TKR recovery progress check

[Wolf68]

I would like to tap into the knowledge and experience of the people on this forum just to check how my own personal progress is going please. You guys have been very helpful and informative and sometimes it’s nice to check if I am worrying prematurely before bothering doctors because appointments are not easy to get these days.

It’s been just over 6 weeks since I had my surgery, I have been able to do most of the exercises given to me by the physio ok although getting out of certain lower chairs I still find difficult and bending the knee is still restricted, slightly painful and tight.

I am walking around the house without any walking aids but I do still use a walking stick up the stairs, however I still have a very pronounced limp and after a while walking begins to feel painful so I still use my walking stick if I’m going to walk very far outside. Whenever I try to increase the amount of walking the pain and swelling in the knee gets worse and similarly with most of the exercises I try to do but especially walking. I have got a little pedalling machine I can pedal from a chair but when I even bend the knee to get my foot in the pedals it feels very restricted so actually pedalling it is difficult although I am persevering with this.

The knee is still very swollen, it is hard and warm to the touch on the outside of the knee and again this seems to get worse as I increase my activity level.

I have reduced the amount of pain killers I have been taking but I get waves of intense pain lasting for a minute or two that stops me doing anything but this does go. I am still regularly elevating the leg and icing it throughout the day but if anything the swelling has gotten worse in recent days. I am also still having trouble getting comfortable at night and change positions from sleeping on my back to side sleeping with a pillow between the knees, but whichever way I sleep my knee feels quite uncomfortable after a short while and I end up constantly moving positions. I usually end up having pain killers (zapain) in the early hours just to get some sleep.

Is all this normal for 6-7 weeks post surgery or is something not right?

[Runrig01]

You usually see your consultant around 6 weeks after surgery, havd you seen him yet. Normally you continue using sticks till your seen at that point. It may be your putting to much strain on the joint, from mobilising without sticks. When you say your elevating your leg, is that quite high, so your legs higher than your heart, this is where it needs to be, rather than just on a low footstool. Slightly concerning that you say it’s red and hot to touch, it maybe there’s an infection, so I would see your gp. The important thing is that you should be able to get your leg straight, otherwise you can have a permanent limp. Your consultant would rather hear from you sooner, you could akways ring his/her secretary

[DorsetLady]

As Runrig01 asks have you had your follow appointment with surgeon yet? If not, then mention it then.. or as also suggested speak to GP… don’t think you should be having that much swelling still.

[Wolf68 in reply to DorsetLady]

My follow up with the surgeon is on the 30th January, I have had physio where they have measured the movement and even though they have mentioned the amount of swelling they didn’t seem that concerned.

I am elevating the leg fairly high, on the bed I have it on lots of pillows and I have a wedge pillow and folded throws for the sofa.

At one of the physio sessions they showed us the artificial knee they have put in and it is quite big so I guess the knee will always look bigger than it was but it gets even bigger after exercise so I am guessing there’s a build up of fluid.

I can straighten the leg perfectly when I am lying down but not when I raise my legs in front of me and when I walk it sometimes feels like the knee cap isn’t moving with the knee when I try to straighten my leg, sometimes this seems to ease up after walking a little while but other times it continues, it’s not particularly painful but it is an irritating sensation.

Looks like trying to get a a GP appointment I think.

[DorsetLady in reply to Wolf68]

Okay…my physios seemed to be more interested in how quickly I could bend the knee…at lot more that most apparently -didn’t have a problem with straightening either. Maybe the difference between male and female anatomy..

But probably wise to get it checked by GP.

[FraserB]

I’m approaching 7 weeks post-surgery, just about 5 days away. Like you, I’m doing my daily exercises and seeing my physiotherapist twice a week. My physio says I'm making good progress overall, but swelling in my knee has been the main factor limiting my movement. I still rely on a walker when going outside because without it, I limp significantly. Inside, I can manage without mobility aids, but by the end of the day, as the swelling increases, I find myself needing a cane again. It’s frustrating, but my physiotherapist assures me it’s a normal part of the recovery process for many people at this stage. It's great to hear here him say that, but this TKR journey has me worried on occasion about the worst, ie infection, lymphedema, cellulitis, allergic reaction to the implant... you name it I've thought of it. Watching Youtube videos of those who recover and out walking for blocks without any aid at 3 weeks doesn't help!

