TKR Two years out from October 2023 TKR

I think one of the hardest parts of this recovery is the patience it takes for recovery. Our heads are ready to get on with life, so we think we should be able to do whatever we want after a very short time. The problem is, our knees are NOT ready for that, and won't be for a long time. Yes, many people are feeling better at around three months post-op, but even though they feel healed and ready to go at that point, their bodies still have quite a bit of healing to do. And you're only just past one month-that's a third of the way to where you'll likely be feeling better, but only 1/12th of the way to where, on average, most of your healing is done.

Some people's knees take even longer to be healed than a year, but the average is around a year. So, my advice to you is to give your knee a break and let the poor thing heal. Stop any excessive activity, and stick with gentle stretches, movements and reasonable amounts of walking. I'd also advise a lot of icing and elevating each day; as long as you use a cloth against your skin you can ice for long periods of time. I iced for an hour or two at a time, then got up and walked around the house, or in my yard, plus did some stretching and gentle movements. As time passed, I walked longer distances, and did more and more daily activities around the house.

Stick with the cane until you can easily walk, with no balance issues, and no limp. It's not a race to see how fast you can give up walking aids; it's a slow and steady balancing act between your knee's readiness to do things and your desire to get on with life. If you try an activity and have pain or swelling, your knee is not ready yet for that activity. Listen to your knee, know that it will let you know when it's okay with different activities, and when it's not. It may also allow an activity one day and the next time rebel, so listening to it is important.

As for the bike, it takes a while to be able to do a full rotation, and for some, they can make a backwards rotation long before a full forward rotation. Skip the bike for now and revisit it at a later date, or just gently rock back and forth for short periods of time.

I never had my ROM measured as I didn't want to worry about numbers. My doctor eyeballed my flex and extension when I would go in for a visit, and that was all we did in regards to any ROM measurement. I think stressing over numbers, instead of just being patient and allowing your knee to heal, is a recipe for disappointment. Between a hand-held device placed on your leg by different people which will result in getting different numbers, and a knee that will be more, or less, swollen day to day depending on a number of factors, the number will constantly change and won't give you a steady indicator of your progress. Instead, look back at where you were previously and where you are in the present at any given time; that will be a much better indicator.

Patience is a virtue, and after this surgery, a necessity. Impatience causes us to do more than our knees are ready for, and will end up stressing you out rather than helping in any way.
 
I had PT today. She measured me and my flexion is the same as it was at our last session 2 days ago . I have been working SO hard to get better ROM. It is discouraging. She said it takes time and not to worry about it. But, I still do. My knee feels just as stiff and tight as it did weeks ago. I ice and elevate several times a day. I am also massaging my scar daily to break up the tight areas where it kind of sticks. One good thing is that my extension is almost 0 without her working on me at all. At our last session, she had to stretch me a lot to get me to 0. She told me that improvements would probably be more week to week as opposed to from one session to the next. I got on the bike today for the first time, but couldn’t make a full rotation yet. I am still using a cane and I have a hard time walking without it.
Full extension means a body without imbalances/asymmetry when upright. Great news!
About flexion - I was about 10 less on a subsequent PT appt. Goniometer measurements are not 100% exact.
My view may not be popular on this particular forum, but I believe stretching is important at this early stage of healing when tissues are most pliable…if you want faster gains and to not have to take the long slow road back to flexibility. Inflammation and stiffness is normal at this stage, stretching or not….and I’m finding it is near impossible to pinpoint exact cause and effect every time I feel a bit stiffer.
I definitely had days when I wanted to give up on ROM because it didn’t always feel it gave instant results and it wasn’t always pleasant when I first started pushing it. I was swollen and stiff and in pain much of the time but who isn’t at 3-4 weeks post op? Nobody could ever prove stretching was the cause. Just like nobody could prove that not stretching will prevent one from being stiff and sore. Thankfully the stiffness came down the past few days…and maybe it is because my joint can move through a fuller range of motion and move more normally - and help the rest of my body move more normally? I am glad I put in the gruelling work that really sucked at the time. Thanks to a knee that bends well (135 now) I can easily get into my bathtub to relax muscles, get down and up from floor, get into car easy, turn pedals on a bike…and so much more. Now I don’t have to stress about flexion; I can focus on other things. Your PT sounds like a good one and I would trust her and her extensive medical training.
In my case, my “impatience” got me the results I wanted. It is okay to feel discouraged sometimes. It is ok to feel impatient. It’s your journey and you got this!
 
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I have a question about knee buckling. My new knee will buckle on me a few times a day. It is the main reason I can’t walk without a cane. I will just be walking along and suddenly my knee will give out. This seems like a problem to me. I don’t think it should be happening. I have done a quick search on the internet and some say it is a sign of needing a revision. Does anyone have any experience with this? Should I be concerne? I am going to mention it to my therapist Monday and see what she says. I’m just wondering if I should let my surgeon know this is happening.
 
