Revision TKR Third times the charm- hopefully

[jboles]

I’m back. I just had the third surgery on my right knee on July 16, 2024. I hope and pray I never have to go through this again. It seems to get worse every time. Maybe I’m just getting older and not able to take it. It was done robotically at Duke Hospital and according to the notes they had to use wedges and osteotomes during surgery to balance and correct alignment and LLD. I’m just now reading the notes so I’m not exactly sure what all was done. The surgeon said he was prepared for a lot to go wrong but everything went really well and he thought I would be really happy with the results. These first few days have been really painful and there’s a lot of bruising and I have a wound vac for 7 days. But I’m hopeful that I can throw away my cane that I’ve had for the last 7 years.

 

[Jockette]

Welcome to recovery again! I do hope this will be the last time for you.

It’s nice to see you again but I’m sorry it’s because of another surgery. Best of the best wishes!!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

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.​

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4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Layla]

The surgeon said he was prepared for a lot to go wrong but everything went really well and he thought I would be really happy with the results.

Hold that thought! May the third time be the charm.
Cheers to you ditching the cane when the time is right, hopefully soon. Congrats on your new knee!

 

[jboles]

@Jockette can you merge this with my old feed

 

[Jockette]

I merged your threads for you.

 

[jboles]

Thank you

 

[jboles]

The first week is behind me. I wish I could say it was an easy week and that I made leaps and bounds in progress, but after reading through my thread I realize that this recovery is as slow as it feels like it is. I do understand that each surgery recovery is different. I was sent home with a negative pressure wound vac that was the bane of my existence we removed it yesterday and my leg immediately started swelling and bruising! It was crazy! I’ve read that is a very common occurrence, but I really feel like my recovery is starting over. I’ve had a couple days this past week of crying, yelling and cursing at inanimate objects (wound vac) hopefully that is behind me!

 

[Jockette]

Sending lots of hugs!

Remember the Post Op Blues are very common. I had quite the melt down on Day 11, so angry that I had invited this onslaught to my body!

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

 

[jboles]

Thanks for the hug. It’s hard to remember when you are crying…

 

[mendogal]

Let the tears flow... We don't know exactly why on a cellular level, but crying does reduce stress... you'll get through this temporary setback.
More ((hugs)) winging their way to you today.

 

[jboles]

All hugs are welcome. Yesterday was a better day. The last 3 nights sleep has been difficult. I sleep in the bed -restless-but I have to get up around 3 and move to the recliner. Then it’s up and down the rest of the night. I’m trying to let my poor husband sleep, I know he’s exhausted the swelling in the thigh is bad and persistent and it makes bending difficult. I believe this has always happened before but I just don’t know if it’s been this bad.

 

[sistersinhim]

(((jboles))), hugs from me, too. I'm glad you had a better day yesterday. I remember well those restless nights and being up and down between the bed and the recliner. Lots of ice and elevating is the treatment for that swollen leg. As long as you have a cloth between your leg and the ice source, you can't over ice!

 

[mendogal]

Insomnia is a real bummer for many of us in the initial weeks after knee surgery. Definitely sleep whenever (and wherever it's safe and comfy!)

Icing, elevating, napping.... All help, but you might also consider some nonprescription remedies....

If you're lactose tolerant, a glass of warm milk! If you're not diabetic, a teeny bit of honey makes it even more comforting... plus milk is high in magnesium! Helps us relax!

If you aren't a milk drinker, or want an easier way to, an evening magnesium supplement has been very helpful for some members.

OTC diphenhydramine, an antihistamine also used as a sleep aid (Benadryl) because it makes you drowsy; it's also included in some cold, flu, etc "nighttime" combination meds.

Low dose melatonin, sustained release - not for long term use but I have used for a week at a time without ill effect. It should be taken an hour to hour and a half before going to bed, and during that time stay in a dimly lit area to allow this hormone to activate.

Valerian root - an herbal remedy, it can be taken in capsule form but that dose might be high compared to my preference, herbal "sleep" blends that include a smaller dose of valerian and make me pleasantly drowsy. Plus the other tea flavorings make it nice tasting! Celestial Seasonings and Traditional Medicinals sell teabags by the box. Their sleep blends without valerian have never ever made me sleepy.

What finally worked for me: a mug of sleep tea with valerian followed by a 3 mg sustained release melatonin, immediately going into a dimly lit room and relaxing. When I got sleepy, turning off the light and lying dowb with my legs up on the Lounge Doctor. After a few hours I would wake, move the Lounge Doctor away, and sleep more.

Be aware: even benign herbals and supplements can interact with your routine or post op prescription meds, either making their effects weaker or stronger. If you're on meds you may want to check with your doctor or pharmacist, or even check online for interactions.

 

[Layla]

You've been through a lot with that poor knee. I am so sorry. Thankfully you had a better day yesterday. Hopefully today is the same. Sending a warm healing hug your way
So many deal with the restlessness early on moving from bed to recliner, while it's unsettling, it will get better. A few more tips that may, or may not, be useful for you -

Pillows really helped me get comfortable in bed, making it easier to drift off.
I suggest making up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness. Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down. Limit caffeine throughout the day and consider natural sleep aids such as Valerian, Chamomile or, Magnesium, my personal favorite, which can assist in muscle relaxation and nerves and promote healthy sleep (falling asleep and staying asleep)

Wishing you a good day!
@jboles

 

[jboles]

It’s 2 weeks today. It’s my husband’s birthday and I always make him a cake with cooked chocolate fudge icing and by-golly I made him one last night. He hasn’t cut it yet, so I hope it’s edible some of the swelling seems to be going down. I’ve slept in my recliner the past 3 nights and that seems better. We have to make the 2 hour drive on Thursday to get stitches removed. I will probably ride in backseat with leg up to try and keep swelling down so my ROM will be as good as possible. I really believe this time is better. Leg seems straight and balance feels better. I’ve tried walking in house without the walker but there’s still a lot of pain in the knee so I think I still need the walker. I really don’t want to use the cane. I’m so scared of becoming dependent on the cane and I really don’t want that.

 

[sistersinhim]

I hope the cake turned out good. I bet it did. Riding in the backseat is a good idea. I did that with a pillow and ice pack! I'm so glad you are better this time around. I think you'll be fine getting off of the cane. It is sometime you will need for a while, but not forever.

 

[Jockette]

It’s 2 weeks today. It’s my husband’s birthday and I always make him a cake with cooked chocolate fudge icing and by-golly I made him one last night.

I really believe this time is better. Leg seems straight and balance feels better.

Awesome!

 

[Layla]

Look at you baking already at only two weeks post op!
Happy B-Day to hubs, I hope you enjoy a piece of cake together this evening. Sounds yummy!

Since you've made attempts to walk around the house unassisted, even though there is discomfort causing you to resort to the walker, I really doubt you'll become dependent on the cane if you use it for awhile. Trust that you won't learn to depend on it and use it for your safety and comfort. This is early days.

Best wishes for your appointment on Thursday. Let us know how it goes.
@jboles

 

[jboles]

@Layla I’m so terrified of becoming dependent on the cane. I haven’t been able to walk without it since my first knee replacement in 2017

 

[jboles]

@sistersinhim the family brought dinner and presents and everyone had cake. Then they all cleaned up. My husband said it was a great day. Now if can get these stitches out tomorrow, I’ll be closer to being independent again