TKR What did I get myself into?

[Jockette]

There really isn’t any “going backwards.” Your ROM is directly affected by your swelling, which varies with activity. You are going to swell for weeks to come. Try to stop worrying about your ROM and just relax and ride out this recovery. Rest, ice and elevate, and do some gentle activity, to keep your knee mobile.

Some PTs want us to recover ”yesterday” and missed the class about how long the recovery from a joint replacement takes. Try not to let their urgency become your priority. Give your knee the privilege of sorting itself out. It will if you give it a chance. One month is a drop in the bucket in this year long recovery.

You really are doing fine. Several months from now you are going to reread these posts and wonder what you were so worried about. I worried a lot about my ROM, also. Mine continued to improve well into my second year, making me a bit angry that my medical team had caused me so much stress in the early months.

 

[Jockette]

Another example is my current 6 year old knee. I fell, the day after Christmas, and landed right on my PKR knee. It swelled up quite a bit and I could hardly bend it. It is 7 weeks today, since I fell, and my knee is still sore, bruised and still has some swelling, though my ROM is better. All this just from a simple fall, and my knee hitting a hard wood floor.

When we have a joint replacement, the knee is cut open, bones are sawed and drilled, the implant is hammered into the freshly sawed and drilled bone. Soft tissue is moved out of the way and put back again. Is it any wonder that joint recovery takes so long, with all the trauma the surgery causes, as compared to my knee just hitting the floor, and 7 weeks later it’s not fully healed yet.

My fall has caused me to see this recovery in a whole new perspective.

 

[benne68]

as the swelling goes down, the stiffness is still there and the knee seems a bit “locked”. Definitely not at 0 extension.

Although the visible, external swelling may have gone down, the soft tissues inside your leg are still very inflamed at this early stage in recovery. If you are any where near straight at just a month post-op, you are doing extremely well. For most people, regaining extension takes longer than gaining flexion.

Have a PT session this afternoon and I’m afraid they’re going to be disappointed.

They have no right to express disappointment! If they do, you should consider finding another PT, because they clearly have not been educated in TKR recovery.

Remember, this is YOUR knee and YOUR recovery. You don't need to please anyone but yourself!

 

[WillB]

Now almost 5 weeks in I see progress with my knee regarding swelling and how its’ feeling overall. I actually spent almost 9 hours behind the wheel picking up my Marine grandson from Las Vegas. Surprised how good the knee actually felt but, again, sleep is still fleeting. My Tylenol and Gabapentin regime doesn’t seem to work well enough to knock down the dull ache which seems magnified at bed time! It’s the only part of my recovery thats still a struggle. PT sessions are going really well right now! Have my 6 week checkup next week and will see my surgeon for the first time since my Jan 12 procedure!

 

[benne68]

Are you still icing and elevating, @WillB? It's especially important when you have a busy day like the one you describe. It might help get rid of that dull ache that is keeping you awake at night.

 

[EalingGran]

actually spent almost 9 hours behind the wheel picking up my Marine grandson from Las Vegas.

Amazed that you can do that so early. Not surprising to me that you have dull aching by night time.
I did my first 2 hour driving trip ( I drove about an hour and my husband did the other hour) recently and I am 16 weeks post PKR. I felt slightly stiff and achey- funnily worst after being the passenger.
I am amazed by the distances some of the US BoneSmart posters drive so early on.
It reminds me of a comment about one of the differences between the UK and the US.
"In the UK a hundred miles is a long way and in the US a hundred years is a long time....."

 

[WillB]

Just went over 5 weeks since my LTKR. I have taken Tramadol the past two nights to help with discomfort at sleep time. Seems to be helping as I’ve slept better the past 2 nights! Good sleep has been elusive.

A question I have is regarding the connection between stiffness (swelling) and pain. While I understand stiffness can go on for quite sometime, is it always accompanied by pain?? Been on my feet quite a bit this week resulting in a bit more discomfort.

 

[trinket]

My knee is still very tight, and I have a lot of swelling, but I haven't had any pain for a long, long time. so in my case, the tightness is not accompanied by pain.

 

[EalingGran]

question I have is regarding the connection between stiffness (swelling) and pain

I think stiffness is a form of discomfort/pain but it doesn't respond to opiates like acute pain.
I think it is closely linked to swelling- certainly for me anyway. What works for me is regular icing and possibly a NSAID like naproxen.

 

[sistersinhim]

My pain left a month or more before my stiffness did. It was the last thing I complained about.

 

[Darkang]

also had TKR, left knee on the same date. And I suffer from the same impatience.

 

[WillB]

also had TKR, left knee on the same date. And I suffer from the same impatience.

Definitely tough realizing this is a solid 4-6 month recovery when one is pretty impatient to begin with!

 

[benne68]

My surgeon likes to say that the single most important muscle to exercise during this recovery is the patience muscle.

 

[beachy]

I think it depends on your activity level.
I was reading through my first recovery thread and I was much better at the 7 week mark. Then, of course, I firmly planted myself in the ODIC. Ouch.
I was feeling my best at the 4 month mark. Its a gradual recovery at our current 5 1/2 weeks. I really believe with gentle pt, short walks, ice , elevation, rest when needed and pain meds when needed we're going to see progress in the next few weeks.

 

[WillB]

One of the issues is that the better you feel, the more you want to do. I spent 3 days on my feet alot, walking around. Sometimes with a cane and often without any assistsnce. At 5 1/2 weeks I know its still early but last night I paid the price as it was a pretty restless night. Today will be a total rest day. PT tomorrow and then my 6 week checkup on Wednesday! ROM numbers could be better but I’m not stressing over it! Still have a loooong way to go but hoping to be able to get back on the pickleball court mid April!

 

[Layla]

Your current situation is not your permanent destination, you will get to where you want to be, even though not as quickly as you'd like. Glad you're taking a day of rest, Will.
Go easy in PT tomorrow if you're still paying the price from the activity of the previous days.
Best Wishes for Wednesday's check up! Let us know how it goes.
@WillB

 

[WillB]

I have two questions as I approach 6 weeks post op. I am wondering if its a bad idea to have a PT session literally 30 mins ahead of my 6 week checkup with my OS? I’m generally imcomfortable immediately after PT. Currently at 102 Flex and close to 0 on extention but still experiencing some pain and swelling. Also, I’m hoping it is totally normal to have additional pain and swelling after being on my feet for hours? I guess thats the ebb and flow of recovery?

Oh and both my PT and OS appt are tomorrow afternoon but after a drive to Phoenix and back (about 5 hours total).

Thanks all and wishing everyone a good nights rest

 

[EalingGran]

Also, I’m hoping it is totally normal to have additional pain and swelling after being on my feet for hours? I guess thats the ebb and flow of recovery?

Definitely agree. I find standing the worst.
I am 16 weeks post op and love art.
I had started to go back to galleries ( currently suspended as back in hospital with unrelated condition) but I would still swell with standing.
As to your OS and PT timings it depends if you think your OS will not believe your true flexion if you are stiff after PT and can't bend. Might be worth making a video at home of you at your best- walking, bending etc. Especially as you have a long drive as well.

 

[sistersinhim]

I am wondering if its a bad idea to have a PT session literally 30 mins ahead of my 6 week checkup with my OS?

I think you should have PT and the OS visit another day. Doing both in one day is awfully stressful on your knee.

 

[WillB]

Wow, being on my feet alot is sure hard on a barely 6 wk old knee. And after the drive to Phoenix and back this morning, my knee is quite stiff. May have trouble getting my OS to believe my flexion was 102 Monday!!