TKR New Knee Me

[Mumu]

Last year my OS’s PA thereatened me with a MUA even before i had surgery! I hated my appointments with him, he was very doom and gloom, whereas my OS is cheery and optimistic. Fast forward to this year with TKR2,the PA is no longer working there, and the OS sees patients for all appointments. I am guessing there were many complaints about the cranky PA.

Anyway, don’t worry! A ROM of 90 should be easily obtained by 6/weeks!

 

[ouch1313]

My mind is going, my surgery was May 21st so I'm only 5 weeks post-op not 6. Everything was going smoothly, then return of pain, especially in the evenings before bedtime. The pain inside the keen was intolerable, could not get it to settle down no matter what. Finally moist heat seemed to help or I was just so exhausted I fell asleep. Can this happen, a sudden set back. I have been going to PT and the therapist said I was starting to develop some scar tissue that is restricting my ROM it was 110 but has decreased to 100. Any advice on message for developing scar tissue. I thought I was over this hump but seems not.

 

[sistersinhim]

At only 5 weeks your knee is still really traumatized. That means it's swollen and that's inside and out. Can you bend a water hose that is full of water...nope. Well, your knee is like that. It's full of water and won't bend well until that swelling goes down. To get that swelling down you need to cut back on aggressive PT and just let your knee settle down. Icing and elevating as much as you can is the way to do that.

 

[ouch1313]

Thanks, this is wonderful site for information and encouragement. I get myself all wound up and excited over results from PT. Then I seek advice from this forum and a voice from someone who has gone through this procedure gives solid reassuring advice. Thank you.

 

[SusieShoes]

Can this happen, a sudden set back.

You betcha! While we often know exactly what causes a setback, truth is sometimes we have no idea why our knee develops more swelling or pain. It still happens to me once in a while (though increasingly rarely). Try not to fret about it. It's just part of a normal recovery.

I have been going to PT and the therapist said I was starting to develop some scar tissue that is restricting my ROM

Unlikely. It's more likely swelling that is restricting your ROM. Have you been doing more or a new type of activity lately? Feeling lots better and doing more around the house or at work? The kind of scar tissue the therapist is talking about (adhesions) are rare and you have already demonstrated good flexion.

Keep in mind that those numbers therapists so love can fluctuate from day to day depending on lots of factors, including how it is being measured, time of day, or if your knee is grumpy due to activity.

Any advice on message for developing scar tissue.

Do you mean keeping the incision looser? I use a cocoa butter cream that makes rubbing my incisions less tiring for my fingers. Some people enjoy knee massages, usually done by their therapist, but there's no proof these massages prevent the development of scar tissue other than that they feel really good while you're getting them, and the knee may feel looser after. But that's due mostly to relaxing the muscles around the knee.

 

[ouch1313]

I have been doing more, lots more. I was recovering at a friends home with bathroom on 1st floor. I just moved home Saturday to my house with 16 stairs up to second floor. That's a big jump for me and doing everything on my own again. Looking at all that I have been doing it makes sense my knee is so angry. Ice, meds, rest and elevation are definitely a priority now.

 

[mom2fencers]

@Ouch1313,
Stairs are a big hurdle as they work the knee and also the entire body. At our church I have 8 steps up to a landing and then 12 more to Sunday School class. So if I go to SS (and I do) I wait til there’s no traffic on the stairs then start my climbing. I also count it as PT! And I climb back down all 20 too. Then I go home and pack in ice and elevate. So think of those stairs as PT as they do drain total body energy. Your knee will be stiff so try to find a balance. Do them when you can but count them as PT even if your therapist does not.

 

[Celle]

I have been going to PT and the therapist said I was starting to develop some scar tissue that is restricting my ROM it was 110 but has decreased to 100.

Your PT has told you wrong, on several counts.

The type of scar tissue she is talking about is more properly called adhesions, and they don't form this early in
recovery.
A drop of flexion from 110 to 100 is insignificant. It can even be because of inaccurate measuring. You have to place the measuring device in exactly the same place every single time, and you need to be in exactly the same position every time.
It is most likely caused by a slight increase in swelling, that could have happened because of a variety of things, including increased activity, less time resting and elevating. If you measured flexion at the start of the day, at mid-day and in the evening, you would be likely to get three different readings, with the lowest flexion being in the evening.

Massaging won't prevent, or breakup, scar tissue. If it feels good, do it. If you don't feel any benefit from it, don't bother.

