TKR Panammaniac’s Recovery Thread

[panammaniac]

Well I made it to the other side! Surgery went well. I wasn’t able to talk to the surgeon after but she talked to my wife. Apparently the damage was much worse than what the x-rays showed. I also had a torn ACL which we didn’t expect. I’m not sure exactly what that means, whether she did any sort of repair or not. It’s something I’ll have to ask in a post-op visit.

I had a few minor complications in recovery and ended up spending about 5 hours in there. For a while it was looking like I might have to overnight but they ended up kicking me out and sending me home. Apparently I lost a little more blood than normal and my BP dropped to 70/30. I remember waking up and thinking “ok, I’m in recovery,” and then looking at the big clock on the wall. My surgery started at 1 PM so I already had it in my mind that I’d be waking up around 3:30 or so. The clock said 4:45, so my foggy thought was that we had a complication in surgery. They finally got me stabilized after a few hours. I was also unable to pass any fluids and they wouldn’t send me home until I did, so I had to get catheterized. That wasn’t at all pleasant but you gotta do what you gotta do.

My in-hospital PT went very well. I was up and walking pretty quickly and one of the nurses said “wow, look at the rock star” as I walked by. The PT said I was far better than normal.

Today I’m feeling ok. I’m getting myself up and around the house. I got a halfway decent night’s sleep. The area on my thigh where I got the nerve block is very sore but I’m sure that’s normal. Home PT is coming over this morning in a little bit. I’d say my pain level is about a 4 or 5. I’m on the ice machine and doing just fine. So far so good.

 

[Jockette]

Welcome to Recovery!

I will leave you our Recovery Guidelines. 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

If you want to use something to assist with healing and scar management, 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.

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​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[lovetocookandsew]

Welcome to the other side! I'm glad everything went well in surgery, and the blip in recovery is over. Keep getting lots of rest, and the ice machine is your new BFF. Don't let PT cause any pain; all you should be doing right now is getting lots of rest while icing and elevating, and getting up regularly to do some walking around the house, and some very light stretching. Make sure to read the guidelines Jockette left you, especially the Activity Progression for TKRs-I read that daily to remind me not to do too much, or too little, as I recovered. Keep us posted!

 

[HoldenOn]

Glad to hear you're home and doing well! Can I ask, what ice machine are you using and would you recommend it? It seems I've gone down the Amazon rabbit hole of choices and now I can't decide.
Thanks!!

 

[WFD]

FWIW, I have the Breg Polar Care Cube and it has worked out well.

 

[panammaniac]

@HoldenOn I was given an ice machine after surgery. It’s a covered benefit with my plan. The brand name is Donjoy. It’s been less than 24 hours but seems to be working well so far.

 

[benne68]

I’m on the ice machine and doing just fine. So far so good.

Yay!

 

[kiwicurls]

Hi @panammaniac , welcome!
As you lost more blood than usual, you might find yourself very tired over the next weeks. Just take it slowly and chill out. I had tkr in April and the recovery was made so much easier because of the excellent advice on Bonesmart.

 

[MJJ]

Well I made it to the other side! Surgery went well.

I had mine 3 1/2 weeks ago, recovery is tough sometimes frustrating, I still have always to go but this forum helped to understand many have the same questions about recovery as I do!

 

[panammaniac]

It’s interesting that as of right now at least, the knee feels fine, but the thigh is very painful. I’m getting a constant dull ache in the quads, and now that the block has mostly worn off, sharp pains when I walk. I’m assuming that’s from them having a tourniquet on it and maybe doing some manipulation during the surgery, but whatever the case it hurts quite a bit. The PT is already on me about needing to get to 90 degrees in 2 weeks. I was at 72 this morning which is pretty good for day one, but I’m going to try to keep that 90 degree in two weeks thing at bay. I’ve stepped up the OxyContin for now because the pain has definitely increased.

As for the ACL issue, my understanding from reading a little more is that some of the modern knee joints don’t need an ACL so they can just remove it if it’s damaged. I’ll have to ask the surgeon that question when I see her.

 

[lovetocookandsew]

Ignore the PT's 90 degrees in two weeks decree and let your knee recover at it's own pace. If he/she keeps bugging you about 90 degrees in two weeks, let them know, in no uncertain terms, that you plan to let your knee dictate your recovery. There is no set date to be at any ROM; everyone is different and their recoveries are different. Keep adding a little bit to your walking time each day, and let your knee tell you what it's ready for, and what it's not ready for. Gently stretching and bending are good, but only to the point of a little discomfort, not actual pain.

