New knee questions

[Photojeep]

I am now recovering from Total Knee Replacement surgery and have a few questions for those who've gone through it.

My surgery was Dec. 9 and I came home on the 11th. I was up and walking about 3 hours after with the help of a walker and the Physical Therapist who used a strap around my chest he hung on to. (I felt pretty safe with him by my side as he looked like he could bench-press a Buick.)

I am doing my stretching and exercises as prescribed and am walking as much as I can but I'm wondering if I'm as far along as I should be in terms of range of motion.

Currently, without forcing anything, I have between 85 and 90 degrees of flexion. If I push it I can get to about 95 degrees. I can almost completely flatten my leg to the bed if I "force" it gently with my hands.

I have a PT coming to the house 2 times a week and she's as conservative as they come and doesn't seem all that interested in increasing range of motion but instead, a complete avoidance of pain. I just know that when I switch to going to PT outside my home, they're gonna push me to the point of a lot of pain and I want to be ready. I should be going there shortly after January 2.

For those of you who've gone through this, am I where I should be?
At 8 days post-surgery, where were you?
How long did it take for the "sausage leg" feeling go away? (I don't mean blood clots, just the feeling like your leg is stuffed.)
How long does it take for the bruising to subside?

Well, I'm off to go stretch and work on it.

Thanks for any info you can give,
PJ

[Fogducker]

Sounds like you lost a tick or two off your 100 meter dash!

Fog

[Lkristians]

Well, you've come to the right place! I had one done 5 years ago, and it was the best move I made. BE PATIENT. My PT was also conservative and emphasized that the old lore about "no pain-no gain" is bunk. The extension, rotation, movement will all come in time. It's imperative that you stay vigilant with your therapy, but you don't have to overdo it. I think in a couple of months you'll be almost as good as new. And in a few months, even better. And going to the therapist should not be any more painful than you currently have. They just do more extensive stuff to get your movement maximized.

I also had a complete hip replacement 9 years ago, and that was tougher, believe it or not. I always thought the knees were, but it's different for everyone.

And, by the way, just this past Thursday I had my other knee scoped, and on the mend nicely.

Get well soon, I know you will!
LarryK

[RustyAxe]

My wife had BOTH knees done at the same time. A week after surgery don't expect a whole lot of ROM, that'll come in time. And pain relief IS very important, you're not likely to become more mobile if it causes excruciating pain to do so. It'll take weeks for the swelling to completely subside ... you've allowed a major insult to your leg, and it's gonna complain for a while. The best thing you can do is listen to your therapist, DO the exercises recommended between sessions (or rest up if that's their instruction). Progress isn't measured in days, even weeks ... but in months. Pat yourself on the back every time you make measurable progress, but don't compare this day with yesterday, rather, compare it to last week, two weeks ago, etc.

Wishing you a 100% recovery!

[Gabby84]

agree with what others have said. my s.o. and my Dad had total knee replacement. In both cases, not pushing it and following the conservative route proved best. The PT on outpatient was not more painful, just more range of motion work, which caused pain in different areas of the knee. Within a few months, my Dad was back on the golf course and back to winning a few local tournaments. My other half was back to kayaking (which entails getting in and OUT of the kayak, the most challenging aspect) with no discomfort.

[Pura Vida]

I don't think there's one definitive answer. Everyone's situation and recovery plan will be different. The overall key is to get your knee moving and keep it moving, so that ROM can be maximized.

I wish you a full and speedy recovery. When you hear about the 2-3% that have problematic TKR procedures, that would be me. I had mine done eight years ago this month and the recovery didn't go as planned. My ROM is 90-100, but the knee won't bend beyond that b/c of previous leg trauma from my car accident (20+ years ago; broken femur, detached ACL, two previous surgeries). Super frustrating!

[Bikewer]

I’m about 4 years out. My in-home therapist was pretty gentle... However, when I went to the outpatient rehab place for several weeks they worked pretty hard on getting that “flat to the table” business going. Not pleasant....

But worth it, I imagine as I was back at work for full duty in 13 weeks and continued my rehab at the university gym.
After the first year, my doc cleared me for more strenuous leg work so I started doing deadlifts and leg-press machines.

I’ve been on that full-body weight program for about 3 years now and at 73 I feel great and essentially at my ideal weight and much stronger overall.

[Photojeep]

I can't thank you all enough for your words of encouragement. My in-home PT has determined I'm way ahead of the curve and don't have anything to worry about so it's probably just my natural impatience showing.

I've almost completely weaned myself off the heavy-duty pain killers as I really haven't had that much pain- just more of a general ache at times.

