PKR MrsJW's Recovery Thread, stitches not dissolved.

[MrsJW]

Hello. I’m back from hospital and have had my pkr. I just have a few questions if anyone can help?
My op was on Wednesday afternoon, it’s Sunday now. I’m still in quite a lot of pain although I’m controlling it as best I can with medication. There’s still a lot of swelling and stiffness. It’s particularly stiff in the morning. I can get about on crutches but I can’t bend the knee much. Is that normal?
thanks.

 

[FourCats]

Pain, yes. Swelling, yes. Stiffness, yes. Normal, yes.

welcome to the other side!

 

[Celle]

Hello @MrsJW - and

I've moved your post and FourCats' response to it and started this recovery thread for you.

Please post any updates or questions about your recovery in this thread from now on.
We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts .

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle

 

[Celle]

Yes, it's normal to still have pain and for your knee to be swollen and stiff.

Even though you only had one compartment of your knee replaced, it was still major surgery and your recovery will be slower than you probably anticipated.

Try to control your pain by taking your medications on a regular schedule, so you don't end up playing catchup with the pain.

You can help your knee to gradually become less swollen if you ice and elevate it. There are articles about how to do that in these recovery guidelines:

Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, but YOU are the final judge as to the recovery approach you choose.

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.​

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. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Jockette]

The swelling and not being able to bend my knee post op was such a shock for me! All I read about partials, and what my surgeon’s office did, and did not, say, made me think this was a very easy procedure and a quick and easy recovery. I expected to be totally recovered in 2-3 months. Reality was a cruel shock.

 

[Rain Dancer]

I had a left TKR on the same day and am in the same place as you--pain, swelling, not much flexion. We will get to the other side. It does seem daunting this early in though. Ice and elevation are our friends.

 

[MrsJW]

Hello again. I have really struggled today (day 5) and my knee has been so stiff I can hardly bend it. I haven’t done my full physio, it’s just too painful and stiff. I’ve elevated and iced it and tried walking up and down the hallway several times. I’m just worried that it’s not really easing.

 

[Celle]

I’m just worried that it’s not really easing.

Give it more time and things will start to ease. This is a long recovery, more like a marathon than a sprint. Complete recovery can take as long as a full year, but you will be able to do most things long before that.

 

[Jockette]

It can be very painful that first week, take your pain medication on schedule, rest a lot, and don’t worry about the physio. All you need are some very gentle bends and the short walks you take to the bathroom and maybe to the kitchen.

 

[beesknee]

Hello again. I have really struggled today (day 5) and my knee has been so stiff I can hardly bend it. I haven’t done my full physio, it’s just too painful and stiff. I’ve elevated and iced it and tried walking up and down the hallway several times. I’m just worried that it’s not really easing.

Did your doctor play down how painful difficult your PKR would be? My doc definitely did.

I was given five or six simple isometric exercises to do the first two weeks as pain would allow before my two week checkup. At two weeks my ROM was barely 40. Once I started self guided and monitoring PT at two weeks I got ROM up to 90 in 7 days. My PT is definitely painful because I push myself very hard, but when it's done for the day I feel much better.

It is important to follow your doctor's advice on physical therapy so you can regain your independence as fast as possible. It seems some people come out of surgery worth a nice bendy knee. Others like me come out with a peg leg it takes a lot of work get it bending again.

 

[Celle]

Once I started self guided and monitoring PT at two weeks I got ROM up to 90 in 7 days. My PT is definitely painful because I push myself very hard, but when it's done for the day I feel much better.

It seems some people come out of surgery worth a nice bendy knee. Others like me come out with a peg leg it takes a lot of work get it bending again.

This method works for beesknees, but it is not the approach that BoneSmart recommends.

Gentle PT is fine, but exercises should never take you beyond moderate discomfort into pain.
Pain is a warning sign that you are trying to do more than your knee is ready for at that stage of recovery.

Painful exercises increase inflammation and swelling in an already-wounded knee - and that is counter-productive.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.

 

[Sisterpat]

Mrs JW, I definitely agree with Celle! Your flexion will gradually improve, but not if your knee is swollen which it definitely will be if you work to the point of pain. Forcing your new knee through painful exercises is not beneficial for most people and not the BoneSmart philosophy. You are so new to this and you have a new baby knee. Treat it with gentle care.

 

[kneeper]

Hello again. I have really struggled today (day 5) and my knee has been so stiff I can hardly bend it. I haven’t done my full physio, it’s just too painful and stiff. I’ve elevated and iced it and tried walking up and down the hallway several times. I’m just worried that it’s not really easing.

Your knee is just an "infant" at this stage of 5 days from surgery. It sounds like you're doing the right things. Remember that walking to the bathroom also counts as walking at this stage. Keep up the and elevation and just do gentle bending at this point. And don't forget the naps in between! Rest gives your body the chance to focus its energy on healing. You can increase the physio activities as the healing progresses.

 

[MrsJW]

Thank you all so much! I feel so much better after reading this. I’ve had a much better day today, done very gentle physio and had loads of ice and elevation. Walking has been less painful and I feel more confident getting about. I think resting yesterday was the right thing. The swelling has definitely reduced today. I’m so glad I found this forum

 

[Jockette]

Please tell us which PKR you had and we’ll add it to your signature.

 

[MrsJW]

I had a patella femoral (I didn’t realise there were different kinds) x

 

[Celle]

Your knee has three compartments, patellofemoral, medial and lateral. Any one of those can be replaced, without operating on the other compartments

If there are any signs at all of osteoarthritis in more than one compartment, a total knee replacement (TKR) should be done..

 

[MrsJW]

Definitely improving day by day (day 8 today). The swelling has reduced a lot but it’s still stiff and I’ve not got much bend in it yet. I’m a lot more mobile on the crutches but can’t stand for too long without aching. Has anyone got any tips for sleeping? I’m struggling to sleep more than 4 hours at night. I have been lying on my back which I don’t normally do because I’m worried about twisting my knee if I sleep on my side. I just can’t get comfortable. Also do I keep taking the pain medication until it runs out? I’ve been taking it like clockwork but not sure whether to start easing off?

 

[GiantFinnegan]

I don't think I was able to sleep on my side until about week 3, maybe even week 4? Before then I just felt like my knee was not stable enough and side sleeping would cause it to rotate too much. Eventually I was able to sleep with a long body pillow in between my legs. It's not in front of me, the pillow is from my crotch down past my feet. I found this easier than trying to keep 2 pillows in place, and I needed the support both in between my knees and to keep my ankle from dangling. And the body pillow kind of "cradles" my leg to keep it from moving around.

I kept taking my pain meds like clockwork for about 2-3 weeks (I'm already forgetting those early days!). Then I just started to forget when I was due - which I took as a sign to taper off the prescription meds. I still take either tylenol or Aleve on most days now, though. Occasionally I just forget, which I think is a good sign that my knee isn't reminding me!

 

[Jockette]

I was always a side sleeper until I had my partial. I became very comfortable on my back if I elevated my legs, which also helped my swelling.

Here are some helpful articles from the Recovery Guidelines we gave you. If you haven’t had a chance to read them please do, as you’ll find a lot of good information in them.

Sleep deprivation is pretty much inevitable - but what causes it?

Time and again members complain about not being able to sleep and after a while, that it gets to making them feel frustrated, despairing, depressed and even ill. I thought perhaps a short treatise on the reasons for disturbance of sleep patterns was long overdue. It won't help you to sleep but...

bonesmart.org

Elevation: Doing It the Right Way

Updated September 11, 2022 by Jamie Proper elevation is one of the best ways to help with pain and swelling following either hip or knee surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate your...

bonesmart.org