Having knee replacement: how to prepare and questions about PT

Posted by ronnie3716 @ronnie3716, May 1, 2016

I'm having knee replacement (L) on June 20th.
Any suggestions on how to get ready for it?
How soon does physical therapy start after one gets home?

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@dkapustin

Thanks for the reply. It really helped. I just have one question. You said it took 10 days before you were able to take a shower? Why that long? I'm not good with sponge baths and I'll probably want to take a shower ASAP. TIA

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Hi @dkapustin - Regarding the shower timeline, I'll check when I go for my pre-op on 1/16 and if I were you, I would ask my doctor directly. It may have not been quite 10 days, but it was definitely more than a full week. My doctor kept me in compression hose for a week - night and day. They were difficult to get on and off and he just said for the first week, do a sponge bath. After that, when I could take the hose off at night, I would shower before I put them back on. Also, he didn't want me to get the wound wet in the beginning of the healing. As others have said, these ortho surgeons vary tremendously in what they allow and don't allow. Go by what your own doctor says.

Also, I agree with @ellerbracke that our recovery timeline was probably in the above average category. My in-home physical therapist told me I was about a week ahead of what he usually sees in getting range of motion and hitting some of the milestones. Extension was so hard for me because I had had a torn meniscus and been on crutches for 3 months going into the surgery last time. My knee had been bent the whole time - I couldn't straighten it. The surgeon told me he straightened it when I was under anesthesia so that gave me hope, but I had to work and work at it. This time, I am going into the surgery being able to get full extension on my own. I am hoping that makes it easier to achieve after the surgery.

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@mari

dkapustin @dkapustin 10 DAYS seems like a long time. Maybe its the type of long bandaid that Dr. puts on? Leaving the Hospital - @ 4 different PA, Nurses, personnel, etc. said "Don't get it wet" to avoid infection! Then I was allowed a shower after 3? days. How long b4 post op? Maybe you Dr. is Old Fashioned ?

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I hope I can shower before 10 days but if not, I'll survive. I'll master the sponge bath!

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@dkapustin

Hi everyone, I'm scheduled to have a total right knee replacement this month and would love to hear from those who have had this procedure. What kind of things will I need at my home, how long were you on a walker, and any tips you can give me for a successful rehabilitation. Thanks so much and this group is awesome!

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@dkapustin Hi, and welcome to Connect.
I have had two TKRs and my ortho told me that what I was doing pre-surgery was perfect. I did a lot of pool exercises and pool jogging, and also my recumbent bike. You can continue those after your surgery. You do have to wait for a while before going in the pool, until the incision heals.
I used a walker for a very short amount of time, probably no more than a week. I never used crutches, just a cane for a short time. When/if you go to PT you will get helpful exercises that you can do at home. It's easy to shrug them off, but don't -- do those exercises! They definitely help.
I was able to shower immediately and had surgical glue, no stitches. My timeline is pretty similar to @debbraw.
After my second TKR, I had a lot of pain for a while. During that time my surgeon was seeing me more regularly than typical because he was concerned. He did xrays but nothing wrong showed up. When I was at about six weeks the pain suddenly just went away. My surgery was on 10.17.2017 and on 12.08.2017 I was in NYC and walking all over the place with no pain or discomfort! So if you do have pain more than like it will pass, and I am sure your surgeon will check to make sure there does not seem to be a reason for it.
For me, the surgery had the best possible outcome. I can walk miles and miles now with no discomfort at all.
JK

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@debbraw , @contentandwell : you both seemed to have fairly quickly and almost overnight arrived at a pain-free level. I am a little envious and grumpy that I still have twinges (surgery 9/13). Perhaps indirectly caused by a decade of dealing with Sciatica - mostly succesfully, mostly with exercise program - but I think that causes me to still not quite put the weight equally on both legs. Plus, of course, the “gift” of having the cracking feeling and noise with every step is a bummer. Looking forward to reaching the point where the TKR knee feels natural, and the last ouchies go away. And - Debbra: I forgot about the joys of compression hose. Those were the days...............!

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@ellerbracke

@debbraw , @contentandwell : you both seemed to have fairly quickly and almost overnight arrived at a pain-free level. I am a little envious and grumpy that I still have twinges (surgery 9/13). Perhaps indirectly caused by a decade of dealing with Sciatica - mostly succesfully, mostly with exercise program - but I think that causes me to still not quite put the weight equally on both legs. Plus, of course, the “gift” of having the cracking feeling and noise with every step is a bummer. Looking forward to reaching the point where the TKR knee feels natural, and the last ouchies go away. And - Debbra: I forgot about the joys of compression hose. Those were the days...............!

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@ellerbracke - No... If it sounded like I quickly became pain-free, that was not my intention. By 2.5 weeks I got to where I was not taking pain meds during the day. My incentive was that the doctor would not release me to drive until I was off of them for daytime. I still took tylenol during the day as needed and then stronger pain meds at night. I was still needing strong pain meds at night occasionally until about 8 weeks. And I had those occasional twinges - especially when the weather changed or the moon was full or whatever. (LOL) for months. I think you will continue to see good improvement all the way up to 6 months out and some gradual improvement for the whole first year. And yes, I hated the compression hose with a passion. I'm having my left TKR the 29th of this month and I'm already having nightmares that involve compression hose. How are you doing with extension? Is it still difficult or have you mastered that?

