Revision TKR Third and final surgery all done

[kayow11]

@Celle, @liam2015 ,
Campervans ROM was actually good in my opinion., but bertschb I can totally relate to. I also like the advice of not doing PT because it just swells up and flares up, that is my experience too.
And Liam, yours was pretty bad too. So yes, hearing these stories does help ease my mind. It gives me hope
I really think I may to be one of these people who stay swollen and don't improve much until two or three years., when my body finally gets used to the foreign parts. I hope not but it could happen.
My body seems to like staying swelled up in these new joints no matter what, but really gets mad if I try to push it at all. It's timeline is one of a snails pace.
Liam, I am curious as to what PT had you doing at your appointments, and what you were doing at home to try to increase your bending? I just sit and bend it back and hold it there. I guess that's as good a stretch as any isn't it?
It also looks like you stayed at around 90 to 95° for a few weeks, and probably just didn't pay much attention to it. It then healed more and swelling went down, and you did your normal activities as able, and before you knew it, you were bending better and didn't even have to think about it or purposefully do it.
I definitely do not plan to have an MUA! I have been having some trouble since my last surgery six weeks ago, with short term memory loss. This is not normal for me and I didn't have it after the other two surgeries.
Yesterday my surgeon said it is likely from the anesthesia propanolol which is use to put you out. I did have a spinal last time but I still had some propanolol. He said it should clear up as time goes on and I get more mobile and active. I sure hope so! And I sure don't need more propanolol during an MUA!
Thanks ladies, it was very helpful and makes me feel better. I just started getting a little scared again when the surgeon mentioned all of this yesterday at my appointment.
I will try to go back to my acceptance and peacefulness about my limited range that will likely improve as time goes on and the swelling goes down.

 

[sistersinhim]

I don't know why some OSs have to be so negative. It seems like many are never satisfied. It's like a child coming home with an A on his paper and his parent said they should have gotten an A+, that they hadn't studied hard enough. I think we should be celebrating each new tiny improvement we are getting and not be concerned with what anyone else says!

 

[Celle]

Campervans ROM was actually good in my opinion.

But did you see how long her ROM continued to improve? 6 years!
I post her progress to show people that there isn't any fixed deadline after which ROM stops improving.

 

[kayow11]

@Celle, thanks for that last post. It is encouraging to me to see that now. I was just comparing my range of motion early on to campervans, and mine is way worse. But I see the point you were making, and it is very encouraging!

@sistersinhim, thank you also for your thought on all of this. I really don't feel my surgeon is negative, but I think all surgeons are conditioned to think that full range of motion is one of the most important aspects of success after this surgery, and most push it without reservation.
They all seem to think the same way from what I gather, and even from other patients who have told me that their doctors said the same thing.
My doctor is very happy that my leg is straight, but he didn't have doubts about being able to fix it. But he won't be totally happy unless my ROM gets a lot better.
Who is the boss of all of this thought? Me, of course! I am my own health advocate, and I know what I am willing to accept and live with. No one, including my surgeon, is going to push me in my recovery. I do too much of that myself.
He told me to come back and see him in a month. Well I set up the appointment for 2 months from now. He also suggested for me to start taking an anti-inflammatory every morning and evening, to decrease swelling. I don't plan to do this either, because of the risks of NSAIDs. I also am pretty sure I will never have an MUA either. That can have its own set of problems.
I don't need another health problem, and have decided to let my body do it's natural thing of healing at it's own pace. So that Is how I am going to handle this situation for now!

 

[sistersinhim]

No one, including my surgeon, is going to push me in my recovery.

Perfectly said! No one knows your body as well as you do and that includes your knees!

He also suggested for me to start taking an anti-inflammatory every morning and evening, to decrease swelling. I don't plan to do this either, because of the risks of NSAIDs.

Those NASIDs are really scary. I had been taking them for over 20 years and have developed an irregular heart beat. It might have nothing to do with the Diclofenac, but I'm doing my best to get off of them.

I don't need another health problem, and have decided to let my body do it's natural thing of healing at it's own pace.

Yay! I wish everyone had your attitude!

