TKR Renmusical’s Recovery RTKR 6/21/19

[Renmusical]

Recovery from RTKR is definitely a journey. I just haven’t had the energy to start my recovery thread until now. Going into surgery I had <90 degrees flexion for quite a few years and apparently that fact has greatly impeded my recovery. Lots of unlearning unconscious compensation behaviors in walking, bending, navigating a stair, etc. it’s like learning how to walk all over again.

I am now a little over 6 weeks post op and am at 73 degrees flexion and 0 degree extension. I have almost constant swelling with activity and have had a lot of emotional ups and downs. Not being able to drive has been a big deal for me and won’t be able to until I can get to 90 degrees and off pain meds.

I had a follow up with my surgeon last week and I am scheduled for a manipulation under anesthesia Wednesday August 7th to hopefully break up scar tissue so I can bend my knee, make more progress and get to the point of being off prescription pain meds and muscle relaxers. At this point I don’t know when I’ll be able to return to work but I am hopeful this procedure will help my particular situation. At the age of 51 I never expected recovery to be such an uphill battle.

The positives are I know time will heal and the pain will lessen. I have the hope I will be able to do more with less pain than prior to surgery. I want to be able to ride a bicycle again. I can’t remember the last time I could. I want my freedom back to be able to drive. Physical Therapy has helped to regain the strength I had lost in my quads and hamstrings and I feel stable when up on my feet.

Through reading everyone’s stories I realize we all go into this surgery at different stages and we all recover differently. I just need to be more patient and know each day I make progress, albeit small, towards my recovery.

 

[Chemist]

Hi @Renmusical :

Welcome to recovery! As you have probably noticed this forum is full of information and support. It helped me a lot during my recoveries

Remember the key words you will see a lot - elevate, ice and be patient.

Take care and good luck

 

[sistersinhim]

Hello @Renmusical. Welcome to Bonesmart! I see you had your tkr done outpatient! Wow, you're one tough lady! Since you had a 90 bend before your surgery, it will take a while to get above that. Those muscles and tendons have to move past that. With swelling bend is less. You can't bend a water hose when it's full of water with the nozzle closed off. Open up that nozzle and let the water out, then the hose will bend. It's the same with your knee. You need to get that swelling down for your bend to improve. You do that by doing gentle exercises, icing and elevating.

The following are our basic guidelines and should help get you started. As you read more on other members recovery threads, you’ll get a better perspective of what to expect and what not to do, especially regarding PT.

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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

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]

Hi and Welcome to the Recovery side of Bonesmart!

Going into surgery I had <90 degrees flexion for quite a few years

I am now a little over 6 weeks post op and am at 73 degrees flexion and 0 degree extension. I have almost constant swelling with activity

Well, your extension is awesome for only 6 weeks!

Swelling definitely affects ROM, the more swelling we have, the harder it is to bend.

I’m really sorry to hear that you are scheduled for a manipulation so early in your recovery. Time and healing will do wonders for your ROM, without a manipulation. It seems many surgeons are impatient and don’t allow our bodies to heal naturally and on it’s own time frame.

Be prepared for this manipulation to create some more swelling and tissue damage, due to the force used to do a manipulation. So, if it doesn’t change much, just know that when your swelling goes away your ROM will improve.

Keep in mind that this is a long recovery, as long as a full year or more. 6 weeks is a drop in the bucket, and patience is the biggest thing we have to exercise.

I am going to tag @Josephine,
our forum administrator and nurse director, to come and advise you.

 

[Josephine]

I am scheduled for a manipulation under anesthesia Wednesday August 7th to hopefully break up scar tissue

Oh, so I guess I am a bit late to advise about your MUA. I hope it went okay. Do tell us what the result was.

I don’t know when I’ll be able to return to work

You are, by my reckoning, now 6 weeks out and I would always consider an MUA at 6 weeks to be far too early and you should remember that it will reset your recovery clock to zero. We also recommend a return to work at 10-12 weeks but I know that's sometimes not doable in the US.

I look forward to seeing your update post.

 

[InkedMarie]

@Josephine her MUA is tomorrow; maybe you can still advise her!

 

[TortiTabby]

Doesn't it seem odd that so many people get MUA recommended so soon? It's almost like they consider it "phase 2" of the surgery. I talked to my regular MD and she said all the patients she sees with TKRs have had MUAs done. Almost seems like a scam of some kind especially since adhesion are considered rare. I wonder if anyone has done any statistics on the percentage of MUAs done after TKR...

 

[kneeper]

With a bend less than 90 before the surgery I'd think it's not just the knee swelling but the tendons and muscles that are slowing your bend.
I was similar to you with a bend of about 108 before tkr. I didn't get to 90 for 6 weeks and that was only as the swelling came down. (I sat in my 70s in week 4 & 5.) I did continue to gain over the next weeks and months by slowly but surely doing things that required the knee to bend. I didn't get a "final" measurement but I think I'm between 115-118 according to Josephine's picture of ROM. I think I continued to gain for over a year. Bottom line is that the knees let me do almost everything I want to do regardless of the measurement.

The MUA may help but most people find they have new swelling to get over b/c the MUA retraumatizes your tissues-- and you'll still have the muscles and tendons that aren't used to the bending. So ice, elevate and keep patient with your progress.