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TKR Sitting with knees bent at 90 degrees hurts

I‘m sorry you had a rough start, but it sounds like you had good nurse that night!

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.

Just keep in mind all people are 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: 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.
 
My thigh is swollen along with my knee—more than I recall with Rightie. I have PT in the morning so if she sees it as a problem, the ortho clinic is in the same building.
 
My thigh was quite swollen also. Your whole leg is traumatized with this surgery.
 
It’s calmed back down and is almost back to regular size/less tight. There’s way more bruising this time—including behind my knee.
 
I had PT #2 this morning with the same person I had for Rightie. Leftie definitely had me concerned and yes I keep being told every knee is different…but that’s not what I’m ready to hear, .

I feel like my pain has dropped off faster (maybe that’s because it was so extreme well into the first overnight). Somehow I demonstrated my PT exercises at the hospital. It had to have swollen after those demos as I could not replicate those maneuvers for days.

I’ve noticed this scar (though still under the cushy bandage which I love and wish they'd put a new one on once they check it at the doctor’s office this week) isn’t sunken at the top part where it ends above my knee like Rightie is. That’s comforting.

I’ve worked on extension stretches with a foam roll under my heel on the recliner footrest and doing ankle pumps. Not my most fun but I didn’t want to leave full extension up to chance. I figure if I could just stretch it a few times each day, my efforts would pay off. Thankfully, they did as at PT, she measured 0 degree/full extension. Ahhhhh, that was validation. My gut told me I needed to work on this. Did I do several sets of the other exercises? No, . I do a few when I think of them. Still need assistance to lift my New Leftie up onto the bed. I’ve just been using the Stretching Strap I picked up online from previous PT on my tight TFL/IT Band. I’ve used it to get Leftie into the car, as well.

We measured flexion and I was at 116. I looked back at a message to a friend from the same visit with Rightie and I was only at 110 for Rightie on the second visit. I hadn’t yet realized it was okay to pull my knees up while in the recliner. I credit that for my ROM being so good with Rightie and hope to have great results with New Leftie.

It continues to be a pain to stand up from the recliner. I have ordered a gadget that might help with that—I’m hopeful.

I’m doing better with pain meds with today being my first refill request. I’m not sure if the actual surgeon is slightly more lenient than his PA or if it was a matter of timing, but they gave me a larger refill than last time, I’m pretty sure. Of course, last time I was just going with what I’d had at the hospital for dosage and after double what they’d listed on the bottle, I was running low before the week was up. I didn’t notice the instructions being different until I was looking at the label (in shock as I didn’t see why they’d change when the pain didn’t drop off immediately to half what it was at the hospital so why would my dose?!). I have budgeted it much better this time and, thus, not running out as fast. I still have a lot of pain but can save most of my doses for overnight.
 
Hi @NewRightie , great report! Fills me with optimism for tomorrow when I get my own LTKR ... despite knowing full well that all knees are different and recoveries unique. Pretty amazing ROM and extension! I'm sure there'll be lots of times when I'll be reluctant to do the bends and stretches early on but will use your work and results to motivate me.

All the best on your recovery/rehab!
 
glidefloss said:
Hi @NewRightie , great report! Fills me with optimism for tomorrow when I get my own LTKR ... despite knowing full well that all knees are different and recoveries unique. Pretty amazing ROM and extension! I'm sure there'll be lots of times when I'll be reluctant to do the bends and stretches early on but will use your work and results to motivate me.

All the best on your recovery/rehab!
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Here’s to a great surgery and recovery! You’ve got this!

I was trying to explain to a family member that this is like the opposite of a bad sprain. A bad sprain hurts and they want you to magically stay off of it (often without crutches or other walking aids—that always confused me as to how that was to be accomplished). With a knee replacement, you must walk on it and much like a bad sprain, it hurts and feels like you’re doing the wrong thing. With a sprain or broken bone, resting it is imperative. With a replacement, some degree of activity is required—I’m not endorsing anything excessive, just that in addition to walking for at least to/from bathroom trips (which also includes getting up and down from a seated position), the new joint needs to learn to move and will feel stiff and sore as it’s healing from this brutal surgery. There will be pain and it is a long process, but we each have to realize we have some control over how we heal (which includes taking our best measures to avoid overdoing it as it’s at least as bad as under-doing). Each of us is different and have different things going on in other parts of our bodies to contend with, but deep down I believe we all know we have to participate in our healing.
 
@NewRightie that is a great comparison that I wish I had last year when my brother was trying to compare the pulled ligament he had to my knee replacement. I finally gave up trying to convince him that there were NO similarities except both involved a leg.

