TKR My post-op thread

[Dearjr]

Hi all
I'm just 4 weeks out and have had success with flexion and extension so far
But what I find now is that the knee feels swollen a lot. I have started work this past week after 3 weeks and am on my feet up and down around 4 hours at a time. The swelling mostly goes down by the next morning and has not impeded my progress
Don't give up hope of a normal feeling knee I've been told it takes between 6 months to a year

 

[kmann]

Well, totally jealous though of tou just being 4 weeks oit and doing so much..ggosh I dont go back to work til12 weeks, and am scared its gonna be tough...went into Walmart today, and now am hurting!! This is a long journey!! Glad its over, but wow, really thought I would be able to do more at this stage!!

 

[PolarBear60]

You're absolutely right about how long it takes to feel normal. You must be finding a balance at work if you're recovering by the next day to do it all over again. That's an awful quick return to work. Make sure you ice, elevate and rest when you get home.

 

[Dearjr]

I try my best to ice it 20 mins on and 20 mins off for 2 or 3 times
At night I sleep with a wedge and pillow with leg up on my back but as time goes on I also go on my side
Today was actually my longest day yet 930 till 8
Tomorrow I'll let you know how it feels

 

[kmann]

Well, I guess also I have the fact that I work on my feet all day, that makes it hard, I do CT scans, so I sit for about 1-2 minutes, then back up for 20 or so, getting next patient ready...repeat all day long. Its gonna be tough, I go back at just 4 hrs a day though for 2 1/2 weeks ao that should help!!

 

[Dearjr]

That's about how I work
Up and down
I'm a pediatrician so I couldn't take off more than the 3 weeks
Woke up less swollen today but back at work got more swollen
Just really annoying feeling...not painful
But my os tells me as long as my Flexion is good don't worry about it
It is not harmful just annoying

We know it will disappear eventually ...we hope. Lol

 

[kmann]

Yep, you are up and down alot too, the medical field sees to that!! Well, none the less, glad you are recovering so well, thats great. Im getting there, reached 0 extension today, I am hoping for more flexion, at 118 now. Which is OK, but there are alot of things I would like to do that require more than 118. It will come in time I hope. I still have alot of swelling which restricts me some on flexion. Yeah, I know on here they say swelling/stiffness is pain...but not in the sense that I think of pain, I too just find it annoying, and uncomfortable...then I walk strange, and my hip gets angry with me...LOL...in time, we will be soooo glad we went through all this, I can tell that already!!!

 

[Dearjr]

The swelling will go down in time. It's a fact that I know to be true. Try to push they the stiffness to 120....and more

Do u do pool therapy too. It's good for motion too

What do you want to do that needs more Flexion?

And lastly don't worry about work...it will get swollen and then it will go down

 

[kmann]

Well just thing like sitting indian style on the floor, there is a stretch for the periform muscle that I love to do, and I have to put my ankle on the opposite knee, and Im just not quite there yet, nothing really exciting!!!LOL. I am actually going to go to a water arthritis class at the YMCA tomorrow, they offer 2 classes everyday. I am working very hard for the 120 number, I pushed really hard today to get the 118, had been 115 on Friday. It will come I hope...Thanks for all the great advice!!

 

[Dearjr]

I just want to ride a bike again and play some mild tennis
Never was able sir Indian style ...how many degrees for that?
They told me I was at 118 last week but I can't do it without pushing hard meaning it doesn't come naturally yet. I hope it will
Good luck for 120
!

 

[kmann]

Not sure exactly, but can tell ya 118 isnt enough...LOL. havent tried a road bike yet, but I can easily ride my exercise bike.

 

[Dearjr]

I started the exercise bike last week. Up to 10 mins on minimal resistance
I keep trying to envision riding a real bike again but now am still scared of falling
How about you?

 

[kmann]

Oh for sure, I have a huge fear of falling from bike. Heck sometimes I have a fear of falling just walking...LOL. I love that I am going through this in the day and age of the internet. I cant imagine not being able to come on here, and chat with others going through the same thing. Knowing that what I feel is normal is very reassuring! I love this forum!!

