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TKR Post tkr hemhorrage

boiseguy

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I am new to the forum. I had tkr on my left knee 8/16/21, so I am almost 6 weeks post op.

I was released from the hospital late in the evening of my surgery day. The very next day my surgery leg hemhorraged and I had a serious hematoma (blood in my leg tissue) from my ankle to my groin. Basically my entire surgical leg. Needless to say but that wasn't what I was expecting nor what I wanted to happen. It has really created a non-standard post-op tkr recovery if there is such a thing.

I am wondering if anyone else on this site has had a similar experience or has known someone that has had a similar experience?

My tkr has not been easy, It has involved a lot of high level pain and discomfort. And physical therapy has basically been physical torture for me.

Any and all advice for me would be greatly appreciated. This has been really tough for me both physically and mentally.
 

Roy Gardiner

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:welome: to BoneSmart

The BoneSmart view is that therapy should never be painful. If it is, it means you're not aiding recovery but compounding the damage. Pain is nature's way of telling you this. We say, 'no pain, more gain'. Please ask the therapists why they think pain is acceptable.

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, 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
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 these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 

Jockette

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The very next day my surgery leg hemhorraged and I had a serious hematoma (blood in my leg tissue) from my ankle to my groin. Basically my entire surgical leg.
What was done to help this?


And physical therapy has basically been physical torture for me.
Please stop allowing your PT to cause you pain.
Saying no to therapy - am I allowed to?

Painful rehab is not necessary to get a good outcome. And with your hematoma complication, pain in PT is hindering your recovery. If your PT won’t back off, find another office with a gentler, more update approach.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
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boiseguy

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The moderator asked what me what was done to help me with my post tkr hemorrhage. The short answer is nothing could be done so nothing was done initially. A day or two after my tkr my surgeon stuck a needle in my knee near my patella and tried to drain some of the hemorrhaged blood from that area but by then the blood had thickened and his attempt wasn't successful.

Blood that has bled into tissue is very caustic to the surrounding tissue. It becomes very painful very quickly. That is what I experienced. The pain from the hematoma exceeded the pain coming from my knee. Oxy was my only way of dealing with the pain coming from two sources, my knee and my hematoma. It was intense!

The hemorrhaged blood simply has to have time to reabsorb which the human body does over a period of time. Unfortunately, that put my knee healing on hold because my surgery leg was puffed up from all the hemorrhaged blood and it was absolutely too tight to bend. By the time my first scheduled PT session arrived my leg was still quite swollen and colorful from the hemorrhage. I dreaded going to that appointment and my fears were well founded. It was torture. My leg wasn't ready to be manipulated the way the two therapists that worked on me wanted it to move. So far I have canceled 2 of my scheduled PT sessions because the therapists caused me so much pain that my knee actually hurt much worse for days after they worked on me. It has been a tough past 44 days since my tkr!!
 

Jockette

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Thank you for explaining all that. What an ordeal.

I‘m so sorry you had PTs that were not knowledgeable about your hematoma and tried to force your leg to bend. I’m glad you cancelled the next sessions. If/when you go back to PT, if you haven’t already, I suggest you consider a different office, for a more updated and considerate rehab approach.
 

liam2015

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Oh my goodness ~ that must have been painful. Not the same but back in December, my hubby had a 2nd recurrence (within a month) of an old high school football knee injury. He was out walking the dog, stiffened up and couldn't make it home on his own; my sister picked him and the dog up. The pain was so intense that we called an ambulance. The e.r. dr. drained a lot of blood from his knee, said it was a knee hemorrhage. He had one more recurrence a couple weeks later but the ambulance wouldn't come that time. Luckily I had some Oxycodone from my femur surgery that helped him. He's okay now after going to physio several times.

I am so sorry you had such a rough time at physio. I found that I liked the treatments at physio, starting 6 weeks post op: massage, TENS, laser, cold pack and relaxed for 20 minutes or so. The bending of my knee was painful once she pushed it further than it was ready for. Once you get back to physio, let them know if they're going too far and ask them to stop. Be careful if you go on the stationary bike that they don't push your knee all the way round before it's ready. Be gentle with yourself when given the at home exercises to do. There is no need to go beyond discomfort. You will get there. Good luck.
 

