TKR pall48's recovery

[pall48]

Had Left TKR on October 17th:

Some observation so far

Day 1: Spent 1 day in the hospital got up and walked about 100 feet leg was a little a sore had bend angle of 93 degrees.. Mainly stayed in bed was able to get up and use the bathroom... The PT did give me exercises glut, quad and leg pumps.. Did not get much sleep that night..
Day 2: More exercises, had OT Show me how to get dress and going into shower using a chair... PT walked with her using a walker, did stairs, got in and out of car... Was then discharged to go home .... We added slides tø the exercise routine.. bend angle was 95 degree
Day 3: Finally, in home PT came over did eval thought my ROM was excellent so far that day I walked 1,400 steps.. This has been critical key in my recovery in additiion i made sure I followed the a RICE method after exercising or walking.. the key for me were quad exercise this allow my knee be straight this is very important bc is very hard straighten out once can not straighten it...

Day 4 In homePT more exercise now 3times aday

Day 5 : Notice that I am black and blue from surgery this to be expected ;pretty much my whole knee was B&B in the front and back..

Observation: Do your exercises , walk as much as possible, Sleep when tried, It is going to be painful for that moment but follow RICE method.. Keep up with Medications... if you do that it will get better wit h time ... Hope this helps

 

[Layla]

Hello and Welcome to recovery!
I'll leave the BoneSmart Recovery Guidelines which many have followed with great success.
Please read through the short articles as I believe you'll find the information beneficial. If you'd like your thread title changed, please let us know and we will edit accordingly. I wish you comfort and all the best as you begin your healing journey.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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.
@pall48

 

[pall48]

My second week post surgery leg was bruised in back of leg and front…. Bruising started to creep down the leg all way to my foot, my leg was swollen too, This hinder my rom from being achieved, the only thing you can do is Elevate the leg and ice every hr for 20 minutes… as far as pain meds started with taking tramadol with tylenol. 100mg/ 1000 mg respectively every 8 hours…. A second week tramadol dose was lower 50mg every 8 hrs..
Regarding elevation I tried 3 pillow method without pinning them that work for a while ,but I decided to get the Lounge doctor pillow well worth the money did help Lower the swollen leg .. I got the wider, l one would recommend the 18 inch w bc would fit better on couch, which where I do most of icing and elevation,,,

Regarding pain,my has been controlled with Tylenol and tramadol pretty well.. only time in any pain when doing slides and trying to extend rom on a chair…. The Only way I find to help with pain,is to do deep breathing that seems to lessen the pain..

if you have a bike I highly recommend using it.. For me it helps loosen the knee and I am able move more freely.. my quads, calf and hamstring are very tIght I use a strap to loosen them, I put the strap around my foot pull foot toward me this stretches out my calf. This is require before and after exercising... talk to your pt if this right for you…

my Pt measure rom I can bend the knee 116 degrees. can straighten knee to 0 degree with a little help from pt once it is loosen up…

Hope this info helps

 

[sistersinhim]

Elevate the leg and ice every hr for 20 minutes

20 minutes really does nothing for bringing down the swelling and tightness. Many of us elevated and iced the whole time we were sitting or lying down. I did. As soon as I sat down, my leg was on the Lounge Doctor and the cold water circulating ice machine pack was on my knee. As long as you have a cloth between your leg and the ice source, you can ice all the time. This really helps lower the pain and swelling, making pain meds less needed.

 

[Flashlight]

Hi, I was used to the 20 mins on 20mins off first aid too. After my surgery they told me that was the old way of thinking. Who knew?!! I was given the SMI cold wrap while in the outpatient center. The cold wrap will last for 3-hours warming up the 4th hour to aid in circulation. I was told to change the ice packs every 4 hours. I did this routinely for the first few weeks. Wow! my doctor wouldn't let me on the stationary bike right away. I'm using it now and it's hard not to overdo. You are doing great!

