TKR Post-op Spasms

If you find the magnesium tablets hard on your stomach- then try the spray form. I use it before bed for sleep.
 
Gosh, this is such an up and down experience. I had to have my incision debrided and four stitches out in because one section was not healing and starting to open more. At the same time, I’ve had such stiffness and pain this week (4). I was out doing some shopping and then attended my daughters grad which was likely too much and made me sore. Physio said to keep moving and was pretty aggressive the next day after which I’ve had the band of pain around the front of my knee, the zingers have started back up and when I walk I’m getting a sharp pinch to the inner side of my knee. My quads and calf are tight and nothing seems to relax them - I’ve tried ice, heat, pain meds, muscle relaxants, elevating it, massage. I’m at a loss and feel like I’ve stepped five steps back to where I am hobbling around my house and dependent on the cane again (I had stopped using it while at home).

Is this normal? Is it always an up and down rollercoaster? I’m losing hope for a full recovery even though it’s still early. Advice welcome?
 
Is this normal? Is it always an up and down rollercoaster? I’m losing hope for a full recovery even though it’s still early. Advice welcome?
I had to have my incision debrided and four stitches out

I was out doing some shopping and then attended my daughters grad

Physio said to keep moving and was pretty aggressive the next day

Yes, the way you are feeling is all normal, especially after all this activity at only 4 weeks post op.

Now that you’re past the graduation take as much time as you can to rest and elevate. With another procedure on your incision, so early in recovery, you now have a bit more to recover from.

Don’t let your PT be aggressive with you, it is counterproductive at this point. If they won’t ease up, find another office, or take some time off going, and let your body catch up on the healing. You can always go back later when your leg feels better. There are definitely times when “less is more.”
Saying no to therapy - am I allowed to?

Besides swelling, Stiffness/Tightness is also 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 has been disturbed and is healing...and full healing takes a full year or more.


I’m losing hope for a full recovery even though it’s still early.
You will recover fine, but it takes time and patience, and overdoing activities will cause set backs. 4 weeks is often when these feelings of “I’m never going to recover” show up.
 
A note on Magnesium tablets- Magnesium Glycinate is a form that doesn’t upset your stomach or cause diarrhea. That and pickle juice have taken away all my muscle cramps.

Laurie
 
I had to have my incision debrided and four stitches out in because one section was not healing and starting to open more.
When did you have this done? Are you healed from it yet?
 
I had to have my incision debrided and four stitches out in because one section was not healing and starting to open more.
When did you have this done? Are you healed from it yet?
It was done this past Friday which was exactly four weeks since surgery. The rest of my incision has healed but they want to keep the stitches in for at least two weeks to ensure it’s closed and no longer an infection risk.
Here is before and after pics

E40F3935-1734-4EDB-9DA0-44C241083F39.jpeg
EC0BF207-E239-4F9F-8A86-59DE7107FD34.jpeg
 
Thank you so much for the date of your debridement. I added it to your signature for you. Hopefully, everything will heal up just fine.
 
Good hello everyone. I had a right total knee replacement on June 2nd and have found this board very helpful in answering questions that came up over the past week and a bit.

Today I wanted to ask if anyone else developed severe muscle spasms to their surgical leg a few days after having their knee replaced? Prior to surgery I would sometimes having spasms in my right hip if I was over extending it but never in my knee. These spasms seem to worsen when I’ve exerted myself, like after physio or showering. It feels like my entire knee twists up suddenly and then let’s go after a few seconds. At times when I was asleep I’d awaken to a spasm that made me scream and start crying which has terrified my whole family.

Is this normal!? I’ve done some reading that mentions they could be a side effect from the nerves being disrupted but does it go away?

Thanks in Advance!
I started having spasms around 8 weeks post op. Very unusual feelings never experienced before. After an MRI at the request of my surgeons office it was discovered I had a severely compressed L5 nerve. Never have had back issues in 75 years. Was told the very unusual position they place your leg may have actually contributed to the L5 getting to a point where symptoms actually started. Still dealing with it after 3 months but finally being seen by a spine specialist in a few days. The spasms run from my hip down through my entire leg. It has affected my healing process now at 5 months post op
 
@BionicMama ... did the doctor take a swab so it could be cultured? And are you taking any antibiotics?
 
