TKR TKRDogMom's Recovery RTKR

[TKRDogMom]

I thought I would get started (finally) with my recovery thread. I had my right TKR done Monday 8/29. I was only in the hospital one night and then home. I was rather out of it and slept a lot the first couple days. When I was "awake", I was trying to focus on my exercises and getting things done that needed done. I came home to my 5 dogs. My son and his wife made the trip to my house both the first and second nights home but had to go back because of his work and no days off. My sister stopped by those same two days and said she would be here for me but seems to have ghosted me. Not even a text as to how I am doing. My mother has been in contact to check on me as has my aunt but they are both reliant on walkers and live alone so wouldn't be help physically if here. I have been doing okay anyway. The dogs have been very well behaved around me. They are able to get in and out and have a large fenced yard. I have worked out a system with half gallon bottles with tops to carry in my walker basket to fill their water dishes. I have been getting rides to and from PT from co-workers (I work and live in the same town where my PT is).

The hardest day was yesterday (Thursday 9/8). I did some good stretches and exercises Wednesday and was feeling good about my progress. Then after I tried to go to sleep that night, horrible pain started in my lower leg and ankle. I dismissed a blood clot since I'm still on the Eliquis prescribed after the surgery. I have a non-union of the fibula in my right leg from a break that was never set in May 1987. It has hurt and affected my gait since then and I have not been able to run or do certain things I used to (play basketball or tennis) since then. My son was born in 1989 and I was never able to "run" and play with him, just gimp along. Over the decades when the pain really flared up, I have gone to orthopedic surgeons and have always been told that "it shouldn't bother me" and that they take parts of the fibula out to do bone grafts. Well maybe it "shouldn't" bother me but it has since it happened. I did have one surgeon tell me that probably at the time it happened, something happened to either my knee or my ankle and that's why it hurts. My biggest fear going into this surgery was that I would get the knee replaced but the lower leg would still hurt and I still wouldn't be able to walk without pain. I guess I may be right. The oxycodone they prescribed after surgery (which I hadn't been needing) didn't even touch this pain. When I went to PT Thursday, they sent me to the ER to be checked out. I was correct about not being a blood clot due to being on Eliquis. The ER doctor said that since they "realigned" by leg during the surgery, the tendons in the lower leg are probably being stretched in new ways causing pain. He suggested I use heat on the lower leg and rest it. But I'm still supposed to be icing the knee and exercising it. I guess I need to separate my right leg in two.

At any rate, today (Friday 9/9) has been a better day. Onward and upward.

 

[Jockette]

Welcome to recovery, and I’m sorry it has brought on extra pain in the lower leg. The ER doctor does have a good point, there could be a realignment which could cause extra pain in this area.

It’s fine to put heat on your lower leg, if that helps it feel better, and ice your knee at the same time. If not, maybe try icing both areas.

Don’t worry about exercising right now, you are alone (I’m sorry about that!) which means you are getting up and down to do things you have to, and that gives your new knee all the “mobility exercises“ it needs. ROM numbers will improve as you heal, and there is no time frame in which you must regain your ROM.

Regaining our ROM does not require forceful bending or painful exercises.
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.

Just keep in mind all people are 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: 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.

 

[benne68]

The ER doctor said that since they "realigned" by leg during the surgery, the tendons in the lower leg are probably being stretched in new ways causing pain.

Don't worry, this is not at all uncommon.

I experienced the same leg pain once I started walking post-op. My surgeon did an osteotomy in conjunction with my TKR ito realign my leg (which was bowed from having a bone-on-bone medial compartment for so many years!. I had pains that appeared in different parts of my leg -- from my thigh down to my ankle -- at different times during the first couple of months of recovery.

Your body will eventually adjust to this new alignment. But expect it to take time for all the muscles, tendons and nerves to figure out what they are supposed to do now that things have changed.

This is slow recovery that takes a lot of patience. We are here for you!

 

[InkedMarie]

Glad you made it to the other side!

Marie

 

[sistersinhim]

Jockette is correct. Being alone means you have to do everything for yourself. This is taking your own PT all day and night long. That's really all the exercise you need to do. I also recovered alone and had to take care of everything. I felt this was all I needed to do so I never took formal PT. I had my days and nights of pain and found that one day after doing extra chores if I took the next day off and did just the necessary things, I was able to control the swelling and pain more. Right now, gentle movements and time are your best healer. You should see little improvements weekly if you don't over work your knee.

 

[TKRDogMom]

If it was just the knee surgery I had to contend with, this would be an easy recovery. I've had no problem with getting chores done and taking care of the dogs. They have been awesome and real assets to the healing process. Going out twice a week to PT has been working well and pretty much covers any socialization I may require. LOL

The part that is bringing me down and making this both a more physical struggle as well as a mental struggle is that 35 year old non-union of my right fibula. I now know the pain isn't in the actual fibula but the nerves running down my leg to my foot. They have always been pressing against all the calcification at the break point but now that my leg has been straightened during surgery, they are being stretched as well as rubbing. The pain is intense at times, quite often at night robbing me of all sleep. I have been on gabapentin for a long time for restless legs and now the doctor upped it to deal with this pain. It worked the first few days but doesn't seem to be working as well. The pain makes it so I can't sit still but it isn't relieved by getting up and moving. I am mentally wiped out.

 

[benne68]

Happy two-month an-Knee-versary, @TKRDogMom !

Hope you are doing well. Give us an update when you have some time.

 

[Layla]

Aww, You're having a rough time of it, TKRDogMom. I am sorry to read of the pain you're struggling with. I hope you've found some relief since you last posted, and that you've been able to get some restorative rest and feel less mentally depleted. Please let us know how you're doing these days...we're here for you.
Happy Three Month Anniversary. I hope your days are feeling brighter.
@TKRDogMom

 

[TKRDogMom]

Sorry I haven't been on and updating. I'm obviously not a natural blogger. I've been doing great. My formal PT has ended but I will keep up with many of the exercises I learned. I am walking without any assisting devices now. My stamina isn't long but I can manage to get around and do what needs to be done. Stairs are no problem. I have been back to work since October 19th. It was hard at first but no problem now. Any issues I have with the right leg still go back to the non-union in my fibula and related nerve pain. The new knee doesn't cause any problems. Often when walking the real problem is my LEFT knee. So I'm trying to decide when it would be best to get that one done.

Thank you to everyone with all your support. Definitely no regrets or looking back!

 

[benne68]

Thanks for the update! Sounds like you are doing well.

The new knee doesn't cause any problems. Often when walking the real problem is my LEFT knee.

I hear you! During the first 3-4 months into recovery after my RTKR, my left knee complained constantly! Strangely, as righty strengthened and was able to "carry its own weight" (so to speak), the pain in lefty lessened significantly. I thought I'd need a LTKR by now, but it has improved enough that I've decided to put it off a bit longer since it doesn't really interfere with daily living.

Keep us posted on what you decide.

 

[Layla]

Hi there, TKRDogMom
Happy Four Month Anniversary!
Sounds like you're doing pretty well. Sorry to read about your left knee. Hopefully it's not hampering your recovery too much. You'll know when the time is right to schedule surgery for, Lefty. Stay in touch, we'll be here for support!
@TKRDogMom