PKR My Second PKR

[Jennszoo]

Great update!

 

[sistersinhim]

You are sure a busy man. It sounds like you have your life back.

 

[bill 3/20]

I celebrated my 7 month anniversary with a 3 mile run on the waterfront.

 

[bill 3/20]

I wanted to change my title to “What is pain free?,” but couldn’t.
I am fairly happy with my new knee, but am not pain free. I have a good level of function, but I become sore and stiff and need to take 2 or 3 days off if I kneel very much (we just did spring cleaning and I am stiff), lift anything heavy (we moved furniture), run fast or far, or push too hard in the gym. I’m thinking this is as good as it gets. Is anyone back to 100%?

 

[Jockette]

The fact that you’re fairly happy and have a good level of function is good. Maybe with more time you’ll be more pain free. Some knees, especially mine, take longer than others to get to that point.

It’s good to hear from you.

We’ll change your title for you.

 

[Celle]

100% of what you had when your natural knee was young is probably not achievable. However, your knee is so much better now than it was before your surgery.
Remember that you now have two large foreign bodies made of metal inside your knee and make a few allowances for that.

MY TKR knees, now 3 and 6 years old, occasionally give me a twinge of pain if I twist them in a way they don't like. Otherwise, I don't have any pain. I allow them that little bit, because they are so good the rest of the time.

It does sound as if you overstressed your knee, but, given some additional rest, it will come right again.

 

[bill 3/20]

Celle, Are there times when your knees feel completely normal so you can’t feel the implants?

 

[Celle]

Most of the time, my knees feel so normal that I forget I have implants. I get quite a shock when I see those big bits of metal on my X-Rays.

Most days, I don't even think about my knees.
The time will come when that happens to you, too. It takes a while, but it does happen.

 

[SuperSnapper]

I have a partial medial. It’s over 3 and a half years old now and feels just like my own knee. I still have a large numb patch but that’s fine. It took about 9 months for complete recovery to the point where I forgot about it. Now I rarely think about my new knee. You are able to do so much with yours.

 

[kneeper]

Kneeling is hard for a lot of us. I only do it when absolutely necessary.

 

[bill 3/20]

Please change my thread name to My 2nd PKR
I had a medial PKR on my left knee on 7/9/19, a little more than 2 years after I had the PKR on the right knee. This was also a Makoplasty Stryker replacement. Surgery went well and I went home the following morning with just a cane. I’m almost 2 weeks out and can walk around the house with just a cane. I use the cane outside just because. My PT says I have full extension and my flexion is 115 degrees.
I was resolved to have an easier recovery this time by not pushing so hard, but it’s too early to know if backing off will make things better for me. Being only 2 weeks out, I am still dealing with more pain than I like. I can manage days with Tylenol/Advil, but nights are not pleasant. Pain is keeping me awake. I am taking meds, but I can’t stay ahead of the pain at night with restrictive approach to opiates. I see my surgeon next Wednesday, 7/24. I hope to get more oxycodone, but am not optimistic. I had lots of general pain after surgery last time through, so I will try to make my case.
So, here I am again.

 

[Celle]

I've changed your thread title and added your second PKR to your signature, Bill.

 

[Jockette]

Hi, Bill, Welcome back. Best wishes for a great recovery. Your ROM is amazing for only 2 weeks post op.

How does your first PKR feel 2+ years out?

Here’s a refresher course for you, following these guidelines will help you have a less painful recovery.

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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.

 

[bill 3/20]

Hey, Jockette, thanks for the note. The right knee functions pretty well. I wouldn’t go so far as to say it’s like the original. It tends to ache at night and I have to be careful about laying one leg over the other. I can pretty much do what I want, but it’s slightly stiffer and never feels perfect. My left leg was getting progressively worse, so it was time.

 

[Rockgirl4]

Hi Bill. I'm glad you're doing so well this time around, and I hope the surgeon is kind with the pain meds. I was lucky and have a surgeon who would prescribe Oxycodone even at 8 wks post-op, though I didn't really need it except the occasional bedtime pill.

Congrats on the other knee holding up so well too. I am jealous of your running and am glad you can still do many of the things you love. Best of luck to you.

 

[bill 3/20]

Almost 4 week update. Nothing significant to report. I was hoping that knee number 2 would be easier because of experience and all that, but not so. My knee is progressing like last time which is good, and I am only doing minimal PT. Cutting back on PT has not slowed my recovery at all.
My major complaint has been the new medication situation. What with the crack down on opiates, they started me on only 5 mg oxycodone every 4 hours as needed; after 2 weeks they reduced dosage to 5 mg 4x a day; at 3 weeks they cut me to 3 a day, and are now pushing me down to 2. I can’t tolerate Tylenol or Advil (stomach cramps and burning respectively) so that’s it for pain. In contrast, on knee one, I was give 10 mg every 4 hours, and encouraged not to take more than I needed. The first time, I could sleep most of the night and keep my pain numbers tolerable. This time, I haven’t had one decent night’s sleep, and have a lot of pain in the morning and evening. I have written to my surgeon and talked to his staff, but I am getting what I can get. So surgery was fine, but the change in pain management makes everything worse. This will pass, but it’s a shame that our response to the opioid problems has been to deny medication.

 

[Jockette]

but it’s a shame that our response to the opioid problems has been to deny medication.

Especially when you didn’t get addicted with the last replacement.

This is one of the reasons I’m not in any hurry for a revision.

 

[bill 3/20]

Toothache question: I am 4 weeks out from my PKR. My post surgical instructions say to avoid dental procedures for4 months. Now, I have a mild toothache. I don’t feel like there is an infection at this time. Any recommendations?

 

[marieltha]

I got cleared to get a crown a month after PKR. Took 2 amoxicillin 500mg one-hour prior and 2 six hours after on both visits (prep w temp crown and permanent crown).
My OS recommends taking this on the day of any such procedures (all dental, dermatology biopsies, mani-pedis) for a year after surgery. He prefers Cipro, but I don’t take fluoroquinolone antibiotics because of their potential of weakening of tendons (highly debated), but it seems to me that every time I took one, about 2 weeks later, I had a tendon injury.

 

[bill 3/20]

Pain question. As with the first replacement, my biggest recovery issue is dealing with pain. In general, my function is good, I can walk several miles, climb 3 flights of stairs, I feel like my function is where it should be, and am not pushing too hard. I have almost no swelling although the knee is always warm. But, the pain is keeping me down. Of course the knee hurts some, so does my lower back, my psoas, and my heel; cumulatively, I am in pain most of the time, and pain is generally the first thing on my mind. I am 8 weeks out and trying to get off opioids, not because I want to, but because my doctor is cutting me off. As long as I take 5mg of oxycodone 4 or 5 time a day, I do okay. Now, I am taking 2.5 mg 4 or 5 times a day along with Tylenol and ibuprofen, and I spend the day thinking about pain. I skip my minimal PT about half the days and spend my nights mostly awake and icing. I know this will pass, but feel at the end of my rope. I have been going to massage, doing deep breathing/meditation, icing and elevating, using a TENS unit. I am open to new ideas.