Pumpkin

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@boiseguy,
If you decide to return to PT, find another office and PT. Call and talk to them before you make an appointment, ask about their approach, with your hematoma you need and deserve a gentle approach to help your knee heal.

There is no rush to gain ROM, many of our members have gained ROM one to two years after surgery.
Your ROM is right there now, waiting to be revealed when both your hematoma and swelling go down.
Right now you time to heal.

I had a Baker Cyst burst a few years ago, a hematoma the size of a baseball formed, it was the the most painful experience in my life. It took a full 2 months before it re absorbed.

Wishing you continued healing,
Chris
 
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boiseguy

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It has been 20 days since I last posted to this wonderful tkr resource site. I am now 2 months out from my 8/16 tkr. My first post to this site was my attempt to find someone that hemorrhaged the day after tkr. No one posted a reply telling me that they had that kind of post surgery experience so I haven't been able to compare my recovery with but that's okay. I just had an added step of having to wait for my hemorrhaged blood to reabsorb before I could start the "normal" recovery journey. That reabsorbtion process took several weeks and wasn't fun!

I almost quit PT after the first 3 or 4 sessions because of the pain they were inflicting on me. I told them that if I was going to continue PT with them that I wanted a certain therapist that used a more gentle approach. They honored my request and I have been going to PT twice a week for about a month now. My ROM progress has been slow but I didn't get off to a standard post tkr start. There are times when I do wonder if I will ever get the necessary ROM or have a knee that isn't stiff and sore or be able to sleep in my bed again and get a good night's rest. I have found out that depression is real after tkr.

I have a couple questions for members of this forum: 1) Is persistent low level nausea common after tkr? 2) Is pain in various areas of the calf common after tkr?

I can walk but my knee stiffens up on me to where it is difficult to do the proper heal toe method that the therapist wants me to do. This happens in just me walking out to my mailbox which isn't that far of a distance. This is very discouraging to me.

I enjoy reading others progress reports. I hope with time that I will have a knee that let's me live an active life again.
 

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Hello and glad to see you are doing better!
To answer your questions, in my experience, the low level nausea was relieved once I was able to wean off the round the clock narcotics (Oxycodone and Tramadol) and also correlated with cessation of daily aspirin and Naproxen (I was on those a bit more than a month post op).
My calf still gives me difficulty but not as bad as it did early on. I would get terrible shin splints at night and need to lay ice packs over my shin. Those have luckily subsided but I still get random calf pains!
Insomnia persists as here I am on Bonesmart at 3:30 am :) I'm glad to offer you some hope.
 

Sun catcher

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I am almost a year out, I had a large hematoma in the middle of my calf muscle after surgery and it was excruciating. For me I found I turned a corner about 8 weeks out with that. Hang in there it will get better. Try not to compare your recovery to others that hematoma sounded huge! Nausea for me was a problem make sure you are taking meds with food. The other thing I experienced was overwhelming fatigue. Kind of scared me but your body is doing a major repair so be kind to yourself. That lasted about 14 weeks for me. Rest, ice and elevate. You will get there. This forum helped me realize that I was not abnormal in my recovery but everyone is different.
 

BBCG

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Hi @boiseguy, I am so sorry for the awful pain of your knee TKR plus hematoma combo! No fair at all!

I’m glad to hear you have a PT now who respects your care needs and will work gently with you; I had to fight that battle too.

You asked about the leg pain, and for me and others I’ve read about, we did have various and sundry pains for months. This TKR (April 29, 2021 surgery) I knew to expect such pains, so I was prepared with several methods to relieve those pains, from magnesium gel for the zingers, the shooting nerve pains as the nerves re-knit themselves, and an herbal/CBD (legal here) salve for more typical aches. Plus, after I returned my borrowed ice machine, I still had 2 of the big ice packs I could bring out to use.

Keep us posted on how you are coming along!
 

sistersinhim

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Don't worry about your ROM, it will come with time. Your knee and leg have been through a huge trauma and have to heal from that. You are only 1/6 of the way through this normally a year-long recovery. As you heal and the swelling, both inside and outside, subsides your bend will improve. This just happens naturally without any pushing or painful exercises.
 

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