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TKR R TKR May 6

Also a few inspiring posts from current members -

JusticeRiders post -
"I just want to add, for all those coming along, a note on ROM. I want to share this because nearly all of us have a tremendous amount pressure put on us to increase our ROM by certain deadlines, or else.

Mine has been extremely slow coming. First I had to wait out the swelling, which in my case took more than 5 months. Yes, months. At that point I began to see real progress. It has continued to this day. I have seen improvement in the last 2 weeks. It’s still going. A this point I think the limiting factor is tight muscles, ligaments, and tendons from 3 yrs of very limited ROM and actually about 25 yrs of somewhat limited ROM. Those tissues are slowly stretching.

I have had to be willing to let my flexion improve at a glacial pace, be very patient, and tune out the dire warnings of my surgeon, PA, previous PT, and some well meaning acquaintances. I refused painful PT and refused a MUA. I have absolutely no regrets. I know my body, and I believe those things would have caused a domino effect of swelling and pain that may have derailed my recovery long term and even possibly have torn soft tissue, etc. I now know I have the added challenges of hypermobility and an immune condition that causes an inflammatory reaction. I think a MUA would have been very harmful to me.

Instead of forcing it, I have relied on weekly massage and using my stationary bike as a stretching aid every single day. I have been very active, but I have ramped up really, really gradually. I have not measured my flexion, because honestly I feel almost a PTSD type of reaction around it. All I care about is function and what I can do. My knee is very functional now, and still improving. I love my new knee. I’m glad I let it heal on its own timeline even though it was so much longer than everyone (most of all me!) would have liked."
 
VolLady's post -
"I want to tell everyone that has went though TKR that it is a long journey to heal. I am going this spring to have my other knee replaced.

Please do not get discouraged and I know you will because I did with my first one and cried more than I had in a life time. Scared mostly.... Surgeons will not tell you everything that you will experience during your healing. It took me 7 months actually to feel more normal but not 100%.

For the ROM I only got to 112 at 4 months and still cannot bend it all the way back to reach 130. But I can drive, sit at a table, put my shoes and clothes on great without a ROM of 130 or 120. There is no swelling at all at 8 months but I still have some stiffness at times but I deal with it and walk. I also still ride my bike with no trouble.

I am telling everyone this because your body will heal without PT and pushing your limit beyond to the point there is more swelling and pain. I have decided when I have my other knee fixed this spring, that I will do my own PT since I have all the equipment and items that they use anyway.

I had a MUA at almost 6 wks., and regretted it from day one. Simply because it did not help me anymore with my ROM but it did set me back on healing. The swelling was awful. I will not have another MUA even if my ROM was 95 at the time.

I will go in with open eyes on this other knee comparing on what I went though with the first one. So, with all that said, I wish everyone a happy healing and let your body decide with healing than someone trying to push you until you scream with pain. Also don't worry about the ROM, it will come -- it might take a year or more, but it will come. I am 67 years old and I don't expect to get past 120, but I do what I want to do at 67. Oh! and I can even bend down with the knee need to kneel on it..... Best wishes everyone!"
 
Hi all. Thanks so much for all of your encouragement. After PT yesterday, I reached 112 flexion, after using the recumbent exercise bike for 13 minutes. The therapist said I am doing very well, and not to give a worry to the PAs suggestion of "aggressive" exercises regarding flexion. Yesterday my "supporter," husband and I went our for lunch, first time out to a sit down restaurant since before surgery, 6.5 weeks ago. So great.
 
:yes!:
Going out for a meal was just about my favorite milestone! Mine was also right around then.
Sounds like you have a safe and sane PT and are progressing nicely.
 
Happy Two Month Anniversary!
Good to read the PT thinks you’re doing well without exercises that feel too aggressive at this point. Hope you’re having a nice weekend after the holiday.
Stay in touch. We love updates! :wave:
@Wanderer123#
 
Hi. Thanks Layla. I'm doing my best. I had to ask the ortho for a nausea med, as the ginger decided not to work anymore. I was given a script for Zofran, which works well. I'm still icing and elevating, doing the post surgery exercises at home, and the pt visits twice a week. No worries, just doing this journey...
 
The journey can be a lot at times. Glad you have something for the nausea.
Keep the faith, brighter times ahead! :happydance:
@Wanderer123#
 
Howdy. So the PT measured my flexion a couple of days ago. I had around 112, and now it measured at 105. I understand that it fluctuates. But doing the exercises daily, with no progress still is a downer. Plus this same PT told me I should be massaging the sutures to get rid of scar tissue, aids healing. I was not told this till this Monday's PT session. The knee cap area appears to frozen in place, not movable. Thoughts?
I have to be careful when I exercise, because I have two bulging discs in my lower back. So exercises like leg lifting affects the back.
Also, I try really hard not to limp when walking, but my brain seems to want me to limp, like a habit?
 
