PKR PKR Recovery & Rehab

[sk44tyler]

Hello,

I completed my PKR (aka UKA) today and I’m now home and recovering. All is going well so far and fortunately I am in no pain so far. I’m sure this will change when my pain pump runs out…

My pre-op thread is here in case anyone is interested:

PKR - Need to decide between PKR and TKR

Best Wishes tomorrow! Hopefully you're all prepared and ready to get the show on the road. We'll be watching for you on the healing side to share some Recovery Guidelines and cheer. Hope to see you there soon! @sk44tyler

bonesmart.org

 

[sistersinhim]

Congrats on your new knee! I'm glad everything went well in your surgery. Take it really easy for the next few weeks to allow your knee to begin its healing process.

You had a PKR, but it's the same recovery for it that it is for the TKR. I will leave you our recovery articles.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

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.

KNEE RECOVERY 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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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 these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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.

 

[Layla]

Welcome to recovery! Thankfully your pain is manageable. I hope it continues. I wish you all the best as you begin healing and look forward to following your progress!
@sk44tyler

 

[Toothfairy]

Great to hear that your op went well. Take it easy

 

[JDinCT]

Welcome to recovery road!

Great to hear that the surgery went well!

I will be interested to follow your recovery in relation to others with TKR.

Best of luck!

 

[sk44tyler]

One thing I wanted to ask everyone about… my knee is pretty numb - especially on the inside going down into the side of the calf muscle. When touched, I can feel the pressure but it is still very numb. From what I’ve read this appears to be normal? Hopefully the feeling comes back. Any thoughts / experiences with this would be appreciated.

 

[EalingGran]

You may well have had local anaesthetic injected to supplement any general or spinal anaesthetic and that can take a while to fully clear out.
It is impossible to do even a PKR without cutting a small branch of a sensory nerve- lower saphenous I think.
This will gradually regrow over months to years - you will sometimes get sharp stabbing little needle like pains ( known here as zingers) which are a healthy sign of nerve recovery.
The numb patch will shrink and sensation will come back but may never be totally the same.
At 22 months my numb patch is now unnoticeable at a day to day level.
If I test it with say my nail- I can feel everything but it still feels ever so slightly "different ". If I accidentally knock it is is more unpleasant than knocking the other knee- like hitting your funny bone. At first pressure such as kneeling on the numb patch was very uncomfortable. But now with practice I can kneel pain free for short periods on a hard floor and longer periods on a thin cushion.
Don't worry about it. Everyone gets this issue and doctors don't really mention it in my experience.

 

[JDinCT]

I had some initial numbness post-surgery on both my TKRs.

Five plus years later on my first TKR (right), I have no numbness at all.

Seven days out from my second TKR (Left), I have large areas of numbness and the "zingers" have started.

 

[mendogal]

To add to the above:
Not everyone gets "zingers."

Some of us get dysesthesia, weird mis-firings as the sensory nerves waken and reconnect. This may manifest as sensations of cold, burning, wetness, itch, pain, or friction.

In the case of my L TKR the sensation for a few months was of friction, like fabric catching on the numb area as I walked (it definitely wasn't happening in reality).

Both my numb patches now have diminished but present sensation without any kind of weirdness.

 

[sk44tyler]

Thanks everyone for the comments on the numbness… definitely makes me feel better.
I had my first in-home PT session this morning. It went really well - my PT said I was doing well and I’m ahead of the curve at this point. For extension / flexion, I’m measuring -16 and 79 degrees currently. I’m still feeling pretty good, however my knee feels more stiff/tight than it did yesterday. I can also feel a bit of pain but nothing too bad at this point.

 

[mendogal]

It's normal for swelling, with its related stiffness, to increase following activity especially PT.

Definitely keep the continual icing and elevating when you're not doing an hourly brief walk or attending to hygiene, siitting into up to eat, etc.

And please don't allow any PT to pull at, push on, or actively manipulate your new knee: we have had members sustain tendon and ligament damage from overly eager, results-focused providers.

 

[sk44tyler]

It's normal for swelling, with its related stiffness, to increase following activity especially PT.

Definitely keep the continual icing and elevating when you're not doing an hourly brief walk or attending to hygiene, siitting into up to eat, etc.

And please don't allow any PT to pull at, push on, or actively manipulate your new knee: we have had members sustain tendon and ligament damage from overly eager, results-focused providers.

Great advice! Thank you

 

[sk44tyler]

Well yesterday afternoon and into the evening was pretty rough. The pain level increased pretty high, while I was in between doses of pain meds (thus I had to wait). I ended up taking my pain meds (around 8:30 PM). I assumed my sleep would be terrible, but actually wasn’t too bad. I slept until 2 AM, then woke up (alarm) to take my next dose of pain meds. I then fell back asleep until about 5 AM. Overall, not too bad of a night.
My stiffness and pain are way less today (so far). I’m actually feeling pretty good. I’m currently laying in bed icing and doing exercises.

 

[Layla]

Sorry you had a rough night and early evening, but it sounds like you had some decent sleep. Some may envy that, although it may not feel sufficient currently. Good to read the pain and stiffness has eased somewhat so far today. Hopefully you're able to sustain this and remain comfortably mobile. Icing always helped me immensely. I hope it does for you too. Best wishes on your journey! I'll be following along.
@sk44tyler

 

[sistersinhim]

Getting good sleep is a blessing, and it sounds like yours was. This early in your recovery, a good night's sleep is unusual, and truly a blessing!

 

[sk44tyler]

Getting good sleep is a blessing, and it sounds like yours was. This early in your recovery, a good night's sleep is unusual, and truly a blessing!

Absolutely agree. I’m very thankful

 

[sk44tyler]

Here’s a current picture of my knee. The swelling isn’t too bad

 

[Layla]

I agree! Not too bad.
Keep up the icing and elevating as you're doing. It truly helps.
@sk44tyler

 

[sk44tyler]

Day 6 post op… recovery progressing well. Yesterday I looked at my phone and was surprised that I had managed to get 1500 steps in just from walking around the house and walking out back a bit.
Sleep is going OK, although I keep waking up at 2 AM and then at 4 AM. I tend to change positions a lot (side to side and stomach), so staying on my back for much of the night isn’t something my body likes. My knee starts to ache a bit (not too bad) and my back hurts. It doesn’t help that before the surgery I pulled a muscle in my back lifting weights. Anyways, the back pain is beginning to annoy me.
For meds, I’m now only taking 1 oxy before bed (none during the day - only Tylenol, Celebrex, and Gabapentin). I might skip the Oxy dose all together tonight - I don’t really feel like I need it anymore.
Had my in-home PT this morning. I’m now measuring -3 and 112 degrees for extension/flexion.
Tomorrow I get the dressing off and on Friday I get the staples out.
Overall, things are going really well. I feel like I am in actually less pain than I was for my previous open knee surgery (ACI). I think I took my pain meds more religiously in the beginning this time around, which helped. Fun fact - this is the 3rd time I’ve had open surgery on my right knee (only 1 scar though - the same one being used for the incision every time). My surgeon this time around said there was a lot of scar tissue he had to get through which caused the incision to be slightly larger.

 

[mendogal]

Sleeping.... In the first weeks I often slept much of the night in the recliner.
After I got the Lounge Doctor during knee number 2, my first sleep of the night would be with both legs on that, then switch to a pillow or two.