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TKR My dilemma.

Roy Gardiner

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My partner was present and is adamant that if I don't loosen my ligaments and try to straighten my knee this might be a reality
Is this person a knee surgeon? A physical therapist? No? Then their opinion, freely given, is worth what you pay for it.

only two weeks post op I wonder if I'm making the right discision
Two weeks??? Like everyone says, far too early to make any decision. Keep resting and watching telly, gentle stretching movements are all you need at this stage.
 

sistersinhim

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Your number one concern right now should not be ROM or exercises, it should be letting your knee heal! Just doing your daily activities is enough for your knee for the next few weeks. If you pull apart tissues that are trying to knit together then you just set your recovery back because they have to knit back together again. It's counter productive!
 
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Chrissyann

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I think it's the dreaded scar tissue, that frightens us to death, but I've n
I think it's fear of the dreaded scar tissue, that makes a lot of rush to get our ROM sorted. By looking at past replies, I've been assured that this is normal and it's a rarity to get complications. Thank goodness for this forum. I will take heed of your kind comment and heal my new knee.
 
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Chrissyann

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Your number one concern right now should not be ROM or exercises, it should be letting your knee heal! Just doing your daily activities is enough for your knee for the next few weeks. If you pull apart tissues that are trying to knit together then you just set your recovery back because they have to knit back together again. It's counter productive!
It's like a breath of fresh air to hear such common sense, isn't it a shame that sometimes we're pushed to far by therapists to hurt ourselves.
 

Dzina

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Hello all,

“I’ve read lots of information here from people with tkr experience, but I haven’t seen any information from the medical profession that supports their advice. There doesn’t seem to be a balance of information. How are you supposed to decide what to do?”[/Q
There are videos with medical professionals from the April joint placement awareness presentation that might address your concerns. I don’t know how to get to them from here but maybe one of the forum administrators can print you in the right direction
 

sistersinhim

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I don’t know how to get to them from here but maybe one of the forum administrators can print you in the right direction
Clink on the upper banner that says "Joint Replacement Awareness Day" and it will take you to the selection. Many videos are available for you to choose from.
 

lovetocookandsew

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Hello. I had my surgery on June 22nd, and the only time my ROM was measured the flex was 65 also. That's actually fine with me as I know that my knee, while not looking very swollen on the outside, is still quite swollen on the inside. As long as I can bend it enough by one year to do things like ride my bike, I'm a happy camper. My OS hasn't even mentioned my ROM, and doesn't measure it himself ever. He'll eyeball it at some point, but as long as it eventually moves and bends well, he's happy. I'm also not doing any formal PT, and actually turned them down when they called to schedule outpatient visits (I also cancelled the home PT visits). PT is up to you and how you want to do, or not do, it. Personally, in my experience with them, they didn't really help and actually set back my progress with all the stuff they wanted me to do to my knee before it was ready. Anyone who tries to push and/or bully you into exercises that cause more pain and swelling, needs to be removed from your care. Only you can decide how you want to allow your knee to recover. As for me, I choose to let my knee recover trauma-free. It's already been traumatized by the surgery, so I'm allowing it time to recover from the assault that is a TKR. Good luck, and listen to your knee when it comes to recovery.
 

Roy Gardiner

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I’ve been to see the surgeon, ... he says (and my partner insists) i have to do the exercise whether it’s painful or not.
They are both wrong. The surgeon should know better, your partner's opinion (unless also a doctor or physio) is, with respect, worthless.

Here is our guide to MUA: https://bonesmart.org/forum/threads/mua-manipulation-under-anaesthetic-and-adhesions.3656/



Post Edit: I am a prophet or a Ronnie Barker impersonator; here I am answering the post after next
 
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Chrissyann

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Hello all,

Ive been following the Bonesmart philosophy, I’ve rested it, iced, elevated and medicated, and it’s made me feel relaxed and I’ve not worried too much.
It’s been five weeks and I’m at 75 degrees flexion.
I’ve been to see the surgeon, however and he said I’ll need another appointment and maybe an MUA in six weeks if I’m still below 90 degrees, and he says (and my partner insists) i have to do the exercise whether it’s painful or not. I haven’t mentioned that I’ve not been doing the exercises or the physio, as it was originally suggested to keep a positive attitude and not moan & groan at the surgeon. Also he is doing my next tkr I wanted him to think I’m being cooperative(!)
Most people probably just do what the surgeon tells them to do, but some of us like to come to our own conclusions.
I’ve read lots of information here from people with tkr experience, but I haven’t seen any information from the medical profession that supports their advice. There doesn’t seem to be a balance of information. How are you supposed to decide what to do?

Thanks to all your kind advice.
 

Celle

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I’ve read lots of information here from people with tkr experience, but I haven’t seen any information from the medical profession that supports their advice. There doesn’t seem to be a balance of information. How are you supposed to decide what to do?
How about you read what my surgeon advises?

