TKR Question on pain and swelling six months post TKR

[Jockette]

before getting up early to exercise,

You don’t need to “exercise” this early in recovery. Just going about your day, being back to work, will give your healing knee all the healing mobility it needs to recover. Some members stop going to PT when they return to work, for this reason.

I have a work meeting Thursday and it is a bit of a walk

This is what I call “natural PT” and is all the formal exercise you’ll need that day.

My goal this week is to make the time to get to the pool at my gym on my off PT days.

I would wait a while before going to a pool and gym. You are still recovering from major surgery and it seems you are doing way too much rehab, in addition to trying to get back to your normal life. Do the things you enjoy and let your normal life be your rehab. It really does work well.

I think the MUA set be back a bit?

An MUA is an aggressive procedure and it does set you back.

 

[Layla]

I know you understand this recovery can take a full year and even longer for some people. The MUA set you back, so you will need to mete out activity accordingly. Gradually, you will be able to add more activity. It's likely too early to socialize after work since you're having a hard time adjusting to your return as it is. You also have PT. Reconsider your desire to go to the pool on your days of no PT, instead allowing your body that time to recover.

Are you able to get a ride to the work meeting from a friend, or co-worker...or Uber, Lyft etc?

Getting adequate rest and sleep will build up your strength and stamina. Once you're no longer feeling exhausted from work, then consider a single night out. Your body is using energy first to heal, not leaving a great reserve for anything else. So help it along by dialing it back and you will have an easier recovery. It may sound boring, but it's the best way.
@Onestepatatime

 

[EalingGran]

Geez it is still rough. I think the MUA set be back a bit

I think it is probably true that you are still recovering not just from the surgery but also the MUA.
It really is a long process and when they say here that it takes a year to really feel back to normal that is pretty accurate. That's not to say that you won't feel better and better as the months go on. I gradually resumed normal activities including some part- time work and grandchild care but would still need to rest and ice if I overdid it for several months.

 

[sistersinhim]

The MUA has definitely caused a setback in your recovery, especially this early in your recovery. Taking it easy until you recover from that is suggested. Your knee is still angry!

 

[Layla]

Happy Three Month Anniversary!
Hopefully you're feeling better and you have a good week.
@Onestepatatime

 

[Onestepatatime]

Hi All,
I know it's been almost a month, so wanted to check in. My knee is still swelling a good amount, and I feel like I am getting bursitis in my hip replacement side. Is it normal to have extremely weak quads? If I go up a stair without a banister I will fall. I do exercises to try and strength but I read this maybe permanent damage. My big milestones is seeing Bruce Springsteen in Asbury Park 6 blocks from my place, and going with my son to Cape May for fall bird migration.But I am exhausted still working a full day. Guess I have a fair amount of recovery to go. Any tips for around four months?

 

[Rockgirl4]

This is what I was told years ago after a few of my other knee surgeries....

A) If you have swelling, you have inflammation
B) Inflammation shuts down or "turns off" muscle fibers and stops them from "firing" properly
C) This leads to muscle weakness, therefore your quad muscle is weak because of the chronic inflammation in/above your knee
D) Knocking out the inflammation will help your quad muscle to recover and get stronger.
E) That's easier said than done.
F) I was given targeted, non-weightbearing quad exercises (very minor ones!!) to try to strengthen it. My swelling always lasts for 5-6 months due to my autoimmune disease, but I needed my legs stronger to function and be safer on stairs. At the time of some of my surgeries, my son was 4 and 7. My "mom" duties meant I needed my legs, and I needed then safe.

Best of luck to you, as I know you are looking forward to these wonderful experiences with family. They sound wonderful and uplifting, so I hope you can get there.

 

[mendogal]

If you're swelling it's because you're demanding too much from unhealed soft tissues.

I hope you are continuing to make time daily for at least a couple of 45 minute sessions of icing while elevating "toes over nose." I understand it can be difficult with working full time, but it's really an important part of getting better.

You might look around your community for someone certified in lymphatic drainage, a form of very gentle massage that improves the movement of fluid out of tissues.

Yes, for many reasons - including what @Rockgirl4 was told about post op inflammation's negative effect on muscle tissue - we all have weakness of our quads.

At 15 months post op my R knee is fully functional for walking three miles nonstop including hills and staircases, a full hour of tai chi, etc - yet my quads are still visibly atrophied! I started targeted strength training on them at about 9 months, when I was sure things had healed enough. They are getting stronger but it's a slow process!

For you, at four months, reducing the inflammation really needs to be your main focus. You can safely do quad sets exercises (easy to find online) while relaxing and icing - I did that a LOT early in recovery. Quad sets are knee friendly and wake up the quads and exercise them.

Please keep us posted!

