PKR Zab’s recovery thread.

[zab]

Week 4 - Well 4 weeks 2 days since the OP and I managed a full rotation on the bike all be it with a lot of discomfort/pain at the top of the rotation so won't be attempting again for a while, but shows ROM is improving as I could not get anywhere near a few days ago. I can feel the knee getting stronger and walking actually feels therapeutic at times the treadmill is great as I can hold on for extra stability so I am not limping. The knee still swells and goes tight quite easily so icing and elevating as often as I can.

PT tomorrow morning I'm hoping she will clear me to start using the pool so I can start a bit of light strength work water assisted.

All of a sudden sleep is becoming a problem it was fine early on but terrible now which is a bit draining with working full time also, it is what it is though hopefully it'll pass.

 

[sistersinhim]

Great that your ROM is improving, but bummer that your sleep is now affected, especially since you're working now. Catch that sleep when you can. It all adds up.

 

[Celle]

I know you want to get on with your recovery, but it's still only just a month since you had this major surgery and you're already back at work. Your knee is still recovering and trying to heal. Beware that you don't over-stress it with exercise - just work is probably enough exercise for it.

Don't start doing work in the pool until your incision is completely healed, with no scabs or open areas. If you go in sooner, you could run the risk of introducing infection.

 

[zab]

Had PT this morning before work again she just massaged the quads and calf muscle and we got 105 and 5 for ROM, cleared to start using the pool she said the incision was looking good, I'm going for a hydrotherapy session with her Monday just to get the exercises then do them myself as the timings of her sessions are not convenient with work, then next PT a week today.

Can feel the knee strength returning when doing things like going up the stairs and walking in general, it just still swells easily though so trying not to over do things. Slept rubbish again, nearly the weekend can try and catch up on sleep then. Planning on just taking it easy nothing strenuous over the weekend.

 

[zab]

Well I had a bit of a break through moment this morning in the gym, was on the stationary bike and just rocking leg backwards and forwards as it has been uncomfortable to do a complete revolution. I decided to push the pain a little and gradually completed a full revolution then another and another and they got easier and easier I ended up doing 5 minutes gentle cycling and even lowered the seat a couple of notches, I could easily see the flexion improving in the end by about 10° really pleased, no adverse affects after so far.

Goes to show sometimes a little pain may be actually needed to make those gains.

 

[zab]

Great that your ROM is improving, but bummer that your sleep is now affected, especially since you're working now. Catch that sleep when you can. It all adds up.

Hopefuly a lazy weekend so I can catch up a bit on the missed sleep

 

[zab]

I know you want to get on with your recovery, but it's still only just a month since you had this major surgery and you're already back at work. Your knee is still recovering and trying to heal. Beware that you don't over-stress it with exercise - just work is probably enough exercise for it.

Don't start doing work in the pool until your incision is completely healed, with no scabs or open areas. If you go in sooner, you could run the risk of introducing infection.

I know @Celle my PT said she's seen it many times before, the younger and fitter you are before a knee replacement the quicker you want to be up and fixed and the higher your expectations. I spent 22 years in the Royal Marines I have a certain mentality it's ingrained fortuntely/unfortunately which ever way you choose to look at it

 

[zab]

Just had my first bath since my OP been showering up until today, a couple of handfuls of radox bath salts, the water as hot as I could stand.............absolute heaven

Glad I worked on my leg strength before my OP though my right quad came in very handy as my bath is quite high sided.

 

[kneeper]

Congrats on the doing the full rotations on the bike! I'm glad the massage is working well for you. Tight muscles can be part of the recovery challenge--they were for me.

 

[zab]

Hydrotherapy session this afternoon looking forward to seeing how the exercises feel in the pool.

Knee feels strong after a weekend of rest, sleep is still hit and miss woke at 1.30 am last night then just nodded off for an hour at a time early night tonight I think.

 

[zab]

Week 5 - 5 weeks since the operation and I'm fairly happy with my progress, I can feel the strength and stability coming back each week. I'm beginning to regret being quite as lazy over the weekend and not doing any PT at all I think I should have kept things ticking along lesson learnt there..

Hydrotherapy was good lots of walking in all directions, extending and flexing my bad leg, partial squats both two legged and single leg, I plan on getting down to the hydrotherapy pool 3 times a week.

Knee still gets quite stiff when the swelling comes on but I'm elevating and icing as often as possible to keep it under control, elevating is the key i'm finding, I probably don't need to Ice as often as I do but I find it soothing so will continue

Off all meds now as I have no pain sometimes a dull ache mainly at night, slept better last night than in a while lets see what tonight brings.

6 week follow up with OS on Friday have to have some x-rays done tomorrow, will see what he has to say.

 

[Lindylee]

Great progress report. Good luck on Friday, hope the appointment goes well for you.