 

[Dearjr]

I so agree with you
My pt told me one rule with tkr was don't fall
That's my biggest fear now ....going on steps....taking a shower....tripping over something
I wonder how much can this knee take?
People go skiing in it ...don't they??

 

[CATSMUM]

@Dearjr I had a fall at 8 weeks, landed on my operated knee, thankfully, nothing damaged. I did, however, put myself back 3 weeks in my recovery and the bruising has not just disappeared. The knee is strong and can take a lot!

 

[Dearjr]

I'm glad u didn't hurt it
I guess your right
Just fall carefully...lol

 

[kmann]

@Josephine ...I am 11 weeks out, and have been experiencing significant incease in swelling, which over the last 2 weeks has began to effect my entire lower leg. Up until then, it was just my knee that would swell now it's the whole leg and much worst swelling than previously. Obviously as I get further along Im increasing my activity. But, since it now includes the lower leg should I be concerned about a DVT ? Just wondered if it was normal for the whole leg to swell. The swelling in the lower leg does subside some overnight, I wear the ice cuff on the knee all night long. I'm pretty much only icing at night now. And the more I'm up and about the worst the swelling get.

 

[Josephine]

Well, that last sentence says it all! However, I'm still going to ask you some questions!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

Can you detail it like this

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Strait leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2

 

[kmann]

1. Mostly a 3 from swelling/stiffness...occasionally up to 5

2. Oxycodone 5/325 take PRN 1 tablet at night..been using approx 3 nights a week.

3. Ice everynight with cuff all night...occasionally during the day maybe 3 times a week for an hour or so

4. Elevate at night, all night...while sleeping

5. 118/0

6. Grocery shop 1-2 x week. Cook every night...clean for maybe 1 hr per day, wash 1 load laudry per day..mowed grass today ona riding mower for 1 1/2 hrs

7. PT 2xs week
Exercise bike 5min
Heel slides for about 5 min
Straight leg raises 25 rep Quadsets 25 rep
Leg press 40lbs both legs 25. reps...20lbs TKR leg 25 reps
Hamstring curls with 5lbs wt 25 reps
Step ups 25reps, side step ups 25 reps
Balance board vertical/horizontal 2min each way
Calf stetches on angled board 3 min
Hamstring stretch...prone leg hanging off table with 5lb wt on ankle

HOME...ride exercise bike maybe 10 min 4 xs a week....thats really all...just housework etc...living

 

[Josephine]

Well the reason I left you the questions was this comment

I am 11 weeks out, and have been experiencing significant incease in swelling, which over the last 2 weeks has began to effect my entire lower leg. Up until then, it was just my knee that would swell now it's the whole leg and much worst swelling than previously. Obviously as I get further along Im increasing my activity.

Now you tell me this

Mostly a 3 from swelling/stiffness...occasionally up to 5

and you're only taking 1 oxycodone at night. Plus you have excellent ROM

Then I see this - my comments in bold

AT PT
Exercise bike 5min
Heel slides for about 5 min - solid batches of heel slides are ill advised read this Heel slides and how to do them.
Straight leg raises 25 rep - 25? That's just crazy! 5 would be plenty - better yet none at 11 weeks!
Quadsets 25 rep - 25? That's just crazy! 5 would be plenty
Leg press 40lbs both legs 25. reps...20lbs TKR leg 25 reps - don't do leg press, it's the one machine that endangers your implant
Hamstring curls with 5lbs wt 25 reps - nor this machine but because it over-stresses your hamstrings!
Step ups 25reps, side step ups 25 reps - these are stressful on your IT band
Balance board vertical/horizontal 2min each way - so is this
Calf stretches on angled board 3 min - and this
Hamstring stretch...and these
prone leg hanging off table with 5lb wt on ankle - as for this - why is she making you do this when you already have 0 extension?

HOME.
ride exercise bike maybe 10 min 4 xs a week that's good!

You may think I'm over top striking out all these exercises but the fact is I see so many members with aches and pains and swelling and all due to the excessive amounts of exercises they are expected to do. Exercises which, in my opinion, are largely unnecessary
1. at 12 weeks or more
2. when ROM is normal
3. when they are generating pain
4. or swelling

12 weeks is the time you should drop all this stuff and just get on with your normal life. You've done it, you're there and it's time you got your rewards!