PKR Should I worry?

NanaMom

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I had a right medial PKR on March 1st 2022 (6-1/2 weeks ago). Recovery has been going well - I have been walking almost every day for 30-40 minutes since week 3, doing PT on my own with exercises prescribed by the physical therapist, and finally got to the point of being able to go up and down my stairs a couple of weeks ago. The last few days I haven't been able to walk for more than 20 minutes without pain in the knee getting worse, and it's constantly sore/painful, which is not the way it has been. The stairs, especially going down, have become challenging again because it causes a sharp "catching" pain under the knee cap and on the medial side of the knee. I didn't walk or do any exercises yesterday or today, have been icing more for the last two days, but no change. The only thing I did differently recently was vacuum out my minivan!! Could that have caused this to happen?

I have read the library suggestions posted by staff about knee replacement recovery, exercise, etc., and understand that if it hurts stop doing it. But I'm worried I've done some damage. Is that possible?

Also, the library is mostly about TKR's, and although I've read them I don't feel like they apply to PKR, especially the one about the timeline after PKR. Is there anything in the library about a timeline for PKR?
Thanks
 

Layla

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Welcome to BoneSmart and recovery. Thanks for joining us!
I‘m sorry you’re struggling with pain. You’re wise to give the exercises and the walks a break and I think you should do so for a few more days as you continue to ice and use OTC pain relievers if need be. It’s difficult to say if you did something to aggravate your knee while vacuuming your vehicle, but possibly you did. If rest, ice and pain relievers don’t seem to be helping after a few more days, consider calling your surgeons office to let them advise. I’ll leave our Recovery Guidelines which are the same for PKR and TKR. A PKR recovery can take just as long as a TKR recovery which can be a full year and even longer for some. I do hope the next couple days of rest bring you relief.
Wishing you comfort. :console2: Please stay in touch and let us know how you’re doing.

Knee Recovery: The Guidelines
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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
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
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


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.
@NanaMom
 

patriciad

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Absolutely everything you read in the articles applies to a partial as well as a full replacement- I’ve had one of each so can attest to the validity of the articles as they relate to a partial. I imagine that vacuuming out your minivan ( yikes) so early in the healing process has caused your setback and just a few days of rest, ice and elevation are not enough to allow healing now you are an official member of the ODIC - over did it club. There is no one recovery size for all with knee replacement. Some partials prove to be trickier and longer to heal than full replacements. Don’t think that because some of your knee joint was spared that your recovery will necessarily be shorter. Can you share what type of partial replacement you had?
In my experience the first months were the same amount of pain, swelling, etc., in both surgeries. My recovery from my partial has been a smoother steady transition due to finding Bonesmart with my TKR and learning from my mistakes the first time around but the timeline is very similar to a TKR.
Its doubtful you have hurt your prosthetic with your activity but all your internal joint tissues can be inflamed and take weeks not days to settle down again. Patience will get you there.
 

partialfixFeb

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@NanaMom

I also questioned whether there may be some differences in the healing protocol for PKR's vs. TKR's.

I found this kindle book/resource helpful for PT suggestions and general PKR recovery timelines. I worked closely with my PT before attempting new exercises from this book as she knew my strengths and weaknesses.

Partial Knee Replacement: Everything You Need to Know to Make the Right Treatment Decision: Understanding knee arthritis - Medial unicompartmental - Patellofemoral ... unicompartmental
by Frank Noyes and Sue Barber-Westin

Jamie, Bonesmart staff member, advised me that he is an excellent and well-known ortho surgeon and that it would benefit Bonesmart if you used Smile.Amazon to purchase it.

The link to sign up for Smile.Amazon is here: AmazonSmile: You shop. Amazon gives.

When you register, designate BS's parent non-profit organization to receive your donation:

The Foundation for the Advancement in Research in Medicine, Inc.
 
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NanaMom

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Thank you all for responding and helping me understand what's going on and what to do. I am definitely a member of the "ODIC" - thanks for that acronym, by the way. Even this morning, I thought maybe I should just go for a 20 minute walk and see if that would help with the stiffness and pain. Thankfully, I opened up my laptop first and read your responses and will take it easy for alot longer. I have been doing so well with the recovery process that it's a shock to have a setback. It's also the reason I vacuumed out the van - I had been getting better and better every day!

Thanks, too, for clarifying that PKR and TKR recovery timelines are the same. The home health PT told me that it's a much shorter recovery period for PKR, and she even had me using weights at week 3 postop, which did not go well. The outpatient PT wasn't any less aggressive, which is the reason I stopped going to PT and do my own PT at home only. And also the reason I went online, found Bone Smart and followed threads that have been very helpful.

