Revision TKR Third and final surgery all done

[SusieShoes]

I am still so thrilled that my knee is STRAIGHT!

We're all thrilled your knee is straight! What a great outcome!

I wonder if lack of icing delays healing of my knee?

Quite possibly. I mean, icing helps relieve swelling and having more swelling means more pain and less movement. Less bend for sure. So if you're using flexion progress as a measure of healing, not icing would affect that.

Icing doesn't, in itself, hasten healing. It diminishes swelling, which can lead to less pain, more well-being, and more activity as part of the healing process. It's a tool.

Do I have to lay down and elevate to get ANY ice benefit?

Elevating and icing are separate strategies, but with related goals; it's also easy to do them together, so they get mentioned in the same breath a lot. You can elevate without icing, though, and use that to help with swelling. And you can ice while sitting in a car, for example, without elevating at all. Some people use wraps that let them ice while walking, though I've never tried that and can't speak as to how effective it is (I imagine icing my ankle more than my knee somehow). Still... you can totally ice without elevating. It's just easier to keep an ice pack on when the knee is up.

 

[Hood1980]

Yay! Yay! Yay! STRAIGHT KNEES! [emoji322][emoji322][emoji322]


Sent from my iPad using Tapatalk

 

[Jockette]

During my whole recovery the only time I elevated “properly “ was when I was in bed, and I slept all night with my leg on my wedge.

If I was in the living room my leg was on my ottoman, and that was comfortable for me. It was not toes above the nose but my foot was way off the floor.

 

[kayow11]

@Jockette and @SusieShoes, for sharing and clarifying about ice and elevating. I believe the two together is optimal, but with my back issue, laying down and getting comfortable, and even with or without elevating without back pain is a real challenge.
And once the back starts hurting, it can ruin the rest of the day and night if I can't get it under control.

Hopefully that will resolve. I will get back to icing when I am sitting because it still hopefully will have some benefit, even though sitting can be painful too, especially in certain chairs. You are right
SusieShoes, back pain is a monster!!!!

 

[Jockette]

I can relate to only being able to sit in certain chairs!

 

[kayow11]

@mlwreader, I have found that going DOWNSTAIRS backwards using railing, is much easier on my knees. Going upstairs, I can frequently do reciprocally, with help from pulling some on railing. That way I feel I am getting some functional exercise. I do this maybe 2-3 times a day, 6-7 steps.

 

[kayow11]

@Jockette, this chair problem is mostly due to a soft or angled chair causing increased low back pain, but a low and/or angled chair can be almost impossible to get up from. I am so thankful for my raised toilet seat with handles!!

I really love the great variety of cute and animated emojis available to use here.

 

[liam2015]

i agree with the walking backwards down the stairs (holding onto railing). i found it to be a very good exercise as it flexed my knee to a good point without going too far and hurting.

 

[Jockette]

I really love the great variety of cute and animated emojis available to use here.

Me, too! It’s the little things, right? When I first discovered them I had to restrain myself from using lots of them!

I am most comfortable in a chair that sits me up fairly straight. Many chairs have a slightly reclining back and they are very uncomfortable for me.

We bought new living room furniture a couple of years ago. Shopping for it was very painful for me. There was a store we went to, and I tried many couches and not one was comfortable. Plus, my knees were very painful from all the “sit to stands”. We finally did find a set we liked. But it was quite the process!

 

[kayow11]

@Jockette, I also like firm furniture for seats and more upright backs too. Also not too low. Never realized how much a problem getting on and off a chair or toilet would be after these surgeries. Everywhere I go I have to use the handicap ones so I can use the bars to help myself get up and down.
I actually don't know if I'll ever be able to use the regular toilets again. I feel like they were designed for very tiny people and never graduated to being useful for anybody over 5 foot two or children.

 

[Jockette]

We traveled in December and paid extra for a handicap hotel room. The second I saw the bathroom I could see it was a regular height toilet. Excuse me, but adding a bar does not make it handicap! I was so mad. They gave us free breakfast as compensation (breakfast was not impressive) but I was still mad. We were there for 5 nights. Thankfully I had my portable raised toilet seat with me, but it didn’t fit well.

When we made the reservation we specifically asked if the room had the higher toilet and walk in shower and we were assured it did.

After a 9+ hour car ride we were not up to looking for another hotel. It was the weekend of our daughter’s wedding and there really wasn’t time either.

 

[kayow11]

What a bummer that experience was! I would have been angry too. It doesn't sound like they compensated you much for the blunder/'misleading info. Did they refuse to do more?
Personally, I have found that people don't really understand what it's like for handicapped people. I didn't know either until I was one. But now I understand fully and have much more sympathy for the situation, and the needs of those that can't get around well.
There is so much I would love to get back to, and hopefully I will, at least some of them.

 

[Jockette]

Breakfast was all they would give us. We supposedly had the only room with the walk in shower. It was not impressive either. Other than finding another hotel there wasn’t anything else I could do. I won’t be staying in that name hotel again.

