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PKR PartialFix -- Recovering...

partialfixFeb

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I am a little over 3 weeks post-op. Glad the surgery is behind me. Experienced horrible anxiety awaiting the surgery and having to put my trust in the surgeon's hands.

Background: Knee gave when walking last August and never healed. Posterior horn meniscus tear and bone on bone medial knee.

Week 1: So painful - round the clock painkillers, ice, and elevation. Struggle to lift leg, move leg. Used walker to get around. Ditched walker before the end of the first week but took a while to "trust" my leg and used walker at night still since didn't trust my leg or balance with painkillers. Could slowly put weight on it with discomfort bending and all discomfort was severe tightness around the kneecap and incision. Felt like a very tight clamp around my knee (swelling I guess). Zero pain in the medial knee area - unbelievable to finally have relief in the medial knee area after limping since August 2019 with medial bone on bone pain. Started PT on day 4 post-op. Memory is a blur, petered out quickly from the PT and the outing itself. Stomach and side sleeper so sleep was not great but lots of naps in recliner. Hubby iced throughout the day and night. (Couldn't handle steps to trudge downstairs to ice self). Ditched walking stick on day 6 or 7.

Week 2: Good days and not so good days. Tried to wean off painkillers. Hubby's idea. It was a no go. Swelling improving daily. During week 2, woke up and felt huge relief like the clamp grip on my knee eased. Still swollen but not very noticeable. PT progressing. PT very gentle. Never has me do anything painful, just some discomfort with bending. Got my leg straight but bending is the hard, slow part but time is my friend. Rom about 110 degrees. Taking painkillers sporadically - definitely spaced out and often just take half a painkiller, take the other half as needed. Had post-op February 20, got green light to drive since left leg. But no fun bending leg to get in and out of car. Walking around the house quite a bit but that's about it.

Week 3: Walking more but no real distance yet. PT wants me to gradually add distance, so far no more than a 5 minute walk at a time. Still taking half a painkiller as needed for PT and home exercises. Wanted to switch to ibuprofen for stiffness - Doc says NO ibuprofen - thinks it inhibits bone growth. Tylenol does ZERO for me. ROM still ab out 110 degrees. Able to run errands and take self to PT but tire out easily still. To be expected.

Hoping to progress with walking a bit in week 4...
 

Jockette

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Hi and Welcome!

It’s interesting how different surgeons think, mine was fine with me taking ibuprofen, he didn’t believe it slowed down the healing. I alternated that with 1000 mg of Tylenol, round the clock, so I was taking one or the other every 3 hours, but 6 hours between Tylenol doses and 6 hours between ibuprofen doses.

We do caution about taking pain relief specifically before doing PT, because it could enable you to do more than your knee is actually ready for, which could cause a setback. While we don’t like to feel pain, it is your body’s way of telling you that you’ve done too much. I’m glad you have a gentle PT, many of us did not.

It’s sounds like you are coming along very well.


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.

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!)​

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.
 
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partialfixFeb

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Thanks, Jockette. The recovery guidelines are so helpful. First thing I read when I found the forum.
 

Cjackso21

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I am 4 weeks post op (2/7) from my 6th revision and I am not sure what I would do without Advil Liquid Gel caps. Couldn't take them until off the aspirin for blood thinning which I stopped a few days ago so I could get off of the Tramadol. In the process of weaning down and adding Advil. Good luck with your recovery!
 
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partialfixFeb

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I think my daily aspirin ends on Monday. After that, I'll reach out to my doctor to ask again about ibuprofen for the inflammation and pain relief. Gosh knows I LIVED on Advil before my surgery.
 

aperture

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I also survived on liqui gels, and couldn’t wait for the ok to go from Oxycodone back to Advil after five weeks. I’ll let you know how it’s working.
 
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partialfixFeb

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Four weeks post-op as of yesterday.

PT going well- less than 1 degree from being completely straight and 120 degree bend. Far cry from the bend I had prior to surgery but hopefully will improve as stiffness subsides. Able to walk normally up the stairs but if I take too many trips upstairs, I revert to the safe way (good leg up, bad leg meets.) Not even close to thinking about attempting going down the stairs normally.

Broke down and bought a "fit bit" as PT would not give me guidelines on how far I could walk until she could gauge my daily activity level so she could add on gradually. Hit over 10,000 steps a few days this past week. Other days, rested more and hit maybe 5,000 to 8,000 steps. Terrified to overdo it so overly cautious. Errands and daily activities much easier. I still wait for that medial pain to return every time I stand up - every single time - and cannot believe it is gone - hopefully for good. I still tucker out easily if I run too many errands and often save some of my to do list for the following day. I still ice a few times a day, especially after activities. Still feel very sedentary and I get a lot more rest than I can ever remember getting.

Sleep: Still some sensitivity to the touch on kneecap surrounding incision that comes and goes. Incision pretty much healed. Sheets can get annoying as they touch my kneecap. Sometimes, I tape cotton over the incision at night so I can sleep on my stomach for a couple of hours without knee sensitivity and while protecting incision. Been able to sleep on my side for a while with frequent adjustments which is HUGE. Still aware of my knee while sleeping and look forward to the day when it is a non-issue...afterthought.

