TKR Rosie's recovery thread

rosieNZ

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Hi @Josephine. I'm currently in hospital and am doing everything they ask, including PT. When I get signed off tomorrow I intend to follow your experience. With my previous TKR I read your interesting posts. I had oedema so I stopped doing too much, rested and it resolved. I never did PT again. At 6 weeks the surgeon was very happy !!!!
 
@rosieNZ ,
You'll notice that I have moved your newest post and started your recovery thread. For several reasons, we prefer that you have your own 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.
  • With your own recovery thread, you will see the posts and advice others have left for you.
  • 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.
 
Welcome to the Other Side!!!
Glad to hear you are doing well.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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 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 a 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 history before providing advice.
 
Hi. Hopefully this helps a little.
I had an epidural for a TKR 5 days ago. I was concerned about it too.
1: Epidural went in relatively easily. I had sensation in both legs like a tinle *not unpleasant) but could not feel touch.
1: I was awake and had no sedation. I could request it at any time.
2: When surgeons began, I could see my knee reflection in the overhead light. I was just about to say I didn't like that when a guard want up and there were no more opportunities to view my surgery.
4: I felt no pain but was aware of some knee movements. Heard hammering and verious saws. Could hear conversations but didn't participate. The surgeons talked to each other and theatre staff asking for equipment etc. The anaesthetist talked to me explaining where we were at.
5; Afterwards the knee block wore off quite quickly. Possibly 4 hours. I had a loss of bladder tone for about 10 hours. There was no pain even when the spinal block was gone due to lidocaine in the joint.
6: At day 5 I am home and comfortable. Im resting. Using ice 4 times per day. My meds are 2 Celecoxibs, panadol 4-6 hrly and I have Tramadol I can take if required. I have done that at night. I am pain free at rest, have a little short episodic pain on mobilising and occasional aching. But I am doing very little although on day 4 I did go out for lunch!!!!
I am walking on 2 crutches but thinking I could drop to one.
I have total extension. Knee at 60 degrees on discharge but swelling dictates this.
I am not doing exercises except as I walk I am trying to walk normally on my crutches i.e. to bend both knees as you do when walking. I'm slow but that's ok.
My leg is very swollen but loosens up with the ice machine
I also use the occasional ice pack on hot spots.
Its brilliant and so much better than my previous TKR. Im really grateful that this surgery is available as I had a totally restricted life prior. Its going to be fabulous. Best wishes for your surgery xx
 
You were awake the whole time?? Not, me!! It sounds like you are going to have a very sensible recovery. You've been through it and know what to do. Ice machines are wonderful, aren't they?
 
I am awestruck that you were awake for this procedure! No way could I do that - as a matter of fact I started to panic when they wheeled me into the operating room. I saw all those tools laid out and thought I was in a horror movie. :yikes: They quickly gave me the spinal and sedative and lights out. I awoke with a painful pulling-tugging on my knee “I said hey that hurts “ it wasn’t but a few seconds then I was out again. Woke up in recovery with the anesthesiologist prepping me and doing a nerve block. You should really get a bravery award! :thumb:
 
Being awake was not an issue. I could have been sedated but didn't need it.
We all know there's a lot of sawing and hammering involved to remove the joint and insert the prosthesis. Its just what happens.
There's no pain just some vibrations. Weirdly it was a little boring and tedious. I got sick of not being able to move!! I gave myself a wee talk about patience!!!

So here I am at 3 weeks post surgery. Ive been following Bonesmart rehab philosophy and resting, icing and elevating.

I can walk well without aids, dit in a normal chair and be totally self sufficient. Im doing some household chores.

My knee is a little swollen and stiff but not too bad. The wound is clean and well advanced with healing. I have an area above my ankle that was a bruise but now feels stingy and is starting to look like cellulitis. I will see the doctor if it doesnt improve today.

I am taking an antiflammary twice daily and panadol (Acetaminophen) when I remember. That's my problem. I forget until my knee feels achy.
Im having problems sleeping at night. Sometimes that's due to an ache behind my knee and sometimes its just because.

Socially Ive been out to cafes, the movies, to see friends, to the supermarket and to spend time with my 18mth old granddaughter. I'm doing well but equally can't wait for the next stage of recovery! I need to be more patient
 
You are doing extremely well, but do beware of doing too much. Your knee needs time and gentle treatment, and plenty of rest, so it can heal.
Check your activity against this article again:
Activity progression for TKRs

It's still very early days and you might be more comfortable if you take the Panadol on a regular schedule - 1,000 mg 6-hourly, 4 doses (4,000 mg) in 24 hours. 4,000 mg is the maximum safe daily dose, so check any other medications you might be taking, to make sure there is no Panadol/Acetaminophen/Tylenol in any of them. If there is, cut back one or two of your other doses, so you stay within the safe daily limit.

