PKR Poorlyknees Returns!!

[PoorlyKnees]

July 19th - Day 0: Sort that right knee out…

Right knee PKR…
Procedure went really well. I was really impressed with the anaesthetists, I had a spinal jab, as I did with the other knee, but reduced the amount so the feeling was restored to my legs much quicker. They hedged this with a local anaesthetic applied to the femoral nerve. Even in surgery, everyday’s a school day.

What difference did it make…
After my left PKR the feeling in my legs returned after several hours, but I was numb around my hips, bum and groin until the next day.
This time it has been very different and much better. The feeling in my feet was returning and I was able to move my legs before I left recovery.
I was up and about with a walking frame within 3 hours!

A bit of context…
At the beginning of March I had a medial PKR (robot assisted) on my left knee. My left leg was in a bad way, a badly broken femur had rendered the knee weak and wobbly.
Meanwhile, the meniscus in both knees was wearing out. Eventually the arthritis set in and surgery was inevitable.
My new left knee is awesome. Fully flexible, pain free and definitely not wobbly.
My right knee was much stronger, but the arthritis pain was more severe, but manageable. I’m confident my new, new knee will be… good as new!!

The recovery journey begins again.

 

[Jockette]

Here’s a refresher course for you:

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

2. Control discomfort:

rest​

elevate​

ice​

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

don't overwork.​

​

If you want to use something to help heal the incision, ​

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.​

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.

 

[benne68]

Congratulations on getting knee #2 replaced, @PoorlyKnees! Happy to read you are on the recovery side.

Keep us posted. Your updates on your other TKR were so detailed, I'm sure lot of members found them helpful.

Happy healing!

 

[mendogal]

@PoorlyKnees - just a Howdy from across the pond from another in the "let's do two knees this year!" club.

 

[PoorlyKnees]

July 20th - Day 1

The day after…
Bit of a rough night. I don’t find it easy sleeping after an anaesthetic. The approach to pain management was far less aggressive than for my previous PKR. It was more driven from what I wanted rather than a force feed approach. I suspect this is down to saving money. I passed my mobility test on crutches (no surprise) and was discharged early afternoon.

What hurts…
My knee is understandably sore but it’s more of an ache than real pain. It’s easy to manage with the painkillers the hospital provided. My thigh muscle is quite sore this is from the intra muscle local anaesthetic injection they gave me. That’ll wear off in a couple of days (I hope)

Must be patient…
I’m very keen to get going again, but I must follow my surgeon’s guidelines and take it easy. I have an enormous bandage on my leg that I have to keep on for 4 days. He said the only reason they put this on is to stop the patient from doing too much too quickly.

It’s like deja vu all over again…
It’s a strange situation. I have my right leg elevated and bandaged whilst my left leg is fully mobile and pain free. It’s strange to think that 4 months ago my left knee had just been replaced and was all strapped up. I’m looking forward to having both my knees back.

 

[PoorlyKnees]

July 21st - Day 2

First day at home…
I slept so well last night a lot more comfortable than after my left knee was done. Sure, it’s sore but with a simple bit of support and elevation it’s absolutely fine.

I’m pretty mobile too. I feel quite comfortable moving about the house on 2 crutches. I’m doing my exercises and applying the ice, as required. The prescribed painkillers are working well.

My thigh is still pretty sore from the intra muscle anaesthetic and I think the whole thigh area is a bit swollen, but there’s no sign of any bruising.

All things considered…. It’s going pretty well.

 

[Mettleinside]

Good luck @PoorlyKnees - you know what to do and what to expect. The way you sound it should be relatively easy.

 

[PoorlyKnees]

July 22nd - Day 3

Going from strength to strength…
My knee feels great. I definitely feel that this knee is stronger and more mobile than the left at the same stage; no surprise.
The painkillers are definitely making me drowsy, but resting is no bad thing.

Get up and get going…
I’m fortunate where I live. I have a garden to walk around and if I’m feeling good I can walk to the end of the road and back. Today, I made it to the corner shop and back comfortably. It’s a leisurely stroll as people are curious as to what I’ve been up to.

Do your physio…
My physio exercises are going well; a little uncomfortable but worth the effort. I’m really happy with how well my left knee has stepped up.

Big day tomorrow…
I can remove the big bandage tomorrow, which is a huge relief. It will feel so much nicer without the added restriction.

How’s my head…
I’m a real fidget so I can get very bored sitting about doing nothing. Claire (my wonderful wife) has tasked me with researching a trip around Scotland that we are planning on taking early in October. That should do the trick.

 

[benne68]

He said the only reason they put this on is to stop the patient from doing too much too quickly.

I love this idea. Perhaps they should require us to wear them for two weeks to keep us out of trouble in those early days!

 

[PoorlyKnees]

July 23rd - Day 4

The big reveal…
Removed the heavy bandage. Hardly any swelling around the joint and just the slightest bit of bruising on the inside of the joint. Still got a bit of swelling of my thigh (from the intra muscle anaesthetic jab), but it’s not as sore.