You did say some time ago that you were going to ask your surgeon about it.

Some folks do experience this as a result of the weakened quads not firing reliably yet. Definitely continue to use a cane or walker until your gait is balanced, no limp, and no buckling. Your PT should provide guidance, and if in doubt do call your surgeon.
 
Your leg endured a controlled trauma. The injured muscles, tendons, ligaments and soft tissue is causing you discomfort, swelling and pain and yes, buckling can occur due to the trauma. Did you mention this to your surgeon at your last visit? If not, you can always phone his office and I'm sure a member of his care team will be able to offer you the reassurance you're seeking. I suggest you make that call for the peace of mind it will likely offer.
@Dmcfad2
 
some say it is a sign of needing a revision. Does anyone have any experience with this? Should I be concerne?
Nope, that is not a sign of needing a revision, it is a sign of a healing knee that is still weak. Almost all of us experience buckling in our early recovery, which you are still in. It was probably 4 months before I quit using a cane outside of the house because of the possibility of being knocked down because my knee was as strong as I wanted it to be. It is normal.

Try to stop worrying so much and be thankful for the things you can do now that you couldn't do a month ago. You have come so far and are doing great. Don't look for problems where there are none. We are here to help you and will answer any questions you have.
 
I have a question about knee buckling. My new knee will buckle on me a few times a day. It is the main reason I can’t walk without a cane. I will just be walking along and suddenly my knee will give out. This seems like a problem to me. I don’t think it should be happening. I have done a quick search on the internet and some say it is a sign of needing a revision. Does anyone have any experience with this? Should I be concerne? I am going to mention it to my therapist Monday and see what she says. I’m just wondering if I should let my surgeon know this is happening.
This still happens to me, but then reflexes kick in and I don’t go down. It’s really disconcerting so I’m never without a gait aide outside. My PT and chiropractor both says it’s muscle weakness and incoordination as they are adjusting to this foreign body part and different soft tissue alignment. I do not have a PCL, so I am relying on the muscle tendons for proprioception (body’s ability to sense joint position without looking at it). And my muscles are still very messed up. So I think it’s loss of strength plus confused nerve signals. I’m to start challenging this now by safely putting myself off balance with more single leg stuff. My OS has no concerns about the implant, X-rays are fine and I don’t have pain when leg gives out. If you had the giving out feeling accompanied by sharp pain, that would merit a call to surgeon asap…especially if it had been doing ok and then regressed. Curious what your PT will say.
 
You did say some time ago that you were going to ask your surgeon about it.

Some folks do experience this as a result of the weakened quads not firing reliably yet. Definitely continue to use a cane or walker until your gait is balanced, no limp, and no buckling. Your PT should provide guidance, and if in doubt do call your surgeon.
I know. I was going to ask my surgeon and then I forgot. I sent an email over today through the portal, because it’s not getting any better!
 
some say it is a sign of needing a revision. Does anyone have any experience with this? Should I be concerne?
Nope, that is not a sign of needing a revision, it is a sign of a healing knee that is still weak. Almost all of us experience buckling in our early recovery, which you are still in. It was probably 4 months before I quit using a cane outside of the house because of the possibility of being knocked down because my knee was as strong as I wanted it to be. It is normal.

Try to stop worrying so much and be thankful for the things you can do now that you couldn't do a month ago. You have come so far and are doing great. Don't look for problems where there are none. We are here to help you and will answer any questions you have.
I’m not looking for problems where there are none and I resent you saying that. You have no idea what I am experiencing. I have had a lot of problems with this recovery, whether you think so or not. And, by the way, I AM thankful for things I can do now. I’ll quit posting.
 
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@Dmcfad2 I suggest you do what I just did: go back to your very first post here and slowly read all the way through. Look at your concerns and your milestones; look at the outpouring of support you have received every day.
You have identified worries, received gracious and compassionate support, continued to worry, received helpful suggestions many of which you brush aside.
The things you call problems are not actual complications; they really are the same things most of us have experienced and worried about.
I hope you'll keep posting. If you need to step away, know that we will always be here if you want or need to check in.
 
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You have no idea what I am experiencing.
Yes, we do know what you’re experiencing, we‘ve all had the same, or similar, issues that you have described. More of us have a difficult recovery than those who do not, because TKR/PKR is a difficult recovery.
 
