Revised PKR to TKR Revision Journey

Pat29627

post-grad
Joined
Jun 24, 2009
Messages
1,158
Age
75
Location
SC, USA
Country
United States United States
Gender
Female
Right total knee replacement revision went well. The 15 year old partial was loose and split. Surgery was mid-afternoon and I arrived in my room in time for a wonderful dinner of grilled cheese sandwich, chicken noodle soup, and salad. I had almost no pain since they’d given me a nerve block along with my spinal. I went home the next day after walking down the hall with the physical therapist while using a walker. I was amazed I could even go up stairs!

Once home, we did well. Our daughter, her husband and three dogs had come to take care of us for a few weeks. My husband and one dog slept on the couch and our Australian Cattle Dog slept in a crate in the bedroom. I had the whole bed to myself and lots of pillows to prop my leg.

Then….three days later, the hurricane Helene came whipping through. Our power went out. We’re in the west corner of South Carolina and have never had a hurricane come over us. It really tore things up and even two months later, there are trees down all over the area. Our entire town of close to 5,000 had no power.

We had no power and no water for seven and a half days (we have a well.) Dark evenings and long nights were extremely boring and I had nothing to distract me from pain. They charged our phones in the car. My husband and daughter would go out early in the morning to nearby towns to search for ice and water. Our son-in-law found our camp stove and French press coffee pot and provided great meals for us, cooking on the patio.

It’s a good thing the hospital had given me a Velcro-strapped ice pack holder since I couldn’t use the ice water machine I’d had for my first knee surgery. Our daughter would keep my spare ice packs stored in the ice chest. I still use those often. The physical therapist said to use ice for about 30 minutes at a time. He thinks using it for long periods of time might slow healing, I think. But he said use it as often as I need to.

So here I am at 8 weeks. I’m doing well….walking without a cane except if I go out. I have great extension and flexion (not sure about the number since it was fine a few weeks ago and he hasn’t measured it again.) My problem is pain. Besides knee pain, I have pain with walking all along the back of my leg and my ankle (which I’d broken when I was 33.) The doctor’s office said I had to wean off oxycodone around a month out and go to tramadol. I can’t sleep with tramadol, so they prescribed gabapentin 300 mg (Neurontin) for night. I still couldn’t sleep, so use melatonin 3 mg along with it, or CBD or even 1/2 ambien (which I shouldn’t do.) I sleep pretty well the first half of the night, but after that I have crampy sharp pain off and on no matter what positions I’m in. I take Tylenol and Advil before PT, but it doesn’t help much.

Luckily, my physical therapist believes in gentle exercises with no pain. He also does some massage which helps. He’s a bit concerned about the continuing pain, but said with removing the old parts and all, maybe there was a bit more trauma. I see the orthopaedic surgeon in two weeks.
 
@Pat29627 I moved your post over to a new Recovery thread for you. Let us know if you’d like a different title.

It sounds like you’re doing quite well, all things considered.

I’m so sorry you are in the area hit by the hurricane. Wow, a lot of destruction there!

Sometimes a lot of pain means we are doing more than we are healed to do, and thst includes the PT and exercises. Maybe try cutting back on those things and see if that lowers your pain level.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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

5. At week 4 and after you should follow this

6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Oh my goodness, @Pat29627. I can't begin to imagine what it must have been like for you dealing with that hurricane and the after-effects so soon post-op. You are a real trooper.

Many of us experience pain and stiffness up and down our legs, into our hips and our backs during TKR recovery as the muscles and soft tissues try to adapt to the new structural alignment in that leg.
Prior to surgery, as our knees deteriorate, our bodies make adjustments to ease the pain. These changes are subtle and, because they occur slowly, we don't even notice that we are favoring the leg or limping or splaying our foot out to the side. We live with that bad alignment for so long that, when the knee is fixed and our alignment is corrected, all the surrounding tissue has to "relearn" what to do.

You are still early days in this year-long recovery. It does get better; it just takes time.

Do let us know what your surgeon says when you visit.
 
We had no power and no water for seven and a half days (we have a well.) Dark evenings and long nights were extremely boring and I had nothing to distract me from pain. They charged our phones in the car. My husband and daughter would go out early in the morning to nearby towns to search for ice and water. Our son-in-law found our camp stove and French press coffee pot and provided great meals for us, cooking on the patio.
Oh my goodness you're a CHAMP, Pat! I'll bet you never imagined you'd be roughing it and basically living like a camper within days of major surgery.