 

[Layla]

Happy Four Month Anniversary!
It is understandable that it's difficult missing out on fun activities and spending precious time with loved ones. However, if we don't allow ourselves the TLC we deserve after major surgery, our body will rebel, which in turn stalls the healing process and full recovery. It's only four months since surgery and 2.5 since the MUA that set you back. Your body needs more time to heal. Please take that time in order to reap the benefits this second chance allows us. Best Wishes for a good day and weekend!
@Onestepatatime

 

[Onestepatatime]

Thanks, all. I will definitely listen to my body and scale back. I do need to now recover from the visit with my son. My job requires a fair amount of running around and that in and of itself feels like a lot. I thought I could resume a normal social life plus work and my body is saying NNNOOOO you are not there yet! I am bummed walking is painful. I found a ten minute daily stretch I like a lot, and been doing arm exercises so I do not feel so gross. I am trying to muster up the energy to get to the pool some mornings too.

 

[Rockgirl4]

I was reading your signature, and you have had one doozy of a year (actually a decade!!) I'm just amazed at how much you can do, and I hope you keep seeing some improvement. You definitely deserve it. I hate that it's so slow at times. Hang in there.

 

[Layla]

My job requires a fair amount of running around and that in and of itself feels like a lot.

It sounds like work, coupled with the activities of daily living is enough for you this early on. Your social life may need to go on the back burner awhile longer. That may be difficult, but the best solution to stay out of the ODIC and continue making steady progress without suffering pain from overdoing it.
Consider focusing on being a good girl until the holidays...there's a challenge for you.
Happy Weekend!

 

[Rockgirl4]

I'm sorry this has come on so quickly. It never ceases to amaze me how fast a joint can deteriorate. I had a similar experience last year my "good", non-TKR knee, though we knew it was bone-on-bone in the lateral compartment. I'd just had x-rays in Aug 2023 showing the damage was stable and fairly unchanged from 2-3 yrs prior---meaning no changes at all from 2019-2023. Then I had a miserable weekend in late Sept 2023. I couldn't walk on it for a week. Things worsened quickly after that. I had hoped for 1 more year until my son left for college. Imagine my surprise this May (& another 4 days when I couldn't walk at all) when I learned the medial compartment looked awful now on x-rays. It happened seemingly overnight. That's why I personally could never do a PKR. I can't imagine going through this much pain without a guarantee that knee would last forever and not need a conversion. Everyone is different though. We all have different experiences that go into our decisions, and I truly applaud you for being so trusting and open-minded. Best of luck as you proceed, and we're here for you.

 

[EalingGran]

That's why I personally could never do a PKR. I can't imagine going through this much pain without a guarantee that knee would last forever and not need a conversion. Everyone is different though. We all have different experiences

The idea is that for quite a few people a PKR may be all they ever need. If the wear is just on one side then just replacing that part may rebalance the knee and help prevent future damage.
In my case I was very knock kneed- so straightening my leg has hopefully prevented the mild arthritis in the other parts from deteriorating.

 

[Elf1]

@Onestepatatime I agree with @Layla , I think between work and your activities of daily living are probably more than enough for now.

Try dialing things back for a week or two, even though boring. Then you can try adding your 10 minute stretch and the arm exercises back in. I would also take the time to ice for at least 45 minutes to an hour when you get home from work. If its possible to store an ice pack at work you could even try icing during lunch.

Once you're feeling a bit stronger and the inflammation goes down/away you could try adding in a social event of some kind each week. And planning it for the weekend when you're not working might make it easier.

I know its a drag, you have really had a long haul but hopefully this is the last surgery for a long, long time. Of course I say this while sitting here icing my knee from my adventures today, which weren't anything out of the ordinary. Darn bone on bone arthritis!

 

[Layla]

Hi there!
How are you doing now that you're three months post MUA?
I hope you're enjoying progress and doing well. Let us know when you have a minute.
@Onestepatatime

 

[Onestepatatime]

Hi All,
So I cannot believe it is past six months since my surgery. I was doing great, and after four months my PT and I decided I plateaued at PT so I got discharged. I joined a gym with a private trainer who handles a lot of clients post surgeries. I had used him prior and was really eager to start again. Gradually my knee started to hurt across the knee cap. I think squats tweaked my knee. Two weeks ago I went to Florida to visit my son and mom, and my son and I did a lot of walking. At least more than I was used to. Plus navigating through the airport. I have been trying to ice and elevate a lot. But now it is really sore. I can weight bear but everyone says I am walking with a limp.
I am afraid I did something to it, and wanted to get some feedback from the group. I might call and go see my surgeon just to make sure.
Thanks!

 

[Jockette]

Gradually my knee started to hurt across the knee cap. I think squats tweaked my knee. Two weeks ago I went to Florida to visit my son and mom, and my son and I did a lot of walking. At least more than I was used to. Plus navigating through the airport.

Most likely it’s just overuse of a knee that is not fully healed yet. We’ve all been in the over-did-it-club!

 

[Onestepatatime]

Do you recall it cutting pain across the kneecap and radiating?

 

[Jockette]

Not specifically.

I had an ODIC (over-did-it-club) episode at 4 months post op that took me a month to recover from. Lots of pain and swelling. Then just as I was feeling better, a month later, my son got married, in a town 90 minutes from me, and over the general 3 day wedding weekend, I totally overdid it again, by necessity, and I had problems for months after with increased tightness and a poor bend. I had a very tough first year!