It sounds like you’re doing great!
 
FourCats said:
@NewRightie that is a great comparison that I wish I had last year when my brother was trying to compare the pulled ligament he had to my knee replacement. I finally gave up trying to convince him that there were NO similarities except both involved a leg.

It sounds like you’re doing great!
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I hope you’re doing well! Sheesh that’s a faulty comparison from your brother. So true—only similarity is they’re both legs!
 
Here’s an excerpt of a text I sent to a close friend yesterday.

“I told my PT gal that just because I look like a ladybug from the outside appearance, there’s a lot going on under my shell just like the (Clutter Bug) organizer lady talks about. I may give the appearance of being at 100% but that’s who I am…and it’s not sustainable so if people were around me 24/7 they would see that some of it is smoke and mirrors vs me being healed.
Also I don’t WANT to be the downer and want to keep up…so my game face is on a lot.
But yeah it hurts a lot and I fight through pain. Sleep is fleeting and used to be something I was great at. My body bears the bruises proving I was manhandled to accomplish this surgical replacement. My brain had to have heard all of the hammering, the power saws and drills during the so-called “brutal” surgery so there’s a lot to heal from. Muscles cut, parts moved out of the way and reattached…muscles to repair, blood loss to rebuild, etc.
So in reality, I minimize a lot . I’m happy to be able to have a mostly supportive family, amazing friends, a good medical team, a new job to look forward to and a home that allows for what I need to recover.”

This was in response to every friend who has seen me (visiting or driving me to and from PT) telling me how great I look and how amazed they are at how well I’m moving. I wanted to explain that while the outward appearance is put together, I’m fully aware I’m concealing 99% of the pain/discomfort I’m in. Each step is taken with efforts to maintain proper gait, not limp, make sure each foot is picked up and placed properly so as not to have a dreaded fall). I try my best NOT to add sound effects (though I mostly cannot help the sound I make when rising from the recliner), sometimes they might catch a wince under my face mask (bring extra cautious as no way do I want to miss doctor or PT appointments from getting sick!)…so basically they don’t see my “tells” that I’m experiencing any pain or discomfort.
 
NewRightie said:
This was in response to every friend who has seen me (visiting or driving me to and from PT) telling me how great I look and how amazed they are at how well I’m moving. I wanted to explain that while the outward appearance is put together, I’m fully aware I’m concealing 99% of the pain/discomfort I’m in.
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Hi @NewRightie , I know exactly what you mean! In my case, I too am someone for whom my outward bravado needs to convince that all is going great guns ... lest my pessimistic self start imagining all sorts of reasons why I'm doing badly (even if not!) The power of positive thinking!
 
Yes! My response to the question of how my knee is doing has been, “It’s a long process and it gets a little bit better every day.”

I was definitely slowed down from my normal old self on a vacation. I made choices compatible with my capabilities so as not to overdo it and wreck the family vacation. I had wheelchair assistance to and from the gates between flights so I wouldn’t be racing to catch each plane and then be exhausted. It was not a morale-booster, however it saved my physical energy for the more fun parts of the trip.

I’ll be in turtle mode for another season now. I’m okay with that as just knowing it’s getting better is like a carrot in front of my nose that keeps me moving forward. If I treat my body well during this season, I can look forward to a healthy, stronger level of activity in the next season! I’m hoping that by fall (lol, the words “trip” and “fall” come with new thoughts of “oh not that!”), I’ll be enjoying scenic hikes in my favorite places without pain and slowing my family down.
 
NewRightie said:
If I treat my body well during this season, I can look forward to a healthy, stronger level of activity in the next season!
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You really have the right approach to recovery. Slow and steady wins the race!

NewRightie said:
(lol, the words “trip” and “fall” come with new thoughts of “oh not that!”),
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Ain't it the truth! :heehee:

Wishing you an uneventful journey to "next season."
 
I had my first post-op visit today with a PA. Dressing removed, looks “great” (to them), tubigrip sleeve on and my form for returning to work was filled out. The initial plan is 5/2 which is 4 weeks off and to start with less hours and see how that goes.

I just need to get a better grip on sleep! I convinced myself to start in bed last night with pain meds but it was hours of pain. I must’ve slept some, but nothing was comfy. Sometime around 2am, I went out to the recliner.