 

[liam2015]

hi @kayow11 ~ to answer your question about physio (started at 6 weeks post op): i only had treatments done there; at first i went twice a week and then intermittently, once or twice a week, sometimes 2 or more weeks in between. i don't remember when i stopped going but the last measurement of r.o.m. was 100 degrees flexion; extension was still not great at around -10 degrees. at every appointment i had (1) massage of knee, calf, thigh, (2) some gentle manipulation (flexing and extending) either while on my back or tummy, except one time it was a little too much and i asked her to stop; (3) a couple minutes of laser treatment, tens machine with cold packs under and over, for 20 minutes, sometimes a little longer. i was left with a blanket over me, soft music from the radio and lights turned down low. it was so relaxing. on a few occasions, melissa (the physiotherapist) would use acupuncture (3 or 4 times i think it was) and cupping (twice, which i didn't really like) in place of the tens machine. she had me use the exercise bike in the gym for 5 minutes after the session, but i could only rock the pedals back and forth. i honestly don't know if any of that actually helped or if my r.o.m. would have come about anyways without it, but it felt good. i like to think that it helped with some inside healing. the swelling always seemed to look the same on the outside.

once or twice she demonstrated a few of the home exercises which she printed out for me and had me show her i could do them properly. they were the standard exercises. there was one that i was getting good at (standing on one leg for 30 seconds) but it caused me pain for around 2 weeks so i never did that again. i didn't even do the others i was supposed to do for very long. i found that the best exercises for me were practising walking up and down the stairs alternate feet whenever i had to do laundry; walking down the stairs backwards holding onto the railing and stair lunges. i tried riding my city bike which was up on trainers, but could just rock back and forth; i found that very frustrating and (for me) not helpful. when i was ready to pedal a full rotation, i knew it and felt it when suddenly i could walk down the stairs more easily. right away i went to my bike and pedalled a full rotation. now i'm riding it outside. (this was not until 7 months and 1 week post op).

i did a fair bit of walking, mostly out the backyard which is on a ravine, going up and down the hill, keeping an eye on our dog and picking up his poops, which he would often do right at the bottom of the hill at the fence line...sigh! at some point i started walking my dog out in the neighbourhood when i felt stable enough.

continue to be patient with yourself. remember it wasn't so long ago you had the revision and that has set back your timeline for recovery. some day soon you will turn that corner and recovery will progress faster.

 

[kayow11]

@liam2015, thank you so much for the specifics and details of your function and recovery. I am a detail person, with myself and all others, naturally. It helps me process and gauge progress, plus set realistic goals. Being vague for me, is just plain frustrating.
It sure does give me hope though for my current lack that surely could improve in this next year. That is what I really need now, and I really appreciate your effort.
Almost every other person I know that has had a TKR, did WAYYYYYY better than me, especially their ROM, and early on. Only on this forum did I hear of others having problems too.
I also am so glad you are doing well now!

 

[kayow11]

Do any of you remember having trouble with your knee/legs aching, hurting, having low tolerance for standing or , a year postop? As I mentioned in Hood1980's thread, this is the case for me. I would expect that from an 8 week old knee, but not 11 month old, despite that I have had 3 surgeries in a 10 month period.
I still seem to have some swelling in that old knee too, and the flexion (bend), seems unchanged for many months now, 95-100 degrees at most.
I know some here have gained ROM for many months, or in a few cases, years later. Could this possibly be me? Time will tell

 

[KarriB]

My rom did get better 18 months after TKR. I continued to use my recumbent bike at 0 resistance and think that helped my rom. But truthfully the only thing that gave me relief when walking or standing was slowly building up a walking regimen. Even though I did months of PT including strength work, nothing prepared me for walking. I still had to sit after walking for a bit when shopping etc. But now I can walk for an hour with no pain in my TKR. I haven’t tried walking for more than hour, but my natural knee might complain at that point.

