TKR So much harder than I expected

[Majic]

Hi @Gigi32 I had my LTKR last November like you, and last week made 115 flexion, and I am pleased. I came out of hospital with none, as my leg was in a splint from hip to ankle. Your dead right in how difficult it was to get me home, I thought I would die of pain. I am doing well now, but still on pain Meds, as other knee due to be done in July, and I can tell how much worse it has got in last six months. I too am sure any further flexion will come.
Jackie

 

[speccybecky]

I was off about 20 weeks, I most likely could have been back sooner if I had to but GP was happy to sign me off.....and I was getting full pay. I work in a bank, up and down all day and carrying quite heavy bags of coin and hauling open heavy safe doors. I think you will find a huge difference in a few weeks. Be kind to yourself, I began to feel better when I accepted that there wasn't a lot I could do about it but just wait till I healed. Good luck

 

[MidwestTKR]

Does anyone know if having a valgus prior to a TKR, makes the recovery longer?

Due to the severity of the osteoarthritis in my left knee, I had developed a significant valgus over the last 8 years in my left leg (deformity of the leg in which my leg became bent/ twisted outward, away from the midline.) This was thankfully corrected when I had my TKR. Does this influence recovery time? I know a lot of people that have TKR, do have a valgus prior to surgery.

 

[Gigi32]

I don't know that it necessarily makes the recovery longer, but I had the same thing and because of it had a lot of soreness and discomfort on the lateral side of my leg just under my knee. My PT and OS said that it was probably due to those tendons and muscles being stretched because they realigned everything. I still will occasionally get some tenderness there if I've done a lot of activity, but ice and rest overnight seems to clear it right up. It took me several months before I didn't really notice it on a daily basis. Fortunately, my knee that I'm having replaced in June is not gotten that bad yet, so I hope I won't experience that this time.

 

[MidwestTKR]

@Gigi32 , thank you for your input! I have increased soreness and pain on the side of my knee as well and I bet it is due to reasons you cited!

@speccybecky , well, I guess if the Dr. feels I can not perform my job fully after the 12 weeks, he would have to either extend my leave or restrict my activities/job duty. I need to stop worrying so much about work!

 

[Josephine]

My home PT told me that my flexion was actually a little ahead of schedule for the first several weeks, however when I had my 4 week post-op apt, the PA that works with the surgeon, measured me at only 105 degrees. Just the week before, the home PT had measured me at 115. The PA told me that he wanted to see me back in 2 weeks and mentioned that my flexion was not as good as he hoped, that he liked patients to be at 115 degrees at their 4 week post-op apt and that when he sees me "at the 6 week post-op apt, the flexion is pretty much as good as it is going to get and ideally I should be at 135 by then!!!!" Is this really true???

Don't believe that, it's rubbish. ROM can continue to improve for a year or even longer. Besides which, 115 at 6 weeks is superb!

I just started going out this past week a little and notice that the extra activity seems to leave me with a feeling of exhaustion and additional pain.

We call that the Energy drain. Everyone gets it, no-one is spared!

One nurse in particular kept on making comments about how her husband had a hip replacement and was back to work within 2½ weeks after surgery

For one thing, there is no comparison between hip and knee surgery. For another, he probably had an anterior approach which many (not all) do have a very speedy recovery. And finally, he could probably have just been stupidly showing off! Lots do!

Does anyone know if having a valgus prior to a TKR, makes the recovery longer?

Since almost everyone has some degree of valgus as a consequence of arthritis, it's generally not a problem.

 

[Josephine]

I'm also going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

Can you detail it like this
At PT:
First description - 5 reps x 2 sets
Second description - 10 reps x 2 sets

At home:
First description - 5 reps x 2 sets x3 sessions a day
Second description - 10 reps x 2 sets x3 sessions a day

 

[kneeper]

It sounds like you're doing great @MidwestTKR . I would have loved your ROM at your stage.

I'm glad you're getting out a little. It is perfectly normal--and good --to come home and rest, ice and elevate after these outings.
As others have said, you just had major surgery and the energy drain is normal. Listen to your body and rest when it tells you to.

I went back to work at 12 weeks and did ok, but I did basically just crash when I got home for the day and mostly rested on the weekends for a few weeks.

 

[referee54]

Welcome to the forum family!!! I taught, and I returned to the classroom at eight weeks---while I was excited to do so, I found out that it was much too early and I was stiff and sore and exhausted at he end of the school day.

I believe that many of us do not realize how invasive and how traumatic this surgery is to the knee and to our bodies.

I just started going out this past week a little and notice that the extra activity seems to leave me with a feeling of exhaustion and additional pain.

You are still very early in recovery, and your body is using tremendous amounts of energy in the recovery process---and stamina is the last thing to return in a recovery---so this is normal and to be certainly expected.

I feel as though I have a super tight bandage wrapped around my knee all the time.

AGain---normal---if yu take a look at the articles posted for you---this tight band feeling around the knee is to be expected---it will slowly subside.

I have so much hypersensitiveness around the knee,

Again---almost all of us had this---the knee is very, very sensitive to ttouch and almost any typ of cloth will upset it. This will go away in time.

