TKR My TKR Experience

[Jockette]

You will be fine doing your own version of PT at home.

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[Gingerbread]

LDN (Low Dose Naltrexone) is an ultra low dose of Naltrexone-usually btw 0.5- 4.5 mg. From the LDN Research Trust page:
LDN is a competitive opioid receptor antagonist. At the standard dose, Naltrexone blocks the effects of both the endogenous opioids, which are in endorphins and pharmaceutical opioids. LDN is a pure antagonist, which is vital to know as a lot of people think it is a controlled medicine, narcotic or an opioid.

LDN is a pure inhibitor, so there is no narcotic effect. The chemical structure is almost identical to endorphins that we make naturally called met-enkephalin, also known as OGF or Opioid Growth Factor.

Low Dose Naltrexone binds to the endorphin receptors for about 1 – 1/2 hours, and the blockade lasts about 4 - 6 hours. The effects of LDN are analgesia and anti-inflammatory. One of the other effects is that it increases the production of your own endorphins.

It is used for many conditions. Your regular doctor won't know about it, and if they do, most likely won't prescribe it. You have to go to a holistic practitioner, or look online for prescription options.

LDN Research Trust

The LDN Research Trust Charity works to raise funds for research trials. We have helped over 100,000 people obtain LDN from a General Practitioner or Consultant, either through the National Health Service or by private prescription. We are proud to have

ldnresearchtrust.org

 

[benne68]

Thanks for the response. I think my slip caused me some more soreness. How is your pain and soreness 3 weeks later

Still having enough pain that I need to supplement the Tylenol with Oxy a couple times a day. I usually feel pretty good in the morning, once I'm up and moving around. I use the cane during the day, try to walk often. Home PT exercises 2x/day. For me, the pain worsens as the day progresses Icing and elevating does help, but I need an Oxy late-afternoon and at bedtime. Was hoping to have less pain by now.

How about you?

 

[Susie-Q]

@benne68 I was still taking oxy at your point too so don't sweat it. You'll be able to taper off soon. At 5 weeks post-op now I'm only taking Tylenol and Advil and not really having any pain, mostly stiffness in the morning and after sitting for a long time. Of course there's some pain and discomfort during and after PT but it's minimal.

 

[dogwalker2]

Hi there! Lots of people go through TKR without PT on this forum, using ADLs and a few simple exercises (see the articles that Jockette posted early in your thread). I have only minimal PT by choice and do a few leg lifts, heel slides along with ADLs throughout the day. Ice and elevate are more important i think.
Sorry to read about your fall, very scary

 

[TCB]

Thank you all for the information. The near fall was pretty scary. When I missed my foot in the slipper I started to fall. The only way to stop my fall was to use my surgical leg to catch myself, and that hurt like all get out. I am a few days short of three weeks post op now, and I think things are starting to get a little better with the pain and soreness. I’ve always been pretty good about doing exercises from the time I got back To my hospital bed after surgery. I’ve been doing most of the exercises I learned from going to PT a few times, And what they taught me at first in the hospital. I’m able to get in and out of the bathtub to take a shower and wash my hair so that’s good. This site has been very helpful and encouraging thank you all

 

[TCB]

LDN Research Trust

The LDN Research Trust Charity works to raise funds for research trials. We have helped over 100,000 people obtain LDN from a General Practitioner or Consultant, either through the National Health Service or by private prescription. We are proud to have

ldnresearchtrust.org

It seems that LDN lasts a very short time. Does this mean you have to take it every 4 to six hours? The medication I take is buperenorphine brand name Subutex, which has a half life of 24 to 48 hours. There is also Suboxone which has buperenorphine and naloxone. You need to be off the buperenorphine for about 72 hours before any opioid pain meds will work, because the bupe blocks the MU receptors in the brain, which are the same ones the opioids target. I got off the bupe 4 days before surgery. Even so the pain meds they gave me post op didn’t work very well. I stayed on the pain meds for 11 days, with little pain or withdrawal relief. I couldn’t take it anymore, and at 11 days I dumped the pain meds, waited 12 hours, and went back on the buperenorphine. That made me feel so much better, because the little opioids they gave me were not strong enough on their own to stop withdrawals from the bupe, which I had been on for many years. There is some wisdom out there that anybody on buperenorphine Therepy should be given higher doses of opioids for pain relief to compensate. Unfortunately with most surgeons this falls on deaf ears, because most aren’t educated on this, and think patients like myself are drug seeking. When they see people are on this Therepy, they think druggie. I have read so many horror stories where patients on these meds have had to suffer terribly after surgery. There really needs to be a push to get doctors educated on these meds, especially with the current opioid epidemic. There will be more and more people on these meds that may need surgery

 

[Gingerbread]

LDN is generally taken once daily, at bedtime. I know what you mean about prescribers seeing these meds and immediately labeling the patient a drug addict. Mine was prescribed low dose (compounded), for auto-immune support during cancer therapy and after.

 

[TCB]

The sore I posted about in the beginning of this record, that I had on the back of my surgical knee got worse. I saw my surgeon, and he said it would probably go away in a few days. That didnt happen. It got worse, and opened up. I will provide before and after pictures. I ended up going to the urgent care. They gave me a prescription topical ointment that I am supposed to use 3x a day for 10 days. I have to wash the wound with soap and water, and then apply the ointment, and bandage. Unfortunately it’s in a place that makes it hard to apply myself. I have also slowed down on my exercises due to where the wound is. Has anybody dealt with this type of thing before? I don’t know if it was due to rubbing on the leg due to the exercises, or just laying on my back with the leg in that position. I just want to get this thing behind me and get back on the road to recovery. I hope this prescription ointment works.