I'm just the naturally impatient type and I tend to worry about what's coming rather than paying closer attention to what's in front of me right now so your stories and words of encouragement really have helped!

Luckily I'm married to the most wonderful woman I ever met who has been taking care of me while simultaneously keeping me on schedule and 'cracking the whip' when needed. (Did I mention I'm also a pretty lazy person when given the chance?)

Thank you all again and I'll post more as time goes on. I hope to soon look back on my complaints and laugh.

Best,
PJ

[Forensicguy]

Sounds like you are doing just fine.

I had a total knee replacement of my left knee on Sept 19 and 3 months later, I'm still dealing with it. If you want to see how a knee replacement can go wrong, watch all of my YouTube videos on my recovery...my channel is called "Russ Is Right". Here's a link to the specific videos about my knee replacement: https://www.youtube.com/watch?v=6sgt...CoI40wpekO_fob

Here's the most recent video: https://www.youtube.com/watch?v=3eP7EA2Nq_s

I had two knee manipulations after the surgery as well as radiation too and I'm only able to have flexion of 110 degrees when pushed to point of screaming in pain by the PT. Typically, I can currently do 90 degrees on my own after a day of stretching and working the knee. Waking up, I'm mostly around 45 to 65 degrees. So if you are doing 90 degrees or so now, you are probably going to be ok.

Watch the videos though. I explain what has been happening with my rehab and the fact that my scar tissues are the reason for my poor results in flexion. My extension measured 20 degrees where it should be at 0 degrees by now. Not good.

Good luck to you! Let me know if you check out the videos.

[JCave]

PJ - Can I ask what caused you to get a knee replacement?

[Photojeep]

Originally Posted by JCave

PJ - Can I ask what caused you to get a knee replacement?

Sure JCave,

In High School I swam competitively. Normally, swimming is great for knees but I swam breast stroke. That meant heavy frog kicking where you spread your legs out behind you then whip them together with a lot of force to propel you forward. Nowadays swimmers no longer do this but back in the 70s this was how it was done.

As a result, my meniscuses are no longer an even thickness with the inner portion of each worn paper thin. About 7 years ago the right one tore and curled up causing irritation like a pebble in a shoe so the surgeon went in and trimmed it to "remove the pebble."

Than bought me 7 years (the surgeon thought it would be only a couple years or relief) but it also meant bone on bone of the medial portion of the joint (the inner half). Once the cartilage on the ends of the bones finally wore away, the pain was too much to keep going so TKR it was. Somewhere along the way all of this mess caused me to lose the cartilage on the underside of my kneecap so that was also replaced.

And that, boys and girls, is why I'm spending my Christmas vacation hobbling around on a walker and a cane with the hopes of needing neither in a few more weeks (4) when I return to work.

Sorry for the long post.

Best,
PJ

[DenverSteve]

Sounds like you're doing great. I haven't had a replacement but while playing college football I tore a medial meniscus and had knee surgery. My post-op PT was weeks and full recovery took about 3 months. Again, you're doing great.

[frances50]

I just had hip resurfacing six weeks ago and I am just now beginning to fell human. I was out of work for 3 full weeks and went back on the fourth week part time. Getting older and major surgery are tough. My advice is don't rush the recovery and do what your doctor and therapist tell you. Good luck.

[JLT]

I haven't had a knee replaced, thank you (although my brother has had both done). But I did have a shoulder rebuilt last summer, and learned some stuff that may be useful to you.

My physical therapist was all about range of motion rather than strength. Strength is important, but it's easier to regain it once the range of motion is good, but it's harder to go for strength first and then try to regain ROM.

Second, we found that the old scales for pain level weren't helpful, so we devised a new scale, which corresponded to what my shoulder was telling me.

1. You can do that.
2. I'd rather you didn't do that.
3. Please don't do that.
4. DON'T DO THAT!

The trick is to go to the second level, for short periods of time, but not to go to the third level. The difference is basically whether you have some residual pain the next day, in which case you know you've exceeded level 2. Then it's time to back off.

My brother told me that it was essentially the same with his knee replacements.

[Photojeep]

Thank you all again for your encouraging words. JLT, I like that scale! So far I haven’t done anything that caused residual pain the next day so I think I’m doing it right.

Funny thing, as I was doing my CPM machine yesterday, for the first 2 hrs of my twice a day routine, it occurred to me that it had only been 11 days since I’d undergone the most major surgery of my life and here I was in my own bed, having just walked 1/4 mile, and felt better than I probably had a right to feel (figuratively speaking).

I know it will probably be a couple months before I feel fully normal again but I’m still very grateful for my recovery so far. I still get the odd stray pain from time to time but overall I really can’t complain.

Thank you all again,
PJ