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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@ellerbracke

@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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Thanks a lot! Not looking forward to this but it needs to get done. One knee will be down and I'll just have one more to go!

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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 I had my knees done by two different doctors and neither stressed compression stockings! I have some that I got for varicose veins and fluid retention in my legs though and if they fit right I don't think they are that difficult to put on. When I had terrible edema (fluid retention in my legs) from my cirrhosis they were difficult to put on, but then my legs were huge with fluid. I actually think I was simply not able to get them on at all.
Also, my ortho does not want his patients icing for six weeks! He feels that ice prevents the healing blood from going to the wound to heal it. I know that's the opposite of pretty much every other doctor but his success rate is phenomenal. The icing is really for pain primarily so if you can manage that then it doesn't help with much else, although I guess it might with swelling if you have a lot of that. My swelling was minimal.
JK

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@contentandwell

@dkapustin I had my knees done by two different doctors and neither stressed compression stockings! I have some that I got for varicose veins and fluid retention in my legs though and if they fit right I don't think they are that difficult to put on. When I had terrible edema (fluid retention in my legs) from my cirrhosis they were difficult to put on, but then my legs were huge with fluid. I actually think I was simply not able to get them on at all.
Also, my ortho does not want his patients icing for six weeks! He feels that ice prevents the healing blood from going to the wound to heal it. I know that's the opposite of pretty much every other doctor but his success rate is phenomenal. The icing is really for pain primarily so if you can manage that then it doesn't help with much else, although I guess it might with swelling if you have a lot of that. My swelling was minimal.
JK

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Thanks so much. I really appreciate you taking the time to respond. Now I have friends trying to talk me into stem cell therapy instead of surgery but I've done my research and there isn't enough hard evidence for me to spend my money on the stem cell since it isn't covered by insurance. LOL Trying not to make this whole thing complicated.

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Many insurance programs are covering stem cell treatment. The main concern is to find ethical and research based drs to perform the treatment. There are a lot of bad actors in this field using over the counter purchased stem cells. I had a tkr 5 years ago and still suffering my decision. Swelling has never gone down and now i have been told the bone is growing over the device in my knee. Am i the only one having problems with tkr? I have read comments for years on this site and many are having problems. I look at it as a coin toss.
In Toledo ohio there is insurance coverage of stem cell treatment but the coverage is for highly qualified centers and not nurses and chiropractors doing it.

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@dkapustin

Thanks so much. I really appreciate you taking the time to respond. Now I have friends trying to talk me into stem cell therapy instead of surgery but I've done my research and there isn't enough hard evidence for me to spend my money on the stem cell since it isn't covered by insurance. LOL Trying not to make this whole thing complicated.

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@dkapustin When I had my TKRs I had not heard of stem cell therapy but I think I would have been hesitant too. That's a lot of money to spend and have to risk that it may not help. Also, being new they really do not know how long the therapy will remain effective.

I remembered after I did my previous post, that although I did not wear compression stockings my ortho had me wearing something on my leg that at certain intervals would get pumped up with air to make it tight. This was to help with circulation. I had to wear it for two weeks, 22 hours a day. It was a nuisance when I had to get up at night for a bathroom call because you had to unplug it and drag part of it along, but other than that it was fine.
JK

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I had such a bad time with the operation, pain pills and the therapy and the recovery i looked for a new option. Granted it was expensive but the recovery was watching tv and reading books for 10 days. i can now garden , and put my knee on the dirt. To each his own. If i had a do over tkr would not happen. When insurance companies realize the expense of $7000 vs $60,000 plus P/T cost i think we will see a shift in their thinking.

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@cobweb

I had such a bad time with the operation, pain pills and the therapy and the recovery i looked for a new option. Granted it was expensive but the recovery was watching tv and reading books for 10 days. i can now garden , and put my knee on the dirt. To each his own. If i had a do over tkr would not happen. When insurance companies realize the expense of $7000 vs $60,000 plus P/T cost i think we will see a shift in their thinking.

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@cobweb you had the stem cell therapy? Were your knees bone on bone?

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@contentandwell

@dkapustin When I had my TKRs I had not heard of stem cell therapy but I think I would have been hesitant too. That's a lot of money to spend and have to risk that it may not help. Also, being new they really do not know how long the therapy will remain effective.

I remembered after I did my previous post, that although I did not wear compression stockings my ortho had me wearing something on my leg that at certain intervals would get pumped up with air to make it tight. This was to help with circulation. I had to wear it for two weeks, 22 hours a day. It was a nuisance when I had to get up at night for a bathroom call because you had to unplug it and drag part of it along, but other than that it was fine.
JK

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@contentandwell Thank you!

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@dkapustin

@cobweb you had the stem cell therapy? Were your knees bone on bone?

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My knee dr said yes, but stem cell dr said i had a chance to make it. Its been 3 years now. Never regret it.

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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 It wasn't overnight, but I didn't have sciatica problems either, and I am sure that complicates things. I never had noisy knees after either TKR, so that was not a problem.
You will get there, when you least expect it. As I have mentioned, I seemed to go literally from some serious pain to feeling great overnight. It was amazing!
JK

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