TKR Second Knee Replacement Done

[Nivea]

I did well yesterday. Was at the hospital at 5:30 and went back to get the spinal at 7:27. I don’t remember anything else, don’t remember the doctor finishing the epidural. Next thing I remember, I was in recovery. I was there for about 2 hours and then to my room, My husband and daughter in law were waiting for me. I did a few exercises in bed and then lunch came. It took my feet a bit to wake up, so needed to wait for PT for a bit. They put a catheter in since I was still numb and drinking quite a bit. I had leaked urine but didn’t know it, so they got me into a chair to change the bed. About 4:30, PT came in and I walked for 75 feet and then up and down 4 steps. PT cleared me and was waiting for my bladder to fully wake up. I did pee but bladder wasn’t completely emptied but I had passed the test so was okay to go home.

Once home, I cleaned up and brushed my teeth and inot the recliner. I fell asleep and slept through the night. This morning was a little rough as I was walking, with my walker, and started to feel tired. Sat done and got dizzy and lightheaded. I passed out but my husband was holding me, so didn’t fall. I had some orange juice and started to feel better. I have been doing some walking and PT exercises and resting.

The odd thing about all of this, my surgeon said do NOT ice and do NOT elevate. I can use a recliner but no putting anything under my knees. I am not a back sleeper so figured I would sleep in the recliner until I get the clearance to be able to side sleep.

Looking forward to go on this journey with others here.

 

[benne68]

Welcome to the Healing side, @Nivea! Glad to read that you are home now.

I will share our Recovery Guidelines. Following them will help you have a less painful recovery. Just keep in mind we are all 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 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.

If you want to use something to assist with healing and scar management, 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.

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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
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

Remember that 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.

 

[sistersinhim]

The odd thing about all of this, my surgeon said do NOT ice and do NOT elevate.

Did your doctor tell you why? Do you have something different about your knee than a normal TKR patient does? How are you supposed to control your swelling and pain? This is really a different attitude from most all other OSs.

 

[Nivea]

This is his philosophy. Period . He said the icing will decrease blood flow and ha prefers the blood to be flowing. I had gotten the lounge doctor and now I can’t use it.

some snippets of the paperwork. I had no ice in the hospital nor were my legs raised more than what the recliner was.

 

[Layla]

I certainly respect your desire to follow your OS’s protocol. After all, we normally research multiple surgeons as we prepare for joint replacement to find the best fit for us. Naturally trust is a big part of the equation. While our disclaimers state that we are not medical professionals, in regard to icing, we’ve witnessed time and again how it’s benefitted members with pain and swelling. Like everything else, it’s personal choice. I’d like to share a bit of info I found awhile back and please understand, it’s not to be contrary, just another viewpoint.

Following surgery ice is frequently used as a means to minimize pain and swelling resulting from the surgical trauma. Following injury, patients are commonly advised to ice no longer than 20-25 minutes several times a day. But with a surgical incision, it is perfectly fine to ice your wound as often as is comfortable for you, providing you place fabric between your bare skin and the ice source. A small towel is ideal for added protection. This is why the ice machines have pads that don't get quite as cold as an actual ice pack. Icing is an excellent means to control pain following surgery and each individual needs to find out what schedule works best for them.

As far as the Lounge Doctor goes. I understand it’s an investment as I purchased one also, but please don’t feel it’s a waste. Six years post op I still often use mine while watching tv on the sofa, or bed, simply because it feels relaxing.

I wish you well in your recovery, Nivea, and lots of comfort as you begin the journey.
@Nivea

 

[Layla]

I will add that I like your OS’s recommendation for THR recovery. No specific physical therapy needed other than walking for exercise. Goes along with the BoneSmart philosophy on THR recovery.

 

[Nivea]

I certainly respect your desire to follow your OS’s protocol. After all, we normally research multiple surgeons as we prepare for joint replacement to find the best fit for us. Naturally trust is a big part of the equation. While our disclaimers state that we are not medical professionals, in regard to icing, we’ve witnessed time and again how it’s benefitted members with pain and swelling. Like everything else, it’s personal choice. I’d like to share a bit of info I found awhile back and please understand, it’s not to be contrary, just another viewpoint.

Following surgery ice is frequently used as a means to minimize pain and swelling resulting from the surgical trauma. Following injury, patients are commonly advised to ice no longer than 20-25 minutes several times a day. But with a surgical incision, it is perfectly fine to ice your wound as often as is comfortable for you, providing you place fabric between your bare skin and the ice source. A small towel is ideal for added protection. This is why the ice machines have pads that don't get quite as cold as an actual ice pack. Icing is an excellent means to control pain following surgery and each individual needs to find out what schedule works best for them.

As far as the Lounge Doctor goes. I understand it’s an investment as I purchased one also, but please don’t feel it’s a waste. Six years post op I still often use mine while watching tv on the sofa, or bed, simply because it feels relaxing.

I wish you well in your recovery, Nivea, and lots of comfort as you begin the journey.
@Nivea

Very comfortable with my OS. They are a very large and well known in the orthopedic community in my area. They are also team doctors for many of my cities pro sports teams. With that being said, I understand all docs are different and all patients are different. I loved the Bonesmart community with my THR, therefore, I came back. It’s a different strategy and I respect that it’s not the Bonesmart way. I may come back and say you were correct and I should have iced.

oh, I am keeping the lounge doctor! Who knows what the future brings and can see it being used down the road.