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

I’ve been to see the surgeon, however and he said I’ll need another appointment and maybe an MUA in six weeks if I’m still below 90 degrees, and he says (and my partner insists) i have to do the exercise whether it’s painful or not.
If your partner isn't an orthopaedic surgeon, and hasn't had a knee replacement himself, tell him (politely is preferable) to butt out and stop telling you what you have to do. He's not qualified to give that advice.

You are the only person who has the right to say what happens to your knee. It is your job (and yours alone) to decide for yourself how much, or how little, exercising you will do. You decide that by listening to the messages your knee gives you. The most important is this: "If it hurts, don't do it."
It's never a good idea to push through the pain. Doing that causes more harm than good.
Myth busting: no pain, no gain

As for having an MUA, you have the right to choose that, too. Your surgeon may advise, but you have the right to say that you'd like a little more time. He can't force you to have the procedure.
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

At this early stage in recovery swelling is still the most likely reason why your knee isn't bending much yet. So concentrate on trying to reduce the swelling, with lots of rest, ice and elevation, and just a little gentle exercise (like walking around the house) to keep your knee moving gently.

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
 
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Chrissyann

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29th of May I had my right knee replaced and with the help of this forum it’s working a treat. On the 20th I had my left knee replaced and I intend to follow your same excellent advice. I’d forgotten the extent of the pain and boy, does it hurt. My wound on my right leg healed quickly, however this time the wound is bleeding quite a lot, I had the dresssing changed 3 times yesterday, is this anything to worry about? I’m not having physio this time as I’m following the bonesmart ethos instead and letting time and normal exercise to help me through these next few weeks. Thank you for all your kind advice.
 

Celle

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Welcome to recovery again, @Chrissyann . This bad time will soon be over. Rest, ice, elevate, and keep taking the full dose of medication on a regular schedule.

Here is the recovery reading again, to remind you:
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.
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. Here is a week-by-week guide for Activity progression for TKRs


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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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.
 

Teecup

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Hi @Chrissyann. Congratulations on your new knee! :yes!:

I feel for you on the pain, and hope those wonderful pain meds, ice, and elevation give you the comfort you need to rest and sleep your way through these early days.

Have you notified your doc about the bleeding? If that happened to me, I'd be calling ASAP! I had both knees replaced this year and had 0 bleeding, but then my doc glued the incisions shut so I don't think my skin had a chance to bleed.

I anticipate the forum advisors will comment on your bleeding very soon. Sending healing prayers up for you now, :praying: and looking forward to following your progress!
 

Celle

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My wound on my right leg healed quickly, however this time the wound is bleeding quite a lot, I had the dresssing changed 3 times yesterday, is this anything to worry about?
Yes, I agree with Teecup. You should let your surgeon know about the bleeding.
It should start to ease off soon, but he/she does need to know.

It's not good to have to keep changing the dressing.
 
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Chrissyann

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Hello bonesmart sympathises, I had my 2nd tkr on the 20th November, even though the first few weeks where horrendous, my leg bruising and pain were bearable. Perhaps I’ve been a bit over confident this time round and done too much, as last week I’ve been in a lot of pain. It’s effected both sides of the knee and when I’m walking my hip and lower leg, I expect it’s angry that I’ve taken it for granted. I’ve not bothered with physio, my first appointment was met with the statement that your natural knees are preferable to your replacement knees and you won’t be able to this and that, I was flabbergasted as I didn’t do this knee replacement thing for fun. I’m supposed to go for strengthening exercises but I think I’ll pass on that. This morning I called the doctor for pain management and ended up with making an appointment for an X-ray, no pain relief given. I’ll take paracetamol and a meptazinol before bed. I do try to rest, ice and elevate as much as I can, but because I was doing so well expectation were made that it’s ok to get on with life. That’s where I am at the moment. It’s a pleasure to read all of your experiences, I do have a good laugh sometimes and it nice to know that I’m not alone on my journey. Best wishes everyone.
 
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Chrissyann

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can anyone else relate to my problem that I’m experiencing after a right tkr. It’s been 20 months now. the knee is stable but I have swelling on the front, top right hand side of my knee, it’s quite painful. It’s always been a bit puffy there but just recently it’s been throbbing. My left tkr was done 6 months after and I had no problems. Can anyone advise me what I can do apart from icing and elevating. Thank you Kindly.
 
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Chrissyann

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Hello, I’ve have an X-ray as suggested and this is the result.

Knee X-ray The prosthesis appears satisfactory with no plain film findings to
suggest loosening. Degenerative change on the posterior aspect of the
patella. This was sent by the X-ray department.
I have an appointment with the doctor. I’ve no idea what the implications of this result are. I was wondering if anyone had a similar diagnosis?
many thanks Christine
 

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