Revision TKR TKR - Feel like a Failure<

[SusieShoes]

@chrisknee, you have been dealing with the most difficult thing about recovery from TKR: people who plant false expectations that make you doubt your progress and, worse, your ability. Everything about your knee, from implant to function, sounds like a success. If you feel more secure with a cane, continue to use it, and do so with confidence. You are not weak-minded! You're taking care of yourself by being careful.

I had my knees replaced on May 10, so we pretty much had them done at the same time. I'm also 4.5 months into recovery. My surgeon emphasized walking for rehabbing knee replacements, so I focused on walking almost from the beginning -- walker at first, then up and down my block using a cane, then taking the cane with me but using it less and less until the day I didn't need it at all. You will also reach a day when you don't need the cane. You'll forget it at home and realize you don't have it with you... and you'll realize that's okay, because you're fine without it.

My knees both have clicked or clunked along the way. As I walked more and my muscles got stronger and tighter, the clicking went away completely in my right knee, and is much less in my left. Some knees continue to click, though, even after complete recovery.

Only in the last couple weeks have I gotten rid of the stiffness and tightness in both knees (my right knee lost stiffness ahead of my left). It was gradual, not something that happened overnight. My exercise regime was and is simple: walking. I did no PT at all after my six week check up. I relied on longer and longer walks to build up my leg strength and improve my flexibility. For getting rid of the stiffness, I credit my two miles of walking a day (long walk in the morning and shorter one at midday) along with simply going about daily life.

You really have recovered very well. Your flexion is amazing! In my opinion, what you need to do now is 1) less exercising (if you are still doing things like leg presses and weights) to give your knee a chance to finish healing, and 2) more walking. Take your cane with you. You can always use it to fend off off-leash dogs and overhanging branches. Walk around the house without your cane, as much as possible. If you are resting, prop your legs up on an ottoman.

I guess what I'm saying is to embrace your recovery. Own it. Tell busybodies you're doing just fine... because you are.

 

[BamaBelle]

Chrisknee, I'm crying as I read your post! Please don't let others frustrate you and make you insecure. It amazes me how the experts tend to bully and intimidate the very ones they are paid to help.
As of last week, I left my PT because of his continued aggressive treatment. I had asked him repeatedly to cease the painful therapy because I felt it was causing a set back for me after each visit. He continued, so I found a Physiotherapy group that adheres to the nonaggressive philosophy. I feel as if I'm finally moving forward, slowly though.
My knee felt well enough to attend church this morning! I was so happy to be back and enjoying seeing everyone. Then a friend commented to me that since it had been 5 weeks since my surgery and I still wasn't moving around as much, that "there must be something really wrong"! "My sister had this surgery and at 5 weeks, she was back to her normal routine and had no pain". Needless to say, I started crying and the negativity and "what ifs" began!
I just pray that I have the success that you're having! I think you're doing great and having a little security (cane) doesn't hurt anyone. Hugs to you!

 

[SusieShoes]

It does seem like people tend to shave off a few weeks from their recovery timelines. It was five weeks before I was up to taking a trip to the grocery store... oh, wait... it was seven weeks, with a cart to lean on, and I only picked out the produce and some meat, then sat on the sidelines while my husband finished the shopping.

Even amazing recoveries take longer than five weeks!

 

[chrisknee]

Thank you thank you thank you for all your responses! I have read each one twice and feel better mentally than any day since my surgery. My husband thanks you too as it has been quite draining on each of us.

Josephine - I should qualify my pain level. It is practically zero now when I sit or lay down. The level 4 is when I walk due to stiffness and soreness. So if you were to average out my day the pain level would be two.

Regarding PT, the first two weeks following surgery was four visits per week. The next two months was three visits a week. The last month was two visits a week. Here's a typical visit during the last month:

30 heel slides with a strap
30 kick-outs with a 6 pound ankle weight
30 straight leg lift with a 5 pound ankle weight
Single Leg Stance repeat 10 times for 10 seconds
Elastic Band Lateral Walks - approximately 5 minutes
Front Leg Step-ups on 8" step - 15 repetitions
Front Leg Step-ups on 6" step with cable tied around knee - lifting 25 pounds - 10-15 repetitions
Pushing 50 pound "sled" up and down the length of the clinic - 3 repetitions
Step up and over cones sideways and back - 3 repetitions

During the period of PT exercise I was repeating many of these exercises at home daily.

