Revision TKR Tabbykit's recovery from TKR revision

[tabbykit]

I know I am a worrier but I really cannot help it ... so I am at 60 bend now at 6 weeks, but read many posts where others are at 90/100/120 etc at the same time or sooner. What exactly is the physical reason that some bend more than others? I have iced and elevated like crazy, done everything I'm supposed to ... I wish I could look inside to see what is in the way!

 

[sistersinhim]

A revision is much worse on a knee than a tkr. There was a lot of work done inside that knee of yours. Don't compare knees, especially a tkr with a revision. They are different. If you could see inside that knee of yours you'd see all the inflamed muscles, tendons, tissues and bones. This causes swelling which causes less ROM. You are doing right by icing and elevating. The more of that you do, the more the swelling will go down. Then you will see better numbers. Don't worry about it now, it will come. Remember that you can't work your knee to get better ROM. That will only give you worse ROM because it causes swelling. Slow and easy wins the ROM back!

 

[tabbykit]

Thank you, @sistersinhim, I know we should not compare, but I read threads about those whose swelling seems to be much more than mine, yet they have more flexion. So I can't help wondering!

 

[sistersinhim]

I read threads about those whose swelling seems to be much more than mine, yet they have more flexion.

How do you know their swelling is more than yours? Unless you take the two knees and compare the them side by side you don't know that. What seems like a little swelling to you might seem like a lot of swelling to someone else. You also cannot see inside both knees to see what work was done. It's depressing to compare knees and totally useless because no two knees go into this surgery the same nor do they come out of it the same.

I can't squart. I can't go down steep hills or walk on uneven ground without a cane. I don't fret because I know my knee is different from everybody else's. What it has been through is different than anybody else's. I look at the things I can do now that I couldn't do before my tkr and that is a time for celebrating and not worrying about what I can't do.

Please stop worry yourself sick. It doesn't help you at all and just stresses you out. Stress slows down healing. Be thankful for each little baby step you make. One day you'll notice that when you combine those baby steps you come up with a big step. This is a very slow recovery and where you are right now is not where you'll be next month this time.

 

[tabbykit]

Wondering if anyone else has had similar to this? For background, my unoperated leg also needs a TKR, and over the last 4 years has become 'bent' to match with the failed TKR knee. Now, after my revision, I am trying to exercise both legs equally as I think the extension is a little better on my new revision knee. However, yesterday I started to get terrific stabbing pains, like an electric shock, in my UNOPERATED leg, when stretching the leg -standing, leaning forward to stretch calf/hamstrings. Even the slightest stretch brings it on. This pain is just above and below the back of the knee, going down the medial side of the calf. Oddly this only happens in this particular standing position, not if sitting on bed and stretching forward, or with foot on stair and stretching forward. I am hoping it is just muscles in this leg 'waking up' and trying to extend a bit to match the new one. ANyone had similar? I am now doing gentle stretchs in this position, and holding for a little while, every time I get up to walk around, and also massaging the back of the leg. Any ideas what it could be or what might help?

 

[Celle]

You've probably stretched the muscles and tendons at the back of your unoperated leg more than they were ready to be stretched. Give that leg a break until that pain goes away - and don't do that exercise again on that leg.
What exercise was it anyway?

 

[tabbykit]

@Celle, it's not a specific knee exercise, it's just standing and leaning forward, to get a stretch up the back of the leg, after sitting.

 

[kneeper]

Muscles can tighten up after sitting for a long time... is that what you mean?

 

[tabbykit]

@kneeper, no it just started suddenly two days ago, but I am more active now at 6 weeks. I try to sit for no more than an hour, then stretch/exercise/ADLs etc, but did not have this sudden sharp pain until two days ago. It's also weird that it happens only in one position - standing and stretching forward (imagine standing facing a wall and leaning your upper body towards it to stretch the back of the legs). If I sit on the bed and lean forwards, or lean forward with foot on step it does not happen. I am wondering if I should be 'working through it', which is what I've been doing, gently leaning into it and holding the stretch. I don't know if I am helping or should rest as Celle says. It is part of walking though so I don't think I can avoid it! It is not IN the knee (unoperated one), but above and below, back medial part of calf in particular.

