PKR Partial Knee post op<

[kneeper]

Most of us take pain meds for several weeks, but taper down as the knee allows. Most of my pain after the first couple of weeks is what I call achy stiffness. Pain meds helped get that down to a background level.

 

[Josephine]

How many days post op were you all able to stop taking narcotic pain relievers? I thought I was over that hump but today my leg just aches.

You're worrying about this at only 2 weeks post-op? Good grief - worry about it when it's 12 weeks post-op!

 

[Smythe89]

Hi Josephine
I’m asking about it, yes. I was under the impression that this was a place to come and ask questions. Judging me because I asked isn’t helpful.

 

[Celle]

I don't think Josephine was judging you. She was just saying that you don't need to worry yet about coming off pain medications. It's not uncommon to need them for 3-4 months, although usually it's decreased doses by that time.
You'll know when the time is right, when you start forgetting to take a dose on time, but don't feel any increase in pain. That's the time to start weaning off the pain meds.

 

[Josephine]

I’m asking about it, yes. I was under the impression that this was a place to come and ask questions. Judging me because I asked isn’t helpful.

That was my answer so you got your reply and yes, this is where a member can express concerns and ask questions but I won't promise not to tease you a bit when I reply!

 

[Smythe89]

The reason I asked is because my OS provided me with a packet that says 2 wks on narcotics is what he expects.
Keep in mind I had a partial, not a total. I just really need straight forward answers if you don’t mind.

One to my next question- icing seems to increase stiffness. Does everyone experience this? I almost feel like heat would loosen things up so it seems counterintuitive. Just a thought. My 1st post op visit is tomorrow. My packet also says if ROM is 0-100 I win. Not sure what I win but I was at 4 and 95 last week so perhaps I’ve gotten there.

 

[SusieShoes]

Here’s hoping you win!

Everyone is so different when it comes to pain control. I had both knees replaced and was off narcotics in a little over two weeks. Tylenol was my friend after that. But many other people, including partials, may find they need strong pain-killers for longer. That’s why we say to use them as for as long as you have significant pain.

Some people, and you may be one, do find icing unpleasant and say it increases stiffness. For me icing was a joy and decreased swelling and stiffness, and that’s the usual experience. Elevation alone may be enough for your knee. Heat causes blood vessels to dilate and more blood (and fluid) will enter the knee and maybe stay around, increasing swelling. Swelling is what causes less ROM, and also more pain, so heat isn’t good to apply directly on a new TKR.

People do experience relief from muscle cramping in the thigh or calf, though, from heat applied there, either above or below the knee. If you do want to try heat, just keep it from going directly on the knee for now.

 

[Smythe89]

Thanks Susie! I actually love icing. I ice a lot and elevate constantly but while decreasing any discomfort (pain seems too harsh a word at this point ) it does seem to make things a bit more stiff. There’s still a bit of swelling in the knee so yeah, I’m not ready for heat there but I do long to soak in a warm tub!!
Thanks so much for your insight.

 

[Jockette]

I did not like icing either and felt very stiff after, too. I did keep it up, though, until about 6 months.

I also had a partial. I found there’s no such thing as “only a partial”. (I did used to use that term, too) Contrary to what I was told and read about partials, my recovery has been very long and difficult. I had a Patellofemoral and it has now been over a year and I’ve come to the sad conclusion that mine has not been successful.

Recovery from any knee replacement is pretty much the same.

I stopped taking the narcotics on day 11 because I’d had blurry vision since the surgery and we thought the dilaudud might be causing it. My surgeon told me to take both Tylenol and ibuprofen, so I did, alternating the two. I didn’t see any difference in the pain relief after stopping the Dilaudid, so I don’t think it helped me much anyway. It was just a bad time. I couldn’t believe I had invited this surgery.

I did finally improve but it was a long haul.

Hugs to you as you continue this journey.

 

[Smythe89]

Thank you jockette. I’m sorry you had such a challenging time. My impression that PKR is faster and easier than TKR is/was based on what my surgeon told me. I’m coming to realize that he may have meant 6 months as opposed to 1 year. In fact my husband was under the impression that there was no bone removal in the PKR. I did set him straight on that...very straight I think we are both a bit blindsided by this post op journey.
I am doing well, I think but I do get an occasional sharp pain underneath my knee cap. It makes doing any ROM activity not a good experience. Even heel slides can be going along great and then out of no where comes that pain.
I realize I’m only 2 weeks out and this is a journey. I thank you for your kind words and for sharing your story.

