TKR Two days forward, one day backwards

[Layla]

Three months post op already, Happy Three Month Anniversary, alija!
I hope you have a wonderful month of March and a great rest of the week.
Take good care!
@alija

 

[alija]

13 weeks tomorrow and slowly improving. Gentle unassisted walking without aids and restricting distance to less than a mile as leg is very sore afterwards. Most I have driven is 45 minutes but am selective about avoiding busy periods. Nice to be a bit independent now and have resumed lots of socialising. Disappointed that leg is so painful at night, turning over still makes me squeak and my foot and calf start to become numb if I don't use a pillow. Massaging foot to thigh has been really helpful. Optimistic enough to have booked Greek Island hopping in May.

 

[benne68]

13 weeks tomorrow and slowly improving.

Optimistic enough to have booked Greek Island hopping in May.

That is SO great to read!

While I know 13 weeks seems like a long time, you are still only about 1/3 of the way through this year-long recovery. Pain and stiffness are completely normal at this stage. Your body is still in healing mode from all the trauma inflicted upon it during surgery. Continue to ice and elevate and take something for pain when you have a busy day.

You are doing really well and I'm sure you will be able to enjoy your trip in May!

 

[WillB]

Alija…Your story is similar to mine. I am 7 weeks now and while there is improvement every week it is often minimal and good sleep continues to be a nightly struggle! Sometimes a contant ache and other times stabbing pain when moving to a new position. I take a Tramadol every night along with 300mg of Gabapentin and 1000mg of Tylenol. My knee is still quite swollen and stiff. And I often get a wierd spasm like sensation which radiates down my entire leg. Have no idea what that is all about. I was able to drive to Vegas and back (900 mi) two weeks ago and knee handled it pretty well. It felt good to get out.
I am having a lymphatic drain massage Friday which I hope helps with the swelling.
My ROM could be better but I am not stressing over it. This has been a pretty tough mental challenge. Tough to stay positive especially knowing I have a long way to go!!! This site has been a Godsend

 

[alija]

Over 14 weeks and have had setback over the last week. Have stopped driving as my stiff clutch is too painful and garage says it can't be slackened. WillB, those weird sweeping contractions, which had all but gone a few weeks ago, are now back with a vengeance. I bought a percussion massager but on the lowest setting it is too strong and makes things worse. I massage the whole of my leg daily and am back to icing. The real disappointment is that I can't turn over in bed without supporting my calf and if I forget then my foot tingles and there is a feeling of pressure under the arch of my foot. I still can't walk the stairs normally as the power in my leg just isn't there. I have been doing specific piriformis and gluteus minimus exercises which has helped the thigh but really feel I should be further along. It's so hard not to compare with friends who seem to be almost back to daily life at 8 weeks or so. Taking meds on demand. Pain and numbness is mainly down the outside of my leg. Starting to worry there is something wrong.

 

[Jockette]

It's so hard not to compare with friends who seem to be almost back to daily life at 8 weeks or so.

The operative word here is “seem” to be back to normal at 8 weeks or so. If you lived with them, their recovery might look very different. Very few of our members were back to normal at 8 weeks, or even 12, or 16.

Now almost 12 weeks post op

I ditched the walking stick on my longer walks (1/2 - 1 mile) this week and think this is why I'm experiencing so much pain afterwards. Yesterday both my legs were cramping and I could hardly get home. Have driven short distances twice and feel quite confident but the pain afterwards is unpleasant, probably because my clutch is very stiff. On the upside I have done some trimming back in the garden and some ironing so feel more normal. Am trying to be patient but my knee is still quite swollen and gets hot after minimal activity

It’s only been about 2 weeks since you wrote the above. It can take a lot longer than that to recover from an activity that increases pain. When I was 4 months post op I went away for the weekend and totally overdid it, trying to keep up with our friends. It took a month to begin to improve again.

If your knee is still quite swollen then you really do need more rest, ice and elevation, even if that elevation is just with your leg up on an ottoman or on the couch. I elevated with a foam wedge all night, every night to help my swelling.

 

[Flashlight]

It sounds like you have been pushing yourself too much. I don't know anyone who was back to normal at 8-weeks. I was still sleeping in my recliner at 10 weeks! I had to lift my leg in and out of the car. The numbness on the outside of my knee is the same at almost 7-months. I was told by my OS this is normal. I don't think it has decreased but I know I don't pay attention to it because it is part of me now. My lower leg feels more like it should. At first there was a lot of numbness below my knee. I have been taking Magnesium at bedtime for a few years now for leg cramps. Unfortunately, it is one of the side effects of my cancer medication. It does help. Also, you need to stay hydrated. If your knee is swelling and stiff, you are doing too much. By 4-months I started to turn a corner. hang in there!

