as it should be .
Pain is also a part of daily life , like normal icing , or sleeping elevated , or elevating while sitting .

Motion is key to healing , as sitting long freezes up the knee . PT is definitely less painful than my normal daily pain ! My surgeon in the Seattle area is pro active . She checks in several times a week .

We use ROM tech bikes , delivered at home. A website ,with lots of daily info ,and exercises called FORCE for TKR post surgery support . Many friends who used this standard method have been active in less than 6 months . I trust my surgeon and medical professionals , Mako and my care are current and advanced in kirkland .

I start outpatient PT soon , excited . It will be week 4. I am at 100 ROM and walk a bunch daily , sleeping well . Everyone's rehab is different ! I trust my surgeon and PT ,and despite normal pain at this stage , I have been told that 6 weeks , then 3 months will show huge changes .
I was very active prior , 6 mile walks , and also PT 3 months prior , so its not new.
This surgery is challenging ! and we are here to share our different healing paths .

 

[mendogal]

You were able to take 6 mile walks on your bad knee preop?
May I ask - respectfully and genuinely curious - what functional limits convinced you it was time for surgery?

 

[namastebeach]

great question .
I was very active for years , did cortisone twice a year w surgeon for 15 years , it worked .then in February 2024 ,cortisone stopped working , my current surgeon of 6 years had warned me the time would come . MRI proved bone on bone , in both knees actually ( too much running , trail running )
She called me , we scheduled for june 6th , she told me to stay in peak condition and stay active as long as possible prior to june 6th , and to lose weight.
I did PT for 3 months prior , and walked a lot . stairs were painful prior , as was sitting long or getting up from chairs . long walks actually helped. I also did Cryo therapy at a cryo center , and iced daily prior, plus yoga every night in a large tub . it was bad few weeks prior to surgery , but still manageable .

I find motion and exercise helps me sleep and recover better . My pals are all similar in Seattle . Cant avoid the pain during recovery now , getting used to it .

 

[sistersinhim]

Some people recover fine doing your type of therapy, and others have a great recovery with doing just their ADLs. I was one of those. At 6 months, I was able to do all the things I did before my replacement, and I reached that milestone without doing any formal PT or painful exercises, just ADLs. So, there is proof that we all are different and can have different kinds of after-surgery therapy and still reach the same outcome. Personally, I go for the 'no pain-more gain' way!

 

[namastebeach]

Whats ADL ? no exercise ?

Most surgeons on the west coast and google mentions therapy, as an advanced form of healing ,to be very athletic ,in future . 3/4 months post op , not 6 months . It depends on how athletic you were prior or leaner weight .
Though total healing is one year per my surgeon . I trust medical professionals of course ,
they did my TKA surgery , They trust in PT !! rest , ice , motion , walking outside more, learning stairs ... all of it . Its a very dull rehab ! when can we take off the shrink wrap on knee to shower normally ?

 

[EalingGran]

was able to do all the things I did before my replacement, and I reached that milestone without doing any formal PT or painful exercises, just ADLs. So, there is proof that we all are different and can have different kinds of after-surgery therapy and still reach the same outcome. Personally, I go for the 'no pain-more gain' way!

Agree with @sistersinhim on this.
I have a very functional knee with 150 plus flexion. I used walking and a very gentle pilates based movement regime. I never pushed my knee to pain.
I can now walk any distance I like- regularly 10,000 steps/ day and the max I have done is 20,000 in a day; with no issues. I can kneel and look after an active toddler 2 days/ week.

Whats ADL ? no exercise ?
yes, most on this site ,seem to prefer zero therapy and push that agenda

Bonesmart doesn't push any agenda apart from helping people to learn to trust their own bodies and not being forced to do anything that causes pain.
ADL stands for activities of daily living. That varies enormously. There are some on this site who do heavy physical/ farm work/ animal care - which constitutes plenty of exercise.They don't necessarily need to do much more to overdo things.
Nobody here is saying don't exercise. Just learning to know your own body and your own needs.

 

[sistersinhim]

ADLs are activities of daily living. I took care of my house, yard, 16 cats and myself. This is natural PT and most of us doing our ADLs only ended up with great recoveries.

I trust medical professionals of course ,
they did my TKA surgery , They trust in PT !!

What about so many of the medical professionals, including orthopedic surgeons, who order gentle movements only for the first few months? Are they all wrong?

yes, most on this site ,seem to prefer zero therapy and push that agenda .

You are completely wrong about Bonesmart. We believe in gentle PT being very important and have never said to do nothing. Walking, stretching, and gentle exercise are always encouraged.

 

[namastebeach]

I dont have any medical evidence for the facts you state here . its informational per your opinions as you note. For any major issues, I always contact my surgeon and PT. There is no evidence for " gentle " exercise. maybe aggressive for you is gentle for me ? I dont know any surgeons in the seattle area or west coast who suggest mild PT and are angry about aggressive PT as my surgeon suggests . After a few weeks of aggressive PT , she said it gets easier ! I agree . Normal pain in knee is way worse than any PT !! I was told that 3 months will show great results . many do awesome fast being lean , fit prior , and following surgeons orders .