I am sorry for the ongoing pain you re dealing with. It doesn't seem unusual that you're still dealing with discomfort only two months post revision. There may still be inflammation which can contribute to pain especially after activity, like walks, exercise, standing for long periods of time. The revision may have included more extensive work which may prolong the pain. Muscles around the knee are likely weaker as the body adjusts to the prosthetic which can also contribute to discomfort. It's good you're going easy in PT as you work to restore your ROM and strength. Keep up the good work and best wishes with your post op appointment in two weeks!
 
I saw the orthopaedic surgeon yesterday. It’s been ten weeks since my knee replacement. He moved the leg various ways and said it was great….”couldn’t be better.” He showed me the x-rays they took after surgery.

I can tell that I’m doing better each week. I’m still having quite a bit of pain and stiffness, though. He said maybe I should quit physical therapy since doing too much can cause inflammation. I told him that my physical therapists are very gentle. He asked if I could do all that at home, and I said “probably wouldn’t.” So he said since they’re gentle, I should keep on for a while. When I asked if I can return to water aerobics, he enthusiastically said yes. He said it would be very good for me.

He thinks the pain might be nerve pain, so advised taking the gabapentin (Neurontin) morning and night instead of only at night. I told him that it helps calm the pain and resulting antsy-ness I had in the evening.


The doctor asked if it felt better than before surgery. I had to say no, and thought not even close! Hopefully in six weeks I’ll be much better.
 
When I asked if I can return to water aerobics, he enthusiastically said yes. He said it would be very good for me
I would be cautious about water exercises. It is very deceptive and the times I have tried it I have found it catches me out and I am sore afterwards.
 
When I asked if I can return to water aerobics, he enthusiastically said yes. He said it would be very good for me.
I would be cautious about water exercises.
I agree, go slow with the water exercises until later in your recovery.

My surgeon was a big fan of pool therapy and had me do it starting at 4 weeks post op. The PT person at the pool had me in the water for 50 minutes doing countless bending exercises. It took me 3 days to recover the resultant pain and swelling. :doh:
 
I’m at eleven weeks and feeling better a lot of the time. The thee physical therapists I’ve been working with agreed water aerobics would be great for me. Friday we went and I mostly did slow walking and some arm movements. The warm water felt heavenly and I had no pain while in the pool. I don’t think it increased pain.

Sunday, I went up and down my two steps (8” and 71/2”) four or five times. I held the railing, but it hurt. It hurt all night and the next day in the pool. The physical therapist said my muscles in my thigh just aren’t strong enough yet.

Yesterday we did water aerobics again. I did about half of what the leader was doing and in slow motion. I felt good afterwards. It was wonderful seeing all the class members and talking to a few favorites. I always said the social aspect was as important as the physical.

I have to babysit the two grandchildren (4 and 12) while our son and his wife go to Christmas parties. I’m a bit nervous about how I’ll hold up, but it will be fun being with them.
 
Glad you're enjoying water aerobics and the socialization that goes along with it.
I'll bet visiting with the grandkids will make your day. Hopefully the older can help with the younger if you need assistance. Have a happy holiday season, Pat! :santa-dance:
@Pat29627
 
We did fine keeping the grandchildren two Friday nights while their parents went to their company Christmas parties. I think they wanted more food every 30 minutes. I was really worn out the next day, but loved being with them.

I told my son that I’d need to have something easy to cook Christmas Day, and he said, “Just come to our house and I’ll cook.” Music to my ears! We had a good time there and tonight our daughter, her husband, son, and 3 dogs will arrive after their 14 hour drive. My son-in-law likes to cook, so I’ll have it made for the next week!

My knee still gives me trouble when I get up. I can’t do stairs yet. I’m on gabapentin 300 mg twice a day which helps a little with the pain and now taking trazodone 50 mg at night to help me sleep. Ambien works better, but my doctor doesn’t want me to use that often. I’ve gained 7 pounds since November 26…I think it’s the gabapentin. I’m not eating much more, but I’ve been so hungry. I’ve got to work on that, but probably won’t for a few more days.

I hope you all had a wonderful Christmas!
 

BoneSmart #1 Best Blog

Staff online

  • Layla
    Staff member since November 20, 2017
  • djklaugh
    Staff member since December 30, 2020
  • mendogal
    Staff member since November 10, 2023
Back
Top Bottom