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TKR Second Knee Replacement Done

sistersinhim said:
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.
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There was no way I could have slept with my legs straight. I never did and ended up completely straight.

Marie
 
@Nivea no one told me how to sleep either. As soon as I could, I slept on my side with a pillow between my legs. It took some time to figure out how to get comfortable doing this but I slept so much better once I did.

Marie
 
mendogal said:
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.
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I can elevate on a recliner, no pillows or anything under my knee. I can put a pillow under my leg from mid shin to heel only. I can not use the lounge doctor, per guidelines I was given.
 
@InkedMarie I tried bed last night and just wasn’t comfortable. It’s still early days for me, today is 1 week post op. I will give it a bit longer and try again. I was having trouble moving at all and laying on my back was just not at all relaxing. Once I can move around a bit, I may try a pillow between my legs on my side.

When I had my hip replaced, I read to make a nest in bed with pillows and I found any of that type of thing to be totally uncomfortable. I slept in the recliner and was much happier.
 
Nivea said:
I can not use the lounge doctor, per guidelines I was given.
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What a shame. The lounge doctor has been a Godsend for so many of us. I bought two, one for my recliner and one for my bed. That way I didn't have to carry one to each place as I tried to sleep in each. I'd sleep a few hours in the recliner and a few hours in the bed. This went on for about 6 weeks. Being alone, I had to figure out the easiest way to do things, and having two LDs was one of the ways!
 
Don't get rid of your Lounge Doctor! I use mine daily to get my knee above my heart. I'm also a side sleeper and the pain in my leg woke me up when it was in the wrong position.
 
@Tentcamper i am not getting rid of it. Who knows what the future needs may be for myself or my husband. I did return the ice machine I had ordered as well. My OS does not want any icing, go figure.

I will try sleeping in bed again in another week or so. It makes no sense to try and skeep in bed and can’t sleep.
 
The insomnia has kicked in! I have been sleeping well until last night. Fell asleep at 5:30 and woke up at 6:30. That’s it. Ugh. I remember this from when I had my hip replaced.
 
No ice or elevation? Did they say why?
 
It’s my OS‘s philosophy. He wants the blood flow to the knee, icing restricts it. That is from the nurse but I trust him as he did my LHR and is with a huge, prominent orthopedic practice. They are the doctors for the cities major league sports teams. In his discharge instructions he states that I will hear others saying different things but follow his instruction.
 
Nivea said:
It’s my OS‘s philosophy. He wants the blood flow to the knee, icing restricts it. That is from the nurse but I trust him as he did my LHR and is with a huge, prominent orthopedic practice. They are the doctors for the cities major league sports teams. In his discharge instructions he states that I will hear others saying different things but follow his instruction.
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I have read of this approach intermittently for many years; the theory behind it seems to be that the inflammation, though creating pain and stiffness, is itself part of the natural history of soft tissue healing; hence the body is served by respecting it. Intellectually I understand it; on my own injuries and surgeries I have not chosen that path. I agree with following your team's recommendations. They are not in the majority but in ten years perhaps they will be.
 
@Nivea Don't get me wrong, I am not suggesting that you not follow your surgeon's instructions. They just seem counterproductive as there is no relief from all the swelling that inhibits ROM.

I'll be interested in following your progress. Please do keep us updated.
 
@Jaycey no worries. I just find it interesting myself that my instructions are so different. We moved to a new state since I had my hip done and went back to use the same OS. Everyone we talk to seems stunned but the people that know this facility say I am in good hands.

what I want to see, if it’s similar to the old adage that you take meds for a cold an you are better in 7 days, don’t take meds and you are better in a week. Lol. In other words, at the end of the day will I be in a similar recovery spot as everyone who is icing and elevating. I know each knee is different and each patient is different so can’t really compare.
 
I feel like I am on an island all by myself. My OS’s instructions for recovery is not the same as everyone. LOL.
Seriously now, I had several busy days that had me up and moving more than I probably should have been for under 1 week post op. I did well but it felt good today to lay low and rest a bit. Did go outside for a bit after dinner, it was nice out and a heat wave is coming.

Speaking with a few neighbors tonight, they were so surprised how well I was doing but shocked at the bruising. It seems as though I missed the spot on my foot. I saw that and was a bit startled.

So far, recovery has been uneventful.
 
Nivea said:
I feel like I am on an island all by myself. My OS’s instructions for recovery is not the same as everyone
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That's okay, I am sure many of us are watching with interest.
You seem to be doing well and that's all that matters.
Keep us in the loop. :)
 
Nivea said:
The insomnia has kicked in! I have been sleeping well until last night. Fell asleep at 5:30 and woke up at 6:30. That’s it. Ugh. I remember this from when I had my hip replaced.
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I remember those days. Still have a few of them! It will get better. Give yourself permission to sleep during the day or whenever your body says sleep. I watched alot of oldie-classics my first weeks at night... quiet stuff I could drop off too that was not too loud or blaring.
 
Not a recovery question for myself but have a question. I was speaking to a former co-worker that had knee replacement in November. She did not have the minimally invasive, she had her quad muscles cut. She needed a knee brace after surgery. From reading other peoples recovery here on Bonesmart, it seems most of us have the minimally invasive. Do most have the newer technological surgery?

As for me, I had good nights sleep last night. Hoping for the same tonight, we shall see. I feel a little better today, mentally. I haven’t been too bad but have felt all out of sorts, which is normal I know. Still quite uneventful, which is a good thing! Amazing how colorful the leg gets post surgery!
 
Nivea said:
She did not have the minimally invasive
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There is no such thing as minimally invasive TKR. That's all marketing hype I'm afraid. Even if your surgeon used a different approach, they still shifted muscles and tendons. All this causes trauma. It is invasive surgery.
Nivea said:
Do most have the newer technological surgery?
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The changes have been in robotic assisted surgery. But this is all about the implant placement - still invasive.
 
Yes, I realize they are both invasive and yes, probably a marketing ploy. However, if you look it up, that’s what it is called. Basically, it’s cutting the quad muscles vs not cutting the quad muscles, from what I understand. My former co-worker had the quads cut, whereas I did not. Her recovery, from the same facility as mine, is very very different. From what I have known, with what they call minimally invasive is the incision is shorter, how they move the patella is different and what they cut is different. It is a newer technique but still invasive and painfuL. I know of the robotic assisted and yes, realize that is also invasive. There is no getting around knee replacement as non-invasive. It may be a marketing ploy, but trying to say it as to how it seems to be interpreted when talking to people, at least around here. It is as question that many of my former co-workers have asked as many of either our selves or our parents have gone through it. Did they cut the quads? Which surgery did you have?
 
Hi @Nivea - re technology... Not robotic, but the things my ortho and suregery team does that I feel enhanced my surgery and postop:
- Handheld software device that scans my joint and computes correct alignment, angles, etc of the components of the joint replacement;
- External reservoir of the local anesthetic via small catheter in the thigh provides 3-4 days of anesthesia and is easily removed by the patient;
- Glue patch instead of external sutures permits showering after the external gauze dressings are removed one day postop.
 
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