Guest viewing is limited

TKR My post-op recovery...

I rented a recliner because I have never liked the look of Lazy Boys. Turns out that this particular model, which is powered by electricity, isn’t that huge and doesn't look too bad and with careful pillow placement, I can get a really decent elevation while reclining. And it propels me forward to step off safely at the touch of a button. It is a very comfortable change from the bed. After a week trying of it out, we decided to buy it. It really depends on the model.
 
@pawprint1125 .... some surgeons are really focused on keeping your leg straight after surgery to help you regain your extension. But....that position can be very uncomfortable to try and maintain all the time. Granted, you do need to do gentle bends and stretches throughout the day to gently encourage more bend and straightening. But you don't have to keep your leg straight all the time for a good recovery.

The Lounge Doctor is designed for those times when you are resting your knee and not exercising. Lying with your leg extended is actually an exercise. There are times when you need to just chill out (literally) with some ice and elevation and you don't want to always be stretching those tight muscles and ligaments. Since you're only a few weeks out from surgery, I'm going to assume that your extension hasn't reached zero yet. That's not unusual as it is more difficult to achieve than your flex (bend). but it will come. What you don't want to do is attempt anything that causes more than mild to moderate discomfort. I would think if you are trying to keep your leg straight all the time (maybe by propping your heel up on a pillow), you might be experiencing a lot of discomfort. That can cause swelling and you don't want that.

Give the Lounge Doctor a try. It won't hurt you to do so and you might just find that the comfortable angle it provides helps with your recovery. Many BoneSmarties have felt that to be true.
 
Greetings, my new best friends at BoneSmart!

So, 2 1/2 weeks after surgery, I continue to be confronted by pain in my leg. It's led to the least amount of sleep I've had since my wife and I had babies, many years ago.

I am mindful about being careful about using oxycodone. I had tried to extend the duration of time to take my next dose, starting at 3 hours to 4.5, 5, and even 6 hours, and then I started halving the amount I was taking (from 10 mg to 5 mg), and I've been left with the kind of constant, dull, aching pain that I am sure you remember.

The only other time in my life that I had surgery that led to this kind of pain was in the mid-1990's (rotator cuff surgery), when they gave pain meds out like jelly beans. Thankfully, I didn't develop an addiction - even though I had a horrendous recovery.

My question is if I should be SO concerned about limiting my pain meds, or move back to a point where I am not totally miserable, able to exercise, and generally not be a horror of a person to be around, or almost 3 weeks in - should I try to muscle my way through it?
 
@pawprint1125 you are only 2 and a half weeks/nearly 3 weeks out from surgery and if you feel like you are totally miserable and in pain you have reduced your medication to quickly and should return to a level where you can exercise and cope. Discomfort is one thing pain is another. This recovery is not a “no pain no gain “one- believe I know! It is a marathon not a sprint and it will require you to have lots of patience with your recovery. You need to be able to do your exercises and stretches to regain your range of movement, ROM. Make sure you rest, ice, compress and elevate your knee - it does help with your pain levels too.
You can try reducing your medication again in a couple of week, you will feel better able to handle it then.
Regarding sleeplessness unfortunately if you have read posts on this site you will have seen it is a very common side effect of the surgery, sometimes caused by pain, sometimes pain free. Your sleeping position in bed should be on your back, using pillows under the leg and between both legs. The lack of sleep can also be caused by a disruption to your medication schedule, if you are not taking the pills at regular intervals you can get breakthrough pain.
You shouldn’t muscle your way through your recovery, your knee has gone through a huge amount of trauma and it needs you to “baby” it for the moment. The BoneSmart recommendation regarding physio is don’t let anyone hurt you and don’t hurt yourself, it takes a gentler approach and has far better results regarding achieving ROM. I tried to muscle through and ended having a pretty big setback so now I follow the BoneSmart way and have found I am making steady progress- there are always good days and bad days but at least the good days are starting to outnumber the bad.
 
You need to properly manage your pain. There are options to do that. Lots of icing helps. Be mindful of how much exercise and activity you are attempting. At less than 3 weeks out, it shouldn't be much. You do need a bit of walking around the house for 5 minutes or so every couple of hours along with a few minutes of gentle bends and stretches. But if you're experiencing problems with pain and/or swelling, you need to minimize your activity for a while. The goal is to keep pain at low levels so your knee tissues do not remain inflamed.

I agree with Eire1 that you have most likely reduced your pain meds too much too soon. When you try and step down like that, it's usually done over a series of weeks, not a few days. Even low level pain can disrupt sleep with is counterproductive when your body is trying to heal.

