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TKR Ready for Recovery TKR Left (9 years since right)

@Rockgirl4 I hear where your coming from. As I am a pediatrician I understand the issues with your son and yourself

I had a pre-op nasal swap that had mrsa so I had nasal antibiotic ointment and washes the week before as well as IV antibiotics post op

My dressing is off and has scans in middle down the knee. Trying to keep them closed.
Itchy all over even the lower thigh for some reason in middle of night

I find the back of my knee is very swollen also . Is that common. It seems to impede my flexion
Any ideas to get it better ?

Everyone have a great Wednesday
 
Dearjr said:
any ways did you try to get rid of the itching?
Click to expand...
Dearjr said:
Today whole calf and upper thigh itchy. Any reason why? Swelling or just dryness?
Click to expand...
Itching is common and can be a result of a healing incision, dry skin or nerve regeneration.

Small sensory nerve fibers are cut with the incision, which can cause sensations that normally resolve over a period of six months to one year post op. While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process. This process is not to be confused with the initial post op numbness resulting from anesthesia or a regional block which can produce numbness lasting for up to 72 hrs post op.

Sometimes the skin around your incision becomes dry and itchy while healing. Although it is okay to put lotion or cream on the surrounding skin if it is uncomfortable, you should not apply anything close to or on the stitches or incision without the approval of your surgeon. It normally takes four to six weeks for the incision to fully heal and close. You don't want to risk infection by applying a product near an open area before that time. Some of the more common creams and lotions used on a healed incision are Bio-Oil, Vitamin E Oil, E45 Cream, Palmer's Cocoa Butter Lotion with Vitamin E, and Coconut Oil.

The one exception to the guidance in regard to applying products topically over your incision is a product called ACTIVE AntiMicrobial Hydrogel Spray. This product contains hypochlorous (HOCL), a compound made naturally by your body to promote healing. It can be applied to your incision at any point during recovery - it's a germ fighter as well as a healing and moisturizing agent. Discuss its use with your surgeon before using it. You will find a link at the top right of the page in a sidebar ad you can click on.

Cool compresses may help also. Ice, or even a cool damp cloth may sooth the area and reduce the itching.
 
Dearjr said:
I find the back of my knee is very swollen also . Is that common. It seems to impede my flexion
Any ideas to get it better ?
Click to expand...
Yes, swelling behind the knee is common after TKR. It can be a result of inflammation related to surgery. It should gradually decrease over time. Ice any / all areas of swelling or discomfort.
 
@Dearjr I think most of have some swelling behind the knee for quite some time. As for the itching, I'm still thinking of trying the saran wrap you mentioned the other day and that others swear by. My entire lower leg seems to be one raw nerve. It doesn't always hurt, but it switches between major itching, burning, tingling, and a few other weird sensations. I had never considered the itching to possibly be nerve-related before, but this time has opened my eyes.
 
Hi all

Went to outpatient PT for the first time today post op d#14
Had full eval
Moderate swelling on knee and behind knee
Mild swelling in ankle
She did not push the knee. Just wanted to see where I was
Gave me some exercises to do as house PT did
Said to do them 3 x day
Ice 4x day
And elevate after exercise the 4 x day
Flexion 93 extension -6
Swelling behind knee impedes both ( how do you get rid of it?..

She said best to keep knee flat when sleeping instead of wedge so extension can get better
Also towel under ankle a few times a day will also help

Have a great Friday all!
 
In my experience
1) every PT who has had a knee replacement says you're fine to sleep with a little knee flexion
2) most PTs who haven't had a knee replacement want you to sleep with the knee straight

In the long run, you will get your extension back regardless of how you sleep, AND being able to sleep is really important!
 
Dearjr said:
Swelling behind knee impedes both ( how do you get rid of it?..
Click to expand...
Other than icing and elevating, there really isn't much you can do but wait. It's frustrating, but it does eventually resolve. It just takes longer for some of us than others. And most of us find that our flexion comes back sooner than extension.

That said, your ROM numbers are really very good for just two weeks into recovery. Be care not to push through the pain or to overdo the exercises. If you notice your swelling increases, cut back on the exercises and step up the icing.