Overdoing things can set you back, so don't allow anyone to dictate to you where you "should" be at any given time. As your knee recovers, the swelling will go down, and as that happens, your ROM will improve. I never even let anyone measure my ROM, as what I could do was more important to me than any random number. Over time, your flexion will get better, and your extension will improve. We don't want you to be a couch potato, but we also don't want you overdoing things and causing more pain and swelling.

 

[SkiBum]

I've researched the acl issue because my surgical report said that they purposely cut my acl which surprised me. It turns out that it's traditional to remove the acl even in cases where the acl is normal. ACL retaining designs are the newer development in prosthetics and I'm guessing not as widely used. The design of the prosthetic replaces the stability the acl provides.

 

[panammaniac]

I've researched the acl issue because my surgical report said that they purposely cut my acl which surprised me. It turns out that it's traditional to remove the acl even in cases where the acl is normal. ACL retaining designs are the newer development in prosthetics and I'm guessing not as widely used. The design of the prosthetic replaces the stability the acl provides.

Great to know. Thanks! The torn ACL explains why I was limping so heavily at least.

 

[panammaniac]

So day two of recovery has been much harder. The nerve block has worn off and pain is much more intense. I’m keeping up on the meds and am now doing two oxy every 6 hours, but everything is still very painful. I’m getting a lot of sharp pain in the middle thigh and hip. My wife was planning on going back to work tomorrow but has decided I’m not quite ready to be home alone yet, so she’s taking tomorrow off too. I know it will get better but things are a little rough right now. I slept less than two hours last night according to my Fitbit. Sleeping is difficult. I’m getting a few naps in during the day.

 

[benne68]

Yes, the first week is hard, @panammaniac! Be assured that what you are experiencing with pain and sleeping difficulties are quite normal.

I know you've heard this before, but the key to recovery in these early days is:
- Keep ahead of your pain by taking your meds on schedule
- Ice and elevate throughout the day.
- Sleep whenever and wherever you can.

While it is important to get up and walk around a little bit every couple of hours to prevent blood clots, you don't need to be doing exercises at this stage. When he released me from the hospital, my surgeon told me the following: "Your ONLY job for the next two weeks is to rest, ice and elevate so your body can recover!"

It does get better; it just takes time -- but we're here for you!

 

[panammaniac]

It’s kind of funny, but some vague memories of the OR are starting to creep back. It’s all very foggy, but I remember being wheeled into the room and there was a small army of people in there, at least 8. They were all very cheerful and there was music playing - Sweet Caroline, and they were all singing along. I also remember it was freezing in there. They had me sit up on the side of the bed so they could inject the spinal and I started shivering and commented about how cold it was. They put a blanket over my back that was warm like it just came out of a warming device of some sort. Then I remember them telling me to scoot over to the operating table, and someone commented on how quickly I made it over. The last thing I remember was them telling me that they were moving the gurney away because they didn’t want me trying to scoot back over to the other side. It’s interesting how these foggy memories start to come back after a couple days.

 

[sistersinhim]

I remember freezing, too. They had a hard time getting my temp back up in the recovery room and kept putting warming blankets on me. They felt so good!

 

[panammaniac]

Doing much better this evening now that we are caught up on meds. In hindsight I should have started with the 2 oxy every 6 hours regimen. I’ve been on that for 24 hours now and it is working out much better. I got maybe 3 hours of napping in during the day. Last night was just a rough and painful night with no sleep to speak of. My thigh was red hot this morning, now it’s cool to the touch. Everything seems headed in the right direction! Tomorrow the PT is supposed to take the outer dressing off.

 

[Jaycey]

Glad to hear you are feeling better! It just takes time and a bit of patience. Sounds like you have established a routine that works for you. Well done!

 

[sistersinhim]

I got maybe 3 hours of napping in during the day.

It doesn't matter when or where you sleep as long as you do sleep! Just about everyone has sleeping problems for a month or two after this surgery. I slept an hour or so in my bed, then got up and slept an hour or so in my recliner, then back to bed...etc. This went on around the clock. So, sleep as much as you can. When you are sleeping your body can concentrate more on healing that knee!