@BionicMama ... did the doctor take a swab so it could be cultured? And are you taking any antibiotics?
No culture, the site was clean with no discharge or sign of infection. They did prescribe abx empirically just in case though.
 
Thanks for the quick reply. I’m glad to hear you were prescribed some antibiotics and that it will be checked again in a couple of weeks. Please post additional photos of your knee so we can watch the progress. That helps others to see how something like this works.

As far as the stiffness you’re feeling in your joint and especially the muscles, that’s likely the product of exercise and therapy that is a bit more than your knee is ready for at this point. You are very early in recovery. I suggest you scale back on the aggressive therapy and take it easy for a few weeks. Once this starts and the soft tissues get irritated, it can take a week or more to resolve once you slow down. You do need to keep your knee mobile throughout the day by getting up and walking around the house for 5 minutes or so each hour. Gentle bends and stretches are good throughout the day too. If you have pain, take something for it on a regular schedule. Acetaminophen is usually a good choice every 6 to 8 hours through the day and night until the pain is relieved. Then you can start to slowly reintroduce exercises back into your recovery. Don’t be in a hurry. Slow and steady is best. If you have access to an exercise bicycle, that is a good way to move your joint in a low-impact way.
 
Week 5 Update:

It’s not officially 5 weeks till tomorrow but close enough. Generally I’ve been feeling pretty down and regretful about having had surgery. Between the contact dermatitis and then the would dehiscence, and now the near constant knots in my muscles, it just seems like it’s never going to get better.

I am expected to return to work in September and although I know there’s still two months to go, I’m truly unsure if I can work as a nurse on my feet for 12 hours if things don’t drastically improve.

Physio seems disappointed with my slow progress. My flexion is at 95 and my extension is 7. I’m able to walk around the house without a cane as physio said I should not need it but during the first few steps I’m still relying on holding onto furniture to stay steady. I have a cycling machine and use it whenever I am sitting up. I’m icing several times a day, and using heat on the quads and calves to try and get them to relax. I’ve been able to walk short distances but it doesn’t take long to fatigue, especially when not using a cane. I do the stretching exercises several times a day and have been going to physio twice a week.

It’s so challenging going to know where I really am on the road to recovery as on one hand I have physio and the journals articles I’ve read telling me I’m not doing well, but on the other hand there’s a whole community of people reminding me this is just the early stage still. It’s confusing to know what to believe.
 
My flexion is at 95 and my extension is 7.
At only 5 weeks out this is great! Tell that physio you are not in training! She is obviously trying to get you to a place you are not ready to go. Please push back!
I’m able to walk around the house without a cane as physio said I should not need it
Use the cane until you are totally confident. Physio should not be dictating when you should give up any walking aids.
I have a cycling machine and use it whenever I am sitting up.
Please stop all this. You are over working that poor knee. Rest, ice and elevate to get rid of the swelling that is causing discomfort. No wonder your muscles are cramping and tight. All this is counterproductive.
I do the stretching exercises several times a day and have been going to physio twice a week.
Try stretching once per day and if you insist on physio, you certainly don't need it twice a week.

It's your choice whether you want to take the aggressive approach or the slow and steady approach recommended here. But if you go through some of the threads in the knee recovery forum there is plenty of proof that our guidelines work.
 
Are you able to back to work for less hours & less days until you feel ready for full time?

Marie
 
Are you able to back to work for less hours & less days until you feel ready for full time?

Marie
When I return they will put me on a modified schedule and gradually build back up the hours. I just cannot envision being at the bedside right now. I’m praying things improve before September.
 
Scar Pain

Just tonight I’ve noticed that my incision site that has healed over is becoming quite tender in the areas between where the staples were. There is no breakdown, some widening of the scar tissue but to touch it’s a sharp twinge. I’m not sure if the deeper layers of sutures are dissolving and that’s what I’m feeling or something else is going on. To be honest I’ve not ever had a scar so long, so I’m new to this stage of healing.
 

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