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TKR TKR September 8th

Sherben

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Hello everyone. I’m new to this forum - or any forum in fact. I’ve been recuperating at home since the day after surgery and find it very ironic that they send you home just as you are starting to have the worst of the pain (2nd and 3rd days after surgery). I’ve been having at-home PT and a LOT of stiffness and swelling around the knee. I’m trying to do the exercises that they give me, but having trouble with lifting the leg from a sitting or laying position and am starting to think it may have to do with the tourniquet during the surgery.
Have any of you had this trouble?
 

Pumpkln

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@Sherben
Welcome to BoneSmart, glad you joined us!
Many members have log leg after TKR or THR, as you heal your muscles will start working, it is from muscle inhibition after the trauma of surgery. It is a protective response to keep you from moving an injured limb.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access these pages on the website


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 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.
 

leejaa

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Hi and welcome to bonesmart. You are very early in your recovery journey. Lots of healing has to happen and the knee decides how fast that will happen. Lots of resting with leg elevation and icing is important as well as taking medication on a schedule at this point.

I did very few exercises except for ankle pumps and heel slides. I would try the other ones and when I could not do them I waited a few days. My PT was not worried she told me we are just checking to see how you are doing and we will not force any motion your leg is not ready for.

Read the articles provided as they are really helpful. Just click on the topic and the article will open. I hope you have a peaceful night.
 

Bob1653

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@Sherben I had my TKR on the same day as you. I actually had better movement last week than I do now. The bruising on my leg is still looking worse each day. The soreness in my thigh is getting better but my knee is still extremely swollen and hard to flex. Good luck on your recovery.
 

Jaycey

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@Sherben Welcome to BoneSmart! I would focus more on icing and elevating versus exercise at this stage. Getting that swelling under control will mean you ROM will naturally increase. No need for any forcing the knee.
 

Jockette

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Many members have log leg after TKR or THR, as you heal your muscles will start working, it is from muscle inhibition after the trauma of surgery. It is a protective response to keep you from moving an injured limb.
This is the first time I’ve read, or at least really noticed, this excellent explanation. Thank you, Pumpkln!
 
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Sherben

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Thanks @Bob1653. I’m not sure I’m doing this right, but the same holds true for me. PT came to me later in the afternoon day of surgery and measured that I could bend my knee over 100 degrees - told me that’s the 2 wk goal! Ha ha! The Surgeon came in and told me that’s the 6 wk goal. I went home the day after surgery and have had 4 home PT sessions and most recently measured about 70 degrees. PT is brutal and swelling and stiffness are the worst after PT.
Is the bruising on your leg on the upper thigh from the tourniquet? I don’t have any bruising other than that because I have a waterproof dressing over the incision that can’t be taken off until my 2 week post op check with the surgeon. I’ve really noticed that when I get up in the morning after sleeping with my leg elevated all night the swelling is at the minimum. Good luck to you too! I was unaware of the opinions that this forum has until I joined last night. They seem to be against PT
 
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Tykey

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The bruising on my thigh took a few weeks to resolve, probably about a month. Here in the UK it's referred to as a dead leg. No worries, there's nothing amiss, it'll gradually disappear.
 
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Sherben

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I wouldn’t have known that they used a tourniquet if the Nurse in the hospital hadn’t told me and said that it would be sore!
 

Pumpkln

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PT came to me later in the afternoon day of surgery and measured that I could bend my knee over 100 degrees
That is fantastic ROM when you are being discharged from the hospital.
4 home PT sessions and most recently measured about 70 degrees. PT is brutal and swelling and stiffness are the worst after PT.
Your PT appears to be out of date, suggest you stop PT or ask for another PT who is current with their continuing education.
Swelling and stiffness should not be increasing after PT, normal muscle soreness that goes away is OK, discomfort is OK. Brutalizing your poor knee that has had recent surgery is only setting your recovery back.
Saying no to therapy - am I allowed to?
I’ve really noticed that when I get up in the morning after sleeping with my leg elevated all night the swelling is at the minimum.
Your knee seems to be doing a pretty good job at night healing itself, and given half a chance it will continue to heal during the day with out being brutalized during the PT sessions you are having.
They seem to be against PT
We are not against PT, we promote gentle appropriate PT, individually designed to fit the needs of each of our members. Excellent individualized PT care will promote healing not set you back.