 

[alija]

17+ weeks update.
Improving slowly until I reintroduced driving again this week. Drove 100 miles over 5 days, in traffic with lots of clutch work and the knee doesn't like it. Having to rest up again and am back on the Tramadol and Paracetamol morning and night. Ice a couple of times a day, followed by thigh and knee massage and a session with a warm beanbag which always helps. Sleeping is slightly easier, down to one pillow for leg support but still painful enough to make me shout when I turn on side. Few weeks ago I could slowly walk upstairs alternately, holding the rail, but unable to attempt that now. Mostly painful to bend knee and thigh feels like it might give way sometimes. Taking magnesium for this. My partner has just bought an automatic car so I am going to learn to drive this so my left leg gets a rest. I am not a great lover of TV but I have watched so much lately with my leg up on the sofa. Would love to hear from people who have had the same experience this far into the journey and how it panned out.

 

[Layla]

Hang in there, alia! This recovery can take a full year and many notice improvement into their second and even third years post op. I hope you have a nice weekend. Happy Four Month Anniversary!
@alija

 

[EalingGran]

Would love to hear from people who have had the same experience this far into the journey and how it panned out

We are 5 weeks apart- I am 22 weeks post my PKR.
I drive an automatic but certainly would have struggled if I was using my operated leg for gear changes at 17 weeks.
I still get some stiffness/ swelling by evening but can walk pain free 5 miles/ day regularly and up to 7 miles/ day occasionally.
It is strange what still irritates my knee. I went to the theatre yesterday afternoon and the seats were quite cramped with very little leg room in front. My knee ( in fact both knees) got quite sore and my operated knee was a bit warm after sitting in the same position for a couple of hours.
I do feel my knee is gradually getting stronger though and there has been improvements in the last 2-3 weeks.
I can walk up stairs normally more often- although I still put some weight on the hand rail and go down stairs normally sometimes at the beginning of the day without pain.

 

[alija]

20 week update:

Improvements: Can turn fairly easily at night if I support lower leg. Down to 1 pillow. Only take OTC meds occasionally when necessary. Almost no pain on resting. Can carry a bit of weight now. Massage whilst having toes above nose really helps.

Setbacks: Not driving at all now, takes about 2 weeks of resting afterwards if I do and this just isn't practical long term. Pain and swelling after any activity, even walking round the house and the swelling has reduced my flexion back to 90 making walking normally almost impossible. The awkward gait also makes me unsteady and more prone to tumble. Was almost able to climb stairs a few weeks ago, hanging onto the rail, but no longer possible as I can't lift leg high enough unless I swing it out to the side first. I think all the previous resting has caused some Quads muscle loss so am exercising to improve this. My pattern seems to be increased pain and swelling after any mild activity, which seems to take at least 10 days to get back to where I was, but then a very slow, creeping improvement. Truly 2 steps forward and 1 back!

 

[Layla]

Hello alija,
I am wondering about the driving. Is stiffness from sitting in a confined space for a length of time what you’re experiencing? This along with the mention of “pain and swelling after any activity, even walking round the house” and “was almost able to climb stairs a few weeks ago, hanging onto the rail, but no longer possible as I can't lift leg high enough unless I swing it out to the side first“ makes me wonder if you should check in with the Consultant, or surgeon if possible? Increased pain and swelling after any mild activity taking ten days to ease, seems worth discussing to make sure all appears as it should at this point. It’s difficult to see you struggling this much at five months post op. Do you agree, or are you content with your progress?

We do heal at different rates and can not put an exact timeline on healing, but you mentioned that the inability to comfortably drive isn’t practical for you long term. I’d like to see you receive some reassurance or advice on what may help you enjoy more progress than you have been experiencing.
Wishing you only the best!
@alija

 

[EalingGran]

My pattern seems to be increased pain and swelling after any mild activity, which seems to take at least 10 days to get back to where I was, but

Agree with @Layla that it might be good to check in with your surgeon if you are getting pain/ swelling that lasts 10 days after any mild activity.