Pleased with my rate of progress thus far. Was terrified to get the surgery but thus far it has exceeded my expectations. Feeling so blessed. Was very active before - hoping to return to a similar fitness level once I have healed. Sorry for the lengthy update.....
 

Qdogpa

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You are doing extremely well! especially for only being 4 weeks post op! Not sure I would kick it up a notch, seems like you are already doing more then most can do , that are further along in time. 1 and 120 is excellent...Time is our friend...rushing PT can only cause a slowdown, will,not expedite your recovery...slow and steady...keep,up the great work!
 

Celle

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Hit over 10,000 steps a few days this past week. Other days, rested more and hit maybe 5,000 to 8,000 steps. Terrified to overdo it so overly cautious. Errands and daily activities much easier.
You're doing well, but I think you're doing too much, too soon.

it's only just a month since your surgery, and 10,000 steps in a day is far too much. Your knee is still in the early stages of healing and it needs time and gentle treatment so it can continue to heal without getting irritated and inflamed.

Do check you activity against this article, to see how much activity you should be doing:
Activity progression for TKRs
 
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partialfixFeb

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@Celle Saw my PT yesterday. Discussed the forum guidelines. She wasn't really concerned about my daily steps so long as I am taking only short walks at a pop (I am- never more than 10 -15 minutes at a time) and so long as I stay on flat surfaces and listen to my body. Last 2 days were lazy for me in fact as I just felt tired. She especially wants me to avoid downhill. My PT does; however, want me to stick with the step up exercises (4" at first now 6" step ups) and would rather me not walk upstairs normally yet because it puts too much force on the knee at this stage of the game so I put that on hold. Thanks again for making me reconsider how fast I progress.
 
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partialfixFeb

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Tomorrow I will be 6 weeks post-op.

My PT measured my bend last Monday at 125 degrees...gradually getting there...I was 135 before the injury and surgery.

I still ice and elevate and don't overdo it. Some days are quite lazy in fact. I am gradually increasing my mileage and I am not too proud to start around the block for as long as I feel comfortable and call hubby for a ride home :) Some days I don't walk; other days a mile or just half a mile or less is plenty...all depends on how my knee feels. I have always been very active but the surgery is too new and I have to be smart about it and patient.

Yesterday was my first walk around our block (little over 2 miles), I broke no speed records but it felt good and no negative feedback from my knee during or after the fact.

I still get the "zingers" (nerves reconnecting?) but I honestly feel zero joint pain. Every time I get up from a chair or the bed I still cringe expecting that awful bone on bone pain but it is GONE and I pray it stays that way. I am amazed at the complete lack of joint pain putting weight on my knees and how fast that happened for me. I also had horrible pain while pivoting and catch myself unexpectedly pivoting in the kitchen (for example) and feeling no pain doing so. I do have uncomfortable tightness/band around the kneecap that is helped by gentle massage. Some days worse than others. Not painful just can be mighty irritating.

I do still get tired more easily since the surgery. I've been shopping for my elderly parents (quarantined them) and I don't always accomplish all of the errands that I set out to do...some errands just wait for the next day and I don't beat myself up about it. This too shall pass and not a big deal.

I am diligent about doing my home exercises to strengthen surrounding muscles to take the pressure off of my knees. None of them hurt. I do believe that my pre-surgery PT exercises, Pilates, and Yin Yoga helped me to recover. Nonetheless, the quad muscles surrounding my knee weakened and are gradually rebuilding.

I am not ready to get back to the gym quite yet but then again, our gyms are closed. My PT is prepping me for re-entry to the gym with a list of forever restrictions. No more of my beloved barre classes and, of course, my running days are over, but she gave me many other activities I can do whilst protecting my knees. And, that's okay.

I am grateful for the recovery advice on this forum and shared experiences. My thoughts and prayers that everyone stays healthy during this pandemic.
 
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partialfixFeb

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I recently found a good book on Amazon Kindle with helpful illustrations for gentle home PT exercises if anyone is interested in checking it out. Its also a very good resource regarding PKR surgery in general. I personally feel there is so little information out there regarding PKR surgery since so few of us qualify for it. Great pre-op book too in my opinion. I'm not to the point of trying the advanced gym exercises in the book and would personally not do them without asking my PT first but it has good guidance for home exercises. It includes general milestones but I don't pay too much attention to them because everyone is different and time is our friend. Not even close to meeting some of those milestones so take them with a grain of salt.

I stopped outpatient PT over a week ago because my PT is in a hospital setting and just too scared with the virus and not finding it necessary at this point - the book helps fill the gap for me.

Partial Knee Replacement: Everything You Need to Know to Make the Right Treatment Decision: Understanding knee arthritis - Medial unicompartmental - Patellofemoral ... unicompartmental
by Frank Noyes and
Sue Barber-Westin

 
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Jamie

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Dr. Noyes is an excellent surgeon and well-known in the orthopedic community. If you decide to purchase this book from Amazon, please sign up for the Smile.Amazon program and make the purchase through it instead of on the main Amazon website. This way BoneSmart will receive a small donation for your purchase and it costs you nothing extra. Even small donations like this help us to keep our site up and running 24/7 for everyone out there who needs us.

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