TKR What did I get myself into?

[Time2heal]

There is no window. I will never understand the scare tactics that PTs use. You can't straighten a swollen joint. Nor bend it to the degree the PT wants.
sistersinhim is absolutely correct about I &E. It takes a lot of patience to elevate and ice for long periods of time.
Jockette is absolutely correct, too.
We are a day apart in surgery dates and your recovery sounds similar to mine. Only difference is I did this before and know what to expect. For the most part. It is a long recovery.

I’ve been told about the six week window. I let my PT “mobilize” my knee because I am behind schedule with extension. It seems only to have set me back, I’m worse today than I was two days ago. My surgery was January 19

 

[Jockette]

I’ve been told about the six week window.

@Time2heal and @WillB

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

 

[beachy]

@Time2heal
You are not behind schedule with your extension. There is no schedule. Many of us improved our extension to perfect by just doing ADLs and a little gentle PT.
I guess you are worse than before. You're only 3 weeks post op. Ice, elevation, rest and ADLs are your friends now to reduce swelling.

 

[kygirl13]

I liked the comment about having a hard time wrapping my head around the concept of no longer going to formal PT. My pre-hab PT did wonders but post op PT with the new knee seemed counterintuitive to what I felt my body was telling me. I finally quit going. Paying for the "privilege " of being told I wasn't where I was supposed to be when the doctor said otherwise. Gentle stretches and normal activities and I see a bigger difference than with the formal PT. Normal activities feel almost 100% normal. Little to no pain but tightness/swelling that comes and goes. I'm 8 weeks post op and I feel like I have my life back. Hang in there. It gets better.

 

[WillB]

Even after two relatively easy PT sessions this week, my knee still prevents me from sleeping well. Last night I was finally up at 3:30am as I could not get comfortable. Tylenol and Gabapentin don’t seem to help much. Dying for some decent sleep! Wonder if I should go back to taking Percocet at night as I have a few pills left??

 

[Remi21]

Hi , i haven't seen the beginning of your thread so I'm not sure what your injury was. I had internal fracture surgery on my knee tibula and fibia back in September . Your sleep will get better , I know it's a nightmare , the past 2 weeks have been better for me , less stiffness when I wake up and easier to sleep. I was a front sleeper all my life , it's been really hard to learn how to sleep on your back. The recovery process seems to go on and on but it will get easier , if you need medication for the pain still then take it , there is no shame in that. I had internal fracture surgery on my knee and tibia/ fibia ,back in September and had strong meds until December. Nothing worse than not being able to sleep and get comfortable it does get easier .

 

[Jaycey]

Wonder if I should go back to taking Percocet at night as I have a few pills left??

You are not even a month out of major surgery. And yes, activity during the day often has an impact on sleep in these early days.

I agree - try the Percocet at night. And maybe think about cutting PT down to one session per week. You are not in training - you are healing.

 

[sistersinhim]

Even after two relatively easy PT sessions this week, my knee still prevents me from sleeping well. Last night I was finally up at 3:30am as I could not get comfortable. Tylenol and Gabapentin don’t seem to help much.

This is definitely an indication that you are doing too much for your knee at this stage of healing. If you back off, you would lose nothing but will gain less pain and swelling and better sleep. You just had a major surgery, not a sports injury. PT for the two is different. Slower = better after a joint replacement.

There's no reason for you not to take the Percocet, but if you back off some exercises and ice and elevate more, you might not need it.

 

[beachy]

I over did it many times during my first tkr recovery. I know how it feels. It sounds like what you are doing. I'm still on pain meds, but way less than early weeks. Our surgeries are 1 day apart. And no, you can't compare because no two are alike.
Bedtime and morning are my " ouchiest" times. I still take pain meds then. Occasionally once during day.
You are 4 weeks today. If you rest, ice, elevate and take pain meds when needed you will see a big difference and feel so much better. Worth a try. What do you have to lose?

 

[LD of Michigan]

Great comments here. There are so many changes and adjustments re. a TKR. Some days I've felt I took a step backwards in progress. Personally, I need the process of going out for formal PT sessions, but I really like my PTs aptitude and approach and most of work remain my ADLs. It all builds toward functionality and recovery IMO. We're all still only weeks in.

 

[LD of Michigan]

...You are not in training - you are healing.

So true. I have to remember that too when I go too overboard!