 

[alija]

@Layla all the advice I have had so far has been to do less, be patient and it takes up to a year to heal properly. We are not routinely offered any PT in the UK but I asked for help at 4 weeks and 7 weeks to ensure I was doing the right things. Both times I was advised to do less even though I was only walking 0.5-1 mile a few days a week. I have found some useful videos on You Tube , sharing exercises for stiff knees and am going to try these for a week to see if there is improvement. I am going island hopping in Greece in 2 weeks time and hoping I will cope okay. If my knee is the same when I get back I will contact the Physio dept to make sure there is no loosening. If I do this before the holiday my travel insurers may be difficult. I'm afraid in the UK NHS you cannot just "contact your surgeon" and appointments take months as we transition from NHS to private health. My disappointments are that the knee is painful at the start of any movement, although it eases as I work it, and I think my bend has reduced -although it's difficult to measure yourself at home. It also bothers me that I have to remove the quilt and support my ankle if I turn from one side to the other in bed. The problem with driving is definitely the stiff clutch and not the cramped space. I have driven my other half's automatic easily and am looking for one for me now.

 

[alija]

23 week update:
Turning over in bed not quite so painful now but still can't drive my car. Having rested up a lot over the last few weeks my quads were getting weak so have been concentrating on rebuilding them with exercises. Can now go up garden steps very slowly but house stairs too high to bend knee enough and have to lift hip and hang on to rail to pull myself up. My flexion is estimated at just over 90 which I think is less than I could get a couple of months ago but in truth it's now hard to remember. More stiffness than pain overall now which is good and can still ice a couple of times a day. When swelling decreases I can get more bend. Hoping two weeks in the sun will help it improve more so fingers crossed.

 

[Layla]

Hoping two weeks in the sun will help it improve more so fingers crossed.

Safe travels to Greece and back. Enjoy!
Stay in touch and let us know how you're doing upon your return.

 

[alija]

26 week update: Had lovely 2 weeks holiday in Greece and walked further than I have since op but had to sit out the afternoons. Very sore since and my gait is really slow and awkward, impacting on my other knee, hips, ankle and lower spine. As pain prohibits me lifting my foot enough when walking, it scuffs the floor and makes me stumble. I can walk up shallow stairs very slowly but am a long way off going downstairs normally. I would estimate my flexion is between 90 and 100 which I think is less than a few months ago when I was less active. I am trying to be patient but it is hard to be this incapacitated at over 6 months. I have contacted my hospital Physio department who can offer me a one off consultation (I assume to rule out anything major) but follow up has waiting times of 30 weeks. I am being given an exercise bike which I am going to start asap. I am on a waiting list for our local health club but that has over 300 people waiting too. Our country is not functioning well at present! Still too painful to turn away from affected side in bed without supporting my lower leg which makes me worry the prosthesis may be loose.

 

[DEL2024Dec-38]

Hi there. I had my TKR in Florida on Dec. 20th and relate to about everything you've said. Good to hear you had a lovely time on your holiday in Greece! You are giving me hope for my upcoming trip to Niagara Falls! I agree, it is very hard to be patient with feeling incapacitated for so long, it can be depressing. You really just have to take this one day at a time. The bike should help you feel better and at least you'll know you're doing something. Please try not to be hard on yourself! It does sound promising that you're able to walk up stairs. Let's face it, going downstairs was never easy before the surgery! I'm past five months and still have sleep issues, and there's nothing wrong with supporting your leg (with pillows?). Also like you, I find I have more stiffness than pain these days, but stiffness is not good either. My gait is pretty bad--can I say I walk like--an old person? Yikes. No way am I old, ha. It's unlikely your prosthesis is loose but do you want to get an X-ray to be sure everything's ok? I'm not sure how hard that is to do in the UK. Please keep posting about what's going on with you. You have support here!

 

[alija]

I really understand when you say you walk like an old person. I've always thought of myself as young for my age but since this op every move is an effort. Getting up and down off the floor is really difficult now. Had previous partial replacement which was slightly tricky but certainly didn't feel it had changed my whole status like this one has.

 

[alija]

7 months update: Have managed full revolutions on the exercise bike for 5 gentle minutes once or twice a day. Very painful to start off with but eases after a few minutes. Still have to support my lower leg when moving in bed but driving is getting a little easier. Disappointed I am not yet managing to walk upstairs alternately despite strengthening my muscles. Knee is still significantly swollen, not straightening completely and my flexion has regressed to about 106. Saw my GP who says this is not a satisfactory outcome and is trying to refer me back to Orthopaedics. She thinks it is scar tissue causing the pain and swelling. We do not have any routine PT post op in the UK unless there is a problem. I requested an appointment at 4 weeks post op and had a follow up at 7 weeks and was told to ease off the activity. I had been walking about half a mile and 1 mile respectively around 3 days per week so didn't think it excessive. I now think it would have been better to do more exercise than less to prevent the build up of scar tissue in the early days. Hoping it's not too late for me to try to break down the scar tissue with the bike and maybe swimming.