Revised PKR to TKR Tosh's PKR to TKR Recovery.

[benne68]

It's the small things that I notice that leads me to believe I'm making progress.

Yes! When I realized that, I started documenting my "achievements."

Once a week or so, I would list of all the things -- even the little ones -- that I was able to do that I couldn't the week before. As the list grew, I saw real progress and it helped me stay positive, even when there were small setback, because I knew the improvements were real.

 

[Legseleven]

Once a week or so, I would list of all the things -- even the little ones -- that I was able to do that I couldn't the week before.

This is so useful, I do it too while remembering it’s not linear. Currently I can sit longer without raising the leg.

 

[sistersinhim]

It's a little easier to put on shorts in the morning.

Oh yes! I remember how good that felt when I was finally able to do that without sitting down.

If you have a rocking chair, rocking back and forth can also help with the bend. I did like you and used my tile floor and socks to aid in mine, along with the rocking chair.

 

[Tosh30]

Today starts week #7. With 6 weeks behind me, the little things, again, helped me. The sliding on the floor, as well as a technique my PT showed me, last week was a good week. By Friday, my inflexion measured at 121 degrees. Made me really happy. I'm going to do it again on Thursday to make sure it wasn't a fluke. Sleep started getting better, with Thurs getting a block of 5hrs, Friday 5.5, Saturday 6, and last night I went almost 7hrs. I've settled on 1 Tramadol, 1 Celebrex, and 1 Cyclobenzaprine. I'm thinking of dropping the Cyclobenzaprine tonight to see how it goes, hoping that I'm training the brain. I've been good about stretching on the off PT days - 2min on each IT band, hamstring stretches for 6min, then some back stretches. I feel like it really helps, both the body and the brain. Still walking downstairs backwards, but planning to work on that with PT this week. Dr appointment tomorrow - I'll let you know what he says.

 

[Legseleven]

All sounds very good @Tosh30 however please be very careful with stretching in particular remembering that it takes significant time for the ligaments and tendons to heal. Here’s a chart with the timelines from our files to help you.
I was doing well increasing my walking and gentle floor pedals and then have had a big pain flare so have eased off until it settles. I’ve done no stretching or resistance yet as it’s too soon for me. I’ve been sleeping well for a while, but not tonight, hence the reply now!

 

[Layla]

Great timeline chart above. I found it interesting the first time I saw it.
Best Wishes for your appointment today. You're doing great! Will look forward to your update.
Happy Tuesday, Tosh!
@Tosh30

 

[Tosh30]

Good morning y'all! Yesterday the Dr said the knee looked good. They took X-rays of both sides. We looked at the pictures from that day and before. He mentioned that the materials he used for this replacement didn't use any glue or cement. The screws were visible in the X-ray. Something I wasn't aware of, he put a small piece on my patella. Is that normal with a TKR? With the x-ray in view, I suddenly realized how much more this recovery could be. Of course, he cleared me for anything that is comfortable, but warned me not to overwork anything. Based on the chart, I should expect bone recovery until the end of Sept, but won't push it. To stretch out my insured PT sessions, I went to 2 days/week for the next 4 weeks. I'm competent on doing home sessions on a third day, but only the easy stuff that shouldn't need supervision (like marches, dig and pulls on a ball, etc.). That's the plan for now. I'm also cleared for massage therapy, which I'm going to book today (yeah!). Knee still feels like it's still bunched up inside, which is a reminder to take it easy. Progress was on display at PT where I was finally able to make full rotations on a recumbent bike with no discomfort - stashing that in the "Little things/I'll Take It" file. Stopped taking the muscle relaxer at night as of Monday night. First night was a little tougher, but not bad, and last night was better. In my dream I was playing tennis (heavy sigh - all good tho. I asked him about taking BPC-157 injections for recovery. He said go for it if I wanted to, but he wasn't a proponent of the idea. I'm not going to after that discussion - if the Dr wouldn't do it, I'm not going to. Hope everyone has a great day (or in L11's case, had a great day).

 

[Layla]

They took X-rays of both sides. We looked at the pictures from that day and before.

I found the X-rays stirred a mix of emotions in me. Disbelief, a little sadness, but also amazement and gratitude for the second chance the surgery was giving me. A reminder that recovery is more than physical, it can be an emotional journey also.

