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[REVISION TKR] Update....3 years on<<'

Discussion in 'Knee Replacement Recovery Area' started by shelli22, Jan 16, 2015.

  1. shelli22

    shelli22 senior
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    Hi I have been reading these posts since I returned home from hospital post LTKR on 8Dec 2014. On Monday I will be six weeks out. I decided to post as although I have been lucky this time initially, I noticed that many were discussing bakers cysts and I too have had these both withe the initial partial replacement and the revision total knee replacement and thought I may help to share my experience.

    Hx
    Sept 2013 arthroscopy to repair tear to medial meniscus with no relief. MRI followed showing rapid onset osteoarthritis bone on bone. Surgeon refused to do more as 'too young'.
    Oct 2013 second opinion and second MRI. Small fracture noted in addition to rapid onset osteoarthritis. Suggested partial (unilateral) knee replacement.
    Oct 2013 partial left knee replacement. Recovery good ROM 120+ Flexion, extension good. Bakers cyst following PKR. Lots so pain for 12 months. Off work (nurse/midwife).
    Nov 2014 final review (monthly reviews). Still experiencing lots of pain. Decision to do either double partial or total knee replacement. Eventually surgeon opted for a total as I need to go back to work.

    Note: for six months prior to TKR I attended gym with a rehab personal trainer and worked on strengthening muscles especially quads etc in preparation for upcoming surgery. Whether that worked or not is debatable but I wanted to give myself every chance of a successful recovery.

    Dec 8 2014. TKR. General anaesthetic only. Fentanyl day one for pain relief. Then tramadol and
    endone for next three days.
    CPM used day 2. ROM 90. Exercise, ice and elevate. Physio. Exercise. Flexion 110. Extension -1. Out of bed. Walker attempted. I carried it (it was in my way and annoyed me lol). Physio amused and went to get cane.
    Day three attempted stairs. No issues. Walked around ward. No issues.
    Home day four.
    Day six no longer required cane.
    Weeks one to four uneventful. Physio once a week. Flexion 120 week two. Extension -1 week two.
    Week five Flexion 128. Extension 0. Commenced Pilates machines with little or no resistance at physio.
    Exercises (only knee bend sliding under chair - ten reps x 2, extension ten reps x 2, leg lift as able,walking as able) under the watchful eye of personal trainer to ensure alignment etc and that I'm not overdoing it. Rest ice and elevate in between.
    Pain relief. Tramadol slow release twice a day and mersyndol six hourly as required.

    Issue: pain relief, difficult to get OTC Meds such as mersyndol from pharmacist. From week five only had paracetamol and voltaren (extreme reaction - stomach pain so ceased) which meant I only had panadol. This did nothing!

    Week 5. Went downhill due to inefficient pain relief. Spent three days in agony. Pain in back of knee excruciating and very tight stiff whole leg. Tears and frustration were my new mantra pfft. Six week appointment (four days early) yesterday with OS. Extremely happy with ROM etc and knee progress.
    Now have prescription for plenty of pain meds. Next OS appointment in six weeks. He said I can now work on strength and weight exercises at gym with personal trainer but refrain from bike as this will aggravate bakers cyst. Continue with leg extension and Flexion to maintain. Ice and elevate and rest re bakers cyst! He will review at next appointment and decide if anything further needs to be done then. I'm hoping swelling will decrease and thus it will resolve itself. Draining or cortisone injections don't appeal to me one bit!
    So, this week I have gone for walks, have done exercises twice a day and had plenty of rest,ice and elevation. Today I'm feeling much more 'normal' compared to the last five days. Cancelled personal trainer as I saw five am for the first five days this week and I was exhausted.

    Wow ! Ramble much? Anyway. I've read many of your threads and I'm intrigued how there are so many differing views though truly I believe the Bonesmart mantra really works and in general it has been the way my post op has been managed. Good luck to you all! I'm new to this and not sure if I'm doing the whole thread thing correctly but live and learn. I will get there!
     
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  2. Legin

    Legin big-cheese

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    Thread thing is fine. Nope you.don't ramble you had a lot to fit in. Your experience and.challenges will be of.use to many I'm sure. Also as you have probably seen there are qualified medical.people here who.can support you. Hope you continue to use this site as if nothing else it.can.be a.laugh.which in itself is good therapy. But most of all.the knowladgable caring support

    Legin THR Sep 14
     
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  3. shelli22

    shelli22 senior
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    Thanks @Legin. I'll get used to it I'm sure. I'm in Australia and some of our terminology is a little different. I have been reading many of the post and there are many that have kept me entertained along the way.


