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Revision TKR Revision RTKR due to laxity in ligament 3rd March 2015

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I'm not a pt! However, I know when my quad wasn't working in the hospital, the PT raised my leg as I tried by lifting at the ankle. That reduced the amount of work I did and there the pain of that exercise. You're the owner of the leg so ultimately you do know best. But trust me when I assure you that time takes care of almost all of these things and don't sweat over it. I do remember how much PT hurt at first and so I didn't do much either.
 
Hello cherub
Hope you and your knee are feeling well?
My hospital referred me to my local hospital where I went for physio for 10 weeks. I found it very helpful in showing me exercises but most importantly in meeting other knee patients to chat to. It appears to be compulsory in my area.
Good luck with that shiny new knee.
:flwrysmile:
 
I'm sure you didn't really mean it was compulsory, Speedy:). Standard perhaps, but an unusual approach for the UK. Just out of interest, which area are you in?
 
I live in New Zealand. I had a visit from the physiotherapist while I was in hospital following my TKR. She showed me a few simple exercises (ankle pumps, heel slides etc), then helped get me out of bed and showed me me how to negotiate stairs.

After that, no physio for 4 weeks - I just followed the instructions on a pamphlet they gave me on discharge from hospital. Little and often was what the pamphlet recommended for doing the exercises. I did very little, very often! :whistle: Actually, I'm a fidget and there was very little time when I was not moving, but I've never been good at organised exercise.

At 4 weeks, 6 weeks and 8 weeks post-op, I went to PT at the local hospital. There the physiotherapist tested my quad strength, measured my range of movement (she wasn't obsessive about it) and showed me a few more exercises to do at home. Sometimes, I remembered to do them! I was really very slack about exercises, but I did walk around the house, then (as I progressed) around the garden and up the street. I did concentrate on walking properly (heel, toe, push off) and trying not to limp.

I had an uneventful recovery and I now have a knee bend of about 130 degrees and can straighten the leg fully.
 
Normal in Sweden as well to have no formal physio but just to be discharged with a sheet of gentle exercises such as heel slides etc
 
Lol Celle you sound like me haha. You did good then without the typical rehab :-) Im going to keep going as i have been. Managed 3 straight leg lifts today after icing (thanks Mary) overwhelmed by the responses and taking everything on board. Thank you all :-)


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Wow this is very interesting to hear. After knee TKR, I thought everyone had physical therapy. I guess it depends on the doctor. I had PT in the hospital and I had PT in my home for 2 weeks / 4 days a week. I could have had more because the insurance covered many more days, but the therapist felt that I would benefit being in a rehab facility as they can do much more therapy wise there. I guess there are different trends of thought as to what works for who.
 
Welcome and it is good to meet you! Sounds to me like you are experiencing normal pain. There is a lot and it is widespread in the body actually. As you begin to walk you will be walking out of balance and it puts all sorts of stressors on muscles in the lower back, butt and really both legs. Eventually I would recommend a therapeutic massage for you. Either a PT or chiropractor can provide such.
Best to you!!!


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In the US, PT is almost always prescribed. Elsewhere, apparently, "physio" is not the norm de rigeur.

I had PT for several months after my BTKR, but, then again, I had some gait issues, as well as a desire to get back on the baseball diamond and umpire games, so my needs were different than others.

I will say, that, after a while the PT/physio is actually just getting on with one's life, and allowing the surgical knee/knees to gradually become a larger part of the patient's life and lifestyle.
 
I agree, Tim. The Atlantic Ocean seems to be the great divide in opinions when it comes to post-op PT.
Both ways seems to work, so what you do seems to depend very much on where you live.
 
Although my surgeon didn't prescribe any physio, he did say it was good that I'd chosen to go so that a local health professional was keeping an eye on me. My surgeon is 1600 kms from my home and my post op reviews were at 2 and 5 months rather than his usual 1 and 3 months.
 
