TKR TKR problems

[Adicoll]

Hi had TKR on my right knee 19th of December so I'm now in my 4th week post opp & Iam struggling with stiffness & swelling around the knee. Iam using the aircast ice cold wrap that was given to me at the hospital I use it 3 to 4 times a day plus iam taking long lasting ibuprofen lasts 12 hours twice a day, not suffering with much pain now but my knee swells & gets stiff when I walk around the house. I admit that I have not been very good at the Pt over the past 4 weeks but I have done a small amount, could this be the reason why I am now getting the problem because of the lack of exercise.

 

[LD of Michigan]

My surgery date is around yours, and in a way I was off to a slow start with PT, but found the home PT I could do or at least START while lying down were great.

The advisors and moderators have many ideas and options. It's an ongoing process to recovery and re-building stamina. I count all steps, including to the refrigerator useful. LOL!

Your knee will loosen up the more you use it. I learned that this week in my off-site Physio sessions.

 

[Jockette]

Hi and Welcome!

The stiffness and swelling is the nature of this recovery and will be with you for a while. It is the body’s natural reaction to this major surgical assault.

As long as you are moving around and walking (but not to excess) it is not harming you to be lax with the PT. Too often it is more than our knee is ready for, anyway.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.


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.

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.

 

[Celle]

Hello @Adicoll - and

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? That will make it easier for us to advise you appropriately as your recovery progresses. Thank you.

Total knee replacement is major surgery and you can't bounce back from it in just a few weeks. Complete recovery takes as long as a full year, although you will be able to do most things long before that.

For the first month after surgery, your knee actually needs very little exercise, so don't think that you have caused anything by only doing a few exercises - you've probably done your knee a favour, by not stressing it, and allowing it to start healing from the trauma of surgery. Just walking around the house is sufficient exercise for a new knee.

You may be interested to know that my surgeon doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week.

After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day.

His patients all do well and achieve good Range Of Motion (ROM), as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

You say you're icing regularly, but how long are you doing it for? You need to ice for at least 45 minutes each time, for it to do any good. Make sure that you protect your skin from the cold. You can elevate your leg while you're icing. There are articles about icing and elevating in the Recovery Guidelines that Jockette posted for you.

 

[Jamie]

Your knee will loosen up the more you use it. I learned that this week in my off-site Physio sessions.

This is a common remark you'll hear from some therapists and patients, but it is only partly true. It is important to move your new knee gently throughout the day and night to keep things loose and mobile. But, more is not better. If you are experiencing pain or swelling following any activity (and it can occur many hours later), that's a signal to reduce some of your activity. In addition, when this occurs, you should increase the amount of time you're spending icing and elevating your knee. If you're having pain, try taking 1000mg of Extra Strength Tylenol every 6 hours on a schedule through the day and night for 4-5 days and see if that helps. You can take it with the ibuprofen, which is actually not a very good pain reliever for post-op. It's an anti-inflammatory medication and post-op pain is a whole different animal. You might also try icing your knee while you sleep at night. That can help. Be sure to ice both the front and back of your knee as swelling can occur in both locations.

 

[LD of Michigan]

Thank you for clarifying my comment. Indeed over-doing it is not recommended.

 

[sistersinhim]

could this be the reason why I am now getting the problem because of the lack of exercise.

No, as long as you're doing your activities of daily living, (ADL), that's all your knee needs to recover and rehab itself. Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing. I used my knee as it was intended to be used by walking around to take care of my daily needs. As I healed I was able to do more. Icing and elevation was a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happens, I found that resting, icing and elevating helped. If you do decide to take PT, don't let them hurt you or make you hurt yourself. No pushing or pulling on that leg, either. That causes inflammation, which causes pain and swelling, which sets you back.

 

[Adicoll]

Thank you for your comments iam now doing more ice & elevation.

 

[Adicoll]

Hi is anyone experiencing any numbness in the leg when sitting or lying down, I am on week 5 post opp & have started getting numbness down the outside of my leg. My thoughts are that it is possibly a pinched nerve or the sciatic nerve, would be good to hear any comments.

 

[sistersinhim]

You will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

 

[sistersinhim]

Numbness around the knee is normal. Many nerves were cut and damaged during this surgery. These will come back and you will notice it because you'll start getting quick 'lightning bolt' type pains. These pains will come from the nerves reattaching and/or repairing themselves.

 

[Sara61]

I'm at nearly 4 months post op, I have a complete numb area to the side of the incision, I have been told by my surgeon and doctor and my PT that this is completely normal, it may or not disappear with time but I'm not to worry about it as it's where some nerves were cut, so don't worry.
I never had aggressive PT, I'm now gently trying to exercise at home(when i remember ha ha) mainly walking the dogs I still get swelling and tightness some days worse than others all you need to do is ice and elevate.. I no longer worry what my Rom or extension will be as I know Thanks to BoneSmart that this will improve on it's own with time xx

 

[Adicoll]

Hi Sara 61 yes I have that as well but iam also having a problem with my lower leg going numb & I was hoping that someone could let me know if they are going through the same thing, I can be sat watching TV with my leg elevated & I get a cold feeling in my lower leg and foot then as I move it gets warm again. My thoughts are that could it be a pinched nerve like the sciatic nerve or worse could it be a DVT.

 

[Macknit]

Hi @Adicoll, I definitely had that problem of numbness, until recently, and I'm close to 5 months. All the nerves that were moved, cut, or damaged with all the knee surgery take time to regenerate. Now my numb area is shrinking, but as I get closer to the scar it has numb spots.

A pinched nerve, which I had a surgery for last July, was a radiating pain running down the leg, not any numbness. I'm pretty sure that a DVT is painful and hot or warmer to the touch...though not everyone has those symptoms. If you are concerned, definitely see your OS office and be sure.

 

[Adicoll]

Hi thank you for the reply got to wait until Monday to contact my P/T but you have ruled out the DVT for me as I've not had those symptoms, so I quess it's more likely to be a problem with the nerves.

 

[sondrals]

Not to be an alarmist, but I had a DVT that was not painful, hot, or warm to the touch. But also it didn’t present as numbness either. My leg swelled like an overinflated balloon was all I had.

I definitely have numbness in both my TKRs but my leg doesn’t ever feel like it’s fallen asleep. I also have sciatica and while it’s not making my leg numb right now despite it acting up, it has in the past. So I’d lean towards a pinched nerve or sciatica.

 

[Adicoll]

Hi thank you for the reply yes I'm thinking the nerves also, my symptoms are similar to yours.

 

[Lindylee]

Hi Adicoll

I get a numb feeling in my foot and lower part of the leg when elevating. I remember it was the toes that felt numb first time round and that disappeared on its own eventually, but this time it's a pain on the outside of the lower leg going down to the ankle and a numb feeling in the top of the foot.

It feels almost as if my ankle has been held in a vice during surgery and feeling is gradually coming back to it, most odd.

 

[Adicoll]

Hi lindylee yes that's how I feel like your just getting the feeling back into your legs after the surgery but I'm only feeling it through my operated leg it's weird.

 

[Lindylee]

Same for me Adicoll, just the operated foot. I can't feel it now whilst sitting here. It gives the sensation that the foot is cold, but it isn't when I touch it. It must be down to a nerve I think.