 

[pall48]

Week 6; stiff and in pain in quad area still have not been able use operated leg to,go upstairs…. Going to pt twice a week using weight 6 lbs. Saw Dr is happy rom but wanted to do second leg in a month… Reason is that I am bow legged now one leg is longer than other causing the operated leg to be bent therefore not going to 0 degrees for extension… I feel that if I get second leg done the left tkr will not support the R tkr going upstairs…. I am going to try a lift in my shoe on the right side and hold off getting surgery on right ,until left leg is strong enough to climb stairs…. Does one have thoughts about this situation has anyone experienced this situation …. Thanks for your input…

 

[sistersinhim]

Going to pt twice a week using weight 6 lbs. Saw Dr is happy rom but wanted to do second leg in a month… Reason is that I am bow legged now one leg is longer than other causing the operated leg to be bent therefore not going to 0 degrees for extension

It is way too early to be using weights on your baby knee, especially a 6-pound weight. We suggest waiting 3-4 months before doing so. Using weights too early will cause excessive pain and inflammation to an already angry knee. Your strength will occur naturally as your knee heals and the swelling and inflammation decrease. Your extension will also improve on its own as time goes on. You can help it a bit by increasing your stride length with a heel-to-toe gait. I did this and have suggested this to others. Of course, your leg length is a different situation which a lift might help. If I were you, I'd ask my doctor for his suggestion.

 

[benne68]

Oh my goodness, @pall48, please resconsider using weights so early in your recovery. You could set yourself back significantly. As @sisterinhim points out, your body needs more time to heal from the trauma of surgery.

 

[Layla]

How are you doing, pall?
I hope you took the wise advice from the two women above and you're doing better on this special day.
Happy Two Month Anniversary!
May your Christmas be merry and bright.
@pall48

 

[pall48]

Hi

Have not checked in for awhile, I am at my 4.5 month since my L-tkr. ROM is great able to ride stationary bike for 20 minutes and walk on treadmill for 10 minutes. I am still getting some pain walking up the stairs I am hoping in time that will stop as I become stronger...My only issue is stiffness around the joint, I do stretching exercises that seems to help a bit, my question is has anyone tried dry needle therapy? If so, was it successful in releasing your muscle tension and was your stiffness lessen by this therapy? In addition, are there any other therapies that have worked or exercises to lessen stiffness around the knee... I will be going in for my R-TKR on April 3rd looking forward to getting it done... I am now off all prescription medicines and any OTC drugs... Have been release from PT but still keeping routine until I have the other knee done... I look forward to your input and thank you for your responses...

 

[Jockette]

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 has been disturbed and is healing...and full healing takes a full year or more.

Tight Band feeling across the front of my knee

That tight band is caused by scar tissue but not the adhesions type of scar tissue. When the surgeon opens up the knee, he has to undercut the skin and superficial structures from that centre line to each side of the knee in order to get good access all round the bones. Part of the healing...

bonesmart.org

 

[Layla]

Hello pall48,
Thanks for checking in. It's good to hear from you!

my question is has anyone tried dry needle therapy? If so, was it successful in releasing your muscle tension and was your stiffness lessen by this therapy?

Here is a link to an article on Dry Needling Technique.
You can also type Dry Needling into the SEARCH at the top of the page and any threads where it's been mentioned will pop up.

Glad to read you're doing well as you are nearing the date of your Right TKR. Stick around and share your progress, we'd love to follow your journey.

 

[EalingGran]

I am still getting some pain walking up the stairs I am hoping in time that will stop as I become stronger.

My surgery ( PKR) was a few days after yours. I have only recently started to be able to do stairs normally and still get some pain/ discomfort if I do too many in one day. I am seeing improvement and working on glute/ quad strength to help with stairs.

