TKR Week 10 post RTKR

[Mankm]

Hi All,

Just thought I would post my story as it has been so helpful reading all the other posts. So hoping my tale might assist aswell. Have to say all the advice on here fantastic!

I'm 51 and have had right knee issues since I was 26. ACL tear, medial and lateral menisci tears. 2 arthroscopies, 2 hyaluronase injections and 2 steroid injections. Eventually had tricompartmental osteoarthritis and valgus so had to have a total replacement.

My surgery was on the 26th September this year. Currently my ROM is 1 / 119 degrees and I'm happy so far. Overall I would agree that this is an individualised journey. My flexion preop was 90 degrees. For me this has been a marathon and not a sprint. So I'm only a quarter way through !!

Day1 to 3.
Inpatient. Nerve block Effective. Nausa and vomiting from oxycodone so switched to tapenthanol.
Mobilised by physio 6 hrs post op. Using frame initially then 2 crutches. Very little sleep. Music my distraction. Showered independently day 2.

Day 3 to 14.
Home. Tired and sore. Taking tapenthanol sr twice daily, arcoxia twice daily and paracetamol 4 times. Have immediate release tapentanol which I need at night. Need help with alot !!! including putting on the TED stockings. Surprised at how sore I am in that I have bone, muscle and nerve pain. Painkillers assist but low level discomfort there all the time and worse at night. Walking with crutches every hour for 5 minutes, icing 6 times a day when awake and doing clot prevention exercises and gentle stretches which were given to me in hospital. Wound good and had check day 12, internal sutures and a glue externally so I can shower ! This part was my worst time.

Week 2 to 6.
Off all prescribed analgesia. Paracetamol and ibuprofen at night. Still very sleep disturbed. I tried lavender, meditation, herbal tea, melatonin and zoplicone, all helped a little have come to terms with resting during the day. Post op review good at week 5 no more crutches and can drive ! Started rehab with physio post op knee classes week 3. Very much around ROM knee strength and general balance. Some exercises I struggle with are stopped and modified. Doing these at home once a day. Physio never pushed my knee or made me do anything that caused pain. TED stockings gone. Reading netflix and knitting my saviours! Going for coffee now and gradually walking outside. Feel a bit down with the blues as really thought my recovery would be quicker because I'm younger.

Week 6 to 10.
Still have aches and pains at times with stiffness and swelling. These aches and pains can be anywhere in my leg. Reassured by my GP and physio this is normal. Definitely improving though as can walk independently for 2km very slowly ! Started swimming but no breast stroke. Can do only 6 to 10 lengths. Back to doing housework but need to break it up with periods of sitting with my leg elevated. Realised recovery from this very slow with some good days and some bad days.

Back to work next week slightly apprehensive but doing phased return.

Overall my arthritis pain is gone so I had to remind myself over the last 10 weeks the why I needed this. Surprised by the physical and emotional drain despite me having a reasonably good post op recovery. What I would say is wherever you are on the journey to be kind to yourself and listen to your knee !

Hoping everyone reading this has good recovery

Thanks for taking the time to read my story

 

[benne68]

Thanks for joining us, @Mankm, and sharing you recovery story so far.

You are still very, very early days in this year-long recovery, so 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.

Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

KNEE RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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
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

Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics

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 a 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 history before providing advice.

 

[Jockette]

Hi and Welcome!

You are doing very well and you have a very reasonable rehab journey. As you have found this recovery is very slow, but you’re doing great! Best Wishes as you continue on!

 

[Layla]

Hello and Welcome to BoneSmart! Thanks for joining us and sharing your journey. We appreciate that you've been reading here and value some of the advice.

I wish you the best as you return to work next week. Thankfully you're able to do a phased return. You'll have to stop by after you've been back to work for a time and let us know how it's going.
Best Wishes, Mankm!
@Mankm

 

[Mankm]

Hi Again,
First day back. Lucky to have phased return so 5 hours today,Wednesday and Friday.

