Revision TKR susieo461<

[Celle]

I am postoperative 6-7 weeks and still experience pain and tightness. As far as ROM I seem to be at a standstill because when I get up to about 110-115 I experience great pain (cramp) in a muscle, located on the outside of the back of my knee.

A ROM of 110-115 at only 6-7 weeks is really very good. You have no need to worry about not getting more just yet. The pain you feel is because your knee is still swollen internally. As your knee heals, the swelling will decrease and your ROM will continue to improve.
Don't try to push past that pain. It's a warning sign that your knee isn't yet ready to bend any further. Be patient and your ROM will improve again.

I have hit a plateau, it seems.

It's normal for your ROM to plateau from time to time. Try not to look on that as a negative thing, but rather as a time when your knee is consolidating the progress it has made. It has done very well so far and there's every reason to believe it will continue to do so.

From the actions your PT has taken, it appears that he has an agenda for you to continue to gain ROM fast. Don't let his agenda worry you, because there's no need for it. You have plenty of time. There's no critical time within which you have to gain ROM, because ROM can continue to increase for a year, or even longer, after a TKR.
Myth busting: the "window of opportunity" in TKR

I am also still on Hydrocodone 4-6 hours. How does one start the move to Tylenol for the use of less opiates?

The time to start cutting down is when you find you are forgetting to take a dose on time and not feeling any increased pain. Then, reduce the doses gradually. It's important not to stop suddenly, or you may experience withdrawal symptoms.

Here is a suggested schedule for cutting back on prescription pain medications. Stay at each level for 3-4 days or even longer if you notice the pain symptoms increasing. This schedule assumes you are starting with one pill every 4 hours before beginning the reduction process.

1 pill every 6 hours and 2 at bedtime
1 pill every 6 hours and 1 1/2 at bedtime
1/2 pill every 4 hours and 1 1/2 at bedtime
1/2 pill every 6 hours and 1 1/2 at bedtime
1/2 pill every 8 hours and 1 1/2 at bedtime
1/2 pill every 8 hours and 1 at bedtime
1 pill if you are really doing something active during the day and 1 at bedtime

It is usually better to wean off these meds over several weeks, not several days. But.....if you are still having pain, then your body is healing and you still need pain relief. And in this case, I would discuss your pain management with your GP instead of your surgeon.

 

[susieo461]

Thanks for the schedule that I will use when ready to get off opiates. Thanks for info about plateau. I love this site!


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[Josephine]

I get up to about 110-115 I experience great pain (cramp) in a muscle, located on the outside of the back of my knee.

Are you trying to force your knee to bend? I must ask this - did you read the articles that Roy left you in post #3 of this thread? Because it's beginning to sound (to me) like you never did. You especially need to read this one Heel slides and how to do them properly.

I am kind of feeling depressed. I have hit a plateau, it seems.

Yes, I expect you are and it is perfectly natural. This article was also in the group that Roy left you Post op blues is a reality - be prepared for it

 

[jaschembra]

I can remember my knee being measured at 105 flexion for over 3 weeks and then all of a sudden it started moving. Plateaus are okay. Sounds like you're doing great!!

 

[susieo461]

3½ months out from knee replacement. I still have some intermittent stiffness and still have swelling. Should I still be elevating when I ice?

 

[lennie]

Good question I am 5 months out on my LTKR and have the same issue.


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[Celle]

3 1/2 months out from knee replacement
I still have some intermittent stiffness and still have swelling. Should I still be elevating when I ice?

If your knee is still swollen, and it's not too uncomfortable to do so, then I would continue to elevate and ice.

By the way, @susieo461 , you'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here.
Don't be concerned that we won't see your new question because, between us, the staff read all new posts every day.
If you'd prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on. It's a good idea to do that.

 

[Josephine]

3½ months out from knee replacement. I still have some intermittent stiffness and still have swelling.

Did you follow my suggestions earlier? In any case, I suggest you go back and read them again to make sure you are. But stiffness and swelling are not unusual at 3½ months so don't fret about it. It could take a few more months for it all to settle down.

 

[susieo461]

Thank you for your suggestions and yes, I did follow them. I am still icing and I was just wondering if elevating still would help more. I walk without a limp is and I am pleased but just waiting for swelling to go away.

 

[flyaway79]

I still do a combination of icing and elevating. Almost always together. If I'm not doing something or going somewhere you will find me with my leg up and wrapped in ice. I figure it can't hurt and most likely will help!

 

[Josephine]

Just right! That's what I used to do also. And actually, elevation is far more effective in managing swelling than ice anyway.

 

[flyaway79]

But the ice feels soooo good!

 

[sistersinhim]

Anytime you swell you should be icing and elevating.

 

[Josephine]

I'm not saying don't ice. But you don't appear to be elevating as much as you should.
And Paula is right - always ice AND elevate.

 

[susieo461]

Thanks for emphasizing the elevation. You were right I had decided that I didn't need to elevate anymore and was just icing off and on. Now I will do both.

 

[susieo461]

Well, I am 6months post LTKR and got bad news from my os on Monday. Still trying to process. My knee has been moving in a way it should not and I showed the doc what it does. He saw it and immediately said "oh, you have a torn ligament". Not what I expected or wanted to hear. I have to have surgery again for him to remove the upper portion of the replacement and put in one that will work with the torn ligament. He reminded me that he will have to chip and hammer to get the upper replacement out because it is glued in. I will have same pain and recovery plus physical therapy again. Not looking forward to it. I am going on a trip in September and then will see him again to schedule the surgery.[emoji37][emoji37]


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[newlybionic]

I'm sorry to hear that you have to have additional surgery. It is hard going in the beginning but your knee will be able to function correctly after surgery. I've had a full revision where the OS removed both parts of the knee. The first two weeks were painful but after that it have done really well with that knee. Don't worry about them taking the old one out. If your OS is experienced in revisions there shouldn't be any problems.

 

[susieo461]

Thanks


susieo461

 

[kmak81230]

I'm so sorry to hear that Susie! I hope you can try to put it out of your mind and enjoy your upcoming trip. We'll all look forward to supporting you after the surgery!

 

[sistersinhim]

I pray that everything turns out good for you.