I like your "Little Things / I'll Take It" file idea! We should cheer each and every milestone, no matter how small.
Is a return to tennis a goal your OS supports? If so, I hope you're back playing next year. You obviously have a lot of confidence in his opinion, made clear through your discussion / decision on the injection you wondered about.
Your doing great, Tosh! Thank you for the update.

 

[Layla]

The screws were visible in the X-ray. Something I wasn't aware of, he put a small piece on my patella. Is that normal with a TKR?

Forgot to touch on your question -

Screws may be used in both PKR's and also PKR to TKR surgeries. My best advice is to discuss with your surgeon why it's there, IF that's of importance to you.
Have a great Wednesday, Tosh!

 

[Legseleven]

Hope everyone has a great day (or in L11's case, had a great day).

Thank you @Tosh30, so kind.
It’s been a good day, steady, and I’ve been out.
This tortoise is going even slower than before after recovering from an unexpectedly painful weekend.
We will both get to where we need to be on our elastic timescales and yes it’s the little things - out to lunch today was mine.

 

[benne68]

Something I wasn't aware of, he put a small piece on my patella. Is that normal with a TKR?

Yes. If the underside of the patella shows wear, it is common for surgeon's to place a small "button" under the knee cap so it moves more smoothly over the implant. I have one in my right knee.

It's called patellar resurfacing.

Interestingly, a recent study in England found that there are quality of life benefits for patients who undergo patellar resurfacing during their total knee replacement when compared with those who do not. You can read more about the study in this article in the Library.

 

[Legseleven]

Patella resurfacing.

Both of mine were resurfaced last year, and perhaps the only good bits about the bilateral. This year the OS said he only had to shave a bit of the lateral edge of the patella, otherwise it was fine, and he didn’t change the button,

 

[Tosh30]

@Legseleven - Your account is really great to read, as I'm feeling the same way, although I'm not allowed to hang my laundry in my community. The drier will have to do. On a side note, I remember using the 2 in 1 machine in our London flat last year and wondering how frustrating it was that I'd be taking mine to someone all the time if I lived there. Back to business - I'm taking a few pages out of your book. I went off of all meds as of last night. As of Thursday, I was taking 1 Tramadol, 1 Celebrex, and 1 Cyclobenzaprine. Friday I dropped the Tramadol and Cyclo for 2 650 Tylenol, Magnesium, and 1 Celebrex. Saturday I dropped the Tylenol. Last night, I only took Magnesium. Not bad - maybe 5.5hrs of sleep total. Knee definitely feels more convoluted, probably b/c there's no NSAIDs flowing. I've been taking Celebrex since day 1, which makes it 7 weeks total and today begins week 8. Dr. G gave me another 60 days to take, but Dr. Google says that prolonged use isn't great. Don't worry - I've already sent an email to check to see if he wants me to continue, which I will if he says go back. For now, I want to see where I am pain-wise. PT has been good. Now that I hit past 120 degrees, the PT wants me to regain flexibility via motion, not intentional manipulation. All good with that. I'm doing mini-squats (only to comfort), ball exercises, sit and stands to a 28in seat, 6in step ups, and just started 3in step downs. The last one is going to take a little more to get comfortable. Still walking down stairs backwards, which I'm sure is fun to watch. I was supposed to be in Dublin this week, but didn't think it was prudent to travel at this point. My goal is to be ready to travel in Sept, when we head to Italy for a month. I can do this... Being off NSAIDs has reminded me how much my left knee needs to be done also. If it gets really bad, I'll take some Ibu before bed. Icing now for the second time and it's only 950am Hope everyone is doing well and thanks for the support.

 

[Legseleven]

That’s good @Tosh30 you are still doing a lot for 7 weeks, and I know you’re both younger and stronger than me.
I can now go up stairs alternate legs but definitely not down, and it’s sometimes but not every time as I have a lot of stairs, the down comes later as it uses different tendons and is more complicated so I’m not rushing it.
I don’t know if I’ll ever get sit to stand back without using my arms, it’s been an issue since before the bilaterals and I’m just taking it week by week. I’m up to 4.5k steps day more or less, after having to cut back some last week, and this is spread over 3-4 walks. Pedals still for one song, about 3-4 mins and started side steps on and off bottom step x 5 each leg once a day. Plus the extension exercises, and general physio calf rises, chair hornpipe, leg raises etc. Physio tomorrow.

 

[Layla]

My goal is to be ready to travel in Sept, when we head to Italy for a month.