 

[Josephine]

Keep in mind I had a partial, not a total. I just really need straight forward answers if you don’t mind.

I never forgot you had a partial but it actually makes little difference in the long run. The recovery progress is very much the same. And I will always give you answers appropriate to your situation.

One to my next question- icing seems to increase stiffness.

Are you putting a covering between your skin and the ice pack?

 

[Celle]

I also felt that icing increased stiffness, but I think that was because while I was icing I wasn't moving my leg at all. Keeping your leg still all the time increases stiffness.

Although heat feels good, using it on your knee in the early weeks can increase swelling, which will also increase stiffness.

In spite of what surgeons may say and in spite of the advertising for them, it does seem to take just as long for most people to recover from a partial as from a total knee replacement.
After all, even though only one compartment of your knee was replaced, that compartment had the ends of two large bones cut and shaped - that's bound to take a long time to heal.

The idea that having a partial leads to a faster recovery has been the source of frustration for a lot of people who had partials.

 

[hedgehog]

Sorry, hit the wrong key. This is anecdotal, but I had my PKRon the same day as yours. My doctor indicated that I should expect to be 50% at 4 weeks, 75% at 8 weeks and 100% recovered at 6 months. Obviously it can vary. He also said getting to 100% with a PKR is about half of the time it takes for a total.

I have found that I love icing, but it enhance the stiffness. For me, I can elevate, I cant sit with my knee bent or I can just sit with my leg extended and each on of those positions will result in stiffness. For about the last 9 days, it is the transitioning from one position to another that causes actual pain (vs discomfort). That was a surprise as I really felt like it would be the bone / joint recovery itself leading the way.

Your recovery seems to be progressing - hopefully you continue to trend in a positive direction.

 

[Celle]

Hi @hedgehog ,
I've edited your post, above, to delete the quotes and I also deleted the post you made accidentally.
You don't have to quote a post in order to reply to it.
Just go down to the bottom of the page, where it says "Write your reply" and start typing there.

If you need to quote all or part of a post, this article tells you how:
How to use the quote feature

 

[Smythe89]

I too love icing. My OS suggests using it as a means to manage pain and I have indeed done that. I will have lots of questions answered today at my first post op vistit. I’m excited! I’m curious what their guidelines are for recovery, I.e. when I should be doing xyz and what my expected ROM should be at each month according to them.
Thank you Hedgehog (good to know we began this journey together) and Celle for your responses and sharing your experiences. I appreciate the feedback.

 

[SusieShoes]

One thing to keep in mind about guidelines is that they are just that: guidelines. They aren't absolute and you may or may not meet a guideline goal on any given day or week (or month, for that matter). My OS had walking guidelines I dearly wanted to meet, but I had trouble meeting them at first. I kept working at them until I did. My OS later told me most of his patients don't meet the goal at first... the purpose of the guideline is to provide a reachable goal, not serve as a pass/fail test.

 

[Smythe89]

Yes, thank you Susie. I won’t judge myself if I don’t meet his guidelines. I’m just curious. Thanks for the reminder. We are often hardest on ourselves.

 

[kneeper]

I'm a person who likes "instructions" or "guidelines" too. What I learned very quickly was that so much depends on your level of swelling and listening to the knee.
Do keep us posted on your followup appointment.

 

[Smythe89]

Well, so much for guidelines my OS doesn’t have any! Post op visit went well. Done with cane/crutch. ROM 0-100 and I can drive whenever I feel safe enough to do so. I can stop PT unless of course I’d like to continue. I can’t yet climb stairs so Apparently it’s all up to me! So I’m continuing PT, will try to drive to PT on Thursday, and life is pretty darn ok right now.
I go back in 4 weeks for X-rays and follow up. Oh, and put sunblock on my suture line because it will burn for the next year or so

 

[Josephine]

Well ain't that a pill! All that worrying for nothing!