I have begun to feel depressed from feeling like I am cooped up inside and that is not like me at all.

Again---sadly---this is normal---almost all of us felt the blues, and one of the articles posted for you addresses this. I would go to the window in my living room and watch the whole world just pass me by. The pain meds, the lack of independence, the inactivity, and the energy drain all play a role in this.

I am in more pain the night after a PT apt and the following day. Is this normal?
Will I ever feel normal again?

Yep---especially if you are overdoing it---do not let any PT hurt you or push you past the point of discomfort---it is not "no pain, no gain"---but rather, "no pain, more gain." Just ice and elevate as much as possible after these sessions.

You will feel normal again---and normal is a great feeling as it has been missing so much due to the arthritis and the pain!

Recovery, as others have said, can take longer than we expect it to and longer than we are prepared for---for some, upwards to a year.

It took me six months to get to 80%-85%, and it was not until around eight months that I was at 90%-95%---and I kept improving after that,

Recovery is a roller coaster ride that lasts a long time and takes a great deal of patience---and we will be here to help you through it!

 

[MidwestTKR]

Thank you all for your replies. I feel like I have made another small step towards my recovery in the last several days. My endurance is a also a little better and I also feel as though the hypersensitivity and mobility is slightly improved as well. I am exactly at 6 weeks post-op today.

I saw the PA that works with the OS today and then had a PT session. I measured at 123-125 flexion, however I did not bring my knee back to the point of pain. My extension was past 0. The PA was very pleased with how I am doing as well as the PT. I did tell both of them however that the recovery process is harder than I expected. I also advised the PT that a few of the exercises she wanted me to do flared up my lower back- chronic condition so I would not be doing those exercises any longer. She understood and said that was fine.

Although I still have quite a way to go to healing and still can't imagine being able to return to a job in which I will need to be on my feet all day in 6 weeks, I feel like I can finally see a light at the end of the tunnel. I have a FU apt with the surgeon on July 6, 1 week before I am due to go back to work.

 

[Kansas Teacher]

Good job, @MidwestTKR . It sounds like you are doing wonderfully!

 

[MidwestTKR]

Thank you @Kansas Teacher! For me, what I really need to put focus on now is trying to walk normally without a limp. I have to constantly remind myself to walk normally- heel -toe and bend my knee. I can feel that my left leg, I had a LKR, is not as strong as my right yet, so I naturally still want to protect it, rather than putting equal weight on both legs when walking. I don't want to wind up with a limp! I don't know if others have found this challenging as well.

 

[Kansas Teacher]

Seems like there's always something to work on -- a new goal just out of reach! Hang in there -- you are still early in the process (says inpatient me!)

 

[MidwestTKR]

Although I really like my PTA, I have had increased stiffness and pain since my last session on Monday. I wish I could figure out what she did during that session that caused it. The same thing happened at the last session. I start the session with bike riding, no tension for 10 minutes. Then various exercises, including putting more weight on the left foot when I walk so I don't limp. Nothing I did hurt during the session, so I can't figure out why I am in increased pain now.

She also has been doing this technique for the last 4 sessions or so in which she works on my knee and presses in a little and pulls on it for about 8 minutes or so to loosen up the area. That does no hurt when she does it either, but I do feel and hear a small pop when she does it. She heard the pop as well, but said that is OK. Is it???? She also for the first time, used a tool in which she gently pushed on the area above the knee, working towards the knee to help with decreasing sensitivity and promote fresh blood flow. It did not hurt, just was a little sensitive when she did it. Does anyone have input regarding the technique that she has been using recently?

 

[Celle]

I have some input. What she's doing really isn't necessary and since you feel unsure about it, why not ask her not to do it for a while? See if that makes any difference.

 

[sabbath]

hang in there,were all going thru this together,lots of great advice to follow on here,all we got to do is listen,,good luck

 

[Hopper]

How people get back to work so quickly I just don't know! I certainly couldn't have 8 weeks after my PKR two years ago. I've just had my second knee done and I'm more realistic this time around about the tiredness, limitations, pain, worries, anxieties, loss of independence, boredom and depression thres ops bring. You have had a major surgery and your bone and tissue needs time to heal and so does your whole body. My mum has had two TKRs in her eighties - now I know how it is I just don't know how she coped at all on her own.
The great people here know how you feel and how it is - but also realize it's different for eachof us!
Good luck with your recovery - slow but sure is fine.

 

[kneeper]

I would say no to the tool and the pushing and pulling. IMHO the last thing you need at only about a month is having a tool used on your sensitive tissues.

 

[MidwestTKR]

My knee has acted up ever since my last PT apt on Monday. I am going to talk with her tomorrow at my PT visit and tell her!!! I was finally starting to feel as though there was a light at the end of the tunnel and feel this put me back! I don't know which exercises/therapy caused this, but I don't want this to happen again!

 

[Gigi32]

By all means if what the PT is doing is causing you pain afterwards, I would back off on that for a while. But even without the PT is normal to have ups and downs at this point. I'm 6 months post-op and I still will have days where my knee just seems a little more stiff and sore than the day before, and it doesn't necessarily correspond to any exercise or activity. Keep working on mobility by walking and stretching and you'll probably improve.