TKR My Recovery

JulesOA

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I had my right TKR done on November 7th as an outpatient procedure at a surgical center. I had a home nurse and home PT for the first four days, then started outpatient PT five days post-op with my regular therapist. Two weeks post-op I was back to work and driving, both out of necessity due to cost of time off (my surgeon was aware of my situation prior to surgery and was agreeable to me going back that fast).

Two days ago (four weeks post-op), I caught myself when my chair started to move as I was sitting down and tore part of my quad muscle. My surgeon checked me out and found that the prosthesis, quad tendon, and surrounding ligaments were all fine, so we were both relieved. It’s just a little set-back. The PT I did that morning will be a little more difficult for awhile as we were adding foot over foot stairs and single leg weight bearing step-ups, so I will not practice those until I see my therapist again on Monday.

I'm struggling a little with pain from a very tight hamstring (the medial branch or semimembranosus) as well as a tight IT band. Any help from those who have had similar problems would be greatly appreciated. My therapist has massaged and taped my hamstring but has not been able to release it yet.

I am hopeful for a good recovery overall, and look forward to learning a lot from all of the members here who have gone through this already and those that are on the same journey now.
Eventually, my left knee will need a TKR as well, but hopefully the HA injections I get every six months will continue to work well for that one for a long time.
 

Jockette

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Hi and Welcome!

The PT I did that morning will be a little more difficult for awhile as we were adding foot over foot stairs and single leg weight bearing step-ups, so I will not practice those until I see my therapist again on Monday.
You are doing a lot, for only 4 weeks post op, plus an injury. I suggest you cut way back on the PT, and give yourself time to heal, after this major, trauma inducing surgery. All that involves getting ready to go to work, working all day, and coming home again, is more than enough “natural PT” at this point. We tend to trust our PTs to know what’s best for our rehab, but I think yours is having you do too much. More does not equal faster healing.

I'm struggling a little with pain from a very tight hamstring (the medial branch or semimembranosus) as well as a tight IT band. Any help from those who have had similar problems would be greatly appreciated. My therapist has massaged and taped my hamstring but has not been able to release it yet.
Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue has been disturbed and is healing...and full healing takes a full year or more.
 

Jockette

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I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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. At week 4 and after you should follow this

6. Access to these pages on the website

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.
 

ski_bum

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@JulesOA
May I suggest you search on Bonesmart top right, IT Band. It is a great piece of information.

Good luck
 

sistersinhim

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caught myself when my chair started to move as I was sitting down and tore part of my quad muscle.
Do I understand that you have a torn quad muscle and still doing PT? Did an ultrasound confirm that? If so, be very careful with PT. That muscle needs to heal and not be exercised. When each of my quads was shortened when my kneecaps were removed I was in an immobilizer for 6 weeks to insure those muscles were healed.
 
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JulesOA

JulesOA

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@sistersinhim my surgeon didn’t do an ultrasound, but diagnosed a small tear in my quad muscle. He said I could continue PT exercises as long as they didn’t cause pain in that area, so I have had to back off from many of the ones that put stress on it.
 
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JulesOA

JulesOA

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My structured PT ended 10 days ago, so I have headed back to the gym to continue my therapy on my own. Big smiles on Saturday and today because I was able to pedal the recumbent bike almost like a normal person. I still am seated pretty far back, so I have a bit of time moving the seat forward before I consider myself pedaling completely normal, but I was able to pedal without leaning to the side when my knee came up.
Lots of happiness this weekend!kk
 

Layla

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Lots of happiness this weekend!
Yay! :yay: Glad you're happy.
Happy Two Month Anniversary! I hope you have a wonderful 2023. :)
 

Layla

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Happy Three Month Anniversary!
Hopefully you're doing well and life is slowly returning to normal for you. Let us now how you're progressing when you have the time. All the best!
@JulesOA
 

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