TKR Review after 1 year

[Pumpkin]

You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

Sounds like you need to rest more and exercise less. TKR recovery take a full year to completely heal. You will need to balance activity and rest to find what is best for your continuing recovery.

 

[SusieShoes]

You ask whether you should exercise less, or more... yet you have answered your own question. You are an astute self-observer. Your reflections on recovery are detailed. What you noted is that your knee gets stiffer after you do a bit more, and also that you tend to do more when the pain subsides, thus bringing on more swelling.

The stiffness all of us feel post-TKR comes from swelling. Swelling inside the knee, even when that swelling is invisible to us or other observers, is what causes that “tight band” feeling or a general perception of stiffness in the knee. If you’re feeling this stiffness that means the knee is still healing; there’s still some inflammation going on. You’ve nailed the things that are causing your stiffness to get worse, even if it only gets worse for a day.

Rest. Elevate. Ice. Keep doing it between your daily activities, or at work, or after exercise. It will help. In the meantime just live your life. You can work on strength later, after the knee has fully healed and stopped being stiff. It really is a balancing act this first year. You already have a good sense of your knee, so listen to what your knee tells you. In the meantime, you can build strength just through your daily activities like walking, doing stairs (make a few extra trips a day), errands, chores... the things you do anyway.

 

[DIYSteve]

Watching this thread. "Walking quite well" and 100 flexion @ 11 weeks sounds pretty good. My OS warned me (and his other athletic patients) to be cautious about too much exercise too soon. My PT and good PT friend (fellow mountaineer w/2 hip prosthetics) say extension is more important early and that "flexion will come."

I'm on recovery day 20 after LTKR w/ patella button. As I noted in this thread I have been suffering ROM anxiety. Other than that, my recovery seems to be going well, i.e., pain has subsided, swelling way down, walking with a single crutch, able to walk with no aid (albeit limping a bit), motor nerves are firing, muscles working.

I have my first out outside PT appointment today. I will learn more today.

Best o' luck to you dcweather. Sounds like you're well on the way.

 

[dcweather]

Neither. Just live your life and go about your business in the usual way. You'll discover one day that you haven't even thought about your knee and that your ROM has mysteriously improved massively. Good luck!

I am a bit obsessed with ROM it is true and you can tell from above. But I keep getting encouraging comments but my last TKR (2 years ago) was successful except for that. It was about 80 deg before and I got it to 90. I didn't push it because people kept telling me it would come. Well it hasn't after 2 years and is stuck at about 85-90 deg. So I am trying somewhat more forcefully (but not too much) to get this one better. It's about 100 and has been there for some time. I'm not expecting more but hoping! I am happy though because in most respects, especially and crucially pain, both are good.
Dave

 

[dcweather]

I agree with kneeper.

It may be possible for the muscles and tendons that had shrunk prior to surgery to continue to stretch , gradually increasing your ROM. That will need to happen slowly, though.
That's OK, because there's no need to rush to get ROM (Range of Motion). It can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Here are a couple of examples from people whose ROM was slow to develop:

This is what Campervan wrote about the slow development of her ROM. (Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time - look what had happened by 6 years post-op!.

"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "

And here's an example from bertschb:
I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.

It must be nice to see progress however slow. Both of mine seem to have taken the path - little pain, average swelling 90 deg ROM after day 1 and never changes more than a few degrees thereafter!

 

[dcweather]

6 weeks further on. More or less given up on it now. No matter what i do the "new" one is stuck at 95 deg. My overall opinion is that I am better off than I was before the replacements but a fair bit of disappointment. The pain is much less, especially when walking. I'm not bandy any more and legs are straight so I walk better.There is still some stiffness and pain from surrounding areas rather than in the joint though and the new one swells up if I stand around or do a fair bit of walking. With virtually no increase in flexion going down stairs and getting out of chairs is still a big problem that I am resigned to for life. I suppose the clue is in a photo I found of me at an athletics meeting aged about 22 (46 years ago) and I noticed I was wearing a knee bandage!

 

[kneeper]

You may get some more bend with the new one over the next 6 months, it's still early days in the big picture. Just use what you've got as you go about your daily life. I found I was doing things more easily and realized I had gained a couple of degrees that way without even thinking about it.

 

[dcweather]

So I'm back again! So how did it all pan out. Well after one year pretty good. Not much pain ever from joint but a few bad days sometimes from collateral damage (Literally collateral lateral ligament!) Bend got slightly better and I am happy with the 95 degrees I can get most of the time although the right knee, now at three years almost is still stuck at 85 degrees so causes some limitations with stairs and getting out of chairs etc. Nice and straight so can walk a couple of miles straight off and stand for quite long periods which was impossible before. The latest one isn't swollen but for some reason is bigger across the front almost as if the patella is bigger. And left side next to patella seems to be a lump of clicking soft tissue which moves when I bend my knee backwards and forward. A bit annoying but doesn't hurt. So all in all not perfect but definitely would rate as a success.
Best wishes and good luck to you all.
Dave

 

[Pumpkin]

@dcweather
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

Glad to hear you are doing well, some little annoyances, and you are able to do a lot more than before surgery.
Success!

 

[dcweather]

The biggest thing I have learned from all of this is that virtually every individual case is unique. The material on here is very helpful and the empathy really re-assuring. Nevertheless it will be difficult to find someone exactly like you! The examples above are I imagine supposed to give me reassurance regarding rom. But they don't because all of those have shown both short term and long term improvements. Mine was pretty much 90 before the op, 90 soon after the op and still 90 a year later after a hell of a lot of work! But did any of those people have limiting rom for 10 years before their op? So I now have a year old knee that I can force to about 95 and a two year old one that is about 85. No good for stairs. I missed a stair the other week and thought there was one left but there were two. The extra extension was so painful that I fell but luckily was unhurt and knee recovered in hours. So, yes, it is limiting but I offset that with that I can now walk without limping or resting for at least two miles and can stand for an entire football match before the aching is really bad. Before it was 10 min max and 400 yards before I was looking around for a seat. At night and other times I am totally pain free. So I am happy and have learned to live with the the lack of rom. But please don't base any expectations on other people, just get as good as you can yourself and for most this will be at worst some improvement and probably a lot in most cases.
Good luck,
Dave

 

[sistersinhim]

Since you had low bend before your surgery it's taking longer for those tendons and muscles to stretch more than what they are accustomed to. Many on here have had a similar recovery and go on to improve in the second and third year. Your knee didn't just develop arthritis in a year. It took years to get in the shape it was in before you tkr. Now, it has to relearn how to bend more than it was used to. Please don't be upset about it. I'm sure it will improve when you least expect it!