Lounge Doctor

TKR Newbie

Sparky791

new member
Joined
Aug 4, 2021
Messages
14
Age
60
Gender
Male
Country
United States United States
60 year old healthy male just had tkr on very arthritic right knee. On day 11 of post surgery. Been to four pt sessions. Was doing well. Yesterday after my at home exercises I had a set back. More knee pain, loss of range of motion I had gained and now swelling.
Also wanted to know if common to have stiff knee syndrome or arthrorombitis symptoms 11 days after surgery. Even before this setback I was no where close to 90 degrees flexion or leg completely straight. Have a real tightness sensation if lower quad right above knee. Can hardly get any bend when doing heel slides. Had two scopes on this knee 30 years ago. Wonder if I have scar tissue from those surgeries. Any advice? Am I over reacting to this setback? Thanks for any help.
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
24,788
Location
Virginia
Gender
Female
Country
United States United States
I am sorry to read about your setback after doing your PT. This is telling you that you are doing too much for your knee right now. A stiff knee is something that we all have or have had for months. It was the last thing to go for me. That stiffness is caused by swelling. Any fluid in or around your knee will restrict its movements. Icing and elevating your leg, toes above your heart, will help get some of that fluid out. Ice is also a wonderful pain reducer. I used it for months!

Please tell us the exact date of your right TKR and will add that information to your signature for you. Knowing this will help us to better know how to advise you.
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
24,788
Location
Virginia
Gender
Female
Country
United States United States
Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax and let it. Don't try and hurry it, don’t worry about any symptoms now; they are almost certainly only temporary.
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when the pain starts!)​
3. Do what you want to do BUT...
a. If it hurts, don't do it, and don't allow anyone to hurt you.
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again for a few weeks.
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


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 a 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 history before providing advice.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep
 
OP
OP
S

Sparky791

new member
Joined
Aug 4, 2021
Messages
14
Age
60
Gender
Male
Country
United States United States
Please tell us the exact date of your right TKR and will add that information to your signature for you. Knowing this will help us to better know how to advise you.
Had the surgery September 23, 2021.
 

benne68

senior
Joined
Sep 5, 2021
Messages
331
Age
69
Location
Connecticut
Gender
Female
Country
United States United States
On day 11 of post surgery. Been to four pt sessions. Was doing well. Yesterday after my at home exercises I had a set back. More knee pain, loss of range of motion I had gained and now swelling.
Hi @Sparky791 My TKR was about a week before yours (on 9/15) and I still have quite a bit of pain and stiffness, and my ROM is very limited. This seems to be pretty normal from what I've read in this forum.

Read all the great information that BoneSmart offers and do worry too much about your ROM until the swelling is gone.
 

Susie-Q

post-grad
Joined
Jul 20, 2010
Messages
1,168
Age
54
Location
Washington
Gender
Female
Country
United States United States
I had very little ROM those first two weeks after surgery too, heels slides were about impossible so I didn't do them. I would try to use my other ankle to gently stretch my leg back when sitting in a chair or I'd dangle it off a bar stool for a little bit. I am glad I didn't start PT until 2 weeks post-op, they wouldn't have been able to get me to do much before then and it probably would have hurt. I was only 70 at my first PT appt and now I'm a little over 100 at 5 weeks. You will get there, it just takes time.
 
OP
OP
S

Sparky791

new member
Joined
Aug 4, 2021
Messages
14
Age
60
Gender
Male
Country
United States United States
Thank you for leg dangling idea. I will try it. Had my fourth pt session today in 11 days since surgery on 9/30/21. Even though I felt bad coming in as I described in my first post they got me to 98 flexion. Felt like she (pt) was breaking my leg. Lol.
Actually feels better tonight though.
This is a great website. Glad I stumbled on it. After reading some info on elevation link it has really helped with swelling. I was doing it all wrong. Basically just sitting in a recliner.
The pictures of the right way to elevate are great. But I still have some pain and feels a little uncomfortable with knee in that position. But I am hoping it is just because of it being new. Not used to three pillows high.
 

Jockette

MODERATOR
Moderator
Joined
Aug 29, 2017
Messages
26,674
Age
65
Location
Delaware
Gender
Female
Country
United States United States
Be careful with dangling your leg, I couldn’t do it this early in recovery.

There is no need to work hard on your ROM, you are very early in recovery. It will improve as your swelling goes down and as you heal.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

kneeper

FORUM ADVISOR
Forum Advisor
Joined
Dec 11, 2010
Messages
13,660
Location
USA
Gender
Female
Country
United States United States
.
The pictures of the right way to elevate are great. But I still have some pain and feels a little uncomfortable with knee in that position. But I am hoping it is just because of it being new. Not used to three pillows high.
It can be a little uncomfortable--is the pain behind the knee? For me, even though my extension was good, keeping the leg straight was uncomfortable for a while.
 