Go back to taking a full dose according to your prescription instructions to get your pain under control. Once you're feeling better, be sure to ice and elevate for major portions of the day and don't worry about doing a lot of formal exercises just yet. If you feel you're ready to start extending the time on your meds, give it a try. But do the lower dose for at least a day to see if your pain levels remain low. Remember that if you are spreading out the time of your doses from 4 hours, to 5 hours, to 6 hours and more but still taking the 10mg of medication, it won't work if you then try and halve the dose on a 5 or 6 hour schedule. You should halve the pills and again start at the 4 hour schedule.
 
pawprint1125 said:
My question is if I should be SO concerned about limiting my pain meds, or move back to a point where I am not totally miserable, able to exercise, and generally not be a horror of a person to be around, or almost 3 weeks in - should I try to muscle my way through it?
Click to expand...
Take your pills Buddy. Your Drs wont let you get addicted. The law wont let you get addicted. Take them on schedule unless you just wanna be superman. You'll be off of them in no time. Better to stay ahead of the pain instead of chasing it.

Booger
 
Hi folks,

Long time no see...

Kindly let me give you an update: While my recovery has progressed, I had/have been bothered by persistent pain in the back of the knee - on standing up, walking, driving, etc. Finally saw my doc (who himself was out of the office for 2 months with his OWN knee replacement - you can't make this up), who thought that the pain was from a disc in my back. Went to a physiatrist (never heard of that before), who prescribed PT for my back. Had an MRI and other kind of test I never heard of, which confirmed that the pain was caused by an inflamed nerve.

Had a nerve-block procedure, which in fact confirmed that that was the problem. It offered me a few weeks of relief, but now I'm back to having issues. My question (and thanks for bearing with me) is if any of you have had a similar issue? What helped, and what didn't?

Have to admit it's a bit depressing when I'm wondering if I'm EVER going to get back from hobbling around to my previous life - which was filled with hiking, camping, kayaking, biking, etc. Looking for any crumbs that might help me...

And thanks, as always.

Stuart
 
All I can say is that this recovery can take an average of a year, which means even longer than that for some. Right now at 6 and a half months, where you are now is not where you will be when you are fully healed. After a tough first year, I really had a lot of improvement in my second year.

That sounds more discouraging than I intended, but it‘s really true, and you will still have lots of improvement in the future.
 
I'm sure it's frustrating to learn that a nerve/disc problem in your spine is contributing to your pain during recovery from your knee replacement.

It is possible that your gait is off and making things worse with your spine. At some point along the line, you might have walked with a limp or in an off-balance way just enough to inflame the nerve. If this is the case, unless you correct your gait, the problem may persist. Be sure and ask your therapist about this possibility. Hopefully whoever is your therapist will have had some access to gait training and know how to treat that aspect of recovery.

You might also explore an app available from one of our partners, OneStep, as an addition to your local therapy sessions. It is available to try for free at no cost for BoneSmart members and then if you want to continue with the program, the monthly cost is reduced 15%. You must sign up through our BoneSmart link to receive these promotions, though. The benefit of using OneStep is that the app has the ability to measure your gait each time you take a short walk, so you always know when you're walking correctly or not. It provides a medical-grade gait analysis that is usually not available at most therapy clinics. The OneStep therapists will work with your local therapy program to be sure you get the best of both worlds.
 
Jockette, thank you for your kind words. They were not discouraging at all. Sometimes, I think I just need to be reminded of things! I've always been an impatient sort, and this surgery, well, just tries your patience...

Jamie - I'll look into that. Have an appointment with my PT shortly and will discuss. Thanks! As always...
 
Hi folks,

About 10 months after surgery, I am having some issues and I hope you might be able to give me some guidance...

Although I picked the right surgeon, his aftercare help has been, well, pretty worthless to me.

I have good mobility, but I am having pain that is difficult to pinpoint and describe - so bear with me.

I am having pain ABOVE the knee and into the thigh muscle - almost, I'm guessing, where the knee was cemented into the bone. There is no abnormal swelling, and the knee looks like it has healed well.

My wife and I are, or were, avid hikers. While I've had to tone it down the past year, a couple of mile hike is enough for me to feel the effects for a few days afterwards. Stepping up or down, the knee feels weak and slightly painful. It's not VERY painful, but I feel it on movement up or down.

I should add that I went to PT for a long time afterwards, and am pretty diligent with exercises and activity.

In addition, to say that the knee is noisy is an understatement. Moving it up or down is like I am cracking my knuckles. My doctor seemed to believe that there was tiny little bits of scar tissue that was in, around, and under the joint. He couldn't say if it would break up and eventually be broken down, or if I'd have this noise forever. He's replaced over 5,000 knees and I thought he should probably have some opinion on the matter.

Either driving or as a passenger, my thigh above the knee just aches and it's a deep, dull, difficult to pinpoint pain. While I have other aches and pains that I'm not particularly concerned about, this just isn't improving. I admit I'm an impatient sort, eager to return to my past activities, but I just don't know if this is well, something that is tobe expected. My doctor and staff pretty much want to see me after a year for a 3 minute appointment.

