TKR TKR 4/05/2022

[obmrsfixit]

Hello,
I'm 14 weeks 3 days out post-op, but who's counting eh?
I am recovering from my left knee being replaced. I had my right knee replaced 11 years ago and it's going strong. I just logged in here yesterday looking for advice/ help. My flexion when I arrive at PT is typically 93 degrees ish and after he works on me a bit I' reach 109. My concern is how stiff my knee/ leg becomes in the meantime. So I have really been concerned about getting to 140 to 150 flexion, wondering if I'm going to have to go back in for the doctor to do it for me. EEK!

I totally liked the description of the "Angry Knee" it really gave me some clarity as far as what I should expect from my knee. It has carried a lot of heat and swelling for quite some time and both these issues seem to be improving. My doc suggested less ice and more warmth to loosen it for stretching. I always get ice after PT, but I've tried to put heat on it prior to a PT session. After reading some threads my takeaway is perhaps my methods are the cause of my stiffness. I have been using a stationary bike and trying to increase my time each time, the top time has been 17 mins but after my reading, I see a few mins might be enough. Also, it still takes me a few tries to get a revolution all the way around since I first succeeded in doing so 4 weeks ago. Short stairs 4" to 5" rise are easy to go up in a normal fashion but my interior house stairs with a taller 6" rise are painful if I try but a banister on each side would help me achieve this. I really can't do either height heading down them other than 1 at a time.

In June I was able to have 2 days where I walked 4 miles. I did this about 1 week apart and the 2nd time I was definitely pooped as I had been at a street fair for 5 hours. But I was thrilled to see this on my phone. Lately, I've been averaging 1.5 to 2.5 miles a day without even realizing it, so this is great since prior to surgery I could walk 1/2 a block. I've been going to a water class which is fairly gentle and I recently started back to a Stability ball class modifying each class to my needs. I also sit on the large inflated ball and rock forward hoping for the knee to release more.

Thanks for reading this and I welcome your comments. Has anyone out there ever had to go back in to get the doctor to break the scar tissue loose? If so, how far along post-op was it when that decision was made?

 

[Jockette]

Hi and Welcome!

My flexion when I arrive at PT is typically 93 degree ish and after he works on me a bit I' reach 109. My concern is how stiff my knee/ leg becomes in the meantime. So I have really been concerned about getting to 140 to 150 flexion, wondering if I'm going to have to go back in for the doctor to do it for me. EEK!

Your ROM is fine, there should not be any need for a manipulation.

Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.

You also may be getting too much PT, there’s quite a difference between 93 and 109. It sounds like they are really pushing that knee to bend. Maybe if you have them let up a bit, your stiffness might be less.

I‘m surprised you are still going to PT, at 14 weeks. I opted to stop going by 8 weeks, and then let my daily actities “rehab” my knee naturally.

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.​

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.​

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

​

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.

 

[Jaycey]

@obmrsfixit Welcome to BoneSmart! Our members continue to see improvement in their ROM for many months - even years post op. There is no window of opportunity. It's all about how your knee reacts to increased mobility. No need to push! Continue to ice to get that swelling under control.