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  4. Legin

    Legin big-cheese

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    Grand as lass well you took first step and started thread and first step is the biggest as I found out looking from.top of a hill. There are many other antipodeans here as well. Oh you.prob have found out re terminology Leganism is out there on.its own.if you are unsure ask away.many do.

    Legin THR Sep 14
     
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  5. skigirl

    skigirl SUPER MODERATOR Moderator

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    I am so glad to find another walker carrier!!! The nurse insisted that I had to bring my walker with me---so I carried it for a day and finally left the hospital, just to be rid of her!!

    When you have a fairly easy recovery it is much easier to overdo. When you sit at home with your leg up you feel like you are "wasting time" but then, when you go to the grocery store and post office---your knee swells. Ugh.

    My doc told me to take one hour down for every two hours up at your stage. I found too, that if my knee swelled, I would stay in bed for a day or two with my knee propped up on three pillows and the swelling would go down.

    Elevating your leg to control swelling and pain
    Using ice

    I also wore support hose for at least a month or two after the tkr--my goal was to contain the swelling at all costs since that was the single thing that delayed my recovery. I focused on getting rid of the swelling. I used a lymphademia massage therapist who helped more that I expected her to help!!

    Most of all, if you do too much now, you delay your recovery---so, much better to take it easy now, let the knee rest and heal and then get on with your life at the 12 week mark. It is like childbirth, you cannot rush it---you have to accept the length of your labor--and when it is done, you have a baby to make up for it. With your tkr, you have to accept the length of your recovery---when you are done---a pain free life awaits.

    Here are the recovery articles for you to read while you are lying down with your knee propped up and iced!!

    First are the BoneSmart mantras ....
    - rest, elevate, ice and take your pain meds by the clock
    - if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
    - if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
    - if you won't die if it's not done, don't do it
    - never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

    And here are some very crucial articles
    The importance of managing pain after a TKR and the pain chart
    Myth busting: no pain, no gain
    Swollen and stiff knee: what causes it?
    Activity progression for TKRs

    Healing: how long does it take?
    Chart representation of TKR recovery
    Energy drain for TKRs
    Elevation is the key
    Ice to control pain and swelling

    Home physio (PT) and activity progress: suggestions
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds
    Post op blues is a reality - be prepared for it

    And wise words from members who have shared their experiences ...
    Where are you in recovery?? (TKR)
    Five “P’s” of knee recovery
    TKR: work “smarter” and not “harder”
    Recovering a knee - from one who knows!
    It's never too late to get more ROM!
    It's worth the wait for ROM
     
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  6. skigirl

    skigirl SUPER MODERATOR Moderator

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    I cannot resist a story to you. I broke my ankle skiing 20 years ago and had to go down in a sled. It was agonizing and every bump would cause a jolt of pain--finally I started yelling!! The ski patroller stopped and said to me, Kelly, try to be brave. I replied that I had had three children with natural childbirth and I was sick of being brave!! He shook his head---another crazy lady on board!!
     
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  7. Nana moon 27

    Nana moon 27 alpha

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    Hello @shelli22

    Welcome to Bonesmart!

    I've been reading your thread with great interest. It's wonderful that you are having such a great recovery xxx

    Yes you've been doing the Bonesmart mantra type recovery and living proof that it works. Well done!!! Keep up the good work x x take care x

    Love Nana moon 27 xoxoxox
     
  8. shelli22

    shelli22 senior
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    Hello @skigirl and @Nana moon 27. Thanks for your replies. Nana moon I have read all of your thread. You've had a roller coaster ride! Ski girl, you're hilarious.i haven't got to your thread yet but look forward to reading with interest! I'm a nurse and midwife (currently employed in a large teaching hospital in the neonatal unit). I have two sons and a one year old grand daughter and three year old grandson. I haven't worked since this all started! I live alone with my two King Charles cavaliers karma and Benson. I'm not allowed to return to work until I'm cleared by my surgeon and then have to do a fitness test at work. Neither has happened for over 20 months! I'm just thankful I have income protection! Thanks for posting the information, to be honest I have already read most of it when reading people's threads. Even as a nurse, I find this whole experience has shocked me. Years ago I fell off a horse and broke my pelvis and at the time I thought that was frustrating and painful but I have to admit this experience takes the cake! Ah well! Onwards and upward! Will continue following your posts with interest.


