TKR TKR September 30

[spikesnewknee24]

Glad I found this site; had my TKR September 30 and have been very slow in making recovery/bending progress, so I am hoping to compare others' experiences and learn. I have gotten to 90 degrees with the aid of a CPM (continuous passive motion machine), and had an MUA (manipulation under anesthesia) on Nov 4 (5 weeks post surgery) because I could only get to 59 degrees with my PT (2-3x sessions) and my own PT activity. I continue to have swelling and stiffness in the knee; use an ice therapy machine 3-4x daily. I can walk slowly but not yet driving. Concentrating on making steady progress every day.

 

[benne68]

Welcome to BoneSmart, @spikesnewknee24

So glad you found us while you are still in the early days of this year-long recovery. 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 we are all 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 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.

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?

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

Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics

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 continue to have swelling and stiffness in the knee;

This is actually very common at your early stage of recovery. As long as there is swelling inside the knee, it will feel stiff and the inflammation will restrict your bend. Icing and elevating as much as possible are important to getting the inflammation under control.

Please read through the articles I shared above. The advice here made a huge difference in my two TKR recoveries and I know it can help you as well.

Also, please let us know which knee was operated on so we can finalize your signature.

 

[spikesnewknee24]

Thank you ok I’ll keep focusing on reducing the inflammation and swelling; it was my right knee

 

[benne68]

I shared this chart earlier today with another member who is worried about ROM is being blocked by swelling and inflammation, no amount of pushing and shoving will increase your ROM. Your knee needs rest, ice, and elevation to help get the swelling and inflammation to calm down and allow your knee to reveal the ROM that has been there all along.

Here is a chart of progress made by members whose ROM returned slowly but surely.

Campervan’s ROM history
92 - 8 weeks post op
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months

Bertschb’s ROM history
2 months - 80 degrees
4 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
12 months - 140 degrees

TortiTabby's ROM
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks: 120

 

[Jockette]

Hi and Welcome!

I’m another one who had a tough time with ROM. But, I continued to have a lot of improvement all through my second year, as my whole leg continued to relax and heal.

 

[spikesnewknee24]

Hi to my fellow MUA’ers,

I had my second MUA this week, Wednesday. The first was done 11/4 and before it I was stuck at 49 degrees after my Right knee TKR on 9/30. I had some post surgery blood pressure problems and had to be admitted to the hospital so that slowed down my bending ability. Then I had knee spasms once home and my PT sessions were delayed getting started. After the first MUA I was able to get to about 70 but still had severe pain in my left inside knee every time I or my PT bent it up or tried to pass that 70 degree mark.

My surgeon recommended a second MUA and I’m glad I did it; once home on the same day I was at 120 in the CPM (only ever got to 102). And the next day with my PT and then on my own I was at 102. Today I clocked in at 107 by myself. Whew.

The surgeon reported that he broke up scar tissue during the second MUA. The pain in my inner knee experience before the second MUA is no longer there. My bending now feels like a strong tension across the knee and in my thigh muscles rather than a sharp pain isolated to one side of my knee like before.

I hope this is helpful.

 

[westiemom]

Hi to my fellow MUA’ers,

I had my second MUA this week, Wednesday. The first was done 11/4 and before it I was stuck at 49 degrees after my Right knee TKR on 9/30. I had some post surgery blood pressure problems and had to be admitted to the hospital so that slowed down my bending ability. Then I had knee spasms once home and my PT sessions were delayed getting started. After the first MUA I was able to get to about 70 but still had severe pain in my left inside knee every time I or my PT bent it up or tried to pass that 70 degree mark.

My surgeon recommended a second MUA and I’m glad I did it; once home on the same day I was at 120 in the CPM (only ever got to 102). And the next day with my PT and then on my own I was at 102. Today I clocked in at 107 by myself. Whew.

The surgeon reported that he broke up scar tissue during the second MUA. The pain in my inner knee experience before the second MUA is no longer there. My bending now feels like a strong tension across the knee and in my thigh muscles rather than a sharp pain isolated to one side of my knee like before.

I hope this is helpful.

Thank you for your report. I am at 8 weeks, going on 9, and the best ROM was 82 with the PT hurting me. The next week I was 78. PT is very concerned about my regression (what alone lack of progress) and actually contacted my ortho dr. to advise him. I have an appointment 1/15 with him to discuss options. I am so lost in trying to decide what to do - continue with PT and maybe start to actually progress slowly or do the MUA and start over again with the pain, swelling, no sleeping, etc. Your story about how your ROM was so low and how much better you got after the MUA is encouraging to me.

 

[Layla]

Three months to date since your TKR. Happy Three Month Anniversary!
Wondering how you're doing over the past couple of weeks since your last MUA? I hope you're pleased with your progress.
Best Wishes and Happy New Year!
@spikesnewknee24

 

[spikesnewknee24]

Hi to my fellow MUA’ers,

I had my second MUA this week, Wednesday. The first was done 11/4 and before it I was stuck at 49 degrees after my Right knee TKR on 9/30. I had some post surgery blood pressure problems and had to be admitted to the hospital so that slowed down my bending ability. Then I had knee spasms once home and my PT sessions were delayed getting started. After the first MUA I was able to get to about 70 but still had severe pain in my left inside knee every time I or my PT bent it up or tried to pass that 70 degree mark.

My surgeon recommended a second MUA and I’m glad I did it; once home on the same day I was at 120 in the CPM (only ever got to 102). And the next day with my PT and then on my own I was at 102. Today I clocked in at 107 by myself. Whew.

The surgeon reported that he broke up scar tissue during the second MUA. The pain in my inner knee experience before the second MUA is no longer there. My bending now feels like a strong tension across the knee and in my thigh muscles rather than a sharp pain isolated to one side of my knee like before.

