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TKR harder than I thought!

Sounds like you are doing fine. I only did exercises when my PT came to my house. Thanked her for the exercise sheet, but then really only looked at it once or twice after that. Only other thing I really did was try to bend my leg just a little farther each time I sat up. For me the best place to do this was in the bathroom. There are tiles on the floor and I could set goals based on the lines in the tile. I would slide the foot in to see how far it could bend, but didn't force it or do a million repetitions.

Doc was worried about my lack of bend when he took my staples out at 10 days, but I still had a lot of pain and swelling. When he changed my medication and got my pain under control, the bend increased greatly and then one week (around 4 or 5 weeks?) the bend seemed to increase overnight.

Be gentle with yourself. This process is much longer than I think anyone realizes until they go through it.
 
To the right side at the end of the post there are some symbols. The hand is like, check mark agree, then funny and there are a few others. You can try checking them. You can also remove them by checking undo rating which will show up once you pick one. Then just leave the post.
 
@stephyratgh ... It appears you may have set up a signature within the app you're using. We prefer a smaller one that goes below your posts, so I've created that for you. If you would be so kind as to now delete the one you created, you'll be just fine!

I'm glad you're taking the approach that recovery is going to take a while. You had a more involved surgery than most people and recovery will likely take a little longer. The more work a surgeon has to do, the more the soft tissues and bones are worked, moved around, and generally irritated. They'll be quite angry at you for a while because of it. This is why we advice folks to spend ample amounts of time up front resting, icing, elevating and keeping pain under control in those first critical months. This is the healing phase. Hang in there and let us know if you have any questions or concerns.
 
Stephyrath said:
I realise I'm just under 2 weeks post op but I get the feeling I should be doing better. Really worried :-(
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My small addition to what everyone else has said...

Don't worry. This is an intrusive procedure and lots of healing is needed. The primary contributor to healing is TIME. All you need to do is keep mobile, but no exercises are needed to speed recovery. Indeed, you can't speed recovery -- but you can slow it down by doing too much. Pain is the indicator; we believe in 'no pain, more gain'.

Sit down relax watch telly. What's not to like?
 
I can sympathize with you having been down a similar road. You were hit with a double wamy, screw removal, it hurts a lot more than surgeons think.

Time is your friend one day you will notice a big difference and say "Wow" I am getting better.
 
take it easy and you have nothing to worry about. I did zero PT because I listened to the advice here and not my family doctor...I stayed active and moved around normally, right from the start but that was it. I now have way better ROM than I had before the TKR. I am 4 months out and back at the gym doing everything I did before surgery. My long-term goal is to play soccer again-we'll see...
 
My apologies in advance for this lengthy post. I think I just need to get this out of my little mind!

It's been 2 weeks since my surgery (TKR and removal of plates and screws to tibia) and according to my visitors I am doing well! The problem is.....I'm not so sure! My ROM is not improving at all, I can't be sure but I think I have around 55-60 without force and probably around 10 on my extension. In terms of exercise, I am still trying to do my 4 sets of PT throughout the day but without pushing myself to the point of extreme pain. I am doing static quads, inner range quads, heel slides, heel hanging, knee bending whilst sitting in a chair. The remainder of the time I am sitting and regularly icing. I'm only walking to the bathroom and occasionally around the ground floor of the house just to shake off the boredom! I go up two flights of stairs and back down again usually once or twice a day as my bedroom is on the top floor. My biggest noticeable improvement is that I can lift my leg onto the bed or the sofa without using my hands or having any other assistance, apart from this, I'm struggling to see much difference.

I'm reading everyone's posts on here and thinking "these guys must know what they're talking about they've been through it". I've noticed that that a lot of the exercises people talk about on here are different to the ones that I have been told to do in the UK. My exercises seem very basic in comparison and I am wondering whether I should continue to do these as best I can?

I had an accident 23 years ago and whilst I've been very lucky, more recently I have suffered a lot with the pain from my knee and so decided to go for TKR after taking advice. I have to admit to being at the point where I wish I hadn't had it done. I'm struggling to see the light at the end of the tunnel. Every minute takes an hour to pass and of course I have forgotten all the pain that I had before the surgery!

I'm trying to get on with it and will continue to do so but this post is my truthful and honest thoughts about where I am at at the moment. I guess I'm hoping that everyone will tell me that this is completely normal and if not, tell me how to drag myself out of this!!!

My mother had a PKR 4 years ago and my uncle (aged 80) had a TKR about 9 months ago. Both of them are telling me to keep going with my exercises and that I won't get the results I want without continuing on with my PT every day. In honesty, I want to believe the advice I am getting on the forum but as I said before, reading some of the exercises that you guys are being asked to do, I am wondering whether the basic things that I've been prescribed to me should be continued as per my family's advice.


