TKR Seven months post op and still having trouble

[Jazzhands]

@Celle Thank you for the link about heel slides. I'm printing that out and will start doing them this way. @NewToMe your recovery sounds like mine. Slow going. And I'm not a patient person.

 

[Jazzhands]

I am now between 7 and 8 months post-op with a TKR. It has been a very trying and difficult recovery from day 1. Even now, I suffer with swelling if I do a tad too much, and I still have some sleepless nights from the discomfort. I can go for a walk of one mile, but if I go longer than that, I pay the price with stiffness. I am nowhere near as good as I thought I would be before having this surgery. I can't walk any more than I did beforehand. Is this it, or could I still continue to improve? I'm only 62 and was looking forward to walking a lot more than I can.

 

[Roy Gardiner]

You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one 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.
• If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• 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.

 

[Celle]

I am now between 7 and 8 months post-op with a TKR.

Is this it, or could I still continue to improve?

No, that's not it.
You still have plenty of time to improve. Your knee is still healing and where it is now is not where it is going to end up.

You're at seven and a half months into a recovery that takes a full year, sometimes even longer. Even though everything looks healed on the outside, you are still healing internally. All the tissues around your knee - muscles, ligaments and tendons - were traumatized by the surgery, as well as what went on inside your knee joint itself. Knee replacement is truly major surgery and it really does take all this time for everything to heal completely.

It's not unusual for your knee to still swell if you do more than it is ready for.
When that happens, sit down for a while, give yourself a rest, and treat your knee to some elevation and icing.

 

[Fran55]

Hi @Jazzhands

I am glad to see you feel you have turned a corner. That happened for me at 4 months so not much difference considering how long recovery takes and how different it is for each of us.

I am almost 5 months post op Bilateral TKR. I had no aggressive therapy. My surgeon does not allow it. His protocol allowed for some stretching exercises while in hospital (2 days surgical ward 10 days rehab ward including some hydrotherapy). I came home with a sheet of allowed stretches and that was it. I still do a couple of them but mostly just do my usual “”stuff” and walk.

I think most of us would say we are still having some problems. For me it has been the lack of sleep. That was the surprise of the whole thing for - the fatigue and sleep issues but they are getting better. My knees generally still have some swelling and some pain on standing but I am happy. If I do a bit much there is some pain so I do less the next day. They feel a bit better each week and I no longer have the bone on bone pain of the arthritis.

Yes, recovery takes a l-o-n-g time we all find out. A TKR is a BIG operation.If things are getting better you are heading in the right direction even if it does seem slow. Hang in there

 

[Jazzhands]

Thanks Fran55. This is definitely slow, and there are days when I feel like I'm going backward instead of forward. If I do a teeny bit too much, my knee knows it. I still get stiffness and some swelling, although nowhere near as much as before.

 

[sistersinhim]

I still get stiffness and some swelling, although nowhere near as much as before.

This is such good news and a sure sign that you are on the healing road.

 

[kneeper]

^exactly--a good sign. Although it's difficult try to think in weekly trends rather than individual days.

 

[Jazzhands]

I am now 15 months post TKR, and I still have constant trouble. The bend in my knee stops at about 90 degrees, and it is like a cement block trying to bend it any further. I can walk for several miles, but if I walk more than that, it becomes even stiffer and painful. I recently went to a gym to try riding a stationary bike. That has caused me a world of trouble. It feels fine while I'm pedaling, but it really hurts and is very stiff later. My question is this...could the bike riding be breaking up scar tissue causing all of this pain? Or is that not a possibility - to break up scar tissue on your own? When I last saw the doctor last September, he said I probably am dealing with scar tissue. And then...see you in a year. Is there some sort of test that can be done to determine if this is indeed scar tissue or arthrofibrosis?
I constantly feel like a tight band is on my knee, above and to the side. It NEVER feels normal or good.

 

[Jaycey]

My question is this...could the bike riding be breaking up scar tissue causing all of this pain? Or is that not a possibility - to break up scar tissue on your own?

No it's not scar tissue. It's all the soft tissues around the joint. You are asking them to do something new.

I'm going to tag my colleague @Roy Gardiner who had BTKR and is an avid cyclist. He can advise on how to use a stationary bike to increase ROM. It's more the slow and steady approach versus leaning in and paying for it later.

 

[Roy Gardiner]

Using a bike to gain ROM is pretty simple:

• Set the bike to zero resistance
• Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
• Gently turn the pedals, through discomfort but without pain.
• Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
• Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
• Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
• And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't

Here is a bit more chat and some pix and how 'healing' and 'training' are different

When I last saw the doctor last September, he said I probably am dealing with scar tissue

everyone has scar tissue. It may be that you have adhesions, where the soft tissues are sticking together. If so, Manipulation Under Anaesthesia (MUA) may be the answer, where the surgeon basically forces movement. But I'd try the bike first.