But the swelling has improved though slowly since the two-week mark, when my staples were removed, though it still flares up, especially in the evening. In the mornings, it’s better, but by the end of the day, it tends to worsen. This seems to be a common experience. Like you, I’ve noticed that pushing myself to walk more can increase the pain and swelling, which my physiotherapist says is normal as the knee continues to heal. As long as we stay consistent with our exercise, elevation, and cold therapy, this is part of the healing process.

I’ve been using a stationary bike, and I can relate to how uncomfortable the first few pedals feel. It gets easier as I go, but I know that it can be tough at first. My physiotherapist, who has treated hundreds of TKR patients over his 25 years, reminds me that everyone’s recovery is different. He encourages patience and consistency with the rehabilitation routine. Regarding the swelling and warmth on the outside of your knee, that’s a typical part of the healing process too, and it’s to be expected as your knee adapts to the increased activity. I’m also seeing my orthopedic surgeon at the end of the month for a check-up and x-ray, and I definitely have a lot of questions ready for him about my knee and my recovery progress.

[Wolf68 in reply to FraserB]

Thank you so much for the reply, the way you described your progress almost mirrors my own experience. It’s good to hear and gives me a bit more confidence. Good luck with your recovery.

[DorsetLady in reply to FraserB]

Agree on YouTube videos.. I had shoulder replaced just before first UK covid lockdown - so no physio F2F.. watching a youngish [obviously athlete] male demonstrating exercises was a tad disheartening. .. but did get there in the end.

[Wolf68]

if I’m honest I don’t think there’s enough follow up appointments after surgery. I saw my consultant the next day after my op, he said x-rays were fine and the physio and nurses said I was getting about well so I could go home. I returned 2 days later to have my catheter removed but there was no real check on the knee, 1 week later I saw a physio who told me I had Lymphedema and should have gone to A&E and I’ve had a further 2 physio appointments since where they have commented on the swelling but not been unduly concerned. I could bend my knee 110 degrees at a push, they did say they would like 120 degrees but were happy enough to say there’s no need for any further physio. My next appointment with my surgeon is the end of this month, I compare that to my father in law who had the same operation 20 years ago and he had visits from a district nurse, had more frequent doctors appointments and more physiotherapy. I guess it’s just the state of the NHS at the moment and I am just grateful to finally get the operation done and I can begin to get my health, wellbeing and mobility back it’s just a bigger battle to get there than I was expecting but I am determined to get there.

[DorsetLady in reply to Wolf68]

I think you are probably right… and all hospitals are really struggling.

I had all my replacements pre covid - spent longer on ward for knee [3 nights], for hip and shoulder only spent one night. Did have one visit from District Nurse re knee, but not others. …

No issues with any, so sounds as if your surgery was more problematic - sorry to hear that. Hope you soon get back to tiptop condition.

[FraserB in reply to Wolf68]

I agree with you about not enough follow up appointments. If it wasn't for the physiotherapist I now have who is very informative I would feel like I'm in a "wasteland" of unconcerned medical care with no appts until the end of this month. Sorry to be so dramatic but unfortunately it seems to be the way of the current system. My swelling the first weeks was dramatic and had me very concerned and I couldn't even make it to 110 degrees because of it, but the last few weeks it has started to come down though still definitely there.

You're right; it's a bigger battle to get there than expected, and determination is key.

[Wolf68]

I am 11 weeks since my surgery and I am still getting pain after and during exercise. My range of motion is pretty good, I am bending the knee almost as much as my other knee and straightening it perfectly but the knee feels sore and very slightly clunky when I walk, probably more now than it did a few weeks ago. I can walk without any aid or assistance but I do limp a fair bit and every now and then I feel an involuntary jerk in the knee that makes me break my stride a bit.

I find standing still for periods of longer than a few minutes makes it sore too and the skin around the knee is rough and numb even though I moisturise and use bio oil twice a day. I know it’s probably still early days but I do feel like I have gone backwards a bit this past week and don’t know why.