 

[Jamie]

Even though you went to urgent care and received treatment, I hope you contacted your surgeon about the wound opening up. It's difficult to tell exactly where this is on your leg. Would it be possible to post another photo with more of your leg in the picture? It doesn't appear to be infected. With it opening up like the photos show, it appears to be a pressure sore and not a bruise.

 

[sistersinhim]

I was wondering if anybody has forgone PT for doing exercises at home? I am on a fixed income, and can’t really afford the copays of PT. My knee works pretty good almost 3 weeks in. I walk around the house with a cane, and do some exercises that I learned the few times I did go to PT. I am hoping I will be OK, just doing my own thing. Any ideas?

I'm one of those who never took formal PT. I've had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I am not a lazy person! I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. So, to answer your question, you will be fine to do your ADL and a few exercises at home. Many of us have done great without formal PT.

 

[Abbylayla]

@TCB I too had almost zero PT, only 3 visits. I did the rest at home & the exercises were very simple, nothing excessive whatsoever. I'm a year out, my knee is strong and I have ROM/extension as good or better than those I know who spent months in PT.
So more is not always better!!

 

[TCB]

@TCB I too had almost zero PT, only 3 visits. I did the rest at home & the exercises were very simple, nothing excessive whatsoever. I'm a year out, my knee is strong and I have ROM/extension as good or better than those I know who spent months in PT.
So more is not always better!!

Thank you it’s good to hear you say that. I stopped PT after Three sessions, I’ve been trying to do exercises at home, but then I discovered a sore on the back of my surgical leg. It has slowed down my exercises. I have to put ointment on it three times a day. As soon as it heals (hopefully) I will go back to full exercises. There is a few I can do now

 

[TCB]

I was wondering if anybody has forgone PT for doing exercises at home? I am on a fixed income, and can’t really afford the copays of PT. My knee works pretty good almost 3 weeks in. I walk around the house with a cane, and do some exercises that I learned the few times I did go to PT. I am hoping I will be OK, just doing my own thing. Any ideas?

I'm one of those who never took formal PT. I've had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I am not a lazy person! I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. So, to answer your question, you will be fine to do your ADL and a few exercises at home. Many of us have done great without formal PT.

Thank you so much for sharing your experience

 

[TCB]

Even though you went to urgent care and received treatment, I hope you contacted your surgeon about the wound opening up. It's difficult to tell exactly where this is on your leg. Would it be possible to post another photo with more of your leg in the picture? It doesn't appear to be infected. With it opening up like the photos show, it appears to be a pressure sore and not a bruise.

The sore is on the back of my leg, a little beneath the crease on the back of the knee. My wife is helping me put Mupirocin cream and bandage on it 3x a day

 

[jaspa]

I ended up going to the urgent care.

I hope you notified your surgeon regarding the wound although you were at urgent care you should at least send the surgeon an email through your patient portal or call them to give them an update. I hope the wound is starting to heal.

 

[TCB]

I ended up going to the urgent care.

I hope you notified your surgeon regarding the wound although you were at urgent care you should at least send the surgeon an email through your patient portal or call them to give them an update. I hope the wound is starting to heal.

I did speak to the surgeons nurse yesterday. She called to check on how I was doing. I told her about it. I go to see my surgeon on the 15/Oct. Hopefully the Mupirocin will have healed it much better by then. I apply the ointment and change the bandage, 3x a day

 

[TCB]

I am 4 weeks today post LTKR. I can walk pretty well around the house, and with a cane out of the house. Nobody told me that I could drive, but I’ve done it a few times. I went to get my 3rd Covid shot yesterday, and walked all the way back and forth to the pharmacy counter in a very large Walgreens. I still do have some discomfort, like getting up from a fairly low chair, or when I’ve been sitting for a long time. I think I have other arthritis than in my knee. My lower back barks terribly if I try to stand too long. I guess that’s my next ortho appointment. I also had swelling on my leg before the surgery, both legs actually maybe from medications I take. I think because I have had the leg swelling so long, I have developed somewhat thin skin on my lower legs. This causes my lower legs to bleed easily. I had a small sore on the back of the surgical leg, probably from the friction of doin exercises, or just stretching out the leg in the same place in bed. I also have a few small wounds on the lower leg from removing bandages. Wounds In my lower legs don’t heal so well. I’m going to my primary, and surgeon tomorrow on Fri the 15th. Maybe they can help with the issues

 

[Maregold]

Hi TCB. I am 10 weeks out from a LTKR, as of tomorrow. My surgeon had me elevating, icing, compressing, and walking for the first 6 weeks. At 4 weeks he added peddling with no resistance, and alternating stairs. At 6 weeks he gave me some strengthening exercises to do, but I have not had any PT. I now have extension of 0 and flexion of 125. 125 is where he suggested I stay at in order to not over stretch the surrounding tissues. I am able to perform all of my activities, although there is still some soreness and swelling when I over do. I do continue to take 1000mg of Tylenol three time a day.