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TKR Heathertee right knee...

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Heathertee2002

Heathertee2002

junior member
Joined
Mar 9, 2012
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24
Age
85
Location
Connecticut, US
Gender
Female
Hello to everyone from a veteran of many joint replacements: both hips, left shoulder, and now the right knee. Undetected Lyme disease and other factors did a number on the joints.

Reading through some letters, I have noticed that many of you hit a low three to four weeks out of surgery. This was the case with me (a mixed blessing, as the depression led me to this forum). Having had both hips replaced, I mistakenly thought the knee would be a breeze. HAH! Little did I know.

It made a difference that I had no real pain in the knee before surgery but the cartilage was so badly eroded that I was getting knock-kneed and this put pressure on my foot causing tendonitis. That is gone now! but I was definitely overconfident regarding the pain level of this particular surgery.

I spent two weeks in a very good rehab facility with PT every day. Home now, a therapist comes to the house 3X a week and the other four days I exercise on my own. Mobility is finally up to 105 degrees with 0 extension but it stiffens up fast after exercise and I know I still have a long way to go! When I am no longer eligible for home therapy, I have a script for water and other therapy at the gym.

Sleeping is the worst problem ... still have a very hard time sleeping at night and have only just begun to be able to get onto my side, my usual preferred position. I still badly miss the hospital bed with the elevating foot; just a couple of inches made such a difference and I slept much better there. If I had it to do again I think I'd rent an electric bed.


Soooo.. I have nothing unique to add here but I want you all to know that just reading about your experiences has been an enormous help! Thanks to everyone.
 
Welcome to BoneSmart.

Make sure at this stage your exercises don't hurt, that would set you back. Stiffening up after exercise may mean you're overdoing it.
 
Wow - you are only the second person I know of having had so many joint replacements 17 Years 5 (FIVE) Total Joint Replacements!

Well, you fell into that trap about the difference between hips and knees! There are many impacts that seem unique to knees and these articles cover most of them
The first set is essential reading, the second is useful and the third is good information, But you will need it all
The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

Plus Sleep deprivation is pretty much inevitable - but what causes it?
 
Hello Heathertee, I just wanted to say hello and welcome to Bone Smart. You've been through a lot, hope you are about done now! You have the potential here to lend advice to knee and hip patients while seeking the advice you need yourself. It is a great place this forum! Glad to have you here!M:doggieshmooze:
 
Hello Heathertee...I also prefer to sleep on my side . I realize the importance of elevating your leg at night. I sleep on my back with my leg on a long pillow. I put another small pillow under the bottom of this pillow. It works for me!
 
Hi Heathertee....welcome to BoneSmart! I'm glad you found us and please know that we are always here to help you if you're having a bad day or celebrate with you on the good ones! You're part of the BoneSmart family now.
 
Thanks to everyone with input, all very much appreciated. I have been doing a lot of reading and so happy I found this forum!! It helps so much, especially with knowing not to push too hard, and with knowing that everyone else has been in the same boat.

A little update here: Now nearly at 6 weeks and during PT I got to 112* today. The knee is still at 0 extension, but I have to really work at that to keep it there. Maybe it's because I no longer am forced by pain to sleep on my back, so on my side with knees bent, the operated one stiffens up a bit more.

That said, nights still are a challenge getting comfortable enough to get more than an hour's sleep or so... but it will come.
 
Heather-

Last week my right knee wouldn't bend to save my soul, this week, the left knee won't bend but the left does???? No clue, I've learned to work with what I have and not think to far forward about either of these finicky knees.

Sounds like we all suffer with restless legs to one degree or another but especially at night. My nights have been pretty good and I am hoping they get better with time too.
 
Heather, welcome! At 18 weeks, I sometimes wake up with pain in my knee from being in the same position too long, but the sleep is much better than in the beginning months. Take care!!
 
So many useful tips; thanks, everyone!

I have finally been able to get some real sleep. OK, I know putting anything under the knee isn't a good thing but I was desperate, having not had more than an hour's sleep at a time in spite of regular pain meds.

I cut a piece of that thin waffle-like mattress topping (no more than one inch thick) to fit a zippered satin pillowcase. When I lie on my back, I can finally get some extension without pain. Evidently the pad allows just enough flex that I can achieve a level of comfort to allow sleep, plus the satin is very cool and smooth to the back of the knee.

I told my therapist what I am doing and she said we'd keep an eye on it and if extension got worse I'd have to stop, but I do my stretches religiously and after five days am still at 0 degrees. Whatever works!
 