You are doing great!
 
@benne68 @mendogal thanks for the responses
This pt doesn't seem to be the "push" type

As for sleeping I start out with the lounge doctor and then 3-4 hours later wake up for some unknown reason and the lie on my back and side like I would before and sleep another 4-5 hours

How long should I continue to elevate versus sitting regular on couch or chair ?
 
Your knee will tell you, not us!

I was sitting in the dining room for short meals pretty early but my knee stiffened painfully with sitting - at post op day 24 I was setting a timer for 10 minutes of drawing time before getting up to walk a bit.

At one month, after eating dinner at the dining room table, my knee told me it wanted a walk rather than immediately elevating and icing.

For months I would sit on the couch for a movie, alternating between leg down and let outstretched on a pillow on the coffee table but have to take three breaks during a movie to walk, then only two, finally one.
 
Thanks
I've been doing the icing and in between taking short walks in house.
Also not pushing too much with exercise. Stopping when I feel too much of a pull

The PT says Monday we will try out the bike
 
@Dearjr My surgeon sent home post-op instructions that explicitly stated not to sit with your leg/knee down on the floor (like sitting in a chair) for more than 30 minutes each day in the first 3-4 weeks...and even that 30 minutes should be in chunks, not all at once. He recommends this to limit swelling. I'm sure every Dr varies to some degree,
 
Rockgirl4 said:
@Dearjr My surgeon sent home post-op instructions that explicitly stated not to sit with your leg/knee down on the floor (like sitting in a chair) for more than 30 minutes each day in the first 3-4 weeks...and even that 30 minutes should be in chunks, not all at once. He recommends this to limit swelling. I'm sure every Dr varies to some degree,
Click to expand...
I had no explicit directions, but that sounds eminently reasonable!
 
Dearjr said:
She said best to keep knee flat when sleeping instead of wedge so extension can get better
Also towel under ankle a few times a day will also help
Click to expand...
My surgeon just laughed when the hospital physio who said that had left the room. He said just sleep anyway you can feel comfortable. I wouldn't worry too much. I found the best things for extension were to try to walk with a full stride and later on to just lie on my tummy with my lower leg hanging off the bed ( but no weights). Gentle exercises but no force and definitely don't let anyone else push your leg. I have great ROM ( 150 flexion and zero extension) and never was hurt. Just gentle regular pilates. Swelling will impede bend/ extension. The best thing for this is elevation and ice.
 
@EalingGran thanks for the advice
I usually use lounge doctor.to start sleep and then usually wake up about 3-5 hours later and get rid of it and sleep whichever way is comfortable

Started walking more and watching stride progression so I can increase my extension.

PT started short crank bike today. Did very well thankfully
Instead of pushing knee PT uses gravity to help flexion like lying on back with feet up on wall flexed and bringing leg toward body

Everyone have a great Monday
 
Thankfully not too bad

The only thing that really bothers me is my calf is still.very swollen and hard. But it's been like.that since I left hospital.
It doesn't stop me from doing my exercises or even just walking...which I did 1.7 miles in two parts yesterday.
The knee is still very swollen but not hurting and the back of my knee is still swollen too

I feel my flexion is coming along although measurements were taken

Back to pt tommorow

I have a glide elliptical at home . I'm going to ask her if that would be good for me ?

Everyone have a great Tuesday
 
My swelling is well controlled.... with exception of behind the knee. Today I'm six weeks post-op and still struggle with this. Icing and elevating seems to help a little, but generally it's with me 24/7.
 
@JDinCT does the swelling behind your knee bother the amount of flexion you have ?

Went to PT on Wednesday and measured and I'm at 95. She said she'd like me at 100.
Calf was swollen as it has been so Ortho just ordered a ultrasound to rule out a clot. Thank God it was normal and just stubborn swelling

Good news for Thursday is no I can walk down steps one after the other !

Hope to get on a stationary bike and off the recumbent one this week

Who cares about numbers if you can do what you have to !


And lastly Sunday will be my first day back at work . Hope to ice after 3 hours of seeing patients thru our the day

Have a Sunday !
 
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