A PT can help you with finding ways to reduce pain with ice, elevation, and TENS, gait training, gentle exercises, and how to pace yourself so you do not cause additional irritation to your knee.
 

leejaa

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Reading your thread where you described your PT as brutal made me cringe. I have had 4 joint replaced and never had brutal PT. I did speak with each PT person and discussed their philosophy and we agreed too much pain and movement adds to swelling and delays flexion/extension and healing. I have had really good recoveries with this philosophy.

Please do not do brutal PT. It is counterproductive.
 
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Sherben

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I’m already just about finished the at home PT. They insist that you have to push to the point of pain to make progress. I will be discharged from them Monday and see my surgeon Tuesday and see what he says about all this.
 

Bob1653

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Is the bruising on your leg on the upper thigh from the tourniquet?
My bruising is primarily along the inside of my leg. It goes from the upper part of my thigh down to my calf and is all different colors. Had a lady at PT today say it looks like a Picaso.lol

As far as PT goes, I do what I am comfortable with. I try to push past the uncomfortable part but I stop before it gets painful.

My OS told me to remove the water proof bandage Thursday after surgery (2 days) and ok to take showers, just don't sit in water like a bath. Plus my incision his held closed with steri-strips only. A solid row of strips all the way down either overlapping or touching edge to edge.
 
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Sherben

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Wow! Things are so different here. My PT wants me to push it to the point of agony, my surgeon is going to take the waterproof dressing off at the 2 week Post Op, and I have no bruising down my leg like you describe. My PT told me yesterday that some people have this knee replacement and get up and about like nothing and don’t have pain and some have trouble and need a lot of PT, etc. That got me a bit down.
 

Jaycey

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My PT told me yesterday that some people have this knee replacement and get up and about like nothing and don’t have pain
You can tell when a PT has had zero experience with joint replacement. They say silly things like this! Sure, some people don't experience pain as others do. That's why PT shouldn't be "one size fits all".

Please don't ever compare your recovery to any other recovery. You are doing really well for only days out of major surgery.
 
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Sherben

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I don’t think that this PT has had zero experience - and I do understand that each person has their own unique recuperation, even if they have different joints replaced over time. I think I am doing really well, but I definitely need to clarify with my surgeon about what PT should feel like when I start outpatient PT on Wednesday On a lighter note, this experience has opened my eyes as to how much my husband does not know about everything related to the kitchen and grocery shopping!
 

Jockette

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My PT told me yesterday that some people have this knee replacement and get up and about like nothing and don’t have pain
This would be an extremely rare occurrence. All that statement does is discourage people having normal recoveries.

That got me a bit down.
Pushing to agony in PT, or in doing exercises at home, is not going to help you heal and can cause unnecessary setbacks which can lengthen your recovery.
 

Mrs. Ciz

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I wouldn’t have known that they used a tourniquet if the Nurse in the hospital hadn’t told me and said that it would be sore!
When I got up to use the bathroom on the evening if my bilateral TKR, I was shocked that my knees didn’t hurt at all but my thighs were screaming in pain. I asked the nurse why my thighs were hurting so badly and she said it was from the tourniquets. She said it really affects some people horribly and others not at all. That pain went away after the first week or two.

As for bruising, I was black, blue and green all over my calves, shins and feet. There were a few bruises on my thighs, but my lower legs were the worst.

Dead leg - I couldn’t do my leg lifts on my own until well into week 2. I needed my husband or my daughter to lift the leg the first little bit off the bed, and then I could lift it the rest of the way. I did the leg lift exercises with their help until my leg woke up, and I could do them on my own.
 
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Sherben

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Thank you for sharing your experience with me! I can’t imagine having both knees done at once!!
 

Dizzy

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Wow! Things are so different here. My PT wants me to push it to the point of agony, my surgeon is going to take the waterproof dressing off at the 2 week Post Op, and I have no bruising down my leg like you describe. My PT told me yesterday that some people have this knee replacement and get up and about like nothing and don’t have pain and some have trouble and need a lot of PT, etc. That got me a bit down.
I think your PT is full of ****! Get a new one!!
 

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