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@debbraw

@ellerbracke - No... If it sounded like I quickly became pain-free, that was not my intention. By 2.5 weeks I got to where I was not taking pain meds during the day. My incentive was that the doctor would not release me to drive until I was off of them for daytime. I still took tylenol during the day as needed and then stronger pain meds at night. I was still needing strong pain meds at night occasionally until about 8 weeks. And I had those occasional twinges - especially when the weather changed or the moon was full or whatever. (LOL) for months. I think you will continue to see good improvement all the way up to 6 months out and some gradual improvement for the whole first year. And yes, I hated the compression hose with a passion. I'm having my left TKR the 29th of this month and I'm already having nightmares that involve compression hose. How are you doing with extension? Is it still difficult or have you mastered that?

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I am trying to figure out how I'll put the compression hose on once I go home because I live alone. LOL I suspect rehab will have a few tricks up their sleeves and will teach me how. I'm not sure how long you wear the hose after surgery but I suppose each person is different. This group is amazing and I can't tell EVERYONE enough how much I appreciate all of your advice and feedback. It is really helping me to get a reality handle on what to expect while bearing in mind that each person is different.

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@debbraw

@ellerbracke - No... If it sounded like I quickly became pain-free, that was not my intention. By 2.5 weeks I got to where I was not taking pain meds during the day. My incentive was that the doctor would not release me to drive until I was off of them for daytime. I still took tylenol during the day as needed and then stronger pain meds at night. I was still needing strong pain meds at night occasionally until about 8 weeks. And I had those occasional twinges - especially when the weather changed or the moon was full or whatever. (LOL) for months. I think you will continue to see good improvement all the way up to 6 months out and some gradual improvement for the whole first year. And yes, I hated the compression hose with a passion. I'm having my left TKR the 29th of this month and I'm already having nightmares that involve compression hose. How are you doing with extension? Is it still difficult or have you mastered that?

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@debbraw : thanks for the reassurance. Yes, I can also do a mean weather forecast with my knee! I am just frustrated with the progress to a certain extent. But then again, I had arthro surgery on the same knee 11 months prior to TKR, and never, ever got to be pain free or fully functional, so I guess my current state is a big improvement. Still working on the extension - I can easily get the knee fully extended with some slight and painless pressure when sitting with legs extended, or when lying flat, it just does not quite want to do it without this little help. It will come. Most everything else is hunkey dorey. Like you, I detest opioids (bc. of the constipation factor, and the limited pain relief, when I still had to add Tylenol). I had a prescription for 42 pills, took 22 of them, so probably no more than 5 or 6 days. Regarding compression hose: somehow I very quickly and easily learned how to put them on and take them off, so that was not an issue, other than the somewhat unpleasant feeling of having to wear them 24/7. I wish you all the best for your 2nd time around, please keep us posted how it goes!

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@dkapustin

I am trying to figure out how I'll put the compression hose on once I go home because I live alone. LOL I suspect rehab will have a few tricks up their sleeves and will teach me how. I'm not sure how long you wear the hose after surgery but I suppose each person is different. This group is amazing and I can't tell EVERYONE enough how much I appreciate all of your advice and feedback. It is really helping me to get a reality handle on what to expect while bearing in mind that each person is different.

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@dkapustin : they should show you at the hospital how to deal with the compression hose. Ask for a spare set to take home so you can wash them once in a while. Pay attention, though - I did not realize that my spare set was only knee-high, so not very useful. I sometimes put the shorter one on the good leg, so I could wash the over-the-knee ones in turn. If worst comes to worst, the home PT person will be able to help out with instructions and taking them off.

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@ellerbracke

@debbraw : thanks for the reassurance. Yes, I can also do a mean weather forecast with my knee! I am just frustrated with the progress to a certain extent. But then again, I had arthro surgery on the same knee 11 months prior to TKR, and never, ever got to be pain free or fully functional, so I guess my current state is a big improvement. Still working on the extension - I can easily get the knee fully extended with some slight and painless pressure when sitting with legs extended, or when lying flat, it just does not quite want to do it without this little help. It will come. Most everything else is hunkey dorey. Like you, I detest opioids (bc. of the constipation factor, and the limited pain relief, when I still had to add Tylenol). I had a prescription for 42 pills, took 22 of them, so probably no more than 5 or 6 days. Regarding compression hose: somehow I very quickly and easily learned how to put them on and take them off, so that was not an issue, other than the somewhat unpleasant feeling of having to wear them 24/7. I wish you all the best for your 2nd time around, please keep us posted how it goes!

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@ellerbracke - Yes, your extension will come, and it will probably surprise you one day that all of a sudden its just comfortable to get the full extension. Thanks for your good wishes. I'll definitely post on my progress!

@dkapustin - I had to wear the compression hose for 2 weeks - until they took out the stitches. But as you can see, every doctor has different orders. Some may be shorter. Best of luck!

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@debbraw

@ellerbracke - Yes, your extension will come, and it will probably surprise you one day that all of a sudden its just comfortable to get the full extension. Thanks for your good wishes. I'll definitely post on my progress!

@dkapustin - I had to wear the compression hose for 2 weeks - until they took out the stitches. But as you can see, every doctor has different orders. Some may be shorter. Best of luck!

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Thank you!

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