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PKR My Second PKR

@bill 3/20 I'm a fellow partial but mine was over 2 years ago. I think you are expecting a bit much from your knee at this stage and certainly at five weeks out, I was not doing much at all. I understand that you want to get back to exercising but if you rush it now you are giving yourself pain and discomfort for nothing except a set back. Your knee will heal in its own time and then you can do all the things you want to do. But take it easy for now, use the cane and be safe. My surgeon told me at least a year for full recovery - it was quicker than that but at least it prepared me for a long wait. I was able to go back to the gym at four months but no elliptical trainer just walking, cycling and upper body. When I did use the elliptical, I found it very hard on my new knee and took it really slowly. It showed how big an effect this surgery has on the whole body.
 
Is there any downside to wearing a knee compression sleeve at 5 weeks out? There is nothing open on the surgical site. I was thinking it might help.
 
As long as it's a soft one and you don't wear it all the time, it can be beneficial.
 
I'm wearing a thigh high TED hose recommended by my PT. It's been great! My swelling is down and discomfort is decreased.
It supports but has enough 'give' for movement & swelling if needed.


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Just an update. I got a massage yesterday - moderate deep tissue leaving the knee alone. What a difference. I don't know if it will work for others, but it made a big difference for me. Yesterday, I only took one Norco in the middle of the night.
 
I'm so glad you have found some relief with the massage. It helps some people and it hurts some others.
 
I want a massage so badly. My massage therapist is kinda far way though. I need to wait til I can drive to go see her.
 
Re Hydrocodone: I am now 6 weeks post op and feel things are going well, but was hoping for some guidance on use of pain meds. My knee pain is generally manageable with Tylenol/Advil, although I have to be careful with Advil due to gastro issues. But, I am still in a fair amount of general pain, back, hip, ankle, and of course the knee is always there. If I take about 3 Hydrocodone 5-325 in a day (two during the day, one at night), I feel pretty good. If I don't, I can manage, but am reasonably uncomfortable. Right now, I am only taking the Hydrocodone when I can't tolerate feeling bad. I have made it for 24 hours with nothing, but at the end of that time I felt beat up. I see my OS Thursday, should I be asking for more meds?
 
Yes, I would ask for more meds for emergencies. There will be many days in the future that you don't need it. Then, there will be nights you will after busy days. He might switch you to Tramadol. It is a really good transition medicine.
 
After I had stopped taking it during the day I took a hydrocodone before bed for about 10 weeks, so I think you're fine continuing as you're going.
 
Good news! I am 7 weeks out today, and feel like I have finally turned the corner. My fatigue is pretty much gone! I can walk for several miles without limping and no cane! I have reduced narcotic pain meds to night only. As others have said, the day comes when you start to feel better. I am grateful that I followed your advice and did very little in the first 6 weeks. I don't feel like I lost a thing. Now that my body is stronger, I can focus on rehab. I still will take it slow, but I am so happy to see progress.

As some other PKR patients have noted, my surgeon led me to believe I would be right as rain in days if not just a couple of weeks. That wasn't true. Left to my own devices, I would have pushed to achieve this unrealistic, for me, expectation.
 
bill 3/20 said:
As some other PKR patients have noted, my surgeon led me to believe I would be right as rain in days if not just a couple of weeks. That wasn't true. Left to my own devices, I would have pushed to achieve this unrealistic, for me, expectation.
Click to expand...
I do wish the surgeons didn't do that! It's obvious they haven't had a knee replacement themselves.
Telling people with PKRs that they will be back to normal in a short time just sets up unrealistic expectations and leads to disappointment and feelings of failure.

While there is the occasional person who has a PKR and makes a lighting-fast recovery, the majority of us learn the hard way that recovery takes a long time. My first knee replacement was a PKR and my recovery took every bit as long as my recovery from subsequent TKRs.
 
I want to thank Bonesmart. I was very anxious after surgery and both the good advice and the ability to follow other's stories gave me guidance and strength. Like I said earlier, my initial expectations were too high.
I am now 8 weeks post op, and am making good progress. My flexion is 140, extension 0. I am walking 3 miles daily on varied terrain including trails and can climb stairs bilaterally with only minor pain. I continue to do PT once a week as my VERY long-term goal is to return to running and my PT is working on proper muscle strength and proper landing to absorb shock. I know I wont be doing marathons, but a short trail run would brighten my day. I go to the gym every other day for light weights. I am gradually the increasing the weight - gradually.
I started out pushing too hard and was in constant pain. I reduced my work outs and PT and have been very gradual in every increase. It has paid off. My knee still has slight swelling, but I ice regularly and keep my activity at a level that there is no significant increase in selling. At this point, my knee pain is very manageable. My major source of pain is in my lower back and hips. I think this is because there has been a significant change in my gait and leg alignment post surgery. I'm hoping this improves as my body gets used to my new knee.
 
