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TKR One year later and all is well

the three posts above are correct, however, you can try a bike---I rode 5 min, then 10 min, then 15 min. I still ride for 30 min a day. It helps to pump the knee and establish some motion. Also, keep doing leg lifts, quad sets and clam shells. When the swelling goes down, your muscles will be ready to provide support to your knee which will keep new swelling from happening.
 
Other pressing commitments have kept me from posting on this forum during the past several days, but let me begin by saying that in the first two minutes of the meeting with my surgeon last week for my 6 week check-up, he said that I was going to be okay and that relieved me of a huge burden. In fact, between him and the physiotherapist also in the room, they must have said those words half a dozen times!

The appointment began with the doctor gently applying pressure to bend and extend my leg and in doing so, he actually helped me gain almost 10 degrees of flexion from the measurement that had been taken just a minute beforehand. He also mentioned that he could feel that the scar tissue in my joint was still soft and, thus, could be dissipated with continued gentle pressure applied by another person in the same manner.

The swelling, and consequent stiffness, in my knee could be attributed to any number of factors, however, with a new regimen of anti-inflammatories, that will reduce and I will begin to regain my range of motion. My surgeon want to see me again in early June and only at that time, IF my recovery has not significantly progressed, will there be any talk of any kind of manipulation.

Before leaving, the PT also gave me several new exercises and other tips that I could follow daily and she reassured me that I do not have to be in pain most of the day. And, I have been given the go-ahead to walk (with my crutches, as I'm not ready to ditch them yet). The 15 minute trips around the block have done wonders for my frame of mind, let alone my gait - I can feel how much better I am walking every time I go out.

Many and sincere thanks to all on this forum who have offered their advice and support. My surgeon confirmed that aggressive physical therapy was not necessary; rather that daily adherence to exercises where gentle pressure is applied, and the stretches are held, is absolutely acceptable. Together with a modified pain med routine (in my case, no more narcotics are necessary) and a boost of anti-inflammatories, my recovery is on its way . . . and I'm going to okay!!!
 
So wonderful to hear! Amazing how much the anxiety can affect our recovery and how much the burden is lifted when someone says we will be ok.
 
It great to hear that you are so encouraged. It sure helps to hear that you are "going to be alright"! Best of luck with your continued recovery.
 
I'm glad you were reassured so well.

Just be very careful about allowing anyone to press on your knee. It really isn't necessary, in spite of what your surgeon said, and it could do harm if they push too hard. Never let it hurt you.
There isn't any scar tissue there that needs to be broken up - that is a fallacy that some medical people (unfortunately) were taught many years ago.
 
That is great news and gives me hope that I'm on the same path as you! Two weeks behind you and my PT is saying by same things. I see my surgeon in another week and a half and I'm hoping to get the same reassure as you received.

What kind of anti inflammatories did your doctor prescribe? I just finished taking Celebrex and an aspirin twice a day for the last month.




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@flyaway79 - the anti-inflammatory is over-the-counter 200 mg Advil. I take 2 at a time every 4-5 hours during the day together with 975 mg (3 X regular strength) Tylenol - also over-the-counter.
 
@Celle - I thought I heard my surgeon say that the 'mass' in my knee joint is scar tissue. There was a lot of information offered in the short period of time I had with him - could I not have heard him correctly? If not scar tissue, what would he have been referring to?
 
@Minstrel Thanks! Will be interesting to see what course of action my doctor takes at my next appointment.


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@Minstrel - Your surgeon may well have referred to it as scar tissue, but really it was most likely to have been just extra fluid, due to internal swelling.

There was a time, unfortunately not too long ago, when surgeons and PTs were taught that bad scar tissue (adhesions) would build up, unless you worked madly at exercises, to ward off this "evil" scar tissue.
Now we know that just isn't true and that adhesions don't develop so early in your recovery. They aren't just sitting there, waiting to pounce if you don't do enough exercises.

However, the people who were taught that still believe it, so many people are told by their surgeons or PTs that they have scar tissue.

