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TKR Shopping therapy too soon after rtkr(9/11/20)

Beas27

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I have finished PT after 8 weeks with rom of 118 flexion and 0 extension. Swelling and stiffness still an issue. I did go for massage and it helped a lot. But then I went shopping. Spent about 3 hours on my knee. What a mistake! Now 6 days later I am still miserable with stiffness. Feels like tight bands all around my knee cap. My knee bends but very difficult walking with a limp due to the uncomfortable feeling. Also painful at times under the knee cap. Any suggestions? I have been icing once or twice a day and elevating twice a day. I was using wintergreen essential oil and massaging with lotion, but I think it was irritating the knee.
 

Jockette

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Hi and Welcome!

At 8 weeks post op you are still in the early weeks, in this year long recovery. Try to avoid overdoing things, to avoid unnecessary pain.

Try icing and elevating 3-4 times a day, for 45-60 minutes, being sure to put a cloth between your skin and the ice source.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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.
 
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Beas27

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Thanks, I am 11 weeks today post op. I know its still early. I will elevate and ice more. Didn't realize it should be done that often at this point.
 

ihavetwins

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Hi @Beas27 ,

I’m 11 weeks out and still icing for an hour at least twice a day. It’s a drag but I think it helps keep the swelling down, esp. since I like to move around a lot during the day.

Take care.
 

Jane66

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Hello @Beas27 .

I am at 10 weeks this weekend and still need elevating and icing at least twice a day.
I hadn't realised I would have to until I had read others posts on here.
Hope your knee calms and settles soon.

Kind wishes
 

Jaycey

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Didn't realize it should be done that often at this point.
Keep icing as long as you have swelling. It's the swelling that is causing pain. And anytime you try a new activity that knee might complain. As Jockette says - still early days!
 

kneeper

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Ouch. You learned the hard way that your knee is only a toddler. Ice, elevate, rest and gentle bending. :console2:
 
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Beas27

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I've noticed a lot of swelling just under the skin has gone away in past few days. Now there is more tightness which I understand is the internal swelling. Pain and tenderness has increased a bit. Can't take much for pain due to stomach issues. I did take ibuprofen today.

I stopped going to follow up appts with my surgeon because he was insisting my extension was not good and made me feel terrible about it. I told him what I was able to do at PT and he didn't believe me, never read the notes from the therapist. He wanted to see me 2 weeks later. I cancelled that appt. And never rescheduled. Is there any reason I should continue to see him? My knee extension is now at zero. He is an excellent surgeon but bedside manner is poor.
 

Jaycey

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Unless you have complications from the surgery I can't see any reason why you need to have so many follow up appointments. Maybe at the one year mark. If all your surgeon wants to do is put pressure on you about your ROM then I wouldn't bother. ROM continues to improve after one year or longer.
 

Jockette

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I wish I’d had the nerve to “defy the system” and stop going to my post op appointments. I had more than some other members here did and they were always very stressful, as my surgeon was a fan of pushing my knee to a painful place to get a number he liked. At my 4 month appointment he did it a second time because the 124 the first time wasn’t good enough. That was the last time I let him do that, the next 2 appointments I refused to get up on the exam table and give him easy access to my leg.

This was my first joint replacement so I was very inexperienced. However, if I ever do this again, I will be much bolder in taking charge of my recovery. If I don’t have any bad issues, Bonesmart and I will handle my recovery just fine. Certain check ups are important, but looking back, many of mine were a waste of time and stress.
 

Celle

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Is there any reason I should continue to see him? My knee extension is now at zero. He is an excellent surgeon but bedside manner is poor.
I agree with the others that there is no need to keep going to so many appointments, but a follow-up at one year post-op would probably be wise.
You see, your current surgeon has the responsibility to oversee your recovery for a year and it could be very difficult to get another surgeon to help you, if you ran into any problems.
 
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Beas27

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Good point about follow up in one year. Thx.
 

TKRsharon

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My surgeon does not even look at my knee at post-ops! He looked at an x-ray! Not interested in ROM when I bring it up. I even asked him if he wanted to look at the knee, and he said, no.

I had a TKR on Oct. 13th and am having a veery difficult recovery. I wish I knew beforehand what was to be expected.
 
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Beas27

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I am now just about 4 months post op. I had a massage this past week which included myofascial release and she liosened my locked up patella and able to move. However, she began to hear a clunky noise she has never heard from a tkr before. Now I hear it a couple of times a day. Its coming from the outside of knee where I still have no feeling. Also, the area near the numbness is extremely sore and is cutting into my leg right below the knee cap. The numb area feels heavy and pushes into my knee.

My questions are should I be concerned about the noise and what can I do besides ice and ibuprofen for the pain. Neither is helping it.
 
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sistersinhim

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We have found that Tylenol is actually better for after surgery pain than Ibuprofen. You can take 4,000mg in 24 hours. Be sure and count the acetaminophen, (Tylenol), in everything that you are taking and not go over the 4,000 in 24 hours.

Clicking/clunking sounds are completely normal after this surgery. Clicking/Clunking after TKR
 
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Beas27

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I took tylenol the first weeks and had no relief but I will try again, thanks.
 

Celle

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The most effective way to take Tylenol is 2 x 500 mg (Extra strength) tablets 6-hourly, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.
 

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