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  9. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hi @shelli22
    I'm pleased to read how well you are doing. Before I retired, I was also a nurse and a midwife and I agree that being a patient, not a carer, gives us a whole new perspective.

    I had a PKR that lasted me for 11 years (I was lucky!) and then had it revised to a TKR. I was warned that recovery from a revision would be more difficult than from the original operation, but, for me, that wasn't so. Maybe techniques and protocols had improved between the PKR and the revision but , whatever the reason, my recovery was quite straightforward.

    Best wishes for continued smooth progress. :flwrysmile:
     
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  10. shelli22

    shelli22 senior
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    Just an observation though. I'm convinced something happens a five weeks! I had a massive energy drain right on five weeks and felt like I had gone backwards in a big way. I'm coeliac so I naturally eat healthy and usually prior to all this exercised regularly therefore was quite fit. In hospital my Hb was on the low side but they decided against a transfusion as I am fit and healthy and it should resolve on its own. I'm extremely pale and tired all the time. It's the strange cravings I've had of late that I find interesting. I'm not a huge fan of red meat and strangely enough to most, I despise chocolate, yet these are the two things I crave!


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  11. shelli22

    shelli22 senior
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    Hi @Celle. Yes I have been reading your thread! You've had a great recovery! Well done! I agree that being on the other side gives one a whole new perspective!


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  12. skigirl

    skigirl SUPER MODERATOR Moderator

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    I started taking a daily vitamin with iron---ONe a day in the states. It has helped since I was anemic as well. It is gentle enough that I don't have any side effects and it has helped my overall well being.
     
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  13. shelli22

    shelli22 senior
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    Lol @skigirl. I have the side affects without taking them so I decided to eat meat and take vitamin c and magnesium until the other sorts itself out!


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  14. skigirl

    skigirl SUPER MODERATOR Moderator

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    Good idea--my PT gave me some elk steaks he was so adament that I needed extra protein to heal well.
     
  15. Legin

    Legin big-cheese

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    I'm flaberghasted a lady not liking choc. that's it all my understanding of nature this world have been turned upside down. Almost had to have a dram. Chortle. Glad you are using.the.forum its such a.good support even to.the.point of escapism some times from.the.toils pain and.troubles life throws at us. Like nom choc lady sheeeeesh I'm going.to have to dunk my head in the loch. Good luck and have a.grand weekend.

    Legin THR Sep 14
     
  16. shelli22

    shelli22 senior
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    Hahaha @Legin. You're not the first to be shocked. I have never liked it. Nor any other desserts. Cake, biscuits or whatever. Yuk. But then , I've always looked at food as a need not a love lol


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  17. Legin

    Legin big-cheese

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    Noooo now my world is about to end. The kitchen is my domaine but love savoury spicy do very few deserts. oh my and I can't even get to my thinking rock. To be fair my daughters prefer same food as.me but they do make a beline for choccy tin not hiya dad. Aged 20 and 18 still kids. Sheeeeeeesh I'm off to.rewrite the world and the.meaning of life

    Legin THR Sep 14
     
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  18. shelli22

    shelli22 senior
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    Hahaha sorry @Legin!!


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  19. Legin

    Legin big-cheese

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    Nae lass.its.ok.like when youngest announced.dad I'm now a.vegetarian. Fine cept her likings of vegetables were potatoes peas and.carrots xx

    Legin THR Sep 14
     
  20. shelli22

    shelli22 senior
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    Well tomorrow will be six weeks post op. Since seeing the OS on Thurs I decided to have a few days of light exercise and attempt to get the pain back under control in an attempt to get some sleep. This worked. I'm finally sleeping all night and the pain is back under control. To be honest it was the worst week since before the op. My personal trainer came out yesterday and we changed the exercises to balance and squats. Then, as he also does massage he worked my quads, ITB , calves and hamstrings using pressure points. Wow this has made a great difference to the horrid pain in the back of my knee!! He will be writing a new program as I will be driving to the gym from Monday in line with the OS request and staying away from long episodes on the bike due to bakers cyst. I have been able to drive since two weeks post op but wasn't game to drive too far until I am six weeks post op as I'm unsure whether insurance would cover an accident. Looking forward to an interesting new week getting out of the house though I'm not sure about continuing with Pilates on the machines or just concentrating on gym strength training though Pilates strengthens core and help with sciatica which I have had to contend with since waking up post op. Happy knees!


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