Keep up the physio…
I’ve been watching the final day of the Open golf tournament today, which is a great excuse to do regular physio exercises. I can flex my knee to about 60 degrees, do straight leg lifts and tighten my quads quite comfortably. Saying that, the ice pack afterwards is really nice.

Extra effort…
I put in some extra effort today and went for a walk (with 2 crutches). I’m slow, but I feel it really helps my circulation. I’ll sleep well tonight.

And tomorrow…
Weather forecast says rain, so tomorrow will probably be a bit of a rest day.

 

[PoorlyKnees]

July 24th - Day 5

Rest is best…
I slept like a log last night. This knee is very different from my experience with my left knee. I struggled to get comfortable at night and often had to sleep sitting up. I woke up this morning in exactly the same position as when I switched the lights off.

Start the day with a smile…
I was awoken (as I am every day) by my over-enthusiastic best friend… Sean, my cat. He comes in through the bedroom window at dawn (or just before), miaowing loudly and insists I give him my absolute attention.

How was my knee today?…
I feared I might be sore after the physio and walking yesterday, but my knee felt really good. There is no puffiness around the kneecap and I can move my leg around independently.

Today’s adventures…
I spent today flexing my knee and clenching my quads. Yes, I went for another walk. I’m still using the same level of pain management and will continue to do so for a few more days yet but the improvements day on day are remarkable and totally different to my previous experience. I still need to work on the range of motion and that will be my focus for the next 10 days.

 

[mendogal]

This is so cool to read!!!

 

[PoorlyKnees]

July 25th -Day 6

Enjoy the weather…
5:15am….? Do I look like the sort of person that wants to be woken up (by Sean) at that time? Anyway, I checked the weather and it was set fair. My knee was feeling really good so I decided it was time to go for a walk.

Out for lunch…
Gorgeous wife Claire and I set off into town for lunch. 2 miles there, and 2 miles back. No problem. The reason I did this was to compare my new right knee with my (not so new now) left knee. I did a similar walk 1 week after my left PKR, I struggled a bit. No such problem with right knee.

In summary…
Reasonable range of motion, minimal pain, no swelling. It’s all good.

 

[PoorlyKnees]

July 26th - Day 7

Is it a week already?…
It’s time to reflect. When I look back at the blog for my left knee it really shows how different the recovery journeys can be.

How does it compare?…
One week in with my left knee I was struggling to do the physio exercises and was proud to have managed to walk to the corner shop. This time around I have walked 4 miles, mowed the lawn (with a push mower) and I’m doing my physio exercises without any difficulty.

What do we learn from this?….
No two knees are the same and no two people are the same. I’m lucky, I’m 58 and strong and fit. It was funny in hospital, because the alarms were going off warning the recovery team of a low heart rate. It took them a few minutes (and reassurance from the ward nurse) to accept that 46bpm was OK .

Left vs right…
I knew my left knee would pose problems, but I believed I would get through it and I made sure I celebrated all the positive achievements, however small. My right knee recovery has been much quicker, but the same approach applies. I keep pushing for small improvements and rest it properly with ice and elevation. It’s up to me.

What next?…
I’m already looking forward to having staples out and having my first physio session but that’s not for another 9 days!

 

[EalingGran]

. This time around I have walked 4 miles, mowed the lawn (with a push mower) and I’m doing my physio exercises without any difficulty.

Crumbs! That sounds amazing but be careful you are not overdoing things so very early on.
I only managed a 4 mile walk at about 4- 5 months.

 

[sistersinhim]

Why go to PT? You are already doing your own PT! What a great recovery you are having!

 

[PoorlyKnees]

Why go to PT? You are already doing your own PT! What a great recovery you are having!

The PT I had last time was very useful in terms of identifying areas to focus on, even though I seemed to be recovering week. For example, I had good ROM etc, but the Physio identified that my gluteus medius was very weak and without attention that would lead to sciatica-like back pain. He was right.

 

[PoorlyKnees]

. This time around I have walked 4 miles, mowed the lawn (with a push mower) and I’m doing my physio exercises without any difficulty.

Crumbs! That sounds amazing but be careful you are not overdoing things so very early on.
I only managed a 4 mile walk at about 4- 5 months.

We’re all different. I work on a “work day, rest day” rota; I always stop if it becomes unnecessarily uncomfortable. I had quite a challenge getting mobile when I had my left knee done. I struggled to sit without my leg up and couldn’t sleep lying down; it was very uncomfortable. It took a lot of work to build up strength in my quads/hamstring. It was my weaker leg. My right leg is stronger and has responded really well. The ROM is already good enough to sit comfortably on a chair and I can complete all the post op physio without any pain.

 

[Layla]

Your writing style is intriguing in the respect that it pulls one in to read and know more. Thanks for joining us and sharing details of your progress. It’s great to have the less desirable of two recoveries over with first I imagine. Best Wishes as you continue the journey!
@PoorlyKnees

 

[PoorlyKnees]

… It’s great to have the less desirable of two recoveries over with first I imagine….

I hadn’t thought of that! It was the surgeon’s idea to do the left knee first. I’m so pleased we did them in that order.