[FraserB in reply to Wolf68]

Hi Wolf68, it sounds like the soreness and clunky feeling could be from lingering inflammation in the joint. Your muscles and nerves may still not fully coordinated, which can lead to instability, and the numbness or rough skin might be due to scar tissue or nerve sensitivity. I also have some of this and been told it's common after surgery and can take more time than we realize to resolve. Nearing almost 3 months now, I was thinking everything should be good but I've been informed It’s normal to experience some setbacks then forward again, likely on the right track to recovery. As I was leaving my appt with my surgeon for his checkover, he said it's going to take more time than you think -- 6 months, 12 months even a few people 18 months — this is because I told him I feel I still have some swelling and certain movements can be painful. Though he did say that if any swelling or pain gets progressively worse than it is now to let him know. Keep going —progress is happening, even if it doesn’t always feel like it.

[Blackknight1989]

Just a quick share of my experiences. Before age 49 I had both knees and both hips replaced, as well as both ankles fused. Each joint was a different recovery despite me being the same age (relatively all done between age 43 and 49. Feelings of good progress then a week of “going backwards” etc are all normal within certainly the first 6 months and even for the first year. Certainly we don’t think of TJR’s as serious operations as say a liver transplant and it isn’t my contention they are as serious as a liver transplant but they are a total tear down of the joint God gave you (or if you don’t save my belief that’s completely fine) or you were born with followed by a man-made conglomeration of titanium and others allows designed by a man (or woman) implanted by another man. It isn’t designed to be the original it’s a replacement. As such just like many other items in our lives we replace, often they don’t work as well as the original. That’s normal and expected. I had both knees and both hips replaced (along with both ankles fused) before age 48, I’m now 58. Sometimes I get all the same feelings y’all describe in my joints though it’s been 5 years since my last replacement and 12 since my first. It’s a man-made joint of polymers and steel not made for you by God ( if you believe as I do) or by happenstance if you don’t believe as I do. Regardless, it’s a man-made replacement of a naturally formed or naturally designed joint. We will never (at least not in any kind of foreseeable future) be able to design a joint as God or nature or the Grand Poobah Granter of Life (don’t want to offend anybody so trying to be inclusive) designed the knee, hip, shoulder whichever that God or nature or Whom/Whatever designed. We can get close but it’s never going to feel natural again. It’s always going to be clunky or flare when it rains etc. We are not our own designers and because of that a replaced joint will never feel like the natural joint. But you’ll get used to it and in 5 years most or maybe all days it’ll feel normal. Mine don’t but maybe that’s because I had bilateral knee and hip replacements as well as bilateral ankles fused before the age of 49. I can say you’ll get used to them and the few limitations they cause. The limitations as certainly much better than the pain was pre-replacements if your like me because the pre replacement pain was tough. I had bilateral knee and hip replacements as well as bilateral ankles fused before fusions between the ages of 43 and 49. That was a tough 6 years but at age 58 now, the last pain free 9 years have been worth it and I can still use a treadmill. Just my opinion after 6 joint replacements or fusions over 6 years. Only thing I’d change is the decision to wait for the first surgery because I worried I might have to have them replaced again. Eventually the pain drives the decision and ends the wait period early anyway. My best to you!

[Wolf68 in reply to Blackknight1989]

Thank you for the reply, it’s always a help to hear about the experiences of others that have been through the same.

I think the drop in temperature this past week has probably made things worse, it’s just quite stiff and sore. Would you say I am better off trying to walk and exercise through it all or should I back off a bit and rest more?

[Blackknight1989 in reply to Wolf68]

Great question. The research says exercise is good for these issues but as somewhat of an expert at joint replacements (Double TKA, Double hip replacement and the ankles as well as a hand and elbow surgery (( orthopod and I decided I have familia-osteoarthritis, that is osteoarthritis that runs in families, manifests early and requires earlier than normal replacements. ))) I found that when the joint is so damaged to cause pain and limited mobility as you’ve described exercise only aggravates it. The only solutions we came up with was the replacements. My concern is quality not quantity of life (though now at almost 60 I’m reducing my thinking…lol) I’m chugging along and have decided no more replacements as the list of joints needing said operation to “fix” my mobility problems is long. I prefer to hobble, and get along. My son is 27 and daughter is 22. My wife is a fantastic caretaker when needed and like the Energizer Bunny I’ll keep going till it all cocks out. Will I see 70/75 most likely not, have I enjoyed and made the most out of the so far “extra” 30 I probably shouldn’t have been blessed with. Absolutely! I firmly believe that attitude and viewing yourself still with self-worth and the ability to contribute to help enrich others lives or perhaps inspire another in a similar situation that a good life with relatively minimal restrictions is not only possible but probable. Many thanks for your kind words and as always I wish you the best!