TKR Post-Op Left Knee Replacement

Lftknerplcment

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I had total left knee replacement surgery on July 22nd, 2022. The surgery went well from what I was told. It took me longer to wake in recovery than others but the nurses had me up and walking with the help of a walker before I checked out late that evening.

I got sick off the Dilaudid. I was nauseated and threw up for 3 days after I went home. I was given exercises to do and I did them as best I could until I went to PT on the following Monday. PT only lasted 20min and it wasn't intense.

I went back to PT on Thursday and had a different trainer and he had me do more difficult exercises. I did them went home and felt okay until I woke up the next morning. I felt like I had pulled a muscle. It was painful walking with the walker and I began having pain around the center of my knee. It wasn't constant and happened more when I wasn't moving than when I was. So I stayed off my knee as much as I could and I iced it twice a day for 20min for 5 days and I skipped PT today because I just don't think my knee can take it and since it's now feeling better

I don't wanna have a setback. I'm supposed to go Friday and I might but I may ask them to keep the exercises light and not difficult. But if I'm feeling even better I may skip PT altogether this week because today I began walking using a cane and my knee is able to bend more without me doing any exercises which surprised me.

The only major problem I'm having is sleep. I can't get comfortable at night. The knee still hurts enough to keep me awake and since I stopped taking the oxycodone cause it keeps me nauseated I'm up at night. I tried Benedryl and it doesn't help so I think I'm gonna try dicyclomine and see if it will help me sleep. I'm glad I got the surgery because I was having radiating pain in my arms, legs, and buttocks and all that pain has vanished. I can say that I'll be relieved when these stitches are removed because in my opinion, they hinder my knee movement plus I can feel them at times and they are painful. I did want to get the wedge pillow to prop up my knee but the nurses and PT told me not to. They said it wasn't good to use for long periods of time. So I guess I'll suffer without it. But so far this has been my experience and hasn't been as bad as I thought it would.
 

benne68

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Hello @Lftknerplcment and welcome to BoneSmart. I'm so glad you found us.

For starters, let me share the BoneSmart philosophy on recovery. There is a lot of read here, but I think you will find many of these articles very helpful.

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.
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.

Let us know how we can help!
 

benne68

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But if I'm feeling even better I may skip PT altogether this week because today I began walking using a cane and my knee is able to bend more without me doing any exercises which surprised me.

Yes, you SHOULD skip PT! You are barely 10 days our of surgery and that is much too soon to be doing all this exercise.

Your body hasn't yet had time to heal from the trauma of the procedure. Remember that your surgeon sawed and hammered your bones, and cut and shoved your muscles and soft tissue. Everything is inflamed right now, and the only thing you should be doing is icing and elevating so you can heal. If you don't give your body a chance to recover from the surgery itself, you will struggle with even more pain going forward.

I iced it twice a day for 20min for 5 days
This is not enough icing for so early in your recovery. You should be icing 5-6 times a day for 30-45 minutes each time. Be sure to elevate while you are icing as well. It's essential to get your knee above your heart. The articles I posted above provide more information about.

Your instinct to take a step back is right. We are here to support you as you navigate this.
 
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Lftknerplcment

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I did not know that I should be icing my knee that many times a day. I will increase beginning today. THANK YOU!
 

sistersinhim

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I iced my knee the whole time I was sitting or laying down, including all night long. As long as you have a cloth between the ice pack and your skin you can ice all the time. Ice is a natural anti-inflammatory and pain reducer. Getting the inflammation down will help to get the swelling down.
 
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Jockette

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The only major problem I'm having is sleep. I can't get comfortable at night. The knee still hurts enough to keep me awake and since I stopped taking the oxycodone cause it keeps me nauseated I'm up at night. I tried Benedryl and it doesn't help so I think I'm gonna try dicyclomine and see if it will help me sleep.
Disrupted sleep is very common after this surgery.


If Tylenol agrees with you, it can be very helpful.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.
 
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Jockette

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I did want to get the wedge pillow to prop up my knee but the nurses and PT told me not to. They said it wasn't good to use for long periods of time. So I guess I'll suffer without it.
You will find different opinions on every aspect of this recovery. And that’s all they are, opinions.

Many of us used some type of elevating wedge. I’m still elevating all night every night on my wedge, as it’s the only way I can sleep on my back. I find it very helpful.


 
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Lftknerplcment

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I'm so glad I joined this forum. I've learned so much already. I was seeking some answers and you guys have helped me realize that there are other options and ways to get relief to help get through this process! Thank You so much!
 

lovetocookandsew

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I can't take any narcotic pain meds, so my ice machine and I were BFFs. I iced around the clock, with regular breaks to walk around the house, gradually doing more as time went on. I also used my Lounge Doctor to elevate whenever I was lying down and icing. I did ice all night, but didn't use the LD to elevate at night as I slept better with a pillow between my knees than on my back. Don't forget to keep a cloth between your skin and the ice and you can ice for as long as you like that way.

As for PT, you've already seen that your knee was unhappy so my suggestion is skip PT, at least for now, and just do gentle stretches, plus regular walking around the house, and see how your knee likes that as opposed to PT. Don't worry about your ROM right now as your knee is still swollen from the surgery and the numbers you have now are not indicative of the numbers you'll have as you heal and the swelling, both outside that you can see and inside that you can't see, recedes. I never let them measure my ROM as the numbers were just numbers to me; I gauged my healing by what I could once again do.
 
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Lftknerplcment

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I'm going to ice overnight and I'll probably hold off on PT. I did order the wedge pillow to help with sleeping at night. What I noticed tonight was two round raised bumps on my arm and thigh on my right side. They don't itch so I think I may be having some type of allergic reaction. Hoping it won't get worse. Thank You for sharing!
 

Mimibmgc

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If the Tylenol and ice don’t work well at night ask your clinician about prescribing Gabapentin. I can’t tolerate narcotics well and it helps with the pain and getting to sleep. And ice as much as you can!
Also for PT I have been prescribed at home PT (much less intense) for 2 weeks before going to a PT clinic. This was down for both knees and helps to get the swelling and inflammation done before you start the heavier work at PT.
 
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Lftknerplcment

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Thank You but I am finally sleeping. But now Im dealing with tightness in the knee so I'm now taking flexeril and a medrol dosepak. It's helping with the pain and inflammation but so far it's not doing much to relax the muscles but I've only been on it for a day now.
 

Jockette

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Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.
 
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Lftknerplcment

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Well that's good to know! Thank You! I was also thinking about getting a recumbent bike and wanted to ask if anyone thought that would be a good idea or not? It seems to loosen the knee up a bit when I go to PT.
 
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sistersinhim

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I used my recumbent bike quite a bit during my recovery. I set the seat all the way back and 0 tension. At first, I'd have to lift up my hip on that side to go around. At first, I was able to go backwards only, but before you knew it, I was going front wards with my hip down! I would wake up hurting during the night and get on the bike for only about 5 minutes and the pain would go away. I highly recommend one.
 

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