Must say I'm exhausted! But I was expecting it. I was office based today and got through !
Things to think about which are already on bonesmart include ;
Early morning for me 615 Am
Drive to work for me 50 minutes
Car park and walk to building
Using brain again !!!!
I took regular paracetamol
I have a reusable ice and heat pack
I brought also etoflam gel which I didn't use
Space to elevate leg
Walking to canteen much further than sitting room to kitchen !!!
Ache and stiffness manageable
Dealing with people, good and bad to this!
Driving home.

However I feel I've achieved a milestone getting back to work so hoping for this to continue positively.

Wishing everyone a happy Christmas and good recovery!

 

[mendogal]

Yes, it's a LOT!!!!
Hang in there. It's good you have alternating days as well as short hours!

 

[benne68]

Using brain again !!!!

Love this! I remember that feeling!

Great report. Sounds like it was a long first day, so give yourself the grace to rest tomorrow. You have a good plan to help you get through. And, it will get better with time.

 

[Layla]

Whew! Glad you made it through, even though you're exhausted. It feels good to get back to "normal" routines.
It's wonderful your able to do a phased return. May it only get better!
@Mankm

 

[Layla]

Happy Three Month Anniversary!
I hope you enjoyed the holiday. Best Wishes as we move into the new year.
Stay in touch...we love updates and thank you for sharing your journey with all!
@Mankm

 

[Mankm]

Hi,
Happy new year to all ! Thanks for the encouraging replies above. Just thought I'd post an update.

I'm just over 3 months now post op and
had my Orthopaedic surgeon review today. So I just thought I'd share it: Alot is so similar to advice on bonesmart !!

He is very happy- xray and wound good. So discharged from formal review. Planned orthopaedic nurse follow up in a few months.

No actual knee pain and was reassured that my achy muscles (calf, hamstring, back ) stiffness and remaining swelling will improve. He mentioned up to 9 mths post op. to see full improvements.
 

I notice there is a huge focus on ROM in alot of posts particularly in the states. With both OS and PT pushing for numbers. Here in europe it seems to me more focused on function. It's interesting as my extension was poor today at 5 (I think due to driving for 1 hour with snow and ice and v stiff when I got to hospital) and flexion 120 . Anyway he said don't worry it will get better in time. He spoke about functionality and again working slowly at it. Important to mention i had poor ROM preop. I'm still attending physiotherapy for advice and guidance but only every 6 weeks now. I go to a gym 3 times a week but no training just rehab using bike etc

Other interesting point is his recommendation if ANY dental work needed to take antibiotics pre. He recommends this for life. I'm also currently on antibiotics for a pilonidal cyst which I never ever had before (not pleasant!!!) . So wondering if anyone has had this issue post op? He said just finish out my course and definitely get any infections treated early.

I'm back to work full time also so still quite tired and at the end of a day my knee is more stiff and swollen ! I ask myself as to why I had this surgery and then I remind myself of my tricompartmental arthritis and pain and poor function ! So overall I'm glad it's done but know I'm only 1/4 way through recovery.

For anyone earlier on in their journeys just a small encouragement to say the pain and lack of sleep should improve!! Listen to your knee and patience and time are your allies.

So my 3 month milestone reached !!!

 

[benne68]

Happy (belated) 3 month an-knee-versary, @Mankm! And thanks for the detailed update. It's great to read you are doing so well at 3 months post-op!

I notice there is a huge focus on ROM in alot of posts particularly in the states. With both OS and PT pushing for numbers. Here in europe it seems to me more focused on function.

I love this comment. It's so true. So many therapists here in the U.S. focus on "the numbers" when what really matters is how well we can function.

his recommendation if ANY dental work needed to take antibiotics pre. He recommends this for life.

There seems to be a huge range of opinion on this. Some doctors say 6 months; others say 2 years; and others, like yours, say for life. In my own case, my surgeon says 6 months, while my dentist says forever (and he won't treat me unless I pre-medicate!)