I will definitely go through AmazonSmile and get the book mentioned - thank you!

I have a 7-week follow-up with my surgeon in five days, so I will continue to rest, ice, and take OTC meds until that appointment, as you all suggested. I needed to hear that because the surgeon and his staff really emphasize staying active, doing the exercises every day, walking daily, etc. Thank you, thank you!
 

Jockette

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I also have a partial, and before my surgery I didn’t think the TKR info applied to me. I was very wrong!
The home health PT told me that it's a much shorter recovery period for PKR,
This is all I read online before my surgery and it is SO not true! They must write about the best of the best amazing recoveries!

I have a Patellofemoral partial, which one did you get? :flwrysmile:
 
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NanaMom

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I agree! There are several websites that say with a PKR you can be golfing by 6 weeks postop (I don't golf but I know that puts a tremendous strain on the knee)!

I had a medial partial on the right knee. Not sure of any specifics other than that.
 

Jockette

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Just knowing it’s a medial is fine, since I also have a partial, I like to have that info in the signature. I’ll add it to yours.

I don’t golf either, but I was a bowler when I had my surgery. I started very carefully bowling at 3 months, just doing one game, then adding a second one and doing that for weeks before I added the third, that we do on league days. I had my surgery in March that year, and didn’t need to bowl with the league again until September, so I had time to do it gradually.

Before my surgery, between what I read, and what my surgeon’s office did, and did not, say, I expected to be fully recovered by 2-3 months. Reality was a shock!
 

Carol Anna

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My PKR was in October (I really must get round to posting an update on my thread) I am getting better daily from the knee op but still have days when if I say go for a 1 mile walk in the morning and to the supermaket in the afternoon - it can still be too much leaving me exhausted and my knee grumbling along with my other none op knee. I too was totally surprised that the recovery was much longer than the 6 weeks I was originally told about by my surgeon who on my first post op visit reminded me that I had had major surgery and should expect the recovery to take longer than I was thinking (Hmmmm it was he who set my expectations high). Anyway this site saved me and my recovery has been much better and less stressful since I stopped doing more and more to only find that I improved less and less. I am now almost at the 6 month point and can do a lot of things but some I struggle with more from a psycological point of view - scared to cause problems. But there is the odd occassion when I forget I have had the op - this has only happened in the last two weeks and not very often but it is progress. I am looking forward to more improvement in the next 6 mlonths but not pushing it. I wish you well in your recovery and can only say that if you follow the advice on this site you will not be sorry.
 
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NanaMom

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Reading your replies makes me feel so much more confident to listen to my body and give myself a break as much as I need rather than continue to push myself. And seeing that you were both surprised at not being fully recovered as quickly as you were told/expected is huge for me psychologically - thank you! I'm so glad I found this site! When I see my surgeon this week I'm going to suggest he tell his patients about it - hopefully he's open to spreading the word because this has been the most useful tool of my recovery.

As an update: I didn't walk or do any strengthening exercises for the past four days, and reduced the stretching exercises to once a day. By last evening I was able to walk up and down the stairs without feeling like someone was stabbing me in the knee with a hot knife, and this morning I woke up with very little pain and swelling. I took a 20 minute walk and am icing the knee as I write, but if it turns out the walk caused a problem, I'm back to resting it completely.
 

Carol Anna

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Don't forget that your normal daily activities will still be excercise and I would rather be able to walk up and down the kitchen lcooking dinner in comfort rather than push myself to do excercise, particularly if it caused pain and too much discomfort - but that's me and I know we are not all the same. I still have not walked more than a couple of milesin one go, if that, and I am not concerned. You are still early in your recovery and whilst you might not believe it yet - it will get better. Take care Carol x
 

glidefloss

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Don't forget that your normal daily activities will still be excercise and I would rather be able to walk up and down the kitchen lcooking dinner in comfort rather than push myself to do excercise, particularly if it caused pain and too much discomfort
Hi @Carol Anna , this makes so much sense and in retrospect is so obvious that I'm surprised that it never even crossed my mind! I'm going to factor this in when I begin exercising/etc next week.

Hi @NanaMom , nice movement in the right direction! All the best on your recovery/rehab!!
 
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NanaMom

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Carole Anna, that is such perfect advice, and makes so much sense!

Thank you both for the encouragement!
 

Carol Anna

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Carole Anna, that is such perfect advice, and makes so much sense!

Thank you both for the encouragement!
I don't always take the advice but I fortunately have a great husband who reminds me - can't always stop me but he reminds me :rotfl: e.g. today I do yoga and we also need to go to supermarket so hubby sensibly says "remember it was too much last time so lets go tomorrow". I might listen then again ..........
 

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