@Dmcfad2 I hope you’re okay?
Don’t quit posting, you’re obviously upset at the moment and I truly get it!!
I’m thankful that I’m walking further and that I’m finally able to get a half decent nights sleep and I can walk with one crutch not 2 but I’m worried every day that I can’t bend my knee fully, that I still have to do stairs one at a time, slowly , that I’m walking with a limp because the silly knee won’t bend enough to not limp…..
You and I are at the same stage, I believe you had your Op one day after me??
I don’t always like the responses that I get when I share my concerns/ frustrations but I do go back and read my thread from the beginning to remind myself how far I’ve come and I also read other people’s threads, like yours, so that I can see that others are in the same boat as me and it gives me reassurance that actually I’m doing okay….. and so are you.
I really hope you get some answers from your consultant and that everything is okay.
Take care of yourself x :)
 
I’m not looking for problems where there are none and I resent you saying that. You have no idea what I am experiencing. I have had a lot of problems with this recovery, whether you think so or not. And, by the way, I AM thankful for things I can do now. I’ll quit posting.
@Dmcfad2
The most important person is YOU! Total knee replacement is difficult initially because it’s major surgery. Agree that stopping posting is advisable. Get your answers from your medical team, they are your resource.
You have the confidence move forward, please do!
 
I’m not looking for problems where there are none and I resent you saying that. You have no idea what I am experiencing. I have had a lot of problems with this recovery, whether you think so or not. And, by the way, I AM thankful for things I can do now. I’ll quit posting.
I am so sorry you misunderstood me. I certainly didn't mean for you to think that I thought you were out there looking for problems for you knee. That wasn't it at all. What you are going through is completely normal and we have all been there. I just hate to think you think something is wrong when it isn't. Stress is not good for you or your recovery and can affect every part of your life.

Before I found Bonesmart after my last scope, my doctor said I should have had a TKR. I was searching the internet about them and some of their stories had me terrified! I had experienced pain and weakness after my two kneecap removals, but the worst of it left after a couple of months or so. It did take at least 6 months to heal from each of those, though. Of course, I was 30 years younger and probably healed quicker! I was blessed to have found Bonesmart 6 months before my TKR, so I knew what to expect for a normal recovery. I experienced the awful pain and weakness after my patellectomies and was prepared that this might be worse and it was. The bad part was it lasted much longer than the kneecap removals did. Even now, I can have some discomfort, but I've had 6 surgeries on this knee and don't expect a pain-free knee. My OS had even said I'd be better but not pain-free.

Your recovery is ahead of the average TKR patient's and I'm sure many would love to be where you are in their recovery, but having questions is normal and this is the place to ask those and give and receive comfort. All staff members here are volunteers and are not paid a penny for our many hours spent here daily. We are here because we CARE about what everyone is going through and want to help make that an easier journey.

Oh, please don't stop posting. Asking your question is probably exactly what someone else would like to know the answer to. Sharing your successes and disappointments is something we all want to hear about. You have been extremely supportive of others going through the same journey and you would be terribly missed if you left us. Please keep your posts coming. Don't stop because of a misunderstanding. I truly do apologize that I wasn't clear in my post. Thank you for pointing that out to me and I will learn from it.
 
6 week update
Knee still very stiff and can be quite painful. Haven’t made much progress in that area. Yesterday when I woke up it was so stiff, probably the worst it has been since surgery. My OS says it can go on for a few months. The temperature dropped about 8° yesterday, so maybe the colder weather is affecting it. It is a little better this morning.
I got to 102° at PT on Monday. I have another session today and I’m hoping for a couple more degrees of flexion. But, the knee stiffness may hinder that. I am at 0 extension,
I was able to rotate the pedals backwards on the recumbent bike on Monday at PT. I was really happy about that. It hurt, but I did it. Still can’t go forward yet.
I do my stretches faithfully 2-3 times a day. I don’t feel the need to ice as much now. It actually makes me feel stiffer sometimes. I will still ice after PT or if my knee is throbbing in the early evening and I still elevate several times a day.
I am still not comfortable walking without a cane. I don’t feel stable. A lot of that has to do with the stiffness I feel in my knee. I am even using it in the house most of the time.
I was able to walk all around Costco for about a hour yesterday. My knee yelled at me and started throbbing when I got in the car to come home. I iced and elevated after that outing.
I am making slow progress.
I am back to taking prescription pain meds a couple of times a day and I will supplement with Tylenol, although Tylenol doesn’t seem to work for me. I can’t take NSAIDS because I am on a blood thinner. When I take the pain meds, my stiffness doesn’t hurt as much.
 
Seems like you are making great progress despite still not feeling great. I'm a few weeks behind you and feel exactly the same way about Tylenol. I can't tell that it's doing anything at all. Still having a terrible time sleeping and finding comfort when trying to rest. If I could just find that one perfect position! Hope to hear more from you.
 
I don't find the Tylenol does much for me either. I got a script for Meloxicam and that seems to help. I still sometimes need the heavy stuff if I have done a lot. Am 2 months now. Too bad about the NSAIDs

Good for you walking in Costco. I am heading there shortly but will use scooter. I find stores are the hardest to walk in. I think it's the standing in line that kills me.
 

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