TKR SkiBum's recovery

[SkiBum]

Well I went in yesterday,6:30 check in for an 8:30 surgery time....I was#2 on the schedule. Spinal and propofol went well. They got me up about 4:00 and I was discharged by 5:00 after passing my test with flying colors. I came home ate well.. RICE the rest of the evening and slept some as well. This morning I had some vasovagel reaction but was better after eating a little.... even took a shower. I'm getting around OK with the walker. Pain didn't start till late this afternoon.. I'm now officially stoned on oxy and pain has calmed down.

This is a long but manageable recovery. I'm feeling hopeful.

 

[Jockette]

Welcome to Recovery!

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

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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 to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[SkiBum]

day 2 has been a weird one... people talk about not being able to sleep but I'm experiencing the opposite. I'm so loopy that it's hard to keep my eyes open. I think it's the oxy every 4 hrs.

what's the best thing to do for thigh pain? I can still see the marks from the tourniquet.

 

[Layla]

Welcome to recovery and Congrats on your new knee!

what's the best thing to do for thigh pain

Try icing any / all painful areas...hopefully it will help ease the pain.
Wishing you comfort as you begin healing.

 

[Susie-Q]

You are lucky to be able to sleep! Most are not so lucky, especially in the early days.

If you end up with constipation from the oxy you can try prune juice, Miralax, or something that worked well for me was Smooth Move tea, by Traditional Medicinals, which can be found in your grocery store.

Good luck with your recovery!

 

[sistersinhim]

Being able to sleep is a blessing. Sleep as much as your body wants you to. You can heal more when sleeping, your body can concentrate more on healing that knee than running the rest of your body!

 

[SkiBum]

today was a better day.. no lightheaded issues this morning. I felt more alert all day. Knee aches but doesn't hurt. Only took a couple of oxy today... I'll take one before bed. Trying to bend that sucker is tough...I only go until it's tight and hold it until it's annoying.. then elevate again. I feel really stable standing so that makes me happy. overall I'm maneuvering quite well. First PT tomorrow...I'm actually looking forward to it.

 

[SkiBum]

I haven't posted in a while so I thought I would check in. So far I've done everything "wrong". It's been 17days and I've cooked some meals albeit with some assistance. I've let my PT get quite aggressive..... yes it hurt but I seem to be progressing not regressing. I rigged a suspended laundry basket from my walker to do my own laundry... lucky for me it's all on one level. But the biggest win is I started sleeping in my normal position of on my stomach with my knee bent to one side. I slept through the night last night....

This community has been really great. It's helped me stay optimistic when I get that things are going too slow feeling. Even though I can only bend to about 90 degrees now I know I'm in an OK place. I still have oxy in the bottle... but I prefer to put up with the discomfort since it's only temporary bouts of it and not constant pain. Ice works so well as an analgesic for those times.

 

[Zanza]

Congratulations on sleeping!

 

[Jockette]

So far I've done everything "wrong".

You are not doing anything wrong. You are listening to your body’s reaction and what you’re doing is working well for you. Keep listening and acting accordingly, and you’ll continue to do just fine.

 

[SkiBum]

I thought I'd update....it's been 4 weeks today. I went from getting sleep initially to not sleeping well for a while, now I'm sleeping through the night. The pain has changed to a deeper ache. I get medial pain and popping sensations when I twist or go sideways.... It's very reminiscent of the pain I had pre surgery. My first post op appointment is next Tuesday so I will ask about that. My range is about 108-3... so getting there. Still very tight across the knee... stiffness... argh this is getting old. When does this part ease up????

 

[benne68]

You likely still have a lot of swelling in the joint from all the trauma of surgery, @SkiBum . As the swelling goes down, the pain and stiffness will recede and your ROM will improve. (Actually, your ROM is great for just one month out!)

I know it's hard to be patient when you are someone used to being active, but this is a recovery that can't be rushed. It just takes tie. I found this chart really helpful in understanding why:

Feel free to vent. We are here for you!

Sending hugs

 

[SkiBum]

First post op appointment at 5 weeks yesterday and everything seems to be OK. Was given meloxicam for the swelling which I've used in the past for arthritis. It seems to help because I woke up this morning less stiff. Big win was I went full rotation on the bike today. I'm starting staggered leg squats, box squats, lunges, and ankle weights for short arc quads and hamstrings. I'm loving the assistance/balance I get from using suspension straps to aid in the exercises. I'm considering getting a set for home since they take up no space and can be attached to a doorway.