Now THAT is a goal worth working toward!
Keep on healing, strengthening and checking off those recovery boxes one by one. Hopefully your new knee will be ready for some Italian adventures when it comes time to travel.
Happy Tuesday!

 

[sistersinhim]

Wow, it sounds like you are doing quite well, much better than the average recovery. Just be careful to not cause yourself any setbacks.

 

[Tosh30]

Well that experiment lasted about 36hrs. On Tuesday morning, around 330am, I was in Wideawakesville after tossing around for 20min. Really crackly inside and uncomfortable outside. 2 Tylenol and 1 Celebrex, and ice. Back asleep by 5 for a few hours before having to go downstairs to work. It wasn't a failure - I know where I'm at. TKR takes more time than PKR - well aware. Painfully curious

PT on Tuesday afternoon was interesting. 3in step downs have started and they are good until the last moment, where there's a slight burn under the patella. PT instructed me to hold the bar on the way down until that goes away. Leg presses get more weight now, mostly to help get my quad stronger. Seems to be a slight issue. I'll be walking and I'll have a slight buckle b/c of the diminishing but still present atrophy. Quad is getting stronger, just not there yet. Last night I put a lidocaine patch on the knee for some extra help. It does a little, but still not perfect. I'm going to test a bamboo sleeve to put over the knee to see it it helps abate the skin discomfort - I'll let you know how it goes.

@sistersinhim - I'm trying not to push it.

@benne68 - like the article about the Quiet Knee - thanks for sharing.

@Legseleven - I just booked my first post-op massage for Friday afternoon. I requested someone who is familiar with TKR post op condition. Hope you get one soon too - we deserve it.

 

[Legseleven]

@Tosh30 a good report. I have an excellent lady for massages, so it’ll be all good, thank you.
Personally, I think it’s too soon for downward steps with operated leg. If you remember the chart with all the timings on tendons and ligaments etc, you’re still early on in a 12 month recovery.
Again the unengaged quads will come back, yet they can’t be forced. If you’re still buckling at times please be sure to always have a sticking or walking aid, to prevent falls, and sounds like they’re indicating to you it’s too much. Quads can take up to 18 m to fully recover, and my physio says always have one hand on the stair rail, even when fully back on consecutive stairs.
Out of interest is your physio a sports one, general one or a specialist one for TKR?
Keep on keeping on.

 

[Legseleven]

@Tosh30 I had an extra thought about your night pain, the many threads and interactions on here frequently indicate that night pain is often a result of too much work for the knee at the stage it’s at.
My night pain is definitely easing, and today I’m down to paracetamol 3 x day and I am making sure I keep to this for now.

 

[Tosh30]

Happy Sunday!

@Legseleven - heard. Took your advice and changed things up a bit, maybe inadvertently even before I read it.

The house is empty this past week while my wife and daughter were in Ireland, and I took advantage of it. I've gone down to 2d/week with PT. The odd days I'm simply stretching and I take a warm Epsom salt bath 3x this week. I think the massage really helped also. I'm also reminding myself that I'm only starting week 9 on Monday and don't expect it all in one swoop. The swelling has gone down a little and I'm walking with more confidence and haven't buckled in a few days. I think another major contributing component I'm experiencing is the incredibly persistent and super sensitive skin. I run my fingers over the area and it feels like there's a layer that doesn't have any feeling. If a strong breeze runs over the area, I'm annoyed. Certain fabrics kill me - denim especially. From my research and Dr's explanation, its from cutting the nerve endings and waiting for them to heal. My left (still partial) was done on Jan 9, 2025 and it's still sensitive. April this year I had bone scans done of both partials and we could see the red blood cells being directed to both the knees. Does this mean there's residual inflammation that I'm not noticing in the LK that I'm not noticing b/c I haven't seen a non-swollen knee in 10 years? Is this inflammation pushing out on the incision area and a contributing factor to the sensitivity? Man I hope so. That would mean that if this RK TKR is successful, I'll feel better on that side. Lidocaine or Capsaicin patches have helped a little. I'll wear one if I have to wear long pants, and I wear one to bed. I found a bamboo knee sleeve and I'm going to test that out to see if it will work instead of a drug patch. All that said, sleep has been a little better. Last two nights were solid 6hr straight - yeah! Sorry for the rant. I'm definitely in a good mood, very thankful for everything, and I'm acknowledging the healing milestones.