Of course you always need to treat an active infection. But, I encourage you to speak with your dentist and get his/her opinion on whether pre-medication is needed and for how long.

 

[Mankm]

for your good advice! .

I will indeed speak to my dentist. My surgeon did say its controversial as no strong evidence. Also he mentioned he has seen a couple of joint infections post dental work. I'm super cautious also so I'll be leaning on treating infections early and or prophylactically.

 

[Maulia]

Hello, just hit my one month post op. Regarding visiting dentist, I was told that for the next two years before going to dentist I needed to take antibiotics. I contacted my dentist and they will prescribe prior to each visit. Taking the antibiotics is a precaution against infection as we are vulnerable when have dental work done. So the take away is to be proactive.

 

[Paparanian]

Hi Again,
First day back. Lucky to have phased return so 5 hours today,Wednesday and Friday.

Must say I'm exhausted! But I was expecting it. I was office based today and got through !
Things to think about which are already on bonesmart include ;
Early morning for me 615 Am
Drive to work for me 50 minutes
Car park and walk to building
Using brain again !!!!
I took regular paracetamol
I have a reusable ice and heat pack
I brought also etoflam gel which I didn't use
Space to elevate leg
Walking to canteen much further than sitting room to kitchen !!!
Ache and stiffness manageable
Dealing with people, good and bad to this!
Driving home.

However I feel I've achieved a milestone getting back to work so hoping for this to continue positively.

Wishing everyone a happy Christmas and good recovery!

Mankm, Thank you for sharing your post op story. The reality in it is helpful for me to be reminded it’s a journey, not a race. Best wishes for continued recovery!

 

[benne68]

Hi @Paparanian. Just wanted to share a tip with you about using quotes.

It's really not necessary to quote the whole message when you want to reply to someone. Not quoting whole messages saves a lot of space on the page, and also saves duplicate reading. There are several options:

1. If you are replying to the post directly above yours, no need to quote. Just type your comment in the reply box.

2. If you are replying to an earlier post, just name the member you want to address and add the @ sign in front of their username (no space) and type your reply. (Just like I did above to reply to you.)

3. If you want to quote a specific line in the other member's post just highlight that line:
- When you do, you will see the words Like/ +Quote/ Quote this message. Click +Quote
- Then, when you go to the reply box, click “insert quotes” and it will put the highlighted area into your reply.

Happy Posting!

 

[Paparanian]

Benne68, I didn’t realize I was sending quotes. I was trying to add likes, agrees, what have you. Sorry

 

[Layla]

Oh goodness, no worries and no apologies necessary Paparanian.

If you're trying to use the reaction emoji's such as - Agree, Like, Friendly as you mentioned, if you look at the bottom right of any post you'll see a little "thumbs up" with the word Like next to it, all you need to do is tap/click on that and the others will show up for you to click on the one of your choice. Try it and see what you think.
Let us know if you have any questions and we'll be happy to help.
A great evening to you!

Using Emojis to react to posts

You can use emojis on a member's post to express your feelings about it without actually posting. Reacting to other members' posts using emoticons At the bottom of every post is a “Like” symbol: If you hover over this symbol a list of emojis appears: Click on the emoji that reflects how...

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@Paparanian

 

[benne68]

I didn’t realize I was sending quotes.

Oh my! No need to apologize about this. Was just trying to be helpful since a lot of members do have questions about quoting other's posts.

Just keep playing with things -- that's the best way to figure it out. And don't hesitate to ask for help! We were all new on the Forum at some point and had the same struggles.

 

[EalingGran]

My surgeon did say its controversial as no strong evidence

It is very variable. I was told not to bother unless having root canal work or other major dental surgery. As risks of antibiotic resistance if used to liberally.

 

[westiemom]

Both my OS and my dentist say I will need pre-antibiotics even before cleaning. My brains is not working so that could be because of my heart/pacemaker. But I swear the OS surgeon asked about dental work and also said pre-treat before the dentist. Don't remember if he said how long.