 

[kayow11]

I am six weeks postop now, and I did finally see my surgeon today. He was pleased at how it looks, and how the x-ray looked. All parts seem to be firmly in place and he anticipates no real problems going forth.
He does feel though that I need to push it more with my bending. I haven't been going to PT or been measured recently, but I think I could be close to 80° bend in the morning when I first get up before it gets swollen again and limits my motion.
He's happy with my 3° of extension which has always been good. But he wants to see me in a month to see how the flexion is going, and then if it isn't, he says he might talk to me about a manipulation.
He doesn't think that would be a fun thing for me, and I told him I'm really not interested in that at all now.
Of course he notices that my first knee still is barely bending to 95 to 100°, and isn't crazy about that.
I asked him about the continued swelling in my almost 11 month-old knee, and he said, don't worry about it because it can take 18 months to resolve.
I know there are a few people on this site that have had a manipulation and felt it was beneficial, but most of you don't feel it is needed.
Would any of you at this point in the recovery and my lack of bend on the first old knee, and possibly the second new knee in a month or two, even consider an MUA?
Do many of you veteran bone smarties think this range of motion will keep getting better despite how bad it is now? I really am against an MUA.! But can it be a necessary evil and benefit the patient?
What if I end up with only 95° of bend on both knees after 18 months? Functionally I am very concerned how this will impact my life, but maybe it won't be so bad because you'll learn to adapt.
I know some of you have shared that you have gained a little extra motion even in your second and third year postop.
But I also know that an MUA would be like putting me back to the first month after surgery and be miserably sore, and I'm just not convinced that it will make a difference. I think my knee just doesn't like these foreign parts honestly, and that it may not gain much.
A few days ago, I got on my elliptical and did a fairly moderate pace for only five minutes. But I could tell it was feeling sore during those five minutes on my new knee. And of course the next day was very extra sore and swollen and painful. So I iced like crazy to get the swelling down. My knee just does not let me push it at all

 

[Celle]

I don't think I'd have the MUA. few surgeons do them once your flexion has passed 90 degrees.

 

[liam2015]

hi kayow...at 6 weeks, my flexion was under 80 degrees and my surgeon was furious with me when he found out i had only just started physio. i did very gradually gain more flexion only by a few degrees each week that i went to physio and finally i think my r.o.m. is good, not as good as my natural knee, but good enough...i don't even know what the numbers are but i can ride my bike and do stairs without pain. i still have stiffness. i would wait a few more weeks to see how you do. from what i've read here on bone smart, there is no window for having a manipulation, so there is time if it is needed. continue to be patient with yourself ~ you've had 2 knees replaced and then a revision. it's not surprising you will take a little longer to heal. (i will look up my numbers and get back to you if that would help ease your mind. i was a very slow bender.)

 

[kayow11]

@Liam, @Celle, thanks for your input regarding MUAs and range of motion.
Yes Liam, I would love to see your actual numbers and at what point you reached them.
Somehow, it helps to ease my thoughts and concerns, about being stuck with a super stiff and barely bendable knee. You know the old saying, misery loves company
I am not stuck on a particular number of degrees, but I just want to be functional like you describe with your activities.
I am curious what PT had you doing at six weeks and forward, to help you gain your range of motion. Do you remember? And did you have trouble's with extra swelling, or just the normal?
What do you think you did that helped you the most, at PT, and at home, to gain your range of motion, and maximize your bend?
Why did you start PT so late? I could be doing PT, but I just get really flared up for a couple days after every session, and he's not even rough on me. I won't let him be. Every time I push my range of motion at home, I get the same result.
Surgeons always want to assume that you are laying down excessive scar tissue that has to be broken up early on, or you'll be stuck that way forever. They truly believe this. I think those cases are rare.

 

[Celle]

@kayow11 -yes, there's plenty of time for your flexion to improve.

Have you seen these?
First, Campervan's experience:
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "

Then,this from bertschb:
"I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM."

 

[liam2015]

hi kayow...i just went through my page and recorded my progress in weeks. the reason i didn't start physio until 6 weeks post op was because: (1) they were supposed to phone me and come to my house but they never did and (2) i was feeling too sick anyways and i probably wouldn't have cooperated. (i'm a little stubborn).

6 weeks 70 flexion (-20 extension) ~ i had no idea my extension was that bad.
7 weeks 76 flexion
8 weeks 79 flexion
9 weeks 83 flexion
10 weeks 87 flexion
11 weeks 95 flexion (with help) ~ sorry, didn't record what is was on my own. released from O.S.
13 weeks 92 flexion
14 weeks 94 flexion

at the last physio appointment i had, i was measured at 100 and 103 degrees flexion. i have not been measured since then and i have no idea what my r.o.m. is now, buy it has improved a lot, hence, being able to ride my bike and go up and down stairs with no pain. i think my extension has improved to 0 degrees.

hope this helps a little to ease your mind.

 

[Celle]

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.