 

[kayow11]

@KarriB, thanks for your reply and it is very encouraging to me. I seem to always be in the 5% of weirdos! Never the norm in pretty much anything.
I guess that is just the way God made me and I need to be thankful that I am living and breathing and still enjoying lots of life.
I will hang onto that possibility and pray for it to come to pass. I have been doing that already but the snails pace is just not my nature at all.
I guess as you said before, that walking really really helped you with everything. So I will Try to do more of that as my tolerance allows.
I also am considering going back to my gym and seeing if I can use a recumbent bike there, since I don't have one. My regular bike on a trainer is to exaggerated range of motion and I don't like how I feel when I am sitting on it. I can also use upper body strength training there too. All of this is a great idea!

I see by your surgery date that your last one was 4 1/2 years ago? I suppose you have been feeling pretty good now for at least two years? I like to have goals and time frames even if they aren't mine.

 

[kayow11]

Or is it too soon to be working my eight week old me on a recombinant bike? That just occurred to me. I have been at this for so long that I keep forgetting about the newest baby.

 

[Hood1980]

I’ve had good luck with the recumbent bike with no tension. I started just rocking it back and forth and finally got a full circle around 6 weeks out.


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[KarriB]

I think riding a recumbent bike is good, just don’t go crazy. Keep it at 0 resistance and only for 5-10 minutes until you’re sure there’s no pain, then add time slowly. It really loosened up my knee and helped with ROM.

@SusieShoes began walking early in her recovery while I waited until 3.5 years (last March) when I saw others here having success with walking. Susie will stop by, but if I recall she tried to walk a bit further every few days, but never to the point of pain. My last year has been my best year since the TKR. I don’t try to eliminate steps, in fact I work towards 10,000 a day. The more I thought about walking the more sense it made. We got these new knees so we could walk so why not train them to walk. Now, I’m not an exercise fanatic and I rely on the Lord to help motivate me because on my own I wouldn’t do anything at all.

 

[Jockette]

Now, I’m not an exercise fanatic and I rely on the Lord to help motivate me because on my own I wouldn’t do anything at all.

The hardest part for me is walking out the door!

 

[KarriB]

This is why treadmills aren’t good for me, I can just get off and I do! It’s a bit harder when you’re a mile from home, then you have to walk home. My treadmill is collecting dust as I type!

 

[kayow11]

@KarriB,
I was happy to see your post with your recommendations, personal experiences, and successes. That is what speaks to my heart the most.
I will try to get going on those suggestions because I know I need increased walking tolerance and range of motion. If walking helped you, it likely has helped many others here too.

Today I walked almost 20 minutes, but my legs had some strong aches right after that for an hour or two. I think I felt rather wiped out for many hours just from that little walk.
My problem is trying to do too much too soon. I want to get better so bad, and I have been pulling back the reins for almost a year now.
Truly, I am a go-getter, have lots of goals, and do like to exercise but not to excess. I just want to be able to do the things I would like to and want to do without having to sit and rest and baby these knees.
And I would be so so happy, if I could just increase my range of motion especially on the old knee that hasn't changed in many many months. Still 95 to 100° flexion. And my extension could be better on that old knee too, I think it is lacking five or 6°.
This week I think I will look into re-joining the gym, but I have to be really careful that I don't overdo it. I will start like you say, and listen to my knee and reassess every time. I can't stand having these continual setbacks from even the slightest increase in activity.
But I do feel hopeful and encouraged now with your post, and have something to look forward to. I feel like I have been at a standstill with the old knee.
But I must say the nine week old knee is getting a little better with less pain symptoms and I have noticed the past week that I am walking with less limping. It feels a little stronger.
I have one PT visit scheduled this week, but I plan to cancel it. I know what to do.
I also have a nice elliptical that I would like to get back on. I tried it out a few weeks ago for only five minutes, but my knee did not like it. I have healed some since then though and I may try it real soon, but only five minutes.
I sure would like to get rid of the 10 pounds I have gained in the past 9 to 12 months, too.

Maybe that is truly all I really need to improve on both knees, is more consistent walking and the gym recumbent bike possibly could increase my flexion range of motion. That would be so wonderful if that occurs!

 

[SusieShoes]

Yes, I did start a walking regimen early in my recovery and am still doing it as my main exercise. My OS told even before surgery that he believed walking was the perfect knee exercise. I could barely walk before surgery, though, not even a block without fierce pain, so he assigned pre-op exercise sets.