I know it's hard, but do try to be patient. It will reward you in the end.
 
Thanks Celle.
Im not very patient (because I've been so restricted due to pain and joint instability, I was close to being immobile).

I set the alarm on my phone to remind me to take panadol but its easy to be distracted and find Ive forgotten!

The hospital physio wants to start PT. Although I dont need motivation to keep moving forward I also want a programme that is individualized . So I'm not keen and have made an appointment with a community physio who is experienced and sensible. I will see what she advises.

I am starting work tomorrow in a measured way. Just intending to do just enough and be home in the afternoon for a snooze, ice and elevation. Controlling swelling needs vigilance and common sense. Next week I will be 4 weeks post op and will be focussing on rehab so I need to make sure I can do this whilst working.
 
Next week I will be 4 weeks post op and will be focussing on rehab so I need to make sure I can do this whilst working.
At 4 weeks you'll still be healing quite a bit, being only 1/12 of the way totally healed. It's no need to work hard on recovery. It comes naturally all by itself. Working out too much actually slows down the knee's healing. It causes more inflammation and swelling. Just use it in your daily activities, elevate and ice as much as you can, and your new baby will come back just fine.
 
4 weeks is very early to be going back to work.
We usually advise taking about 12 weeks if you can, and then doing a Phased return to work
 
Thanks Guys.
Firstly, I do have to return to work. I have 2 jobs which are both unique roles that require me to attend to. Ive planned it to be the best I can.

I attended my private physio today (3 weeks and 3 days post op). I have perfect extension and an unforced measured bend of 110 degrees.

Thanks Bonesmart. I have kept the faith! Done no exercises at all apart from walking. Just rested, elevated and iced!!! But of course I can only speak for myself. I think my recovery is spectacular.

Without the information provided by Bonesmart I think I would have had a repeat of my previous swollen misery first TKR. For me reducing swelling will continue to be the guide to activity. I have 2 exercises to do to improve balance and to gently begin to strengthen the wasted muscles around my knee and will continue to attend physio for the next few weeks.
 
Spectacular indeed! Are you prepared with ice packs for when you return to work? It can be tricky but hopefully you can find a place over lunchtime or while you work to ice.
 
@rosieNZ I use an Ace bandage to hold Ice packs in place at work, If you don't have to move around too much it works great.
 
@rosieNZ , just got caught up on your recovery. You're amazing!!! I hope your return to work has gone well
 
Thanks Guys
I wish I knew whether my progress was luck or due to something I did!!!

I had an appointment with Professor Horne this week and post op xrays.
He was amazed at my progress and said that he normally would advise patients to expect to keep improving for the next 4 months. However I have already reached normal healthy knee range of movements.

He approved of my knee strengthening (by walking up and down a hill near me with a rambunctious Springer Spaniel and our 18 mth old granddaughter.
I admitted to no post op exercises to which he smiled! I expected a lecture.

My icing regimen: ( please note, this was what I did. I am an experienced health professional , can monitor my own progress and realise that it may not be for everyone). This is the only thing I changed for my second TKR (first TKR was quite horrible).

First 2 weeks I used a hired Game Ready. Initially on low pressure but quickly increased to medium pressure with no problem. The cycle was set to 30 minutes on and 30 mins off for about 2-3hours during the day with an interval of approx 2hrs then between each session.

I monitored the coldness of my knee. It came back to an equal temperature to my other knee within an hour then became hotter to touch over the next hour. Skin colour and skin sensation was the same as the other knee.
At night, in bed, I left it on auto cycle for around 4 hours then removed it to take a break.
I used it less in week 2 as inflammation and pain were significantly reduced.
After 2 weeks I used an Aircast daily and after work plus I also put ice packs on any small hot spots from time to time.

My knee is well healed. My last measured ROM was 145 degrees at I think maybe 5-6weeks.
I get some swelling if I don't walk enough or when I take an air flight for work but it always resolves completely overnight. I need no medication.

I am no longer tired (8 weeks post op).
I try to walk around 10,000 steps per day but Im not crazy about it and bail out in bad weather.
In a month or so (when my work is not so crazy) I will start a strength and swimming programme at the gym. I can't wait to improve my fitness and hopefully diet and lose weight!!

What I haven't tried yet:
- kneeling on it. I'm a wimp.
- attempting to get up from sitting on the floor.

So this was my recovery. Maybe there is something here that could help someone else or maybe I just was incredibly lucky.
 
Well done @rosieNZ you have done so well. I am 7th March so about the same time frame. I admire you going back to work. I am still not ready!
I haven’t knelt but can get up off the floor though it’s not very elegant!!
 
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