Thank you.

 

[Jockette]

Oh wow that's a lot of strenuous exercises!!!! I could never have done those and I'm sure even now at 6 months I wouldn't be able to.

I would love for a person in their 50's who has NOT had tkr to do those exercises that many times a week and see how they fare. I bet they couldn't do it either!

 

[kmak81230]

I agree with Jockette - that seems like a lot of exercises, particularly those with weights and also the fact that you are also doing them at home. If you are more swollen and sore after all of that I would definitely cut back on the exercises. Walking is the best therapy and riding the stationary bike is also great. Glad you found BoneSmart - and you're right / our spouses are also relieved that we have found this support.

 

[chrisknee]

Oh yes - definitely more stiff and sore after completing exercises. After reading responses and Josephine's advice, I will cut back on the PT exercises and concentrate on walking. Love to walk with my husband and dog - a good mental boost as well. I will strive to use the walking stick less and less but makes me feel more positive about myself that others on this forum don't see that as a weakness. So tired of getting looks/advice from others who believe there is something wrong with me "after all this time" - so glad to have a place to come where I can learn from others' experiences.

 

[Celle]

Chris, your knee is really doing so well that I think you could stop going to PT altogether. Just concentrate on walking. You don't need to do those exercises any more.

 

[Josephine]

Thank you so much for the additional information - most helpful.

I should qualify my pain level. It is practically zero now when I sit or lay down. The level 4 is when I walk due to stiffness and soreness. So if you were to average out my day the pain level would be two.

I don't differentiate like that. Four is four, not two 2s!

Regarding PT, the first two weeks following surgery was four visits per week. The next two months was three visits a week. The last month was two visits a week. Here's a typical visit during the last month:

30 heel slides with a strap
30 kick-outs with a 6 pound ankle weight
30 straight leg lift with a 5 pound ankle weight
Single Leg Stance repeat 10 times for 10 seconds
Elastic Band Lateral Walks - approximately 5 minutes
Front Leg Step-ups on 8" step - 15 repetitions
Front Leg Step-ups on 6" step with cable tied around knee - lifting 25 pounds - 10-15 repetitions
Pushing 50 pound "sled" up and down the length of the clinic - 3 repetitions
Step up and over cones sideways and back - 3 repetitions

During the period of PT exercise I was repeating many of these exercises at home daily.

Those were gruelling exercises. Time and again here I have said that nobody should ever be required to do exercises using weights or bands. Worst kind of thing you can ever do. Makes the knee swell up like a balloon for starters! As for the step-ups, sleds and cones, VERY bad! I don't wonder you're been having problems.

So to summarise - including from my last post as well -

stop all exercising
take Tylenol 1,000mg 3-4 times a day - at least
be gentle with your general activities for another 2-3 weeks
​

Follow these gems of advice and I will be most surprised if you don't eventually find some improvement.

 

[chrisknee]

Thank you Celle and Josephine. I will follow your advice and discontinue the PT exercises - appreciate your input.

 

[sistersinhim]

Hello @chrisknee. I, too, had birth defects in my knees that caused dislocations. In '91 they totally removed my left kneecap and in '93 my right one. I understand what you went through and are going through with people giving you 'the look' and the hateful comments. I used a cane for over 20 years. I went down stairs backwards because it hurt less and if I fell, I fell up the steps and not down the steps! Even now, if in really crowded situations or very uneven ground, I still use a cane. I think you should use yours as long as you feel you need it. It's no ones business whether you use it or not. Your safety and security come first! Don't take any chances of falling. I do know how you feel with needed the cane and please don't worry about those people. You need to be concerned about you and your knee!

Many of us never took PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them the kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard. This included a lot of walking! This was enough therapy and would be for any tkr patient. All the awful pain of PT is so unnecessary. All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new!