Sent from my iPhone
 
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@Stephyrath You will notice I merged the thread you just started with your existing recovery thread. We like recovering members to keep all their input on one thread so that we have a history and can advise you if necessary.

I think your problem might be two-fold:
1. You are comparing your recovery to other recoveries. No 2 recoveries are the same even on the same person. What uncle, mother, neighbour or friend experienced does not apply to you. Each and every one of us moves at our own pace.

2. You are expecting way too much for only 2 weeks out. Your surgery was not just TKR. You also had hardware removed. This may lengthen your recovery.

We posted the BoneSmart mantras for you earlier on this thread. I know that at 2 weeks you may be getting bored. But frankly I am wondering why you are doing all that PT? It is only limiting your ROM - not extending it. If it were me I would stop all that forcing your poor knee and focus on icing and elevation. If you get that swelling reduced your ROM will increase.
 
I agree with Jaycey.

You are doing too much and expecting too much of such a new knee.

Your knee is just where it's meant ot be.

It can't bend further, because its still upset and swollen from the trauma of a major surgery. THe swelling stops it from bending or straightening further. As the swelling goes down your ROM will lautomatically improve.

You're doing far too much exercising. At the very most, only do your exercises once a day, with no forcing or pushing. Don't allow your PT to push on your knee either - that just upsets it still more and increases the swelling.

It's not exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. Your ROM is there right from the start, just waiting for all that to happen so it can show itself.

BoneSmart philosophy for sensible post op therapy
TKR: work “smarter” and not “harder”
 
I understand that feeling of being pulled in 2 different directions. I wanted and did listen to my surgeon and p/t people for about the first 4-wks or so, it was at that point when no matter how hard I was striving at home to achieve what they asked in the line of exercises and gaining ROM only to go in and fall short and get discouraged and depressed. That I kind of threw in the towel and said enough, they wanted me to go thru a MUA and I felt pushed all the time, but once I took ownership of my knee and the path I would follow I began to do better and feel better. I didn't start to follow everything on here from the start, in hind sight I wish I would have, think I would have been further a head. But it's hard to take us all at face value as were just people communicating over the internet, where as our family, friends, p/t and surgeons are people whom we actually see, so it's hard not to believe in all that they are telling us. I guess all you can do is to try the approach that is presented on here and see how things go for you.
 
@Stephyrath I feel exactly the same way you do. My surgery was only the day after yours and I feel as if I am getting no where also. I had some extreme swelling and my ROM was only about 30. After reading a lot of stuff on here, I took a week off from everything and pretty much did nothing except ice and elevate. Had good days and bad days. At the end of my "week off" I had my follow up appointment with my doc (Monday). He measured my ROM at 90. I was elated! He was happy with how everything looked and how I was progressing.

Next day I had my 2nd PT session. She went very, very easy on me, giving me some very gentle stretches and more stair training. She measured my ROM at the end of the session at 98. I actually felt good when I came out of PT for once. I felt as if I had a good session. And of course today has been spent in bed icing and elevating and again doing nothing....

Take a week off like I did and see if it helps.
 
Stephyrath said:
My original surgery was insertion of a plate and screws as a result of an accident in 1994 when I was in my mid twenties. I fractured my tibia in 6 places and dislocated my kneecap. I've been lucky to have it last as long as it has tbh. According to my TKR surgeon and PT they had to do a lot of addition work to the joint area in order to get the prosthetic knee to fit due to it becoming distorted over the years
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Hi there @Stephyrath :wave: This is not so dissimilar to my experience in that in 2003 l sustained a 'very nasty comminuted fracture to the left tibial plateau and fibular head with extensive damage to the knee and surrounding soft tissue'. I was considered for external fixation at either Edinburgh or Sheffield as these were the places which specialised in this kind of repair. I was fortunate in that my then surgeon and his colleagues decided to try MUA whereby they stuck the bony pieces into some kind of order and l then had total immobilisation for 3 months followed by a further MUA and partial weight bearing for further month.

All this resulted in the development of Osteoarthritis secondary to trauma which apparently does tend to result in more swelling and sometimes a longer recovery time due to the revisions they have needed to make in order to fit the prosthesis. It also means that because of the correction of any valgus deformity (l was very bow-legged!) we have to re-educate the leg into a whole new way of walking and that takes time.

Regarding exercises, just let mobility happen and see how it goes. Less really is more in most cases!
 
@Cratchit. Wow! You have described almost exactly what happened to me in my original accident with the exception that my surgeon operated and plated the pieces back together (I had my accident is the Canary Islands). During my TKR my surgeon apparently had to do an extensive amount of work on the inner part of my knee in order to get the prosthesis to fit as it had become very deformed. Like you my leg was a completely different shape by the time the osteoarthritis had done its thing.