Yesterday, my recliner gadget came. The Universal Stand Assist sounded like such a promising aid. One of my sons assembled it and got it fitted for the recliner. It seemed great as there are little rubber capped feet to keep the recliner from rocking forward which coupled with the handles made it a lot easier to stand up. The problem was, the back bar that goes behind the cushion (attaches as a squared off “U” shape to the sides which have the handles). After a short time, I was noticing the bar behind my rear end. I got up and tried to reposition but the way this recliner is made, there’s no way to really sink that bar to a space that won’t protrude. It would probably be better on a couch where that frame would be completely under the cushion.
I thought I could solve the problem with one of my pillows, so at 2am I brought a pillow with me. There was just too much displacement of where my back wanted to be. Got up and pulled the gadget completely out of the chair, set the pillow aside and fell asleep.
 
I’m so sorry that gadget didn’t work for you. :console2:I would consider all you did with trying to fix it as PT session.
 
Jockette said:
I’m so sorry that gadget didn’t work for you. :console2:I would consider all you did with trying to fix it as PT session.
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Thanks—guess I’ll just get through it like last time. The issues of being tall….

Yeah, between acrobatics in bed trying pillows and alternating sides plus the chair stuff…definitely a PT session. :heehee:
 
I was comparing my side by side x-ray pics and can see they went much higher with my quad dissection for Rightie which I attribute that divot to. Leftie has no such divot. Leftie has been mad since the appointment but I’m holding off on pain meds until closer to bedtime.

I think they need to actually do some pill-math and get a dose of reality. For instance, they had me on 2 pain pills every 4 hours the first time. I am next to positive I was on WAY more this last time as during the night I was taking something in pill form hourly as well as IV (and sure some of it was acetaminophen and stool softeners but I am sure that nearly every hour had pain meds). Then you get a bottle as a Rx with the instructions to both stay ahead of the pain AND wean off of them. The dosage is 1/2 of that in the hospital yet for most folks the nerve block wears off a day or two later and you have more pain but warnings to only take 1 pill every 4 hours, max. The first bottle was enough for 1 week at the recommended dosage. Then boom…”no refills” but I call anyway as they claim to be sympathetic and that “all pain is real.” The refill is a bit more than 1/2 the original Rx and another warning to wean off. One is just supposed to create such a schedule for oneself, apparently. Yet at the follow up, the nice PA tells me to go ahead and take 1 1/2 if 1 isn’t enough at bedtime/during the night. Oh and be sure to take some before PT. Yeah so that would be 3 pills each night and 1 during the day twice a week (never mind weaning) which basically takes just over a week to use up…oh but wean off of them. I know they will resist refill number 3 and that will be a downgrade in Rx but still helpful though then you have to calculate the acetaminophen dosage so you don’t take too much of that….but that’s also on me to figure out.

I get it that some people can get by with zero meds but not me.
 
Taking pain meds before PT is not a good idea. The pain meds can mask pain enough for you to do way more than your knee is ready for, and you will pay a price in pain that can last days. Unfortunately the opioid crisis has doctors running scared, so because some people want to get high, patients that need pain medication are left to suffer instead.
 
FCBayern said:
Taking pain meds before PT is not a good idea. The pain meds can mask pain enough for you to do way more than your knee is ready for, and you will pay a price in pain that can last days. Unfortunately the opioid crisis has doctors running scared, so because some people want to get high, patients that need pain medication are left to suffer instead.
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Yeah so I did it today but it wasn’t taking away pain…just made me dizzy. Sheesh, I am literally still dizzy 7 hours after taking the pill.

I know saying this after having taken a pain pill will have people thinking I pushed too hard at PT, but I didn’t feel any less pain or stiffness…. For my first and now my second knee, I’ve been able to be in the gym by the 3rd appointment on the recumbent bike and a couple of leg machines. Last knee, I had to pedal in reverse a minute or so and then was able to go forward. Today, my first time using the bike with Leftie and I went forward from the first pedal! That was exciting. I’ve known my ROM increased since Monday’s PT so I was thinking this would actually be possible and was happy it happened! The leg machines went well, too. After all that, she measured ROM. I asked for both knees to be measured out of curiosity as it feels like Rightie was going further lately than it had when I graduated in January. Leftie is 120 and Rightie is 145.

Again, not because of lack of pain or any extra pain. For me, ROM is more like a nice stretch feeling vs pain (that’s the best way I can explain it). The stopping point of my ROM is just like it stops vs hurts. My exercises like seated leg extensions—THOSE cause patella tendon pain but pulling my knees up towards my chest while in the recliner is just a stiffness/stretching feeling. Possibly because I don’t push harder than my body lets me…:shrug:
 
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