 

[WillB]

I over did it many times during my first tkr recovery. I know how it feels. It sounds like what you are doing. I'm still on pain meds, but way less than early weeks. Our surgeries are 1 day apart. And no, you can't compare because no two are alike.
Bedtime and morning are my " ouchiest" times. I still take pain meds then. Occasionally once during day.
You are 4 weeks today. If you rest, ice, elevate and take pain meds when needed you will see a big difference and feel so much better. Worth a try. What do you have to lose?

Curious what pain meds you are using now. For the past 10 days or so I’ve just been using Tylenol plus Gabapentin at night 300mg. Last night, Thursday, I took a Percocet around 9:00…went to bed and slept well until around 2. So great to have some decent sleep. Took 1000mg of Tylenol at 2am and slept okay until 6…

As my swelling reduces, thankfully, it seems as if my knee is a little less stable. Been able to walk without assistance for a week or so, but pulled out the cain for a bit of support. Interesting.

 

[beachy]

I take hydrocodone 5mg. Sometimes I take 2 in the morning if I can't walk off the pain. 1 in the late afternoon and 1 at night. Some days I don't need the afternoon dose.
Gabapentin 2x/day (nerve med)
Baclofen 3x/day
I've had several refills.

You'll sleep better if the Percocet helps the pain.

 

[kneeper]

I over did it many times during my first tkr recovery. I know how it feels. It sounds like what you are doing. I'm still on pain meds, but way less than early weeks. Our surgeries are 1 day apart. And no, you can't compare because no two are alike.
Bedtime and morning are my " ouchiest" times. I still take pain meds then. Occasionally once during day.
You are 4 weeks today. If you rest, ice, elevate and take pain meds when needed you will see a big difference and feel so much better. Worth a try. What do you have to lose?

Curious what pain meds you are using now. For the past 10 days or so I’ve just been using Tylenol plus Gabapentin at night 300mg. Last night, Thursday, I took a Percocet around 9:00…went to bed and slept well until around 2. So great to have some decent sleep. Took 1000mg of Tylenol at 2am and slept okay until 6…

As my swelling reduces, thankfully, it seems as if my knee is a little less stable. Been able to walk without assistance for a week or so, but pulled out the cain for a bit of support. Interesting.

Are you taking tylenol during the day? Pain tends accumulate and hit you at night even if you don't feel too bad during the day. I tended to find if I kept the pain at bay during the day, the nights weren't as bad (and I did take something before bed too.)

I also found at your stage of recovery that the knee would have "wobbly" moments. I think it is the ligaments, muscles etc. settling down as the swellling diminishes. That gradually went away.

 

[beachy]

@kneeper
Was that question for me or Will?

 

[Layla]

I hope you're feeling better this weekend, Will. If not please consider stepping away from PT until you are feeling better, or at the very least cutting back on your visits.
Happy One Month Anniversary!
@WillB

 

[WillB]

Interesting the 2nd night being back on Percocet I did not sleep as well as the previous night. But all in all nightime pain has diminished a fair amount. 4 days since last PT session but may be walking too much as knee stiffens afterwards. Really a fine line to walk. Zingers are finally subsiding! But there is still some swelling and with the reduced swelling, the knee feels a bit loose…a feeling of instability. Coming up on 5 weeks, so I guess I can’t be too disappointed with the progress but I sure wish I had known the enormity of this knee replacement so I could have shared that enormity with my wife! I’m not sure she was prepared for all of this…

 

[sistersinhim]

It is a shame doctors aren't more realistic about this recovery. It would save their patients a whole lot of unnecessary worrying if they were. Maybe they are afraid that many wouldn't have this surgery if they were told about the long and painful recovery time involved, so they're quiet about it. I think it wrong, though, to mislead people.

 

[WillB]

Pretty sure I’ve gone backwards as to my extension rom. Was at 0 a week or so ago, but as the swelling goes down, the stiffness is still there and the knee seems a bit “locked”. Definitely not at 0 extension. Have a PT session this afternoon and I’m afraid they’re going to be disappointed. May move future PT sessions out several weeks as our Marine grandson is coming for a visit this week. While the zingers appear to have stopped, sleep was tough last night due to random aches and pains.
The sleep deprivation has been the toughest issue to overcome!

 

[beachy]

You do know that swelling keeps your knee from having perfect ROM at 4 1/2 weeks post op, right?
Your extension will continue to straighten after more time.
Mine was never at 0 until 3 or 4 months post op. Neither PT nor my surgeon were concerned. Just walking and ADLs gave me perfect ROM.
But, not right away.