 

[zab]

Had my 6 week follow up today, had to get some x-rays done earlier this week. Was in with OS for all of 5 minutes pretty much said he was happy and if i'm happy see you again at the 12 month mark.

 

[Jockette]

I am so envious of all the members who get discharged so early! I had way too many check ups that caused me so much stress.

 

[zab]

I am so envious of all the members who get discharged so early! I had way too many check ups that caused me so much stress.

Awww @Jockette your time will come I'm sure

 

[Jockette]

It’s been 2 years and I’m only now beginning to do steps better. I have more limitations now than I did before the surgery. My Patellofemoral partial has not been a success.

I should not have trusted the first and only surgeon I saw. Ignorance is definitely not bliss.

 

[zab]

One of the x-rays I had to have done was a MAQUET view which is a full length waist down view which with the help of modern technology measures where you are weight bearing in the knee, I also had one done pre-op he put them up side by side on the screen and the difference in the weight bearing line is incredible, pre-op all the weight was being taken completely on the extreme medial compartment (where it was bone on bone). Now the weight is being taken slighty off centre towards the medial side which he said was perfect. He said this level of accuracy can only be acheived with Makoplasty and as the prothetic was designed exclusively for me Stryker have it all in the system so should I need any sort of revision due to component failure that would make it easier.

However the weight bearing line on my right knee was not so good! Exactly the same as my left pre-op however I have not touch wood had any issues with my right knee and he said chances are I may never need any work on it provided I get the left knee strength back and sharing the load.

My OS is all about root causes and he believes the root cause of my issues are not the menicus tears I had back in my 20's they just compounded and excellerated things. He thinks a combination of being fairly flat footed (weight is taken more on the medial side) along with slighty bow legged (again weight is taken more on the medial side) are the root causes, the menicus tear mearly excellerated things. A 22 year career in the Royal Marines probably hasn't helped things

 

[zab]

It’s been 2 years and I’m only now beginning to do steps better. I have more limitations now than I did before the surgery. My Patellofemoral partial has not been a success.

I should not have trusted the first and only surgeon I saw. Ignorance is definitely not bliss.

@Jockette To be fair I've not read of any completely successful Patellofemoral partials perhaps they should take it off the menu and start giving you guys a TKR, but you have to see it from there POV if everything else is good...........it's a tough one but don't go hard on your original OS I'm sure they had good intentions, I'd like to think all surgeons want good outcomes just unfortunately that is not always how it works out.

 

[zab]

Well 12 weeks post op today time has flown. I'm doing OK I know I'm a bit of a slow healer from previous broken bones so I'm trying to remain posistive. I'm back in the gym every morning doing a 20 minute on the stationary bike followed by a strength training routine to get some strength back in the left leg, last week added in some ankle weights on advice from my physio. I'm also trying to get to the hydrotherapy pool 2-3 times a week.

ROM is 115 (120 with a bit of help) and 0, the knee still feels very stiff and tight and swells slightly as the day goes on. Been back at work since week 3 and I've found sitting really makes the knee stiffen up so have set a reminder every 30 minutes to get up do a lap of the building and sit back down again.

Still seeing the physio every 2 weeks she has been great usually just massaging, although she did aggravate things last week I didn't feel it at the time but the knee has been sore for a few days now just a bit more tender than normal so I've been icing and elevating something I haven't had to do for a few weeks now.

So staying positive atm only real downer is the 4 kilos I have put on since Feb need to get fit to shift that

 

[maryo52]

I'm at four months and I find that very much activity aggravates my knee. My goal is to not aggravate my knee. If you remember the tale of the turtle that won the race, TKR recovery is a lot like that.

As far as strength, this is somewhat determined neurologically. I was told by my OS (head of the department at Mass. General) that the leg will regain its strength in 6-12 months. He recommended straight leg raises with ankle weight (which I've been doing for years); bending types of exercises tend to irritate the front of the knee, he reminded me. Yes, challenging our muscles creates strength . . . in a healthy knee. When knee joints become unhealthy, the brain registers that and puts the break on the quad muscle. I have a very atrophied quad on my right as proof. It takes 6-12 months for the neuro system to catch up with the fact that the knee is now healthy. That's one argument for delaying a training level of challenge on your new knee.The other is that at 12 weeks, those traumatized tissues just are not ready for the level of performance we want so we get pain and swelling instead of good progress on strength. As a metaphor, can you imagine toilet training a 6 month old, or sending a two year old to kindergarten? I took a small bike ride and my knee rebelled for two days so I'll wait a few weeks to try again.

Just as an aside, I was having trouble with the extra weight (sweets became part of my pain management!). My PCP asked if I was practicing portion control. My answer rambled on for 5 minutes, to which my PCP replied "In other words, no." That's when I finally got it that food habits have greater impact on weight control tham exercise. Just by cutting out sweets I lost the extra weight.