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[TKR] Roller coaster recovery of Jas

mannbub

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Hello everyone. I am 12 days post op after my Left TKR. I have this very sharp intense pain that arises at the end of my incision. Most of the times it happens when I try to do straight leg raises or stand up after sitting down for a while. It seems like someone is trying to pull my skin with a knife. Has anyone experienced this?
 

Jockette

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Hi and Welcome to Bonesmart!

There will be all kinds of pains here and there for a while, your poor leg was surgically assaulted in the effort of fixing it. Some cannot be avoided, some can. Don’t push the straight leg raises if they hurt. You can’t avoid standing up from sitting, so do the best you can. Maybe if you stop the leg raises, there will be less pain standing up.

I refused to do leg raises, they hurt my lower back. And guess what. In time, as I healed, I was able to put my leg up on my foam elevating wedge by myself, which was basically a leg raise! All without working at it.

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.

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
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.
 

Rockgirl4

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Welcome to Bonesmart!!! The first 2 weeks are the worst, and I'm glad you're progressing. As for the sharp pain you're experiencing, I remember it well---in the same spot! My right TKR was just 7.5 weeks ago, so my memory is very fresh. My sharp pain was at the bottom of my incision, and there was absolutely no rhyme or reason to it. Sometimes it felt like an invisible person walked up to me and stabbed an invisible ice pick into that lower inch of the incision---even if I was just sitting still. I remembering thinking it odd because it was the last inch below my knee, and not where the incision/skin was being pushed/pulled as I moved or tried to bend.

@lovetocookandsew was recently explaining this to @ArmyVet a while back in his Recovery thread. I found it super interesting because it happened to me at about the same time in recovery as it did him, though mine lasted a good 2 weeks, on and off. Maybe they will see this and chime in. :) She explained it as possibly "stem tip pain," as that's the approximate location of the implant's stem in our tibia bone. As our leg moves, the rod is metal and doesn't bend, but our bones DO bend. So when we move, sometimes the tip of the stem touches the bone. Then the nerves in the bone get shocked, thus the pain.:gaah: Supposedly as the bone fills in it stops, but I will still get an occasional zinger there---again for no rhyme or reason, and often when sitting still. They are less and less though over the last few wks. Again, for reference, I'm at 7.5 wks post-op, but it happened numerous times a day during weeks 1-3.
 

lovetocookandsew

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@Rockgirl4 The stem tip pain, as I understand it, happens sometimes with the longer rods implanted above and below the knee implant during a revision, but not in a regular TKR. I could be wrong of course, but that's what I understood when my OS explained it to me. I'll tag @Josephine to explain it better, and so she can give her advice on your pain, @mannbub . Also, would you please give us the exact date of your surgery? Thanks.
 
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mannbub

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@Rockgirl4 @lovetocookandsew I am 12 days post-op. It is a TKR not a revision. Pain is so severe since yesterday that I am scared to even move my leg. And yes you are right it’s a good inch below and around my incision in the soft tissue area in the front of the leg. Feels like sharp stabbing pain. Gets triggered even with the slight movement of my leg. Before it was bearable and happened usually during my PT sessions when I tried to raise my leg but since yesterday it’s happening even when I am sitting or try to move my leg. I don’t understand if its my nerves or coming from my muscles.
 
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Denny39

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I am 26 days post op from my RTKR. Just as you described, for the first 10 days or so, I was afraid to even move my leg. When I did, even a very small amount, it shot a #10 lightning bolt right right through the center of my knee. But that only applied to either an attempt to raise my leg, or bend it at the knee. I could move it sideways, or I could support my upper leg and let it hang 90 degrees with only minor discomfort. But sending a signal to lift or bend was definitely a no-no. It was so different from the first one (On that one I could do leg raises and heel slides by the third day), that I became quite concerned. Finally, after about a week, I could let it hang, and bend it 5 or 10 degrees, but still with considerable pain. Over the next few days, it improved rather rapidly. One night on returning to bed after a bathroom trip, I sat on the edge of the bed and without thinking about it, raised my leg up onto the bed without supporting it. I was really kind of shocked on realizing I had done that.

For several days now, I have been walking around the house with neither walker or cane. I still have pain and stiffness, and still need the pain meds, but the improvement is amazing.

