Revised PKR to TKR Tylermit's revision recovery

[tylermit]

Well I made it to the other side of recovery. I can't sleep so I decided to start my own recovery thread.

The surgery went well. I went with the spinal block with sedation. That was a great choice. They wheeled me into the OR and transferred me to the operating table. I leaned forward on a pillow and felt the needle pain in my lower back (not bad). I laid flat and was talking to the nurse when the anesthesiologist said he was putting something in my IV (don't remember what) and then I was waking up in recovery.

I received an On-Q pain pump instead of the femoral block I had last time. It is supposed to supply 4 days of pain relief. I hope this is better than the 40 hour pain baseball bat I had last time.

Swelling is better this time around. Last time my knee looked like a soccer ball. Pain is under control. Nurses are great. I may get to go home tomorrow depending on my PT performance.

My PT today consisted of walking down the hall 50 feet and back. The only problem so far is not being able to urinate. If I don't do it soon they will put in a straight catheter. I don't want that. Everything else is going great. The anxiety is gone and I look forward to getting this behind me.

 

[Jockette]

Welcome to recovery!

I needed a catheter once, just long enough for it to empty my bladder and then they took it right out. The nurse said I couldn’t urinate due to the anesthesia.

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.

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.

 

[swmrgirl]

Congratulations on your new knee. Sounds like you and I are having very similar experiences. Take good care.

 

[tylermit]

Well here is my 1 week update. I have not even turned on my computer for a week. This surgery has been a tough one for sure. I have had problems with pain control since being discharged from the hospital. I have had to use the lowest recommended dose interval to make sure I have the 10 days worth until my follow up visit. That does not allow me any extra for "bad days". Every day has been a bad day. I go in Friday to get my staples out so this is going to be a discussion with the PA. Once I got home from the hospital my bladder started working overtime. Up every 30 to 45 minutes. That lasted through day 6. Sleep? That is funny. I may get 1 or 2 hours a night and the same for day time. Home PT has started and I am sticking to a hands off program with the PT. The crafty little fellow has some tricks up his sleeve. He has had me try to bend further than my body wants to. I stopped that at that moment and said "no, that is all you are getting." My ROM is 0 and 75. He is all worried about the 75 for some reason. I am not.

Overall I am gaining little victorious improvements every day now. I am trying to keep everything moving forward without any setbacks. That is a huge goal for me.I have lots of reading to catch up on to see how the other bonesmarties are doing over the last week.

 

[Celle]

Well done for setting your limits with the PT. There's no need to rush.
No matter what the PT thinks, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[Woodpusher]

Tylermit, your surgeon used robotic assisted surgery, right? I'll be interested to hear how you ultimately think it went. I've got mine in May, he doesn't use robot assisted.

 

[tylermit]

@Woodpusher Yes that is correct. Both my PKR and TKR revision on the same knee were using the Mako Robot assisted surgery. The PKR was to the medial side on my right knee. Unfortunately the lateral side of that knee had developed Osteoarthritis and quickly started to go downhill after about the 4 year mark of the implant. My OS sold me on the PKR as ea way to push off the TKR for 12 to 15 years. Looking back I should have just had the TKR to start with. If you don't mind watching surgery videos on UTube, watch one using the mako robot and one using standard techniques. It will amaze you what the technology of knee implants has evolved into.

 

[Irish471]

@tylermit , congrats on making it through the painful first week! Good thing you set your limits/boundaries with your home PT. I did not like my home PT! I thought he wanted me to do way too much, way too soon. I attempted some things and decided it was too early to try (leg lifts and short arc quad exercises), so I just tried to only do the things that did not cause me pain. I was at 74 degrees flexion at the end of my 2nd week and he tried to push my ROM. At my 2-week follow up, my OS said he expected me to be at 90 degrees, but once he removed the dressing, he saw that there had been a bleeding issue and a hematoma had formed, which he tried to drain blood from I told him about the home PT and he said I should only be spending one hour MAX on exercises per day and to do what I can. He ordered me to start out patient PT, thank God! The out patient PTs are much better trained and I have a long history with the PT I see. He helped rehab me from my other knee surgery in 2010.

Yes, sleep is elusive. Still is at 5 weeks. The pain pills help with it to some degree, but like you, I am rationing mine. Such a shame that we have to feel the need to do that!

Keep up the good work

 

[Woodpusher]

@Woodpusher If you don't mind watching surgery videos on UTube, watch one using the mako robot and one using standard techniques. It will amaze you what the technology of knee implants has evolved into.

I'm not sure I can, I get grossed out just looking at the pictures

 

[tylermit]

I got my staples out this afternoon. Ouch. The glue on the bandage was stuck to my skin with a very good bond. About half of the staples came out easy, the other half were somewhat painful. Between the bandage and staples it took 20 minutes to complete. I had a very limited supply of pain meds prescribed when I left the hospital. Unfortunately I used my last one up Thursday night. Note to self, put aside 1 or 2 pain meds for staple removal and have an Ice pack waiting for the ride home.

 

[sistersinhim]

Overall I am gaining little victorious improvements every day now. I am trying to keep everything moving forward without any setbacks.

This is a really good recovery outlook! Stick to it and you should do just fine!

 

[Triple J]

Hey Tyler. Did you have to have revision surgery because of your polpliteus mm? I think thta what I have going on 5 months postop

 

[Jamie]

@Triple J ..... please provide your surgery information (date and type of surgery) so we can create a signature for you. It would also be helpful if you would start a recovery thread for yourself that explains a bit about your situation so we can get to know you better.