 

[benne68]

I went full rotation on the bike today.

That's a milestone that's a cause for celebration!

Please be very careful about doing squats. They are not recommended this early in recovery and could cause you a setback. I know you are eager to get back to skiing, but pushing too hard too soon can make the recovery longer.

 

[sistersinhim]

I'm starting staggered leg squats, box squats, lunges, and ankle weights for short arc quads and hamstrings

These are very bad for a baby knee like yours. If you have increased pain or swelling, I suggest you stop them for at least a month. Remember, you are in healing mode, not training mode! Less pain and swelling=more healing! You can not speed up your healing but you can slow it down by doing too much too soon. This will cause increased inflammation. That will increase your swelling and pain. Let your knee be your boss for the first 4-5 months and you'll have a less painful recovery with fewer setbacks.

 

[Summeryy]

Just curious did your OS approve of al of that exercise? I am 9 days post op, and expected to be able to be back on skates at 3 months...but now I hear different. I have my 2 week post op appt in several days, so I will ask then what to expect. Like you, I want to get back to being active, but I also want it to heal well for the long term. Recovery is a longer stretch than I had anticipated!

 

[SkiBum]

My OS didn't ask to many questions about my PT. I didn't volunteer too much info. I will say that my goal of being on skis within 4 months seemed copasetic with him. I still have a pain that's reminiscent of something I had pre surgery... if my knee twists at all (which frequently happens when I'm changing position in bed) I get a sharp pain on the medial side.. followed by a lingering ache. My PT and I believe it's the ligament being stressed because of the muscle imbalances in the leg. So as far as I'm concerned the faster I gain muscle strength and balance the better I'll be. The nagging medial pain is the most bothersome symptom I have. I can't deal with sharp pain every time I roll over in bed.

 

[Flashlight]

My pain was from the medial side prior to surgery but now it is from the lateral side. More of discomfort than pain at 10 weeks when turning in bed. I was told it was caused by the implant stress on connective tissues. You are so active. You might not want to, but it would probably be better to just slow down. I know you are so much younger than me and will heal faster. It's hard for me to be patient but we have to. The internal swelling will go down as we heal but it won't resolve if we continue to aggravate it aggressively. You will get there faster than me and before long skiing down that mountain. We will get there!

 

[SkiBum]

@Summeryy .....skating and skiing share so many of the same movements. Yes the recovery does take more time than either of us would like.

@Flashlight .... that makes sense. My damage was largely lateral due to an old injury, so I had a valgus deformity which is rarer than the more common varus. So my leg got corrected out.

I think some of the assumption is that the majority of pain comes from swelling and stiffness.... which may be true. This is the pain I and I'm sure many of you are accustomed to. For years a typical ski day always ends with limping and ice maybe some anti-inflammatory and then doing it all again the next day. However this is not the only source of pain.

Muscle imbalance also causes the body to compensate in ways that cause stress and pain. As my knee degenerated I started having more back issues.... piriformis issues... etc.. I started compensating and using my weak leg less. My quad atrophied ... the HA injections no longer helped. My knee lost range of motion. I was not however in daily knee pain. I was somehow compensating too well. But the growing disfunction of the leg became untenable. I did not have a replacement to stop pain.... but I did do it to restore function. PT alone wasn't doing the job anymore, my knee was continuing to deteriorate and my body alignment was going with it.

I can rest and let the swelling subside and I will be more comfortable. With gentle exercise and movement (motion is lotion) my body will heal. I don't disagree with that concept...for many it's the right thing to do. I crave more..... even if it means a little more discomfort for now. I think the important thing is if I'm going to do more aggressive PT I have to do it right. I have a therapist that watches my every move and immediately corrects me if I try and compensate in any way. If something hurts (which is different from fatigue) we either make a correction or stop doing it. I think people get in trouble because they don't listen to their body and do the moves incorrectly and/or too much which leads to all kinds of problems. I'm trying to be deliberate and focused which is very hard for my ADHD self to do. The new knee needs as much balance and support from the surrounding tissues as the old knee in order to function well. So I've decided to focus on that. Mark my words.... I will be skiing before this season ends. It's the golden ring that keeps me moving forward. I'm already bummed watching the snow beginning to fly and watching posts from my friends making their first turns of the season.

 

[Flashlight]

It sounds like you have a plan. The best of luck to you!