Layla, thank you for being there for all of us. I may have more questions and I like spending this recovery process with others.

 

[Mutti3]

@Nivea
I am very interested in your recovery without ice and elevation. With my last replacements I was “ in love “ with my ice and elevation. There are so many changes in ortho care. Will follow your progress!!

 

[Layla]

I may have more questions and I like spending this recovery process with others.

Good! We love that you’re here and look forward to following your progress and supporting you along the way. Thanks for joining us and sharing your journey.

 

[InkedMarie]

Hi @Nivea ! Those are very different guidelines for sure. Who knows? He may be onto something. I worked on the ortho floor at a hospital while in my 30’s. Hip & knee patients were over the age of 70. Now, people are in their 30’s on up. I think the current thinking for many surgeons is quality of life. Hip people stayed in the hospital for 3-4 days, most released home but some to rehab. Knee patients we’re kept 4-7 days and I don’t recall many going home.

Things have changed; keep us posted how things go, please.

Marie

 

[Nivea]

@InkedMarie `So far so good with my recovery. I am off the narcotics and walking normally, with the walker. I am doing my stretching and walking and now walking outside. I am sleeping well and starting to feel like myself again. When I had my THR, my surgeon had me up and walking every hour, which was a bit out of the norm. I had no restrictions at all and did well. I trust my surgeon and despite being the opposite of what most are doing, I am feeling pretty good. We shall see as time goes on, what it is like. I am taking one day at a time.

I will say that I wouldn’t try this approach, follow your own surgeons path.

 

[Jockette]

So far so good with my recovery. I am off the narcotics and walking normally, with the walker. I am doing my stretching and walking and now walking outside. I am sleeping well and starting to feel like myself again.

We have had a couple of members over the years who were told not to ice and they did well, and you also seem to be doing well.

As always, we are all 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.

Best wishes!

 

[Nivea]

I took a few steps before I realized I wasn’t using the walker! I was told to use the walker until my first post op appointment and will do that. However, I do feel as though I can walk without it, God forbid I do fall.

My neighbors are all supportive and cheering me on. Several of them have had knee replacements themselves, so know what it’s like. My husband has been my rock star. Last night I was getting a bit antsy and so we went for a walk outside, which was nice. It was cooling off with a nice breeze.

This is not an easy recovery and it takes work but so looking forward to the time I am all fixed up and recovered.

 

[sistersinhim]

Your future looks bright and now both knees are new!

 

[Mutti3]

My husband was very supportive with my last replacement. ( He is a “ survivor “ of both knees replaced) It’s so helpful to have able and willing people around you! Makes recovery a tad easier!

 

[Nivea]

Still doing okay without the narcotics and am taking Tylenol. I was up and around yesterday and today and am tired, will relax tonight.

Question, I was told in the hospital to not shave my leg and asked how long. The reply was, you can shave your other leg. I am assuming not unail the staples are out at least.

I have been sleeping well in the recliner. I was not told I can’t be in bed but have been a bit afraid to. I am not a back sleeper and just afraid of moving my leg the wrong way in bed. I can’t put anything under my knee which is why I am afraid I will move it the wrong way or when I try and move it, will wake up in pain. So, the recliner is where I have been. I may try the bed tonight and see what happens. When I had my hip done, I was in the recliner for quite awhile as I never felt comfortable with all the pillows.

A neighbor told me that her knee has been hurting and she went to urgent care, this was several weeks ago. She told me at at that point, her knee was bone on bone. Found out last night, the urgent care never xrayed her knee and they diagnosed by feeling it. Is this even possible? She is seeing an orthopedic doctor in a week or 2.

I have gained several pounds since the surgery and assuming that is caused by the swelling? I am hoping that is the case.

 

[sistersinhim]

I have gained several pounds since the surgery and assuming that is caused by the swelling?

Yep, that's from the fluid buildup in your knee. As the swelling comes down your weight should, too. Also, you will be more active as time goes on and that will help the pounds come off.

I was told in the hospital to not shave my leg and asked how long

You don't want to do anything that might cause a cut. That could introduce bacteria and that's a . You should wait at least until all your opened areas and completely healed.

 

[mendogal]

So I think there's confusion about what "no pillow under the knee" means, and I defer to the moderators here to clarify.
My understanding is it literally means "don't stuff a pillow under your knee so it bends with pressure being applied to the back of the knee, because blood clots" since the pictures from my surgery folk show pillows, my PT who has had a TKA says "yep, use a pillow until you can extend the leg comfortably," and I suspect pretty much all of us sleep on our backs postop with the entire leg elevated on a soft pillow or with a wedge pillow like the Lounge Doctor.

 

[sistersinhim]

A few OSs want their patients to keep their knees completely straight. We have found this to be extremely painful for most members. Having a slight bend feels so much better and causes no harm to the vast majority.

 

[Jockette]

So I think there's confusion about what "no pillow under the knee" means,

A few OSs want their patients to keep their knees completely straight. We have found this to be extremely painful for most members.

This is Bonesmart’s recommendation:

Elevation: Doing It the Right Way

Updated September 11, 2022 by Jamie Proper elevation is one of the best ways to help with pain and swelling following either hip or knee surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate your...

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