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TKR Pain on my kneecap

Jockette said:
Hi and Welcome!

Please give us your surgery date and we’ll make a signature for you. :flwrysmile:

Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more, even for a partial.

If you can take Tylenol, and your doctor approves, then the most effective way to take it 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 Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.
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My surgery date was Dec 3. Thanks for merging my posts!
 
One other question, which partial did you have, Medial, Patellofemoral or Lateral? We’ll add that information to your signature. :flwrysmile:
 
Thanks for all the input about my ROM, PT and swelling pain. I have one more related question. I’m pushing myself pretty hard because both the doc and the PT keep warning me about scar tissue healing before ROM is reached. In that case, they say they’ll have to put me under and manually bend the knee, “breaking”’the scar tissue. This is something I want to avoid at all cost! Thoughts?
 
Debbie S said:
I’m up to 110 unassisted and 121 assisted.
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Debbie S said:
both the doc and the PT keep warning me about scar tissue healing before ROM is reached. In that case, they say they’ll have to put me under and manually bend the knee, “breaking”’the scar tissue.
Click to expand...

Your ROM is already excellent for 6 weeks post op. I don’t understand why your medical team is pressuring you. Most doctors won‘t do an MUA if you are better than 90.

Debbie S said:
I’m pushing myself pretty hard
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There is no reason to push yourself really hard. Doing this early in your recovery maintains pain and swelling, which can delay healing.
Saying no to therapy - am I allowed to?

bonesmart.org

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...
bonesmart.org bonesmart.org

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.
 
I, too have had the severe skin sensitivity. Remedies: Satin long leg jammies or other super soft fabric long leg jammies; Satin sheets (have to put up with all the other covers and pillows sliding into the floor); generic aspercreme with lidocane lotion (temporary, lasts about 2-4 hours), magnesium sulfate muscle pain ointment/cream; a combination of all or some of the above, apply lidocane, walk for 10 minutes to get blood circulating in your calves and allow the lotion to start to soak in and take effect. Jammies covers the stickiness of the cremes. Satin is the most comfortable on the irritated sensitive skin. I wish I had figured this out several weeks ago when the nerve pain and muscle spasms started. (TKR was Thanksgiving, muscle spasms and nerve pain started about 3 weeks in). So nice to sleep at least 4 hours at a time! Too bad I have to repeat at midnight, but still able to sleep again.
 
@LifeinParadise Welcome to BoneSmart! Why don't you start your own recovery thread here so that we can get to know you?
 
Debbie S said:
Good idea! I’ll give that a try! Do you recall
How long that sensation lasted? It’s very annoying!
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I am at wk 13 and the sensitivity is still there but only a little - I do still do the tunnel thing with one pillow under the quilt but I can tolerate the covers more than I could a couple of weeks ago. xx
 
Debbie S said:
Thanks for all the input about my ROM, PT and swelling pain. I have one more related question. I’m pushing myself pretty hard because both the doc and the PT keep warning me about scar tissue healing before ROM is reached. In that case, they say they’ll have to put me under and manually bend the knee, “breaking”’the scar tissue. This is something I want to avoid at all cost! Thoughts?
Click to expand...
I have just spent 3 days in hospital (nothing to do with my knee) on complete bed rest, I wasn't even allowed to walk to the toilet. Went in with a ROM of about 95 -100 and came out with a ROM of about 110 - 120. My knee had a good rest and improved on its own. Your ROM at this stage is excellent so don't worry. I really wish docs and PT would stop their scare tactics. Good luck with your recovery and you are in the right place for good advice.
 
I am 16 weeks post-op (Dec 3, 2021) and am doing well I think. I’m biking regularly and doing light weight resistance exercises and walking. But on some days, my lower leg (shin area) and behind me knee on the back of my leg feels SO bruised I’m limping. Any thoughts as to why? I see my doc again in 2 weeks and will discuss with him but I’m interested to see if anyone else has had this issue.
 
You might be doing too much this early in your recovery. It probably seems like you “should” be ready but the reality is that you’re only four months in a year long recovery. Are you icing after you exercise? You might try and see if that helps. But you probably need to cut back on the amount of exercise.
 
You could be doing more than your knee is healed enough to do. Try backing off and see if it improves. This recovery does take an average of a year, even for a partial.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery! :flwrysmile:
 
I had PKR on Dec 7. 2021. I continued having pain all summer even after all the PT and recovery. I finally went back to the doctor late September, X-ray indicated possible loosening, bone scan confirmed it. Back to surgery on October 7 for a FULL replacement <sigh>. I’m at 7 weeks now and it’s going well HOWEVER I’m having pain on top of my kneecap that feels kind of like bruising. It’s not all the time but when it hurts it really hurts and I can’t put weight on it. I’m scared to death this full replacement has loosened or failed too. Looking for reassurance if any can be had!
 
Hi and Welcome back. I’m sure it’s hard to not fear the same issue will happen again, but try to have faith that this TKR will be successful. Many times partials are not.

Please remind us which knee this is so we can add that information to your signature.

By the way, I merged your newest thread with your original recovery thread, since it is a continuing history of the same knee.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery! :flwrysmile:
 
@Debbie S Pain this early in recovery is normal. I’ll leave you a refresher course for you, each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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​
ice​
take your pain meds by prescription schedule (not when pain starts!)​
​
If you want to use something to help heal the incision, ​
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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
​

5. At week 4 and after you should follow this

6. Access to these pages on the website
​

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.
 
Welcome back, @Debbie S. I can certainly understand why you'd be anxious given your history. But as @Jockette said, it's common to experience pain and weird sensations for months in this year-long recovery.

You might find the information in this chart reassuring, It helped me understand why recovery takes so long.

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Hi Debbie,
How are you doing? I hope things are slowly improving for you while you're moving through recovery. Consider sharing an update as time allows. We'd love to read about your progress.
Happy Two Month Anniversary!
@Debbie S
 
Thanks for your note. I’m at 11 weeks and doing pretty well. I still feel a lot of stiffness and sometimes muscle and ligament pain. I have a lot of popping in my knee, like a WHOLE LOT. the popping doesn’t hurt but it feels weird and is annoying. I also have popping behind my knee in just one place. I’m walking about a mile a day, riding my bike twice a week for 5 miles, and still doing PT. I’m hopeful this go round worked but am ready to be fully healed!
 
Hi again - I am now 12 weeks post op for a tkr on my left knee that was a revision since my partial I had done 12 months ago failed. Everything is going great BUT I still can’t go down stairs (up is fine). It doesn’t hurt really, I think maybe I don’t have the leg strength yet maybe. Any suggestions on how to speed up the process. I’m so tired of taking steps one at a time!
 
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