The first 2 or 3 weeks post op is quite unpredictable, and as you read the posts you will find descriptions of all kinds of unexpected and sometimes rather scary things happening. What I finally came to realize and accept is that as long as you do not encounter any of the things on the “watch for” list they gave you on discharge, you are probably doing ok. Surprises, mysteries, chaos, and a few “what the heck is going on here?” Are “normal” for the early stages of recovery.

Put your questions and concerns on Bonesmart. We’ll share with you and learn with you. It’s a tough road, but there is a happy ending to it.
 

Pumpkln

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@mannbub
I have added the surgery date of July 1, 2019 to your signature for you, 12 days ago. Let me know if this date is incorrect.
Sharp pains, dull aches, etc are all normal at this early stage of recovery, they will resolve with time to heal.
 
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mannbub

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Thanks everyone for the responses. I broke out in a bad rash after taking Gabapentin, Celebrex and Aspirin everyday after my surgery. I broke out in this rash after 10 days of my surgery. My PCP thinks rash came from celebrex but she also made me stop taking Gabapentin. I feel like this sharp intense burning pain below my incision is probably some irritated nerve. It’s robbing my life from me. Also this rash I have had for the last 3/4 days have really pulled me down. I hope I recover from all this.
 

Rockgirl4

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@mannbub I'm sorry these first 12 days have had more than just the usual misery. It sounds like you have plenty on your hands to drag you down. All I can say it WILL get better. I'm not a dramatic person and have a high pain tolerance, but the first 10 days after my TKR were absolute :censored:. I literally wanted to just check out at times and never wake up.
 

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@mannbub I am a little ahead of you as I am now 1 month postop, but I have the same sharp pain you describe. It is however about 1-2 inches above the lower end of the incision, below the kneecap as far as I can tell. At rest I'm OK, but any movement - leg raises, bending, walking, causes a stabbing pain there. I am wondering if it is stem tip pain. You will get good advice on here, hang in there and once the first few weeks are over, hopefully you will have a smooth recovery.
 
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mannbub

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@Pumpkln @Rockgirl4 @Josephine I noticed little oozing at one of my stitches and the area around it is very sore. Is it ok to have little discharge about the size of the dime 13 days post op? I think I have self dissolving stitches.
 
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mannbub

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@tabbykit Are you still experiencing that pain 1 month post op? I am not able to lift my leg up without assistance and if I try that sharp burning pain is so intense that even if I want I can’t move.
 

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@mannbub yes, I still have that pain at 4 weeks postop, when moving. At rest it is not a problem. However I was able to raise my leg straight away after the op this time, 4 years ago I couldn't do so for a couple of weeks. It's fairly common I believe, and will come in time as the quads start to work again. When I first tried to raise my leg to start exercising this time, I couldn't, as the knee is saying 'no, can't do it', and your body is trying to protect itself from pain. I found that visualising the leg moving can help, or I close my eyes, put my hands on either side of my knee and tell it to relax. Sounds weird but it does help.
 

Josephine

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@mannbub Would you show me the site of your pain using this chart?

aa knee-references-horz.jpg
 
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mannbub

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@Josephine Its at E & F RF1 level. Its at the front right below where my incision ends. It’s a sharp burning pain.
 
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My incision was super glued, and I had one stitch that wove its way from top to bottom and then tied in a knot at the bottom. Sort of the way a seamstress will tack a hem before sewing it on the machine.

Well at two weeks I had that "stitch" removed and it left two deep dimples at the bottom where it was cinched tight. About a week or so later I mentioned to my PT that I had a sharp pain at the bottom of my incision. He told me it probably was the incision where it was attached under the surface and recommended I gently massage it a couple times a day.

One night I massaged it pretty thoroughly before going to bed. In the middle of the night, I woke up in horrible pain. I thought for sure something was seriously wrong. The next day I noticed that one of the dimples was gone and my leg was flat on one side.

I suppose what happened was that the incision was stuck to whatever is underneath it, and when it popped free, it was excruciatingly painful. It didn't hurt much after that.
 
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mannbub

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@Josephine It only happens when I try to lift my leg up in a sitting position. So trying to avoid straight leg raises when I am in a sitting position. Its sucks but I don’t know what else to do. Pain is crippling when I try to do it.

My knee buckles here and there. Does it happen initially after TKR?
 

Rockgirl4

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@mannbub I had the occasional buckling and hyperextension with this TKR and had both again after a couple of other extensive knee surgeries. I was told it's because the swelling interferes with quadriceps function/strength. Once my quad was stronger, it all stopped and things normalized.
 

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