Your new knee is only just over a month old, so you have plenty of time to increase its ROM. You're already at 100-120 degrees and that is great for so early in recovery.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[ouch1313]

Thank you again for your advice and encouraging words. I have so much invested in this procedure and can get overwhelmed with trying to keep up with someone else's schedule. My knee is very painful at night right after I settle in bed. A deep pain on inside of knee. Nothing seems to quiet it. I'm now just starting to use heat. This gave me some relief last night and will see how it goes tonight. I think I'm just doing too much and need to rest, elevate and ice more then I am. Listen to your knee it will tell you when to rest.

 

[SusieShoes]

Listen to your knee it will tell you when to rest.

You’ve got it. If there is one piece of sage advice any of us can give it is simply this: Listen to your knee. It’s telling you things, important things. Pay attention to what it is saying. No one else can “hear” your knee. Surgeons, therapists, relatives, strangers on the street... they are all operating on second and third hand information. Only you have the first-hand information your knee is relating in the form of pain or no pain, swelling, that subtle “I want to move” feeling, and which positions challenge it or give it relief.

Because you mention your knee being painful at night... do you always sleep (or try to sleep) in the same position? Have you tried other positions? I ask because sometimes a TKR in early recovery will only be comfortable in certain positions. Just which position varies from person to person. If you can find a position that makes the knee comfy, even if it is one you don’t personally prefer, you might get both relief and a little sleep.

 

[ouch1313]

SusieShoes, yes I usually sleep in the same position since operation on May 21st. I have started using a moist heating pad prior to going to bed and this has brought great relief. I have also on occasion moved on my side. Cautiously, with a pillow between my legs and resting on opposite side of surgery. I can't stay in that position long but it feels so good. On my side is my normal sleeping position. I have also started rocking my knee in a rocking chair I have. Not pushing to point of pain just a good stretch. This one exercise alone has brought more movement and range to my knee. I can feel the knee getting stronger. This forum has been invaluable to me in regards to my sanity and knee recovery. Thanks to all for their support and insight.

 

[sistersinhim]

I'm now just starting to use heat. This gave me some relief last night and will see how it goes tonight.

It's wonderful that the heat is helping you. But, please watch out for increased swelling. Many times heat will cause more swelling on a healing knee. It sounds like it's really helping you though. Great!

 

[ouch1313]

Thank you sistersinhim, I will watch for increased swelling. I'm careful not to leave it on for long just to pain subsides. I ice and elevate during the day. I don't know if others feel this way but sometimes I can't bear the thought of putting ice cold on my knee. This entire experience is a true mystery at times.

 

[pacosmom]

I’m glad you found a way to get some sleep, exhaustion makes everything worse! I’ve had the same type of experience as you describe. By week 4 I felt great, ROM wasn’t great though. Then I started doing too much I suddenly had more swelling/pain, and felt so down. This group has been a real lifesaver! It’s so hard to be patient, but it’s our only choice

 

[mom2fencers]

Ouch1313,
I use my glider chair and it helps too. I can judge how my knee is doing just by the amount of glide I get/don't get.

 

[Laurenkate]

There must be some rule someplace that the assistant's have to threaten people with manipulation, blah, blah, blah. Mine did the same and my p.t. said not to worry about it because the ROM was fine and my doctor never mentioned it during my first actual check up with him.

Recovery takes a loooong time. I didn't start feeling anywhere near normal until 7-8 months out so just keep doing what works for you. Do what you need to do (within limits) and get some rest. The constant exhaustion can really take a toll so give yourself a break. Isn't it wonderful the first time you can sleep on your side - if only for a few minutes?

 

[mom2fencers]

Side sleeping—yes! What a nice surprise I had and what relief when I first turned over and felt my muscles relax.

 

[SusieShoes]

I’m a side sleeper too. It was pure heaven when I could do that again!

 

[Jockette]

I was always a side sleeper, too. I haven’t been able to get back to it.

 

[ouch1313]

6 weeks, I can feel my new knee captured in the stiffness wanting to get out. I have rocked in the rocking chair more the Grandma Moses but can't seem to break through the stiffness. It is very frustrating. I wanted to return to work part time next week but don't feel steady enough on my feet yet. Stiffness is worst in the morning, but I have been able to sleep better. When, when, when, will this knee come around? Should I be doing more exercises? I'm reluctant to push my knee to the point of extreme pain. So far I push till I feel a good stretch, hold a few seconds then release. I feel I should be further along. Feeling depressed and frustrated. Just needing to vent with folks who would understand. If I hear one more story form someone who knows a person who had a TKR and was up and about in two weeks and had no real issues at all I'll spit. I have gone in a pool but the sensation was good and weird at the same time. I'm so protective of my knee from the years of bone on bone pain that I can't let go of old habits. Well, this has turned into quite the rambling post but needed to vent. Thanks for a forum to do so.