 

[OJ2]

Why do people think we all have to heal in the same timing? We are all built difference, we have different hair color and eye color, we have different health histories, we are different ages, etc. We even had different levels of arthritis before we took on this journey of a tkr. As I progress (slowly) through this rehab, I become more and more convinced of the importance of our mind. It is far too easy to become depressed by what people say, how we feel, our expectations not being met, and the pain level. We need to protect our mind by surrounding ourselves with kind, understand people, and tell ourselves we are doing well. I don't mean to belittle true medical advice, but most of what we hear is what non-professional people are saying.
Keep up the good work, ice as much as you can, and remind yourself how strong and persistent you really are.

 

[KarriB]

Holy Smokes! Your PT sounds like training for the Iditerod race! I'm glad you're stopping.

 

[rubyyarn]

I hate it when people turn their impatience into your problem. It is not your problem, it is theirs.

Relax, give your knee what it needs, and don't worry. We've got your back.

 

[Polkadot]

@Minstrel, and @SusieShoes, your replies were so helpful that I bookmarked them as "inspiration" for when I have to do the second knee.

@chrisknee, conquering your own personal situation can be difficult, but you are definitely on the way. Looking forward to hearing more of your story, too!

 

[jaschembra]

Hope you're feeling better since you cut out all those exercises. Yes, your PT made me hurt just reading it.

 

[sistersinhim]

@chrisknee, how are you doing?

 

[chrisknee]

Thank you for checking in.

Although the pain has diminished since I stopped the PT exercises, I am still very stiff and sore. Still using a walking aid as I don't feel confident when walking yet. At the six month mark and very discouraged as I had been told by my doctor and other former knee replacement patients that three months was the "end game." Wondering if something is wrong with me.

I have great ROM and feel fairly normal when sitting or laying down now but when I stand up to walk the stiffness is overwhelming. I am upset with myself for having this operation - everyone I spoke with was so enthusiastic about their operations. I know everyone is different but don't understand how some people are completely OK by 6-8 weeks. I am worried that I made a decision that will affect me for the rest of my life. Trying to be positive and some days better than others! I appreciate your concern.

 

[Jockette]

It is so good to hear from you, I have thought of you often!

I’m sorry you still are still stiff and very sore. I am 7.5 months post op with a partial, and while I rarely have the kind of pain that makes me say Ow, I do still often have quite a bit of discomfort and inner swelling that makes it feel tight.

My ROM is not great, somewhere around 114. I thought by now I would have more than that but I try to accept it for what it is. I still need the car door open fairly wide to be able to get in. And, I am still uncomfortable in certain chairs sitting with my foot on the floor. If I’ve been in a restaurant for an hour or more it’s very uncomfortable when I get up and it’s hard to walk until my knee gets going a bit.

Shocking that anyone who has had a knee replacement would tell you that 3 months is the end of recovery. We have talked about that on here and have come to the conclusion that they just don’t remember. I agree, I will never forget mine. I may forget the time frame of certain milestones but not how hard it has been or how long.

I think, unfortunately, the pain and stiffness is within normal range for some of us at 6 months, at least I hope so, because that’s where I am. I have only in the last month or so seen an increase in ROM and improvement.

If you have time, why don’t you hang out with us here more often. We understand, and we care, and we don’t sugar coat our recoveries, we tell it like it is, and there’s usually someone experiencing the same thing. It’s very comforting.

 

[Knees4Me]

@chrisknee - My heart goes out to you. Just wanted to offer my support and say that before my operation I, too, spoke only with people and doctors who were enthusiastic about TKRs. I never heard a bad thing about this surgery. I went into surgery feeling optimistic that 10 years of arthritic pain would be gone. But I had a hellish "recovery," and, like you, have not progressed since about four months post-op. In fact, the pain is much worse than before surgery. I was led to believe in rehab and in follow-ups with my OS, that it was my fault because I wasn't exercising enough, etc. I exercised plenty. My GP said mine was not a normal "recovery" - and my surgeon said last month that I may well be facing a revision TKR if my chronic daily pain doesn't resolve by the time I see her for my one-year review in January. It's not getting better. Looks like I probably have impingement of soft tissue/IT band caused by my surgeon putting in a tibial tray that's too big. I'll definitely get full testing and a second opinion. But I fear a second surgery on the same knee. There's no guarantee it will (eventually) get rid of the pain. I'm also okay when lying down and, sometimes, while sitting. Do you know what's causing your continuing stiffness? Are you actually in pain? I really sympathize!! It wasn't supposed to turn out this way for us!!