Well, everyone gets scar tissue. It's a normal part of healing and it's what holds your wound together. You need it. But when your surgeon or PT talks about scar tissue, they really mean adhesions - which are actually quite rare.

This article might help you to understand: Scar tissue and adhesions - what's the difference?
 
I wasn't allowed to bend my month old TKR for 4 weeks and I did not develop scar tissue or adhesions, nor did my OS mention an MUA. He did prescribe non-aggressive PT, just sliding my heel about 2 inches at first. A month after being allowed to bend I was able to get full revolutions on a recumbent exercise bike with no pain involved.
 
Each of my legs were immobilized for 6 weeks in the early 90s when my kneecaps were removed. I never took PT afterwards and was able to achieve ROM within a few months later. Adhesions are extremely rare. Don't worry about that ROM. It will come in naturally when the swelling is gone.
 
Minstrel said:
@flyaway79 - the anti-inflammatory is over-the-counter 200 mg Advil. I take 2 at a time every 4-5 hours during the day together with 975 mg (3 X regular strength) Tylenol - also over-the-counter.
Click to expand...
@Minstrel, I want to caution you about the level of over-the-counter medication you are taking.

The maximum amount of ibuprofen you can take is 800mg per dose and a total of 2400mg in a 24 hour period. If you take your 200mg every 4 hours, that will just exactly be the maximum dose. That level can cause stomach problems for some people, so please be on the lookout for any symptoms of stomach irritation.

The maximum levels of Tylenol (acetaminophen) are 1000mg per dose and a total of 4000mg in a 24 hour period. Your 975 dose is just fine, but you definitely should not take that level of acetaminophen every 4 or even ever 5 hours. You are getting too much of the active ingredient and it can be harmful to your liver. Taken every 4 hours, you get 5850mg and taken every 5 hours you get 4875mg. You need to take the Tylenol every SIX hours or 4 times a day to be within the medication guidelines.
 
@Celle - thank you for clarifying what my surgeon probably said to me about the fluid on my knee. There was a lot of information conveyed in that 20 minutes with him and upon hearing that I was going to be okay, I probably did not accurately hear what he was explaining to me.

In the past couple of days, I have (perhaps unconsciously at first) been leaving my single crutch behind when I have a very short distance to cover while indoors only. I am definitely more efficient with my crutch, but I am feeling okay taking 5 or 6 steps. Is this too early? I am now Day 47 post-op.
 
@KarriB - I am continually reassured by your comments regarding your recovery. While still attending physical therapy sessions, I was put on an upright bike twice and was only able to rock the pedals back and forth. On the second occasion, I was there for over 30 minutes, of my own accord, desperate to move the pedals more than I was, tears streaming down my face the whole time. I now suspect that this activity was responsible for the swelling and the stiffness that ensued.
 
@sistersinhim - I am also continually reassured by your additions to my thread. I don't think I can hear often enough that the swelling will subside and the ROM will come.
 
@Jamie - thank you for your suggestions regarding my OTC medications. I do note times of day that I take these meds and it has pretty much been at meal times, which is 3 times per day. At this point in my recovery, I am pleased to be able to say that I now do not take pain meds at bedtime, and because I usually sleep through the night, I do not take any then, either. So, that is working out to be 1200 mg of Advil and 2925 mg of Tylenol in any 24 hour period. Fortunately, I have not had any adverse affects with either of these drugs, however, I am very much aware of the possibiity.
 
I'm glad to help you a bit. :yes: It took a week or more of rocking the pedals before I lifted my right hip a bit and got a full rotation. Easy rocking for 5-10 minute a day is all you need. Then when you get the revolution don't go hog wild! Only pedal for 5-10 minutes for a few weeks before moving it up 5 minutes. Right now it's about getting and keeping the knee loose, not building muscle or burning calories. And keep the resistance at 0. I ride 8 miles a day now reall fast because the resistance is at 0 due to my gimpy left knee. Oh, when I got that full revolution I let out a loud whoop in the PT gym!
 
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