I hope this is helpful.

Thank you for your report. I am at 8 weeks, going on 9, and the best ROM was 82 with the PT hurting me. The next week I was 78. PT is very concerned about my regression (what alone lack of progress) and actually contacted my ortho dr. to advise him. I have an appointment 1/15 with him to discuss options. I am so lost in trying to decide what to do - continue with PT and maybe start to actually progress slowly or do the MUA and start over again with the pain, swelling, no sleeping, etc. Your story about how your ROM was so low and how much better you got after the MUA is encouraging to me.

Oh I’m so glad you found this helpful in your decision making. It’s scary too when the surgeon says the 3 month window is closing. I know there are different opinions about that. I just felt in my case I was struggling with a lot of pain and limited in my pt abilities. I am now driving and played tennis today for the first time (I didn’t move much but it felt great to hold the racquet and hit a few balls with my friends). I can also use the recumbant bike with full rotation and get up to 50 min/10 miles and it feels like I’m exerting myself but not in pain.

 

[spikesnewknee24]

Three months to date since your TKR. Happy Three Month Anniversary!
Wondering how you're doing over the past couple of weeks since your last MUA? I hope you're pleased with your progress.
Best Wishes and Happy New Year!
@spikesnewknee24

Thank you Layla! Yes I am doing much better since that second mua. I can drive, use the recumbant bike, and do my pt without as much pain as before. My ROM is at 109. I continue to use the CPM for bending and PT appointments 2x week. Things seem to be progressing nicely now.

 

[mendogal]

Oh so happy you're making progress!!!!

 

[Layla]

Wonderful news! Thanks for responding.
I am happy for you making such great progress. May it only get better!
@spikesnewknee24

 

[spikesnewknee24]

Question about dental cleanings post-surgery: When do folks generally schedule their first dental cleaning after a joint replacement? I was told that I'd need to be on antibiotics before each dental cleaning/appointment for two years following my TKR. I am trying to wait as a long as possible for a dental cleaning because it seems a little risky with the risk of infection and a new body part.

 

[spikesnewknee24]

Jan 9 update (14 weeks post surgery and 4 weeks post second MUA)

ROM: measured at PT 122! I began the session at 112, then went up to 119 after cupping and scraping/massage, and the final measurement was 122. No pain.

I can do air squats, recumbent bike (40 minutes full rotation), no pain; comfortably do heel slides with strap and without. I was also on the leg extension machine at PT, 20lbs, for 4 sets of 8-12. And I did TRX assisted deep squats which felt fantastic.

My quad muscle started coming back online about 2 weeks ago. At my last surgeon checkup 12/26, he checked that it was activated and it was--just not strong enough yet so advised me to continue doing the quad kicks (surgery leg on a foam roller) and quad sets.

My PT gave me an awesome band exercise which helped me learn how to walk with a nice rotation and follow-through/lift. Overall, I am feeling really strong and progressing nicely at this point. I even played pickleball last night, standing, no lunges or movement, just let my partner do all the running around.

 

[eaglemom]

It sounds like you are doing fantastic. Your numbers certainly are good. But don't just concentrate on the number, concentrate on proper form walking - heal toe. Your numbers will continue to improve over the next year or so.

As for a dental cleaning, personally, I'd put it off a bit longer. But that's me. My surgeon always has his patients have a dental cleaning 2 months prior to surgery. He also has you take antibiotics prior to any dental procedure post surgery. His rule is 6 months post surgery. Again, that's my surgeon and how I handle it. Different dentists and surgeons look at it differently - both of mine tend to be more conservative and I just follow their rules!!

 

[spikesnewknee24]

Mid-January update: 15 weeks post surgery and 5 weeks post second MUA

I am progressing nicely, maintaining 122 knee bend and getting to 128 in this week's PT session, feels nice and easy to bend the knee. I am working with my PT on resistance band training, to help with knee extension, quad strengthening, and doing unassisted squats, these also help me with improving my balance. She performs cupping along the top and sides of my knee, and up along the quad muscle. The numbness on the right side of my knee/lower calf is starting to go away.

Stairs: Stairs deserve their own section. I am now able to walk up stairs (holding on to the railing) and when coming down stairs, I can now fully bend my knee and lead with my unoperated leg, quite comfortable, still holding onto the railing, taking it slow, and doing this from about the fifth step down to level floor. I'm not quite ready for a full flight of stairs. Getting there though.

At home, my regimen is a combination of: heel slides (both with a strap and without), sitting with the knee bent underneath my chair for about 5-10 minutes, calf raises (my right calf is smaller than my left), extension exercise (laying with the legs off the bed, on the stomach), resistance band exercises for quad/knee bend/extension. Sleep is improving and sleeping on my side has gotten so much more comfortable. I have a surgeon check-up next week and am excited to show him my progress after that second MUA.

 

[spikesnewknee24]

It sounds like you are doing fantastic. Your numbers certainly are good. But don't just concentrate on the number, concentrate on proper form walking - heal toe. Your numbers will continue to improve over the next year or so.

As for a dental cleaning, personally, I'd put it off a bit longer. But that's me. My surgeon always has his patients have a dental cleaning 2 months prior to surgery. He also has you take antibiotics prior to any dental procedure post surgery. His rule is 6 months post surgery. Again, that's my surgeon and how I handle it. Different dentists and surgeons look at it differently - both of mine tend to be more conservative and I just follow their rules!!

Hi there, thanks for your reply and words of encouragement--I'm reporting my ROM because I was stuck at 59 and then 90, and needed to have two MUAs so it's something I'm definitely curious to track, report on and suspect others will be interested in too. It's important to me to share and record this in case it's useful to others who experienced a similar "stuck" situation. Plus every degree change is such a triumphant feeling.