TKR Tourniquet feeling

[Candyapple]

I'm 17 weeks post op and my knee feels like there's always a tourniquet around it. The surgeon and PT say it's scar tissue and to give it time, but is thete anything I can do in the meanwhile for relief?

 

[Layla]

Hello and Welcome to BoneSmart and recovery. Thanks for joining us! Please leave the date of your TKR and which knee was replaced so we're able to create a signature for you.

I will leave an article on the tight band sensation you described you're dealing with, along with our Recovery Guidelines of which some may still apply. If you're not already, try OTC meds as necessary for relief until it eases for you.
"Tight band" feeling across the front of my knee
Best Wishes as you continue healing, Candyapple!

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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​

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.

 

[JusticeRider]

Candyapple, I still have it at more than 5 months post op. It’s a lot less intense now than it was earlier on, more of an annoyance than actual pain. I think it will go away as more time goes by (hope so!) but even if it doesn’t, I’ll take it over that sharp stabbing pain I had before surgery any day!

 

[Candyapple]

Thank you! My pt says it happens to 20% of patients, so of course I'm in that 20%. I find it causes stiffness and sometimes pain, but I'd rather not take pain meds. Any ideas on exercises to help?

 

[Candyapple]

Hopefully this is posting in the right place for Layla. It was my right knee, total replacement using MAKO, on Oct 12, 2022

 

[LD of Michigan]

I think it will go away as more time goes by (hope so!) but even if it doesn’t, I’ll take it over that sharp stabbing pain I had before surgery any day!

I hear you on that. My RTKR hurts sometimes if I overdo it at the gym but I can live with that over the weak-collapsing problem I had before surgery.

 

[LD of Michigan]

My pt says it happens to 20% of patients, so of course I'm in that 20%..

I too get get that tourniquet tight-band feel behind the knee this TKR compared to my RTKR in 2019.
It is lessening but I was surprised initially that it happened... No two TKRs are the same.

 

[Candyapple]

Hopefully mine will lessen too. It's been 3 and a half months. Glad to know it's not permanent because I couldn't do that

 

[trinket]

I'm 8 weeks post surgery and everything is coming along just great, however, I still have that tight band around my knee. It is getting a bit better every week. My surgeon said it's normal, but will eventually go away. Edited to add ... it does feel better when I do some quick heel slides and extension exercise.

 

[benne68]

@Candyapple This article in our library gives a bit more information.

Tight Band feeling across the front of my knee

That tight band is caused by scar tissue but not the adhesions type of scar tissue. When the surgeon opens up the knee, he has to undercut the skin and superficial structures from that centre line to each side of the knee in order to get good access all round the bones. Part of the healing...

bonesmart.org

I found that icing, elevating and keeping up with pain relief medications (Tylenol or Advil) helped a bit, but, for me, the only really "cure" was time.

Remember, this is a year-long recovery, so you are still less than halfway there.

 

[EalingGran]

I still have tightness too at about 14 weeks post PKR. It is better with stretching and exercise and gradually improving. It is worst if I stand for any length of time.

 

[Candyapple]

Unfortunately, acetaminophen not only doesn't touch it, but it makes my liver really mad, even when I take less than the RDA. Ibuprophen makes kidneys and stomachs angry, so it's a trade off I suppose. It's discouraging to not notice any improvement at all, despite religious pt and 3 and a half months.

 

[JusticeRider]

Candyapple, I hear ya! It is really hard mentally when you feel like you’re spinning your wheels and you’re never going to be normal again. If it makes you feel any better, my recovery really turned a corner at about 4 months. It was creeping along at a glacial pace, but it is picking up speed now! I know it’s hard, but try to just take one day at a time and not push too hard. You’ll get there! It just takes a while. Apparently about a year. Dig in for the long haul friend.

 

[Candyapple]

It's sometimes hard to give it time when I see zero improvement, and nothing I do helps. Hopefully I will turn a huge corner at some point like you did. To make it worse, I have a torn peroneal brevis tendon in my ankle on the same side, so the knee makes some of those pt exercises more difficult. Hopefully time will help!

 

[JusticeRider]

Oh no, an injured ankle too? I’m sorry you’re dealing with all this That is probably slowing down your knee recovery. Last year, I was trying to recover from a hip surgery with a very painful knee and it sure made my hip recovery harder. Hang in there and baby that knee and ankle. The icing and elevating will help both. The mental part can be the hardest.

 

[Jockette]

My pt says it happens to 20% of patients, so of course I'm in that 20%

I think more than 20% have this tight band feeling. It’s par for the course for this recovery.

It's discouraging to not notice any improvement at all, despite religious pt

Unfortunately religious PT may be contributing to the tight band. Movement for the knee is good, but too much is not good. Try cutting back and give your knee more time to heal. If you still have a lot of swelling, ice and elevation are very helpful. If you don’t have much swelling, then elevate as much as you can, even if it’s just an ottoman level. I slept every night with my leg on an elevation wedge.

It's sometimes hard to give it time when I see zero improvement, and nothing I do helps.

Since nothing you are doing is helping, try not doing some things. This is a long recovery. Don’t look at cutting back the exercises as doing nothing, look at it as giving your knee the best opportunity to heal.

 

[EalingGran]

To make it worse, I have a torn peroneal brevis tendon in my ankle on the same side,

So sorry to hear that and I am sure that is not helping your recovery. Everything seems to hit you when you are down and it is so hard to see the light at the end of the tunnel. My own recovery is slow and not helped by other joint issues- although some have definitely improved with straightening my valgus deformity.
I also know what you mean about not tolerating pain killers. I managed to take naproxen by taking omeprazole first thing in the morning and then taking the naproxen an hour later with food.

 

[Sades]

I had my left knee done in July 2021 and then the right one in March 2022. I am still feeling that tightness and pain. The first knee was going pretty well but started acting up after I had the second one done. I ended up with bad scar tissue which my surgeon broke under anaesthetic. I felt like I had a spare tyre around my knee which disappeared after the manipulation. I did more physio after that which seemed to work. Both knees have that tightness and nerve pain. Is that normal after all this time?

 

[Candyapple]

Wow! The thought of that feeling lasting 11 months is brutal. I have no choice but to reduce exercises, because I have them for neck, shoulder, hip, knee, and ankle issues and to do them all takes 2.5 hours. There's no swelling, so I don't ice. It gets tricky because I'm told to walk for knee and not walk for ankle, so advice is conflicted. Makes me wonder if this is the new normal with the aging process! I guess giving it more time is the best option. Thanks!

 

[EalingGran]

It gets tricky because I'm told to walk for knee and not walk for ankle

That's tough. You are right about getting older. It does seem as though each day brings fresh challenges and it is really hard to keep positive....
Good luck!