TKR TKR & pending THR

[jacobschar]

Cross posted on the hip forum.

Hi! I just had a right TKR in January. I had hip reconstruction in 2022 and it has failed. Now, I have moderate osteoarthritis and my labrum has multiple tears. I will need a THR. The pain is pretty intense and it is definitely affecting my physical therapy efforts for my knee. Has anyone needed both TKR & THR in such a short time frame. I’m trying to delay the THR for a year. Both issues are on my right side.

 

[Layla]

Welcome to BoneSmart! Thanks for joining us.
It is understandable that an ailing hip on the same side as your recent TKR is hampering your recovery. I am sorry, it's unfortunate. I'm guessing the pain and limited mobility is altering your gait and putting added stress on your knee.

You want to give your knee sufficient time to heal before undergoing another major surgery. It's important you consult with your OS to determine the optimal time based on your circumstances. Wondering if your PT is concentrating on strengthening the muscles around both knee and hip. If so, hopefully it will help relieve some of the symptoms associated with the labral tears.

I will leave our Knee Recovery Guidelines below since it is still early in the healing process for you. Please keep us posted on your progress. Best Wishes!

 

[Layla]

KNEE RECOVERY GUIDELINES
(Administrative Note: For those reading here, please be aware that these links are a premium service and only available to Insiders Club Members).

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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.

If you want to use something to assist with healing and scar management, 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.

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
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?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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 a 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 history before providing advice.

 

[benne68]

I'm sorry you are dealing with hip pain and a knee recovery at the same time, @jacobschar.

It's not at all uncommon to have pain in the hip after a knee replacement as our leg adjusts to its new, improved alignment. Remember that, prior to surgery, as your knee deteriorated, your body make adjustments to ease the pain. We favor the leg, limp and more. We live with that bad alignment for so long that, when the knee is fixed and our alignment is corrected, the rest of the leg has to relearn what to do.

As far as timing goes, it takes at least 3 months for all the ligaments and tendons to recover from the trauma of surgery. For that reason, most surgeons will recommend waiting at least three months between procedures.

Keep us posted.

 

[benne68]

Hi @jacobschar. Just checking in to see how you are doing. Let us know when you have a chance,

 

[EalingGran]

I'm sorry you are dealing with hip pain and a knee recovery at the same time, @jacobschar.

It's not at all uncommon to have pain in the hip after a knee replacement as our leg adjusts to its new, improved alignment. Remember that, prior to surgery, as your knee deteriorated, your body make adjustments to ease the pain. We favor the leg, limp and more. We live with that bad alignment for so long that, when the knee is fixed and our alignment is corrected, the rest of the leg has to relearn what to do.

As far as timing goes, it takes at least 3 months for all the ligaments and tendons to recover from the trauma of surgery. For that reason, most surgeons will recommend waiting at least three months between procedures.

Keep us posted.

Agree with @benne68 that the the joints are intimately linked and changes in alignment can affect other joints.
It's also true that once your knee is better it can produce improvements in your other joints.
I had serious hip pain before my knee replacement and I have moderately severe hip arthritis and a labral tear on the side of my PKR. After my knee surgery and straightening my leg, my hip pain gradually disappeared. My surgeon still thinks I will need a THR at some point but currently ( two and a half years later) I have no hip symptoms.

 

[Layla]

Hey Jacob!
It's a special day...Happy Two Month Anniversary!
I hope you're doing better in PT. It's understandable your failing hip is hindering your recovery. Hopefully as your knee strengthens there is less strain on your hip. Please keep us posted on your progress and know that we're here for support when you need us. I hope you have a good week!
@jacobschar

 

[Jamie]

It is not the norm by any means to need two different joints close together, but we have had members who went through that. Your surgeon will be your best guide as to when you are able to have your hip replaced. But I’m not sure why you’d want to wait a whole year. I believe you should be able to do it sooner. You will be surprised at how well that can work once you have both joints repaired. You’ll have surgery pain, of course, but the pain is different than what you’re experiencing now and is temporary as you begin to heal. Hips are normally easier to recover from than a knee, so that will be better for you as well.