You are doing really well for just 2 months! Good that you're listening to your knee and knowing what to do and what not to do! Hip and back pain is pretty common until our bodies adjusts to our different walking styles. Your body will adjust and you will start to feel much better as time goes on.
 
Oh bill, you are what I needed to hear! I am so happy with your recovery. Gives me hope. I too want to get back to running short (5k-10k) distances and trail races.
 
A question on managing exercise. How much swelling am I allowed to ignore?
I am doing well, but I do get swelling and a warm knee after exercise. For example, yesterday, I walked a total of 6 miles and did all my pt exercise including squats with a ball, shallow lunges, calf raises.... Yesterday, I felt fine. Today, my knee was mildly swollen and was warm to the touch. I followed the BS model and rested and iced today. No exercise.
My OS has a physician assistant who said don't worry about mild swelling. He said my knee may be swollen to a minor degree forever due to implant. His advice was to continue exercise if the swelling was not too painful. Today was supposed to be a gym day, but I didn't go because, swelling and heat. Is it safe to exercise with swelling and heat?
 
Bill, I think your knee is giving you a message that yesterday's exercise was too much.

It's really too early to be doing squats at all - they're very hard on a new knee - and walking 6 miles during the day was too much as well.
There's no reason why your knee should be permanently swollen. It will get used to the implant.

I wouldn't ignore any swelling, because even a small amount can impact your knee. It's only a small space inside your knee capsule, so just a little bit of swelling can jam up the works a bit.

You're not much more than 2 months into a recovery that takes a full year, so don't try to rush your progress. There's plenty of time and no deadlines you have to meet.
 
Swelling and heat mean inflammation. Inflammation comes from over use. Your knee is still a baby and needs to be treated as such. Your knee is 1/6 of the way to being healed. Give it the TLC it needs. You know what the guidelines on here are, and know they work. Doing all you are doing is going to set you back in the long run. You need patience and your knee needs time. Your knee is telling you that it's not happy with what you are doing to it.
 
Week 11 and another update. Everything is going well, but of course there are still some issues. My flexion is 145, extension 0. I am able to go to the gym every other day and do weights although still keeping the weights low. Also, doing squats with a ball, shallow walking lunges, jumps on the reformer... On the other days, I do PT at home. I am stronger every week.
My only beef is that I continue to have low back pain: while my knee still causes pain, it is manageable. But the back... I have tried chiropractic with no relief, deep-tissue massage with some relief, and have accupuncture scheduled for Friday. I had cut back on hydrocodone to 2.5 mg 3 times a day, but at that level I was at pain level 3-4 most of the time. I just kicked back up to 5 mg x 3 to see if I could break the pain cycle. This drops the pain level to 1-2. The problem is that my internist will not prescribe opioids, and so after my current supply runs out, that's it. I can't take advil, and tylenol doesn't help, so I am concerned. Without hydrocodone, my pain level shoots up to 5 +, and I just end up thinking about pain.
Pre surgery, I was a runner and when I had back pain, I could go for a long run and the pain would go away after 10 miles or so. Sadly, I can't run or walk 10 miles now. I have got my long walk up to 4 miles, but that isn't enough to relieve my back. Neither Chiro nor massage sees any problem with my back, it isn't even that tight. They agree with my surgeon that my body is just getting used to my new knee that is no longer all twisted. I have faith that at some time my body will fall in line. I just hope it happens before my meds run out.
On another subject, my dream is to be able to run, at least short distances. My Pt has been having me practice landing on the reformer, doing lunges, and a bunch of exercises to simulate landing. In a week or two, she may work with me on starting the couch to 5k program which starts with one minute of jogging followed by 4 minutes of walking. For any runners, I used to run in Asics GT2000. If I start the couch to 5k problem, I would be interested in any opinion on shoes. Should I be looking for more cushion, etc.
I have found much encouragement and strength in following the stories of all of you. Thanks for sharing your journeys.
 
Today, I ran for one mile on the treadmill. My longest run post surgery!
I had my 6-month exam yesterday. Everything looked good. My surgeon was pleased with my progress and condition, and guardedly agreed with my plans to resume running. To be clear, he doesn't advocate running, but said, if I need to do it for my mental health... He did set me up for an annual x-ray rather than the usual every 3 years. He recommended running on trails or the treadmill for the most part.
I had been running, but keeping my runs to multiple repeats of 3 minutes or less with cumulative mileage of just over a mile. I had been holding back waiting to touch bases with the doctor. In the mean time, I have been working on posture, form, strength, building a light foot strike, and keeping my weight down to minimize stress on knees.
In the past 3 months in addition to short runs, I have been doing lots of exercise including balance, building quads, glutes and abs. Weight machines, bike, squats, lunges, planks, lots of walking. I continue to ice daily, and use a compression sleeve at the gym. Also, lots of stair climbing; I live in a 14-story condo, and on days I don't go to the gym, I climb the 14 stories 5 times in addition to home exercise. I am so excited to be able to resume running even if it's only a little. I don't intend to over do. I have become very used to watching my knee for any complaints.
 
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