 

[Layla]

Best Wishes for you surgery tomorrow!
Let us know how you're doing once you're feeling up to it.
@pall48

 

[Layla]

Hey there,
We haven’t heard from you since you’re latest surgery on April 3rd.
If it remained on schedule, I hope you’re doing well and enjoying steady progress. We’d love to hear from you next time you’re on the forum.
Best Wishes and Happy Two Month Anniversary!
@pall48

 

[pall48]

Hi
Had second knee done on April 3rd this knee was much different then first…. Flexion was much harder to get to120…. My main issue is IT band as I do slides my leg can feel the IT band rubber across the outer part of knee joint…. I have tried to stretch the band seems to improve a bit…. This issue limits me from going up and down stairs…. Also my extension is at 10 I am working with PT. Got down to 3 with Pt applying pressure on the knee in time will get it to zero…. I am using dynasplint on left leg to get better extension started at 12 now at a 7 with no external pressure on the knee.

first question I have is when does PT release you with my extension not at zero they are planning to release me in 3 weeks.. Is this normal?

second question has anyone use dynasplint what was your experience?

Third question anyone had issues with IT band After tkr?

thanks in advance for your input
for it.…

 

[EalingGran]

Third question anyone had issues with IT band After tkr?

Not exactly but I had some hip pain on my unoperated side recently which was thought to be IT band issue. My pilates teacher did some work on my hip flexors and used spiky balls under my buttocks and massaging along the IT band- which seems to have helped.

 

[benne68]

You are living proof that every knee is different -- even two knees in the same person!

first question I have is when does PT release you with my extension not at zero they are planning to release me in 3 weeks.. Is this normal?

Yes. It usually takes longer to regain extension than flexion. Many of us find that both continue to improve well into the second year. Please don't let your PT force it. Just keep moving; your ROM will come with time.

anyone had issues with IT band After tkr?

Yes! I sought help from a massage therapist who worked on it for me, but also taught me some simple massage techniques I could do at home. It took about a month, but it cleared up for me.

 

[pall48]

update on recovery left Knee

the left knee is doing well however still have tightness below the knee and if I walk long distance the top off my knee the quad region becomes stiff and sore. I am walking in the a pooll for 45 min I do feel tightness in the knee... it seem to loosen up as I walk more... I ice when I come home from the pool.. that seems to help too... Ice 2 -3 times a day... The knee was operated on October 17th 2022 about 10 months into the recovery...
Now Right knee Update:
This knee is a total different beast... I do sildes and I can feel the IT band rubbing up against the knee..in the knee is still swollen on the lateral side... I do stretching and some cupping to see if I can move more blood to help heal the area and to lessen the pain that seem to help... I have completed my PT and keep on doing exercises and walking plus icingi which does help... This knee is a marthon and will take much longer then the left knee.. I am going back to PT to a practice that will work on musculoskeletal aspect of my recover.. I am hoping they will be able stretch out my muscles around the knee and get more flexiblity throughout lower have of my body... Plus teach me the some exercise that will help me to continue to be come more flexible... Just to let you know I have alway had tightness in my legs.. The knee was operated April 3 2023

One question as I go though this Journey:

1) On this site it would be nice to have an area where it could help us figure out what is the best rehab center in our areas.. For Instance, I go Spaulding rehab in Massachusetts however they have many differentt site that have different specailities.. One site might be very good strenghtening another gait and flexxiblity so on... I did not get any help from my surgeon... This has been most frustrating area for me what has been your experience in finding a rehab that meets your needs?... Any thoughts or comments thanks for your response in advance

 

[mendogal]

Re finding rehab that meets your needs: it's highly variable!
PT was originally largely based on a paradigm coming from the profession's growth in the polio epidemic, reinforced by post stroke rehab: flaccid and spastic paralysis with high risk of permanent flexor contracture. That's not an approach well suited to post-op or post-injury rehab, though there are certainly many fine PTs out there who have specialized in postop or injury, or backs, or whatever.

The very best PTs I have worked with as a patient were ones who developed a particular specialty they were interested in after starting work, either independently taking courses in types of body work or affiliating with a particular surgeon or physiatrist. The facility is less important than the individual practitioner IME.