TKR Robotic Assist Right TKR

NanaBird

new member
Joined
Jun 13, 2022
Messages
3
Age
58
Gender
Female
Country
United States United States
Hello all!
I had tkr on my right knee May 9, 2022. I found BoneSmart about 1.5-2 weeks after surgery.
Surgery went well, was under the mistaken impression I needed to get into PT right away. Well, that didn't go well... I went to PT on 5/13. I then had tremendous swelling and additional pain. I went back on Monday, to a different PT who was even worse. My surgeon indicated that PT should be led by me, and nothing should be forced. I requested the therapist be aware of and adhere to my Dr.'s protocol. A few more visits where I seemed to loose more ROM than gain I quit that location. After finding another facility and letting them know they needed to be aware of my Dr.'s protocol, they assured me they did. Go in and guess what, they don't know my Dr's protocol. And he hasn't contacted him either. Granted this PT was much gentler and seems more open to not pushing as hard. However he still thinks ROM has a window of 6 - 8 weeks. Trying to decide if I should continue with this guy, find someone else or just quit. Unfortunately, I am not good at doing things on my own and I like the accountability going to PT gives me. I did pick up a recumbent bike for gentle movement and I have 0- neg1 on the extension. I have had up to 90º on my flex, but it really seems to be sporadic.

Current PT uses red laser therapy, and indicated it continues to have a positive impact for up to 24 hours, unless ice is applied, then it stops. So I've tried to not use ice for as long as I can stand after PT- when I want ice the most! lol
I have no idea if the laser does anything, or if it matters when I use the ice...

I see my Doc again on 6/22

Looking for any insights! So great to be here!
NanaBird
 

Jockette

Staff member since March 18, 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
31,236
Age
66
Location
Delaware
Gender
Female
Country
United States United States
Hi and Welcome!

Unfortunately too many PTs believe in a window of opportunity and too many also believe in “no pain, no gain.” We here at Bonesmart believe ”no pain equals more gain.

Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR

Painful PT causes increase inflammation and swelling, which limits ROM, so it’s counterproductive and defeats the ROM they are forcing. It still amazes me that so many PTs believe this. We read about these experiences all the time here.

If it was me, I’d stop going to PT, rest ice and elevate and take short walks around your house, and just do your daily activities, and give your knee a chance to heal. Then, when you see your surgeon, tell him of your PT experiences and see what he thinks. You are lucky that he doesn’t believe things should be forced, too many believe in forcing the knee to bend.

While formal PT can be helpful, it has to be the right PT, for it to be helpful. So far, you haven’t gotten the right PT, and your doctor will agree.

Contrary to popular opinion, going to formal PT is not essential to a good recovery. We have members that don’t go, and they don’t do a list of exercises, either. That doesn’t mean they stay in bed or on the couch all day, movement is important for your knee to heal well. But gentle bends when you think about it, and the short walks I mentioned, are all you really need. As you have found, too often, the exercises and the forcing of the knee cause unnecessary setbacks.

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!) :egypdance:
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" :yes:

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 

Jockette

Staff member since March 18, 2018
BoneSmart Staff
Joined
Aug 29, 2017
Messages
31,236
Age
66
Location
Delaware
Gender
Female
Country
United States United States
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!)​

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.
 

sistersinhim

Staff member since March 20, 2017
BoneSmart Staff
Joined
Dec 4, 2015
Messages
26,920
Location
Virginia
Gender
Female
Country
United States United States
I'm one of those who never took formal PT. I've had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do.

I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he was interested in was to see what my knee would do and never measured. He never even asked about PT! Of course, he knew I was a single lady that had to take care of myself and obviously trusted that I would not be just laying around all the time.

After all these knee surgeries, I know that I do not need formal PT, and neither do many others if they do their own daily activities and not just sit around all day and night. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!
 

Samsrf

member
Joined
Apr 29, 2022
Messages
113
Age
44
Gender
Female
Country
United States United States
Hi @NanaBird , @Jockette & @sistersinhim are full of wisdom! We all have to get there on our own, but I now know they are right.
I went through 1 home health PT and then 3 out patient PT’s and 2 offices before I “gave up” at 7.5 weeks. I move and stretch, and am very active but have found recovery to be easier without formal PT. Every day is different in this recovery. Some days, I need ice and elevation more, some days I use heat, or swim, some days my calf or quad are tight and I stretch more. I found the “cookie cutter” set of exercises not taylored to my needs and the “you should be further along” attitude of all the PT’s discouraging and stressful. At 7.5 weeks I walked out of PT and have found following my gut and continuing to move much more beneficial in recovery. Now I can do all my normal ADL (activities of daily living) again (I am at 11 weeks!) and not be sore and unable to walk for 1-2 days because I am too damaged from “getting the number” at PT. Which was my continual experience regardless who I saw.

Every recovery is different, as someone who tried to fit in the box , I can tell you I wish I would have trusted myself & followed my instincts earlier. Trust yourself (and your surgeon- who sounds very reasonable) that you can guide your own recovery. This was a major surgery and healing requires time and patience. Best of luck healing, be gentle on yourself ❤️
 
OP
OP
N

NanaBird

new member
Joined
Jun 13, 2022
Messages
3
Age
58
Gender
Female
Country
United States United States
Thank you Samsrf,
I really appreciate you sharing! It’s reassuring to know that following my gut instinct is best.
 

Jaycey

ADMINISTRATOR Staff member since February 2011
Administrator
Joined
Jan 27, 2010
Messages
38,658
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
Just listen to that knee! It will quickly tell you when you have gone too far.
 

Axx72

junior member
Joined
Mar 31, 2022
Messages
37
Age
50
Gender
Male
Country
Canada Canada
Welcome to the club!

This is the greatest bunch of individuals who are going through or have experienced the same thing you are going through.
Little by little, day by day, do what you can do, your TKR will act up and tell you if u have pushed too far. Listen to your body and take care of it, it will let you know what to do.

Little victories win the fight when the fight is really long. When you’re ready, take that next step
 

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
60,664
Messages
1,519,831
BoneSmarties
36,969
Latest member
CanadianLiz
Recent bookmarks
0
Top Bottom