This is interesting. I had physical Therpy in the Hospital and then at home. My first knee I went to the hospital afterwords but with the second I didn't. I do think it is up to the doctor but I had the same doctor for both. I also had the rpm machine for both. Now I find that I must keep them moving or they will get stiff. My last surgry was easier. Hope that you keep moving the knees. tashia
 
My post op review will be at 3 months. And its not even a consultant its a specialist physio nurse!!


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Celle said:
I agree, Tim. The Atlantic Ocean seems to be the great divide in opinions when it comes to post-op PT.
Click to expand...

Plus I suspect there's a different understanding of what "PT" actually entails. Plus the different approaches to funding healthcare.

Any road up, none of it should be a disadvantage, except where either approach is taken to extreme, which we see far too often, sadly.
 
I have learned to adopt a rather Brit way of looking at PT. Not so intense not so stern. I really think it has benefited me tremendously thanks to what I learned early on from you on this forum!!!


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My OS wrote an Rx for PT, but he left it up to me on whether I should go or not. He told me that I was making great progress (at two weeks!) and that he didn't really think that PT would do that much more for me. I chose not to go, but was very conscientious about doing the exercises that I'd been taught in the hospital (three-day stay) and what I'd been sent home with. I didn't need the distraction of having a PT looking over my shoulder. He told me that studies have shown no significant difference in recovery and ROM at 6 months post-op between those who had gone to PT and those who hadn't. He bases his recommendations on evidence-based studies and is recognized as one of the top Ortho surgeons in the US. I have found that he's been right every time he's made a recommendation for me. That being said, I think that it's a highly personal decision that needs to be made between patient and OS. This might not work for everyone. It takes a lot of focus, determination and dedication to keep up with the exercises. Best wishes as you make your decision.

Elaine
 
The first thing you need to keep in mind is that you are only 3 weeks out and therefore your knee is yet just a baby! I see you are taking your daughter to school. That's not advisable as you should still be resting lots and allowing your knee to heal. If you don't you risk creating pains that might prove difficult to resolve.

Let me ask you some questions ......

1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)

2. what pain meds are you taking, how much (in mg please) and how often?

3. are you icing your knee and if so how often and for how long?

4. are you elevating your knee and if so how high, how often and for how long?

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and driving

6. what kind of physio/exercises are you doing? How much and how often? Details would are required!

I'll be back shortly! :wink:
 
Hi Josephine,

1. I would say a 7

2. Tramadol 100mg every 4-5 hours, paracetamol 500mg every 4-5 hours Ibrufen 400mg 3 times a day. Morphine sulphate 20mg twice a day.

3. I am icing about 5 times a day for 20-30 mins

4. I am elevating have 3 staggered pillows underneath as shown in the reading material on here. Was doing it incorrectly previously.

5. No driving, online shopping and light housework like wiping up in kitchen, vacuuming downstairs only, bed making. Making only odd meals that take little prep and watching.

6. No formal physio was discharged with none. Only the ones given in hospital for now. Twice a day i am doing straight leg lifts (stop if it hurts) heel slides, side leg slides, knee pressing into sofa/bed although my flexion was 0 before discharge. I am also sliding foot back at dining table.

Unfortunately we have no family help so i have to take my daughter to school. Its really only a 3 min walk normally and not too far. As soon as i come in i elevate and ice. My husband is back at work and my teenage daughter starts school an hour before my9 year old so really have to thus.


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chereb said:
I was discharged with no physio. I had the normal heel slides/ leg lift basics ect but no formal physio required. Is that usual?
Click to expand...
Perfectly normal, usual and okay. As others have said, there is nothing required that you can't do perfectly well on your own. Usually there are 3 or 4 physio assessments to make sure you're okay and they should move it up a notch to formal physio if they think you warrant it, but otherwise, nothing.
 
brings back memories...I remember lying on the bed and also at the physios and he would say lift your leg up held out straight and no matter how hard I huffed and puffed I could not even raise it half an inch...my leg was like concrete and I was beginning to wonder if I would ever be able to lift it....... then one day..yah I lifted it....then there was no holding me back !
 
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