Lounge Doctor

What You Should Not Expect To Do After a TKR


Nurse Director
Jun 8, 2007
The North
United Kingdom United Kingdom
Written by Tim (referee54)

Many of you have written that you are prepared "to work really hard in PT/rehab after your TKR or your BTKR." You have to remember that this is not an athletic-type injury; it is true that many of us have had some type of arthroscopic athletic surgical repair done to our knees---but this is far from that type of surgery---it is, if you consider it from a certain perspective, akin to "a double amputation", as two of your bones were sawed off. True, these bones were replaced with implants, but the surgery was far from gentle! Please also remember that the knee joint capsule itself is rather small and tight and has very little room for swelling or irritation!

You, therefore, should not expect to work hard; what you should expect is to be very patient and gentle with your surgical knee. You may exercise diligently, but gently. Your knee will let you know when you are doing too much; if you overwork your knee, your knee will get angry and “go on strike.” When this happens, work to keep your knee happy---do not keep working harder. Therefore, listen to your knee and pay attention to what it is telling you---it is always right, and your job, regardless of how you feel, is to agree with the knee. Do not expect hard work to speed up recovery or make your knee feel better!

I have a statement that I often use with students who are struggling. I ask the students, “What is the definition of insanity?--- Doing the same thing over and over again and expecting different results.” Think about it---if your “hard work” is making your knee hurt and swell, and your “hard work” is causing your recovery to slow down or come to a standstill, then why are you then still employing the “hard work” work ethic? The key to this, then, is to not expect rapid recovery or normalcy in six weeks. Recovery can take upwards to a year---true, many of us recovery faster than that; from my own expereince, though, my own recovery took me on a journey that came to a conclusion around eight months.

Do not expect miracles---I have read of a few folks on the forum that have recovered very, very quickly---but those people are far and few in between. Most of us have gone through a roller coaster recovery ride that was oh-too-slow, but that is just the way it is. In that regard, you should not put a timetable on your recovery, as your knee is in charge of the schedule. If you keep saying, “I am at six weeks, I should be doing this---why am I not?”, you will set yourself up for disappointment---repeatedly. Different people recover at different rates, and your knee will let you do all kinds of things that you want to do---when the knee is good and ready to let you do it. ROM will come---but not immediately or overnight. Strength and stamina will come---but in due time and in due course.

Do not compare yourself to others; again, this will set you up for a frustrating time and you will be tempted (again!!) to work hard and to play catch-up. There will always be people who recovery a little bit faster and easier than you---trust me on this---I know from my BTKR. It seemed like everybody was moving faster than I was and my two knees were spending a great bit of time in the “slow lane.” I did, though---and you will, too---reach the destination of being fully and happily recovered with a great life---you will get there! If you want to work hard, fight the urge and realize that you will actually slow your recovery down.

Do not listen to those stories about “a friend of relative’s coworker”. We have heard it all before, everybody knows “somebody” who had a TKR and was back to normal in no time---and this person whom you are speaking to is accusing you of slacking, taking it easy, or not pushing yourself in PT---and your recovery is too slow. Remember---you are normal, and so is your recovery---do not listen to those who are “experts”---the world is littered with people who are “experts" even though they have no expertise or experience in recovering from a TKR! It is like this---almost all of us have flown in a passenger plane---that does not make us experts on flying one. The fact that most people know somebody who has had a TKR or a BTKR does not make them an expert on recovering from one!

Do not let PT’s push you around! We have a hard time understanding this, but those PT’s actually work for us! I was lucky that my PT’s dealt only with joint replacement patients---others worked with ACL’s and such---so they kept me in check---they told me when to work harder and when to cut back. Do not let these people push you too hard and make you hurt. Remember one of the Bonesmart mantras---if you do it and it hurts, stop doing it! Again, it is not “no pain, no gain.” You have to keep the knee happy; let the PT’s obsess with numbers and ROM---do not let yourself worry about the silly numbers. Remind yourself of this---all ROM is, is numbers---quantitative---you worry about qualitative---and understand that, when you are recovered completely, your knees will allow you to do what you want to do---the numbers will not matter. Do not obsess over ROM! Your quality of life after recovery will be amazing---the ROM is not what matters---what matters is what you can do and that you can do it pain-free!

Do not let yourself worry! I was one of those worrywarts---I kept asking “When will I lose this limp?” “When will I be recovered?” “When will my swelling in my legs go down?” The PT’s and the folks in the know just smiled gently and said, “Tim, you will get there---but it takes time, so just keep on moving forward and looking forward.” They were absolutely correct! I did make it, and, as I have stated, it did take longer than I expected it to and longer than I would have like it to, but I made it! You will, too! Do not let yourself worry about it, and we will be here for you and for your questions, your concerns, your rants, and your vents---we will help you through this, and we will work to help assuage your concerns and your worries!


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