PKR Unicompartmental knee replacement<

[Mutti3]

@NancyEn
You are 3 months postoperative, you are progressing fabulously. I started working on balance on one leg at around 3 months. I never like inverted positions very much.

 

[Josephine]

1. Resting. 0-2.
On initial standing sharp pain at top of fibula and down shin:10.
Sleeping: 4 intermittent throb.

I see - I shall have cause to mention this later!

2. Paracetamol 500 mg x2, 4 x day
Ibuprofen 400mg 3 x day.
Was also prescribed dihydrocodeine 30 mg to take 4 x day but anything with an opiate in it makes me very unwell. So only take half a tab at bedtime.

Paracetamol fine
Ibuprofen NOT fine! That's an awful lot to take on a daily basis so obviously you are unaware of the dangers involved. I suggest you take a look at this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers

3. Moderate swelling

If you have any swelling then you need to ice and elevate

4. ROM is very good.

I sooner have numbers!

5. Not very good about icing but did it twice today since I read recommendations on this site
6. elevating 15 mins each morning

This is inadequate. You accomplish little or nothing in 15 minutes. Ice/elevate for at least 40-60mins and more than 4 times a day.

7. I live alone. Do not own a car.
I do go out with rucksack on my back for the odd pint of milk or fresh veg to a corner shop.
I have a small two bed flat. Easy to maintain, but no help with housework etc.

Okay


swing my lower legs back and forth to get the circulation going once a day - okay but not too much. 5-10 mins is plenty
straighten the leg, hold for 5 counts and bend it x 10 times - why do you do this? I see no call for it at all!
extend leg along floor and work on flattening thigh to floor, bend it and straighten it - same here
put a yoga pad on floor and heel on it allowing gravity to take back of knee to floor - and again
lean back on elbows and do straight leg lift 15%, hold for count of 5 and repeat X 10 - a tip: once you can do a straight leg raise, you don't have to do them any more!
sit ups with a high seated chair, sitting and standing x 10 - for what purpose? I think these are unnecessary
standing, holding back of chair I do heel raises onto toes x 10 - same here
yoga practice which consists of head down dog with hands raised on several pads 5 min headstand close to wall - and here - not for your knee, anyway.

I have 51 steps inside my communal block to my top floor flat (building is 19th C) no lift, to climb up and down when I go out each day, even to empty rubbish. I consider that enough exercise for the time being - I SO agree! And I'd add that with all those steps you really, seriously don't need to do any other exercises AT ALL!

PT I get one short session of physio at UCL Hospital once a month. Have had 3 session so far. The plan is for me to eventually join a group physio twice a week at the same hospital.

I do recommend that either you don't take part in this or if you do, you do NO other exercising at home whatsoever.

I try to do a short walk around my locale each day, using one crutch, weather permitting. Used to enjoy the nearby park but cannot manage that yet.

Well you know what? You've just passed the 11 week point and reported this

As soon as I sit, even for a moment, I get this sharp shin pain (medial side) as soon as I put any weight on the right leg on the flat I get the pain in on medial side shin and some in the new joint area. It's almost 3 months now and still not pain free!!

I would tell you categorically that all that you are doing (and especially what I crossed out) is the direct cause of this pain. I've seen it time and again on this forum and when people get pain they immediately go into the mode that more exercise is need to cure that pain. Wrong!

When the pain is activity generated, the only resolution is to stop it all and allow your body to rest and recuperate. Thus I would make a further suggestion which is a little guarded as you haven't given me the actual numbers of your ROM so I only have your word that it is 'very good'. What I would suggest is that you put joining the physio on hold for a while as well as ceasing your home exercise routine. I know much of it is your Yoga routine but you also need to remember the and also that all this activity is fatiguing your body past the point were you would be safe against muscle strain and pain. So before things get any worse, give yourself a break - the 50 steps up and down to your flat is more than enough for the time being. Your body needs to rest as does you knee!

 

[NancyEn]

Dear Josephine,
Thanks for your detailed reply. Shall certainly ease off everything.

Thanks shall stop Ibuprofen.
Wonderful suggestions. All makes my life a lot easier, so shall concentrate on icing and elevation.

Glad to get your advice before any further damage is done.
It really is difficult to gauge how much exercise one should do, especially when one had been used to a fair bit prior to knee op.
Once again so grateful to you. Shall stop trying to keep up with the Jones’s. Shall come back to you with this calculations about ROM.

 

[Mutti3]

I had a yoga instructor whose teaching methods was exactly as described ! Good stuff! Still ice / elevate occasionally especially after walking.