So, two months out.... You're doing well!

Your flexion may be hampered by swelling, as could your kneecap.

105 - 112 is ok at two months; it's a functional flexion and if you're careful to not overtax your knee and to continue icing and elevating (toes over nose, at least 45 minutes, a few times daily) it will slowly improve. (Tip: focus on your small functional milestones, record them here!)

The kneecap: With your leg out in front of you (like in a recliner or on a coffee table) and finger on each side of the kneecap can you gently wiggle it side to side? Does your PT watch you walk and observe it moving up and down? If PT thinks it might be unmoving, you might want to call your ortho team.

Massage: I assume there aren't sutures anymore? I was told by my ortho team to start very gentle massage along the incision line at a few weeks.

Limping: We definitely encourage using a cane until you're not limping, as you want your structure to develop a good habit. Are you practicing a mindful heel-to-toe gait?

[Bonesmart.org] R TKR May 6
 
Hi. I checked with the PT today, and she checked the kneecap, and it is moving as it should. My ROM is still measuring at 105 today. The PT went over how I should be gently massaging the suture line. I have to be very mindful when I'm walking, Heel toe, heel toe, to stop limping. It is working.

I would rather not use a cane, as that had a tendency to make my bulging back discs unhappy. It's a journey. My back doctor gave me a script for prednisone, to reduce the inflammation in my lower back discs. So I do PT for my back and my knee at home every day, and PT for my knee at the hospital physical therapy.
 
Wanderer123# said:
I have to be very mindful when I'm walking, Heel toe, heel toe, to stop limping. It is working.
Click to expand...
Glad to hear that it is working for you. It is tedious having to slow down and concentrate on each step. But it will get easier -- and become habit -- as you practice.

I also have a bulging disc (between L4&L5) and it really flared during the first few months post-op as my body realigned itself to the new knee. It took time, but that daily stretching and strengthening for the back paid off. I also found that once I could walk more, my back improved.

You are doing all the right things. Be patient, though, because it takes time.
:flwrysmile:
 
Howdy. After my PT yesterday, I thought I would give an update. My flexion has reached 114, so that is good. A goal is to be able to use my electric recumbent tricycle, so I think I am getting close. I use the nustep at the PT sessions, so that helps reach my goal. I still have a bunch of swelling, so I'm still icing and elevating. Some days are definitely better than others...
 
Sounds like you are progressing well, @Wanderer123# . It is a roller-coaster recovery, and those ups and down will continue for another few months. The good news is that the downs will happen less often and be less intense!

You are wise to continue icing and elevating to manage your swelling. Your flexion will continue to improve as the swelling goes down. Slow and steady!

:flwrysmile:
 
Howdy. Ten days after my last post, so I figured to give an update. I had a ortho doc check a couple of days ago. She is now happy with the flexion of 116. I requested additional PT, because I can do most of the exercises at home, but I get a better workout at the outpatient PT, as they have additional equipment. She put in a request for three additional sessions, so hopefully insurance will approve. I will continue the exercises at home as well. The flexion at PT the day after the doc appt was 120, and I was stunned. It is amazing what a good loosening up (35 minutes) can do with flexion and extension.
I'm wondering how long this tightness around the middle of the joint will last, months? I guess as we age, it is good to do stretches, strength exercises, walking for cardio anyway.
 
The tight band feeling can persist for months! It's partly swelling and partly a normal part of the healing of layers of soft tissues.

Tight band feeling after knee replacement is one of the most common complaints I read from members, and it sure bothered me.

Josephine, our Nurse Director Emeritus, explained it quite nicely:

That tight band is caused by scar tissue but not the adhesions type of scar tissue. When the surgeon opens up the knee, he has to undercut the skin and superficial structures from that centre line to each side of the knee in order to get good access all round the bones. Part of the healing process is when those flaps reattach themselves to the main body of the leg. This healing creates a thin layer of scar tissue across the front and sides of the knee. But scar tissue isn't anywhere near as flexible as normal tissue so it feels like a tether or a clamp across the knee if there is any swelling and during later normal activity.

It will gradually reduce in size and thickness over the following months until it reaches a point where it's not substantial enough to cause this sensation, same way as does the incisional scar in the skin. But be warned that this can take several months to dissipate completely and sometimes or every time, lots of walking or standing can make it worse. It differs greatly for every individual.

This should be regarded as pain and treated as such. In the early days, take your prescription meds. In later days, take some otc meds like paracetamol (Tylenol).
 
Ok. Good to know. That explains it so well. Well I'm doing good. Thanks so much for being here, like friends encouraging. Seriously this has been a good day. My husband ran errands, and brought back popcorn from a co-op, so good. I did a bunch of stretches, 6 laps around the house, took my meds, reading a great series again. Can't get any better for a tkr recoveree.
 
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