 

[kneeper]

Hmm, I don't know. You may have moved funny and overstretched something. Maybe rest it for a few days and not do the stretches that aggravate it.

 

[tabbykit]

At the end of week 7 now ... not doing very well I fear. Bend seems no better than 60, extension maybe 10-15. I can sleep on my side, which is so good news at least, and getting enough sleep at night. Walking still painful, and pain in raising the leg when sitting in particular - pain is right in the middle of the knee.. My other leg needs a TKR and is also painful now as it's borne the brunt of my failed LTKR for the last 4 years, so this is not helping.. Still icing, elevating, normal ADLs, few simple chores. Tried driving but it was difficult and painful so will leave it for now. Still on crutches indoors and out, sometimes one indoors if I need to carry something. I'm going for a massage this week, to a sports PT who also does Myofascial Release, so will see what he has to offer. Then my usual PT next week, and second follow-up with OS in about 6 weeks. Feeling a bit down as I was hoping this revision was going better than the original TKR, but seems I am not making progress.

 

[Celle]

I am more active now at 6 weeks. I try to sit for no more than an hour, then stretch/exercise/ADLs etc, but did not have this sudden sharp pain until two days ago.

I think you're trying too hard and doing those exercises too frequently. Once a day is plenty. If you overwork your knee, you'll be keeping its soft tissues inflamed and swollen. That doesn't give them a chance to calm down and heal.
TKR: work “smarter” and not “harder”
Knee recovery - Lose the Work Ethic!!

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, and it will gradually increase as your knee heals.

I am wondering if I should be 'working through it', which is what I've been doing, gently leaning into it and holding the stretch.

No, don't ever try to work through the pain.

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.​

 

[marieltha]

Your description of the pain sounds like my pain with a medial ligament sprain in my “good” leg. My good leg got a nice lateral partial knee in April 2018. Then in August 2018 I sprained a tendon in my left foot. So my recovering leg and knee was overtaxed for months while the foot was healing. You might want to read my knee thread.
Hope you feel better.

 

[tabbykit]

Thank you @Celle and @marieltha, will read your thread.

 

[tabbykit]

A new development, sorry to say. Now in week 8, and feeling a real stabbing pain through centre and lateral side of knee when moving, particularly on raising leg. Ok when static, and I can sit with my foot on the floor without much discomfort. Bend still poor, been continuing to ice and elevate, walk round the house. Seeing PT in a week, and hope she might have some advice. Any ideas on what this could be? Wondering whether to bring forward my OS appointment scheduled for September 19th?

 

[mannbub]

@tabbykit I had a real sharp and burning pain when I tried to do the straight leg raises. It happened to
me in the early weeks of my recovery. I avoided the straight leg raises to avoid that excruciating pain. It got better after a week or so. May be you can try to avoid doing straight leg raises.

 

[tabbykit]

Thanks, @mannbub, it's not only on straight leg raises but on any kind of movement. I am trying to avoid the movements that cause the pain but it's really every time I move, walking etc.

 

[tabbykit]

I would appreciate it if someone more knowledgeable than me (so, most of you!) could offer some advice using Josephine's leg diagram chart which I see in so many threads? I am at my wits end with the sharp pain in my operated leg AND the pain on stretching my unoperated leg too - even with doing nothing deliberately it is a sharp shooting electric-like pain even just when I stand from sitting. Could someone please advise?

 

[sistersinhim]

I suggest you call and make an appointment with your doctor, especially since both of your knees are involved.

 

[tabbykit]

@sistersinhim thanks, I realise that is an option but I guess I was hoping for the same kind of advice I have seen so many others receive here ... usually from Josephine it seems. Is that possible?