United StatesHi,
I had a left knee TKR on 7/15/19. It was outpatient surgery, so I went home the same day. (You have to agree to have someone with you 24/7 for the first week) My surgeon has a little bit of a different protocol than a lot I heard about, and you must agree to his protocol. I had to drink a surgical recovery drink twice a day for 5 days leading up to surgery and swab my nose with Bactoban twice a day for 5 days prior to surgery. You also have to get a dental clearance. You have to agree to not leave your house for 4 weeks, with the intent being you are to rest, ice and elevate. A home health nurse came to the house the day following surgery, and luckily, based on the amount of blood in the drain, she texted the dr. and he allowed the drain to be pulled. (Most people have the drain for 3-4 days so I lucked out here) Once the drain comes out, pt could come. Another difference, and what I was a little nervous about, was that he doesn’t prescribe narcotics. I was prescribed Celebrex for swelling, Tramadol, and Tylenol. He also uses a long acting lidocaine in the soft tissue before closing, so I didn’t have much pain at all till day 3, and that was really the only day it was uncomfortable, but the meds worked. By day 4, it was all very manageable with the meds he prescribed.
My surgeon employs a pt at his office, who ended up creating her own company, so they can be hired through home health agencies. He has 4 pt’s that only see his patients, so he has complete control of the protocol. It is all about keeping inflammation down. All pt is hands off. They give you a few isometric exercises to do, and slowly add rom exercises. You also walk a little bit each hour. It starts with 5 min. and maxes at 10 min. You must use the walker for the first 2 weeks, and then the pt will decide when you can move to a cane. There is also no sitting in a chair till 2 weeks post op, and then it is limited to meals only. The pt pulls the staples at 2 weeks, and you go in for your first post op appt. at around 4 weeks. He does NOT prescribe outpatient pt because he believes they overwork the joint and cause more harm than good.
One issue I had dealt with was burning nerve pain in the lower inside area of the knee this is now numb. It made the exercises difficult and painful. My pt had them call in a prescription for Gabapentin and it helped almost eliminate the burning pain.
The number of people who told me that this surgeons protocol sounds crazy and I should look at another surgeon was a lot, but, I am now 4 weeks post op, off all pain meds, and have extension of 0 and Flexion of 124. I see my surgeon for my first post op this Wed. and am looking forward to be released to drive and return to work. Following seeing him, I will meet with his pt, and she will evaluate and give me new exercises to do for the next month. I follow up with her at 8 weeks, and then see him at 3 months. I got to admit that staying home for 4 weeks has been difficult, but I can’t argue with my results.
My pt has been with him for 4 years now and she says his patients by far recover better than most other patients she has treated before joining his team. She attributes it to his surgical technique. She says his patients have far less swelling, bruising, and pain than other surgeons, as well as his pt protocol.
I was very nervous heading into this process, but it has gone far better than I expected. I also have a saint for a husband. I will eventually need the right knee replaced as well, but I won’t go into it with the same trepidation as I did with this one.
PS. I am also ready to be rid of the battery operated calf compression sleeves you have to wear for 16 hours a day for 4 weeks. My favorite sound is when the batteries die and have to be recharged for 3 hours.
Well, I’m off to walk again. Good luck to everyone with their recoveries!
I had a left knee TKR on 7/15/19. It was outpatient surgery, so I went home the same day. (You have to agree to have someone with you 24/7 for the first week) My surgeon has a little bit of a different protocol than a lot I heard about, and you must agree to his protocol. I had to drink a surgical recovery drink twice a day for 5 days leading up to surgery and swab my nose with Bactoban twice a day for 5 days prior to surgery. You also have to get a dental clearance. You have to agree to not leave your house for 4 weeks, with the intent being you are to rest, ice and elevate. A home health nurse came to the house the day following surgery, and luckily, based on the amount of blood in the drain, she texted the dr. and he allowed the drain to be pulled. (Most people have the drain for 3-4 days so I lucked out here) Once the drain comes out, pt could come. Another difference, and what I was a little nervous about, was that he doesn’t prescribe narcotics. I was prescribed Celebrex for swelling, Tramadol, and Tylenol. He also uses a long acting lidocaine in the soft tissue before closing, so I didn’t have much pain at all till day 3, and that was really the only day it was uncomfortable, but the meds worked. By day 4, it was all very manageable with the meds he prescribed.
My surgeon employs a pt at his office, who ended up creating her own company, so they can be hired through home health agencies. He has 4 pt’s that only see his patients, so he has complete control of the protocol. It is all about keeping inflammation down. All pt is hands off. They give you a few isometric exercises to do, and slowly add rom exercises. You also walk a little bit each hour. It starts with 5 min. and maxes at 10 min. You must use the walker for the first 2 weeks, and then the pt will decide when you can move to a cane. There is also no sitting in a chair till 2 weeks post op, and then it is limited to meals only. The pt pulls the staples at 2 weeks, and you go in for your first post op appt. at around 4 weeks. He does NOT prescribe outpatient pt because he believes they overwork the joint and cause more harm than good.
One issue I had dealt with was burning nerve pain in the lower inside area of the knee this is now numb. It made the exercises difficult and painful. My pt had them call in a prescription for Gabapentin and it helped almost eliminate the burning pain.
The number of people who told me that this surgeons protocol sounds crazy and I should look at another surgeon was a lot, but, I am now 4 weeks post op, off all pain meds, and have extension of 0 and Flexion of 124. I see my surgeon for my first post op this Wed. and am looking forward to be released to drive and return to work. Following seeing him, I will meet with his pt, and she will evaluate and give me new exercises to do for the next month. I follow up with her at 8 weeks, and then see him at 3 months. I got to admit that staying home for 4 weeks has been difficult, but I can’t argue with my results.
My pt has been with him for 4 years now and she says his patients by far recover better than most other patients she has treated before joining his team. She attributes it to his surgical technique. She says his patients have far less swelling, bruising, and pain than other surgeons, as well as his pt protocol.
I was very nervous heading into this process, but it has gone far better than I expected. I also have a saint for a husband. I will eventually need the right knee replaced as well, but I won’t go into it with the same trepidation as I did with this one.
PS. I am also ready to be rid of the battery operated calf compression sleeves you have to wear for 16 hours a day for 4 weeks. My favorite sound is when the batteries die and have to be recharged for 3 hours.
Well, I’m off to walk again. Good luck to everyone with their recoveries!
After all, we had to be on time. (My husband is a very caring man and took excellent care of me, he was not rough when he did this but it still hurt a lot!) 
I am currently day 8 post op on my second TKR. So far this recovery is going much better than my first, which was in 2015. I had same doc, same knee. I'm curious about where your surgeon practices, and where you're from. Obviously you don't have to tell me either fact. (I seem to recall from 4 years ago that everyone's profile used to mention age and place of surgery. It made it easy to follow people of like ages and experiences. This is really a question for the administrators, I guess.) It sounds like you are in the UK. The idea of a home nurse or home PT visiting seems both quaint and progressive at the same time, and I sure wish this were available here in the states. Regardless, it took a lot of courage to take that protocol on. I'm so happy to hear how well you're doing.