Last edited:
OP
OP
S

Sparky791

new member
Joined
Aug 4, 2021
Messages
14
Age
60
Gender
Male
Country
United States United States
Pain is on the front. But doing better now. Getting used to position of pillows. Have two week visit Friday. Looking forward to what os says. Pt today. Not looking forward to heel slides from hell. Got to 98 flexion the other day put with therapist doing most of work. Rest of therapy exercises are hard and a little discomforting. But manageable. Will report two week status Friday.
 

Jockette

MODERATOR
Moderator
Joined
Aug 29, 2017
Messages
26,674
Age
65
Location
Delaware
Gender
Female
Country
United States United States
Do not let your PT bend your knee for you. This is not good for you, ever, but especially so early in recovery. Your bend will improve in time as you heal, and as your swelling goes down. There is no rush and you don’t have to be at a certain number by a certain date.
Saying no to therapy - am I allowed to?

 
OP
OP
S

Sparky791

new member
Joined
Aug 4, 2021
Messages
14
Age
60
Gender
Male
Country
United States United States
Two week check up. 85 degrees flexion. Full extension. Was hooing for 90 on flexion but just cannot get there. Hoping flexion doesn't become a problem. Bandage off and healing is great according to os.
Soreness and swelling constant right above knee. . Mostly from an aggressive pt session two days prior. But swelling and soreness still pretty constant regardless. Os told me to tell therapist not to be so aggressive. Doesnt have to be fixed in a day.
On good days pain is a 5 or 6 right now. For those in the know. When does pain reach the 3-4 range and below? Some days I just get tired of it hurting. On hydrocodone every 6 hrs.
Really having trouble sleeping. Just cannot get comfortable. Usually after midnight and then up every 2 hrs minimum until 7 when up for good. Right now sleep in recliner with feet hanging over a little at the end feels the best. Or heels just on end of recliner. Although heel is getting sore now.
Had a moment yesterday for about 30’ where had recliner was fully extended and I had my calves resting on end of recliner and rest of feet extended off. No pain at all. I immediately fell asleep. It was heaven. I try to recreate that position as much as possible when attempting to sleep or alleviate pain. Most of the time to no success.
 
OP
OP
S

Sparky791

new member
Joined
Aug 4, 2021
Messages
14
Age
60
Gender
Male
Country
United States United States
I am sorry to read about your setback after doing your PT. This is telling you that you are doing too much for your knee right now. A stiff knee is something that we all have or have had for months. It was the last thing to go for me. That stiffness is caused by swelling. Any fluid in or around your knee will restrict its movements. Icing and elevating your leg, toes above your heart, will help get some of that fluid out. Ice is also a wonderful pain reducer. I used it for months!

Please tell us the exact date of your right TKR and will add that information to your signature for you. Knowing this will help us to better know how to advise you.
Sorry. Thought I had given that date. It was Thursday September 23. Thanks for advice.
 

Sisterpat

MODERATOR
Moderator
Joined
Feb 14, 2021
Messages
1,194
Age
74
Location
Arkansas
Gender
Female
Country
United States United States
Try not to be too anxious about sleep! For many, including myself, it took months before normal sleep returned. Keep going for naps when you can. I slept in my recliner for months, unable to get comfortable in my bed. It will come.
 

Jockette

MODERATOR
Moderator
Joined
Aug 29, 2017
Messages
26,674
Age
65
Location
Delaware
Gender
Female
Country
United States United States
Os told me to tell therapist not to be so aggressive. Doesnt have to be fixed in a day.
Excellent words from your OS!

One way to keep a lower pain level is to not do things that increase it. Painful PT and home exercises can increase your pain. You are in very early days of this recovery and you need rest more than activity. Very gentle bends and short walks are all you need right now. No pushing your bend to the max. There is no rush to regain your bend and no date by which you must be a certain number. Swelling is preventing the bend right now. When the swelling goes down, your bend will improve.

Tell your PT to back off. Ask for modalities to reduce swelling, instead of exercises and focus on ROM. If they don’t agree, take some time off from going to PT and give your knee rest and a chance to heal.
 

Susie-Q

post-grad
Joined
Jul 20, 2010
Messages
1,168
Age
54
Location
Washington
Gender
Female
Country
United States United States
You might talk to your OS about taking your pain pills every 4 hours instead of 6. Good days of a 5 or 6 seems like too much pain to be having to me. You can't heal if your body is in constant pain or sleep very well. Also, make sure you are icing your knee whenever you are in the recliner. Use a thin towel between your knee and the ice, don't put the ice directly on the skin.
 

Jockette

MODERATOR
Moderator
Joined
Aug 29, 2017
Messages
26,674
Age
65
Location
Delaware
Gender
Female
Country
United States United States
Also ask your OS if you can add Tylenol to your medication regime.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.
 

New

OneStep App

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
58,077
Messages
1,478,687
BoneSmarties
35,610
Latest member
Nancy Realtor
Recent bookmarks
0

Top Bottom