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[KNEE INFECTION] Still Struggling

juzzy

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Hi everyone. Like a lot of people I’ve had a number of issues with my right knee. I’m 44 and had an early arthroscopy 2007 and also a distal femoral osteotomy, 2012 a unicompartmental knee replacement and Dec 15 2017 a TKR.

Just going through the motions at the moment but having a lot of problem with stiffness, swelling and bruising on medial side. Physio wanted to get me at 90deg before leaving but could only get to 83deg with pushing to an excruciating amount of pain. Was pretty sure they just needed me to get out of hospital(which they did)

Anyone else restricted by this, particularly on medial side. If so what did you do?
Thanks
 

Roy Gardiner

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Hi Juzzy welcome to BoneSmart.

Please don't allow anyone to hurt you, it is counter productive. Your knee is wounded, pushing it won't help. And you can't do anything special to speed 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
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
5. Here is a week-by-week guide for Activity progression for TKRs


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.
 
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juzzy

juzzy

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Thanks Roy, much appreciated


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funkymuse

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but could only get to 83deg with pushing to an excruciating amount of pain.
Hello Juzzy and welcome... it hurt me just reading this part of your post!!! So glad you found Bone Smart at this point in your journey... you will be encouraged and well supported here.. Look forward to following your 'healing' journey!!!
:merryx:
 

Jockette

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Welcome to Bonesmart! I had a unicompartmental replacement also, mine is a Patellofemoral. Which one did you have?

Now that you are home you have more control over what happens to your knee. Even though the health professionals will tell you they must push your knee to bend, it is not true. Don’t let them do it again. It only does more harm than good. Gentle and easy is the way to let your knee heal from this major surgical trauma.

Best wishes on your recovery!
 
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juzzy

juzzy

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Hi, it was a unicompartmental knee replacement, 2012. It never real did the job hence the reason I had to have a revision.
I certainly won’t be allowing the Physio to take me to that extreme again.



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Jockette

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Oh, ok, I missed that.

Yes, my fear is this partial wont last long. I didn’t know that before surgery. Partial was all I was offered and I thought by catching the arthritis early, it would take care of me for life. It was a rude awakening when I found out otherwise after surgery.

I am 9 months post op and still don’t feel as good as I did before surgery with the arthritis.
 

Josephine

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I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
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juzzy

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Hi Josephine, I am more than happy for you to ask any questions.

Also, do many people use hydrotherapy in their rehab? If you do, how beneficial do you find it?


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Celle

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Hydrotherapy can be helpful, as long as you don't overdo it. It's all too easy to do too much, because the water bears most of your weight.
You shouldn't immerse yourself in any water until your incision is completely healed, with no open areas or scabs at all. To do so sooner risks introducing infection.
 
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juzzy

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Hello everyone, I’m just writing to ask what people might be doing to alleviate the uncomfortable aching that occurs during the evening from midnight to 6 in the morning. I’m taking x2 naproxen, x2 paracetamol and icing before bed but I still wake every 11/2hr-2hrs aching and uncomfortable. I put my leg on a pillow which helps. Other the upping my meds, I was hoping someone might have found something to make the evening more tolerable!


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sistersinhim

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Nighttime pain is usually a sign that you have done too much during the day. Pain at night always seems to be the worse. Slow down your daytime activities. I iced and elevated all night long. It helped. You might want to try that, too.
 

kneeper

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And you are very early in the recovery process. Sleep is hard to come by anyway and then pain makes it hard to sleep also. I had more pain meds than you describe, but I also would read or watch (listen) to a tv program for a while rather than just lying there *trying* to sleep. :) I slept in installments for weeks.
 

Josephine

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I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
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juzzy

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Hi, please feel free to ask any questions. Thanks


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Josephine

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Juzzy, first - you don't need to quote a post to reply to it. This isn't Facebook! When you want to reply, just scoot on down to the bottom of the page where it says "Write your reply here ..."

Here y'go then!

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 forget to factor in 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 swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

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

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
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juzzy

juzzy

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Hi Josephine,

I’m now into Day 15 of post op and think I’m doing ok.
Have my up and down days.

1. 4-5

2. x2 500 paracetamol 3 times a day
X2 250 naproxen morning and night
X1 omeprazol
2.5-5ml liquid morphine when required

3. in between slight and moderate

4. I haven’t been to physio since I left hospital but I think 90 flexion, 3deg extension

5. icing 4-5 times a day 30min

6. elevating when icing and in between as much as I can

7. I’ve been following bonesmart advice and really resting. I do short walks hourly. I do quad sets when lying on back straightening until I feel tightening. Straight leg raise. Heel slides. When I was in hospital they pushed me to excruciating levels. I’m a 44 year old active male and was made to feel like a small child in pain. I manage it a lot better.

I did step outside for the first time today and managed a 5min walk using both sticks. My leg felt so tired, weak and like jelly. I also felt quite low from the experience but understand I have a long, long way to go.
I’m still getting my head around resting is the key!


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Josephine

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2. x2 500 paracetamol 3 times a day
X2 250 naproxen morning and night
2.5-5ml liquid morphine when required
I don't know why GPs prescribe oromorph because it's a naph pain med for knees! I suggest you ring your GP and tell him you're not happy with it and can you have something else, like you've heard that Tramadol is pretty good!
I also recommend you take the paracetamol 4 times a day rather than 3
3. in between slight and moderate
Okay
4. I haven’t been to physio since I left hospital but I think 90 flexion, 3deg extension
So not so bad then!
5. icing 4-5 times a day 30min
You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
6. elevating when icing and in between as much as I can
God but always elevate when you ice!
7. I’ve been following bonesmart advice and really resting. I do short walks hourly. I do quad sets when lying on back straightening until I feel tightening. Straight leg raise. Heel slides. When I was in hospital they pushed me to excruciating levels. I’m a 44 year old active male and was made to feel like a small child in pain. I manage it a lot better.
No don't do quads, or SLRs, or heel slides. You don't need them. I never did a single one of them. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)
I did step outside for the first time today and managed a 5min walk using both sticks. My leg felt so tired, weak and like jelly. I also felt quite low from the experience but understand I have a long, long way to go. I’m still getting my head around resting is the key!
Yes, that's the Energy Drain - you did read that, didn't you? People often underestimate how bad it can be. I remember with both knees, how I trembled and sweated when I went up and then down stairs to get my daily shower!
 
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juzzy

juzzy

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Thanks for the advice Josephine.
I can’t use tramadol as I had an issue with that when I had my partial knee replacement and will not go down that route again. Any other suggestions?



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Josephine

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What issues did you have? If you don't mind me asking. I'm always anxious to learn.
 

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