 

[Mutti3]

I know the feeling ! Since knee replacement, I been doing my own home yoga practice. I do props as well. Bolster, blocks, straps! Been practicing kneeling to adjust to the new feel. I feel very blessed to have obtained range of motion of 145 early in my recovery. But strength is lagging behind, and occasionally muscle discomfort.

 

[NancyEn]

Dear Mutti 3,
Great stuff!
I love my props! I always say I can still do everything, but just have to find different ways of doing them.
Never was very good at padmasana (lotus pose) and certainly giving that pose a wide berth at the moment after a PKR. Perish the thought, would not want to dislocate anything.
I have a chin up bar across the lintel of a doorway and have some yoga ropes attached. So can put some blankets across the ropes like a hammock, lay across, belly down my belly over and do a very well supported adho mukkha svanasana (hd down dog). No strain, no pain.

 

[NancyEn]

Sorry I posted before I finished. This IPad is a bit too sensitive. Apologies for a few typographical errors in previous post.

 

[Celle]

Nancy, you can edit your post, as long as you do it soon enough.
See the little "Edit" written just beside your username at the bottom of your post? Just click on that and you can edit the post.
Editing a post
The article says the ability to edit a post expires after 5 days, but I think it's actually only about 24 hours.

By the way, I took out your link to the article about the pose you do and just substituted a picture from the article. While it's a very good article, we have to be very careful here and we don't want anyone deciding to try the pose without proper instruction.

 

[NancyEn]

Dear Celle,
Thank you. Thought that I had seen an edit option somewhere. Totally understand your deleting the link about the yoga, do not want to offend anyone. It was primarily a conversation between me and Josephine to demonstrate what I am doing in way of exercise as she hoped that I was not doing savangasa as shown in her illustration. Had not realised the whole community would see it. You are right to be cautious, would never forgive myself if someone injured themselves experimenting.

 

[Celle]

Thank you for understanding, Nancy.
Anyone can read your posts, so there's no knowing who might decide to try something they read. We have to be so careful!

If you want to have a private conversation with someone, use the PM function:
How to use Personal Messages (PMs)

 

[NancyEn]

Dear Celle,
Thank you for your help. Am a novice on this site as well as a novice with joint replacements.
I shall certainly heed all your suggestions.

 

[sistersinhim]

We are here to help the best we can!

 

[NancyEn]

 

[NancyEn]

Hi, much happier since I listened to Josephine and took on board her suggestions. Have stopped lots of the PT exercises I was given. Just elevation and ice.

I went out in our local park two days ago for my first decent spring time walk at 3 months post surgery from a PKR. I really could not resist the temptation, needed to see the buds popping and hear the birds singing. Was walking like a tortoise, but hey who cares, my walk was pure joy, with no pain during the walk.

Also prior to surgery had an enormous popliteal cyst behind knee, which had burst and the fluid had gone into the head of the gastrocnemius muscle. Despite having it aspirated and having cortisone injections there was nothing more to do, other than knee surgery which I had done on 12th Jan.

I still use a crutch at 3 months, because I feel a little unsteady on my feet. I got home and elevated and iced immediately to take care of myself. Not totally without pain all the time yet, and the cyst has settled as I was told it would too. No pain in the calf now.

There is some good advice on this site.

 

[Celle]

HI @NancyEn
I'm glad to read that you are doing so much better.
I copied your post, above, from another thread, because I thought it was nice to have such a good update in your own thread as well.

 

[NancyEn]

Super! Wondered how it got there. Thanks very much!

 

[Josephine]

an enormous popliteal cyst

You should read this Baker's cysts and other knee bursae

 

[NancyEn]

Dear Josephine et all,
Thank you for the expansive and generous information on Baker's Cyst otherwise know as popliteal cyst.

I now have the 'numbers' for my ROM. I saw the physiotherapist at the hospital today and she measured it. It is 134 degrees and 1 degree on the examination couch. I hope that makes sense.

Having put in a written complaint to the hospital about her aggressive treatment towards me previously, her approach was so much softer and kinder today. She has stopped suggesting that I go onto the group PT twice a week. Phew, was going to refuse it anyway at the moment.

So all in all am progressing at my own speed! Thanks to you and all your suggestions on here. It has given me so much more confidence and assertiveness in managing my own recovery

 

[Jockette]

Wow, 134 already! Wouldn’t we all love to have that!

 

[Mutti3]

You are doing great! Range of motion of 134 , fabulous! I see a lot of yoga!