It's time for an update; tomorrow will be the 7-week mark. Recovery continues to be pretty uneventful and may it remain so! I finally am driving again (when I HAVE to), and have done food shopping on my own.

This will be the last week I can have in-home PT, which has been twice a week. I seem to be stuck at 112* and hope that is temporary! Extension is still 0* but the therapist told me I will probably always (as in, forever) have to work at stretching it to keep it there. Oh well, whatever works. Next week I begin water therapy in the PT unit at the Orthopedic Surgeon's building, and that is good for four weeks. Then I should be on my own.

I have just yesterday begun doing complete rotations on the Aerodyne stationary bike. Up to then I'd only been able to "rock" back and forth, so Barbara was thrilled. :dancy: I nearly sold this bike in a tag sale a couple of years ago and am SO glad I kept it!

I have begun working on low steps, going up on the bad leg, but, no down yet. All in good time!

Nights continue to be problematic with frequent waking and pain in the back of the knee, and I am still having to take one 2-mg Dilaudid at bedtime and at 1 or 2 am, in addition to my arthritis-strength Tylenol three times in 24 hours, plus an occasional Advil. Daytimes are much easier, of course, as I can get up and walk about when it gets stiff or achy. It's too cold at night to do that!
 
On my first TKR I really benefited from water exercise a lot. You can move with no pain which is lots better than regular PT. I joined health club with indoor pool so I could continue for months afterwards. My stationery bike also was part of my schedule after formal PT ended. My ROM very slowly improved for the first year.
 
Thanks for the feedback, Bridget. I see your right knee was done about two weeks after mine (2/15/12). It is just amazing how much difference two weeks makes, isn't it!

PT in the rehab facility was very aggressive and after reading all the precautionary stories here, I know why it didn't get any easier. (The hospital therapist was the worst, three days after the operation, she made me bend it to 95*. Then I wondered why, when I started therapy in rehab, they could get it only to 80. Hm.)

My home therapist has been very gentle and has gotten much better results. I wish I had known about this forum before I had the thing done; things would have been a little different.

I'm a member of Silver Sneakers (AARP) and there's a really nice YMCA in a nearby town where I can use the pools for free, so that's where I'm headed once the formal therapy is done. All I have to do is just DO it. The hardest part is getting out of the house.
 
I really appreciate hearing about the continued improvement in ROM. It is stressful when you are continually reminded that ROM should be at least 120 by week 4-6. I do everything I can to focus on the PT and not the numbers knowing that improvement can continue for quite a long period of time. Thank you!
 
Bev, I try to focus on the PT, as you say, but I am a numbers person and tend to get easily discouraged by these sticking points. Just have to ignore them as best we can and keep on working!

It is stressful when you are continually reminded that ROM should be at least 120 by week 4-6.
Click to expand...

I should say it would be! Nobody ever told me that, but after reading this forum, it's easier to ignore, isn't it!.

Now if I could only figure out how to get a GOOD night's sleep! The knee seems so good all day and then I get into bed. It feels so good... for about ten minutes. Then the back-of-the-knee pain begins and with it the tossing and turning. None of my current meds seem to work with this extension pain, and much as I'd love to stop taking it, the Dilaudid at night is the only reason I get any sleep at all.
 
I've done pretty good sleeping. I added acetaminophen to my meds when I was taking just the dilaudid. I still go from pillow between my knees, to no pillows, to slightly sitting position ( we have a temperpedic bed with controls to raise feet/head) so I change position every 20-30 minutes but I do sleep. I also followed suggestions from the other smarties to get up, read, play on my iPad, it seems to be just enough to knock me out for the next round of tossing and turning. Best of luck!
 
Wow... I would probably kill something if that would get me a bed with controls! ...I need to keep the house very cold at night to save oil, so there is no getting up except under the direst circumstances, and then for only a few moments. But warm weather is nearly here!

Still taking Dilaudid but have only three left; have been taking two every night four hours apart, along with the Tylenol AND an occasional Advil. I think I'll cut that to one Dilaudid tonight and see how I do. BUT I'll also stop and pick up a new prescription for it in case I need more before the weekend is out. Second daughter and her family are coming for Easter weekend so I'll be on my feet more than usual. :)
 
Forgot to say, last in-home therapy this morning and I hit 114*! WOO HOO!

I have an evaluation appointment with the water therapy people Monday afternoon. Can hardly wait to get into that warm pool!
 
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