I intend on finding another doctor and staff and this will take some time, but in the meantime - any thoughts on the above? Thank you in advance. I've had my share of aches, pains, and procedures in my time but I just cannot seem to get my head around this, and I'm worried that I'll be stuck like this forever.
 
Last edited:
Hi there @pawprint1125. You are not alone. I am also 10 months out and experiencing debilitating pain. I also diligently exercised until chronic pain stopped play. My surgeon has been pretty supportive. I had x rays, which showed the prosthesis looks good, and blood tests that ruled out infection. My pain is on the outside of the knee and the whole joint is swollen and five degrees warmer than my good knee. My surgeon keeps reassuring me that I will recover in time but if not, he will do a scope procedure and deal with any adhesions. Unfortunately he can’t do it while the knee is swollen. Currently I see him every three months, hoping for a reduction in swelling. Meanwhile.. in an attempt to reduce inflammation I have tried a variety of modalities including acupuncture, cold baths (my surgeon is a Wim Hof fan) massage, laser therapy and dosing with turmeric and CBD. Nothing has helped. I aced hip replacement and numerous other surgeries including breast reconstruction with no problem so nothing prepared me for this miserable outcome. I was able to manage my pre op arthritis with exercise and medication so while a positive person by nature, right now I am regretting not being able to hike, sit comfortably at a table, or play with my grandson. as you don’t have any swelling, I hope you can find a surgeon who will do an arthroscopy to see what is causing your pain. Hopefully you will find relief.
 
@pawprint1125 ... you definitely need another set of eyes (or more) to try and get to the bottom of this pain. You need to find revision surgeons as those are the specialists who will be more likely able to properly diagnose what is going on. If you need help finding someone, please let me know where you live and how far you're willing to travel to see someone.

The noise you're experiencing can come from the movement of your soft tissue over the hard implant. Usually this type of thing does resolve itself eventually. It's also possible that there could be a slight overhang of the prosthesis on the bone that is catching your soft tissue with movement. Do you have any current x-rays you could post her for us? I'm not saying this is the problem, just that it is a possibility. Your best bet is to find a couple of good revision surgeons for consultations.

One thing I would advise is not to try and push yourself with exercise or activity until you know what is causing this pain. It's not something you can "work through" with exercise. In fact, you may be causing it to continue if you do try to completely resume your normal high level of activity. Try giving yourself a good rest for at least 2 weeks with lots of gentle movements and ice. Take Tylenol or ibuprofen to keep pain and/or inflammation minimized. See if that makes any difference.
 
Vida, thank you for replying and sorry to hear of your continued difficulties. It's great that your surgeon is "on it," and I'm sure that eventually you will find a solution. I feel exactly the same way though - I was going to have a terrific outcome that would allow me to resume my activities. Problematic outcomes - well, that would happen to "other" people - not me. I didn't expect any of this.

Jamie, as always, you make a lot of sense. I haven't had an x ray in a few months, if even then (I get it mixed up with x-rays of my OTHER knee), and I'm loathe to return to my surgeon (who is THE knee replacement doctor in the humongous health care practise that is swallowing everything up in New Jersey).

I live in central New Jersey and will try to find some good names. My own GP, who I trusted implicitly for the past 25 years, recently retired, and I've been thrust into a health care system with new doctors that I don't have the same level of trust with. Any referrals, gratefully appreciated. Thanks again.
 
@pawprint1125 .... unfortunately I don't have any recommendations for central New Jersey. Would you be willing to travel to HSS in New York City? If not, if you locate some possible surgeons, post the names and I'll be happy to do some checking into them for you.
 
Thanks, Jamie. I'll look locally here, but not a real problem for me to go to NYC to HSS. If ya got someone that you can recommend, that will go a LONG way with me...
 
Here are surgeons I would recommend at HSS. I'm personally familiar with Dr. Della Valle. You might start with him in your search.

Revision surgeons (knees and hips) at Hospital for Special Surgery, New York City

Dr. Goeffrey Westrich
Dr. Russell Windsor
Dr. Seth Jerabek
Dr. Michael Cross
Dr. Michael Parks

New York City
Hospital for Special Surgery (HHS) surgeons for knee revisions:

Dr. Bostrom
Speaker at 2018 ICJR workshop on problem hips and knees
Dr DeFelice
Dr. Della Valle
Dr. Jerebek
Dr. Westrich
 
Jamie, thank you so much for this, and apologies for my tardy reply - I've been dealing with a family emergency.

This is very helpful, and the route I will take next. Thank you again!

Stuart
 
No worries. Sorry you are dealing with a family emergency on top of your knee. Update when you can and let us know how things are going.
 
You must log in or register to reply here.
Corganics CBD
Active Antimicrobial Hydrogel

Staff online

Members online

Total: 971 (members: 1, guests: 970)

Latest posts

Back
Top Bottom