Having knee replacement: how to prepare and questions about PT

@nightwatchrenband I agree totally. I worked hard at getting in shape beforehand and the recovery was much easier. By the time i had my TKR I was actually in considerably less pain because I had strengthened the supporting muscles.
JK

Totally agree with @contentandwell & @nightwatchrenband - You will be well rewarded for all of the effort you put into "pre-hab" as my orthopedic surgeon calls it!

I had a total right knee replacement several years ago with no trouble during recovery or physical therapy. I followed the instructions of my doctor and e rested a great deal in the beginning especially. The little machine with the ice in it (don't know the name) was a huge blessing, Physical therapy was not a cakewalk. but I got through it and I don't have any residual pains in my knee to date. I did, however, develop a rather large blood clot in that leg about a year later...maybe a little bit less...and have had some problems with that with ankle swelling on a daily basis, several follow-ups to check for another clot based on symptms. I have read that blood clots can be one side effect of knee surgery. I have not had that confirmed. Today my knee is as agile and useful as my left knee! There is no way I could have functioned with the knee as it was prior to surgery. The surgery has been a blessing.

@debbraw, @jillypooh : I read this ancient post/question while browsing for another subject. Anyway, for what it’s worth at this point in time: I had right TKR in Sept. 2018. Pretty decent recovery, nothing out of the ordinary, except it took months for me to get full extension. Flex was easy. PT basically forbade me from walking until leg was at 0 to prevent hip issues. Fast forward: I did lots of swimming, some recumbent biking, not too much walking for exercise. Suspended indoor pool membership end of May, transitioned to lots of walking. Hip bursitis! On and off. PT exercises did not help. Cortisone shot did, some. Mid July suddenly problems with gait. Could not take a full stride with my left (good!) leg. Legs measured, TKR leg is about 1/3” longer than the other. Not sure if it was like that before, but never had problems, so it MIGHT have been result of surgery. Working with orthotic inserts now, big improvement. I did have to do 2 weeks of specific exercises to make sure it’s not a muscle imbalance or tendon issue before being fitted for orthotics, but repeat measurement after those 2 weeks still showed the same leg length difference.

Wow @anncgrl - sounds like a textbook recovery except for that blood clot. It must have been so discouraging to get that news. I just had a knee replacement it January and like you, I didn't have any serious recovery problems, but that is scary about the blood clot developing one year post op. I'm curious about what caused you to have the doctor look at it and discover the bloodclot. Was it the swelling? Were there any outside factors like a long plane trip or anything?

Wow @ellerbracke - That is great information on difference in leg length. Thanks for sharing. It would not have occurred to me to have that checked. It was good that they did that kind of thorough assessment for orthotics. I don't have any experience with that. Can you wear them with any shoes or do you have to have one for each pair?

I am supposed to wear them most of the time that I’m actively moving. They work with “closed” shoes, like running/walking shoes, I suppose with boots, later in the season. I’m cheating some, though. I wear the orthotics when I walk for exercise, of course, or when I know that I’ll be on my feet a lot, as in extended shopping runs. However, living in nice, steamy, hot SC, I still wear sandal-type shoes for short errands, for style, for vanity, for ventilation! I have already seen a marked improvement even with the limited use of the orthotic inserts, so as long as I don’t hurt, I’ll play it by ear how many hours each day I use them. One pair only, so far. Still waiting on the invoice! Perhaps I’ll spring for a second pair, depending on the financial pain. Until then I’ll move them around between different shoes as necessary.

I did not have any indication. I worked from home and did a lot of sitting but I don't know if that mattered. I stood up to take a break one day and my leg hurt as if I had stepped in a small hole and twisted it badly. I thought it would pass but ended up going the doc who sent me immediately to the ER for tests. There were actually two clots. One ran from. My ankle to just under my butt and the other from the back of my knee up further. I was in the hospital for week. I am on a blood thinner all the time

@ellerbracke Good afternoon......I am interested in your finding that the TKR knee has caused an uneven gait and pain in the left leg. That is very concerning. I have had bone spurs and arthritis in the right "good" leg. Tried the cortisone injections and it took a few weeks for them to work. You can only have 1 or 2 per year so I decided to just keep walking and enduring. Sometimes you just reach a point when enough is enough. What have you done in addition to orthotics? What do you do in the summer with sandals? Does heat or cold help? Why is the TKR leg longer? How did you measure it? Any clue?

As I relate to this, I also realize that my reverse shoulder has left me with a right arm that is 2" longer than the good one. My surgeon told me to expect that and so I never gave it much thought. It is a problem because I cannot eat with my right hand. Nor can I do anything that requires coordination. You should see my push ups.....LOL. The one positive outcome. I became ambidextrous for most tasks so I can use the non-surgical arm.

Please share with me as your story evolves. And be content and at peace today. Chris

@artscaping : I’ll try to be concise. The hip bursitis (repeated episodes), as well as the gait problems were supposedly caused by differences in leg length. At least, that’s the only thing that was likely to produce those symptoms without any other factors. Whether the TKR was the cause of the length difference, or whether I have had uneven legs all my life, and it was simply aggravated by the surgery, nobody knows. The actual length difference is “only” 1/3”, but that can still cause a lot of trouble. My PT said that I may eventually get used to living with the discrepancy, but because I had already gone through 2 episodes of hip bursitis, as well that I have a decade long history of sciatica, he strongly advised custom orthotics to prevent further episodes. I use them when I’m very active and on my feet a lot, but still go barefoot or wear sandals part of the day. Or, for example, when I do yard work, where because of the terrain my legs would anyway never be level respective to each other, I don’t use the orthotics either.
Other than judicious use of the inserts, I do a 10 minute set of leg/back exercises to keep my sciatica in check (every day, 5 years running now), I walk 2 miles 5 to 6 days a week, and most days do 30 squats or 20 bridges, or both, or something similar, and do roughly 1 to 2 hours of yard work per day. Just turned 70 recently, and in generally decent shape (both health-wise, and weight-wise.... proud to be 37-29-37!!!!!) = Not my social security # 🙂...