Up until the last three days I have really struggled with conflicting advice that I was receiving from this forum compared to what I had been told to do upon discharge from hospital. I was doing my very best to keep up with the PT regime and as a result my mojo was suffering to say the least! I think I hit rock bottom on Monday this week and as a result I didn't do my physio anywhere near as much as I should have. By the evening I felt a little better. On the Tuesday I didn't get up early to do my exercises, I slept in a bit, and again Wednesday (yesterday). I've done a few physio exercises here and there, as I have felt like it, but have not done the full sets prescribed since the weekend. My swelling appears better although it is a slow process because of the extent of my surgery but I can feel my leg repairing itself if that makes sense? - nerve endings knitting together etc. My ROM is still poor at around 60 but I feel my confidence building a little more and I do believe that it will come back with very gentle exercise and patience.

I have changed my physio from the hospital one to a private physio that I've seen before and I'm due to see her for the first time today. She has treated my knee prior to my TKR using massage and acupuncture techniques instead of traditional PT exercises. I'm two weeks and three days post op now and I really am starting to feel a lot more comfortable because I finally took ownership of my knee and made my own choices. It took me a long time to feel comfortable with the advice that I was given on BoneSmart but I am beginning to believe that it's the right way for me.

Your comments have reassured me even more as, without doubt, your situation is the most similar to mine that I have come across. Thank you for taking the time to tell me your story.


Sent from my iPhone
 
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I'm not 100% agreement with Bonesmart philosophy. I do agree that people need time to recover from this major traumatic surgery, icing and elevation helps BUT not all physios are the same. Some are extremely helpful and experienced with TKR and should be listened to. Also the dreaded MUA if required is not the end of the world and can be the start of big improvements.
The task for us TKR people is to pick our way through the conflicting information and find out the best way to help ourselves on an individual basis.
 
I've tried recovering from a TKR doing all the exercises I was given plus some to try to hasten my recovery. I went to PT twice a week. I even allowed the therapist to push with all his weight on my leg to bend my knee all the way. I was crying with pain. I was going nowhere. After my second TKR I followed the info given here. I chose to go to a different PT that was gentle and I didn't do anything that hurt. The only time I allowed him to touch me was to do some gentle massage. I reached 130 extension which was better than what my OS thought I would do.

The moral of my story is to let your knee heel for a few weeks. Do gentle PT if you want. If you do then don't do very many exercises at home. Gentle stretches and walking around will be enough. Here's an article you may want to read.
https://bonesmart.org/forum/threads/bonesmart-philosophy-for-post-op-therapy.37103/
 
@Stephyrath it seems that if you are now resting a bit longer in the mornings and skipping all that home pt you can see for yourself that you are feeling better. That is a good sign. One of the main exercises that the OS and pt should put first is the practice of patience. It takes time. Your surgery wasn't like the TKR I had, so you shouldn't expect to be "ahead" on recovery just because you are working hard at your pt. Take each mini improvement and savor it. Rest, ice and elevating is the work you have right now. One day at a time. It has been worth it to me. And, I'm one of those looking forward to my second surgery in 3 weeks. Frankly, I don't even worry if what I experience is a different recovery with my second. It is about having less pain to walk and do everyday activities. Stay strong and rest to heal.
 
@newlybionic @GingerP I have been to see my old physio today who I was seeing prior to surgery. She was really pleased with my progress and measured my ROM at 75°. She explained to me that because I am only 48 and because I had much more surgery than a normal TKR, I would experience far more swelling and a slower, more uncomfortable recovery. She massaged my scar and the surrounding tissue and told me to stop doing the four exercises four times a day that I had been given by the hospital (I already had!). She then gave me three new (easier) exercises to do, three times a day or if I couldn't manage three times a day, to do them only as I felt able to. She warned me not to overdo it, to rest often and to believe in that fact that I was doing well. She really set my mind at rest. Her advice was to keep in touch with BoneSmart members and to take their advice into account whilst doing the exercises that she has given me without putting myself in a position where I cause any pain.

At the end of the session when she was measuring my ROM again, she pushed my knee very very slightly to see if it would go any further. The moment it became uncomfortable at 77° she stopped. She does not believe in the methods used by some other PT's.

Feeling much more settled now as I have a clear plan of action. Exercise in moderation coupled with elevation ice and rest. Also, going back to my old PT was exactly the right thing to do. She knows my history, she knows how bad it was before and I trust her judgement completely.

Day 17 - overall, a good day!
 
Its amazing the difference a good physio that really knows what they're doing with a TKR can make! Sounds like you've got a good one too.
 
Aw, @Stephyrath what a fabulous and uplifting report! I can feel the positivity oozing off the page! I`m so glad you went back to your old PT. You obviously have a great rapport and a good therapeutic relationship. Chuffed to bits for you! Onwards and upwards!

:yes!:
 
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