After surgery I made walking and stair-climbing the focus of my PT at the rehab hospital. “Let’s skip the exercise sets. I want to walk!” Walking was a pure joy, even with post-surgical pain, after so many years of not being able to walk properly. So I walked. Even with a walker, it felt right.

When I got home I started going outside to take little walks three times a day. At first it was just down my driveway and back. After a few days of that, I walked the sidewalk to the neighbor’s driveway and back. And a couple of days later I walked to the next driveway... and back. And so I conquered my street. After a week or maybe two I was walking down one side of my street and back up the other side all the way to the end of the block, then back to my house. A full block. I was very happy.

And so it went. If my knees didn’t protest, I would add a half block. After two months I was walking a mile and cut back to once a day. At no point did I ever have significant swelling or pain after. I guess I didn’t push much. I just wanted my knees to get stronger and more able, and I could see progress so I was happy. My OS had goals for the walking distance (3000 feet at one point) and I didn’t meet that goal early on. I wondered why I couldn’t, but I just chalked it up to being bilateral. The goal was the same for single TKR. So that was my rationale and I kept with the walking.

At this point I walk two to four miles most mornings. I skip rainy days. I also vary my route to include hills on some days or stop by the local Wawa for a coffee if I meet up with a walking pal (keep a few dollars in my pocket just in case). I pounce on opportunities to walk like going to the mall or other shopping. Walking just feels so wonderful!

I also rejoined the local health club and do other exercise, like swimming which I love, and some easy yoga. But it was walking that got my knees to a good place. It helped, I think, that I didn’t expect miracles overnight. A little progress meant a lot to me, so I didn’t get frustrated as happens with some TKR patients. Maybe I was just fortunate in that my progress was steady. But I was very deliberate about my walking, and totally bought into the “slow and steady wins the race” philosophy. It wasn’t the Fastest Recovery race I wanted to win, it was the Full and Complete Recovery Race.

 

[kayow11]

@SusieShoes,
Thank you for your detailed experience. I am very happy that it went that well for you.
So far in my journey, walking even if it was for 10 minutes, seemed to increase my knee swelling, for at least another day, along with some pain because of that swelling. I can't say that it feels great to walk, but I admit that it is nice not to have any bone on bone pain.
But now I have straight legs, and I will work on this walking regimen, but listen to my knees to see how much they can handle. You, and a couple others on this forum, have found that this is the best exercise, and it has helped the most to increase your function and return to life. So it surely is worth me trying this to see if I can at least get some improvements also.
Neither of my surgeons ever mentioned walking as their preferred exercise. They just really push PT and exercises and range of motion.
I don't like swimming, but I do plan to re-join my gym and see what I can do there on the recumbent bike and at least some upper body strengthening. Also have an elliptical at home that I can try again with limitations.
I just have such a hard time accepting how long this recovery is. And mine has been extra long as you know, because of other problems.
One thing though, that I am really happy about it, is the Bonesmart forum where so many of you lovely people have shared your experiences and been kind and patient with me. I really look forward to seeing who has responded to me, and what they say. I often think how wonderful it would be if I could meet all of you in person.

 

[SusieShoes]

I think we all end up having to decide what works best for us. Our bodies, our personalities. Our limits. My mom didn’t walk for her knees; she used a stationary bike, the real old-fashioned kind that she’s had in her house since the 80s. She just rode her bike a few times a day for several months. She doesn’t use it at all anymore, but she has all the ROM she’ll ever need. She can sit on her feet, which is pretty amazing.

You have the patience of a saint, going through what you have and now a revision. This recovery beats the stuffing out of mere mortals. No one in their right mind would want to do it twice, and yet there are people like you and so many others who must do it again... and again sometimes. The only sane way to go about it is to do it YOUR way.

I would love to meet so many of the people on this forum! Never have, though it sometimes feels that way.

 

[KarriB]

Just remember slow and steady wins the race. Don’t push the knees too hard or they will complain and that means a set back. You’re just 2 months post op, so be careful. No walking for me today, 77 degrees in the am with 99% humidity. That’s pure torture!