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10 days post tkr and pain unbearable

Joint Replacements | Last Active: 4 days ago | Replies (58)

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@lenchiksf

Try to stay on meloxicam for at least 30 days or celebrex 7-14 days (as long as you are not taking any blood thinners other than aspirin profilacticly). When there is an advanced OA (ie bone on bone) there is lots of inflamation. Oxy only works to block pain signals in your head and is short term and doesnt address the source of the problem. Work on reducing swelling and pain with elevation and ice. Use ice packs 20 min every hours with a barrier to skin (pillow case) while awake or if you were given ice machine , you can use that one around the clock definetly first 3 days, then just during the day (you can make it colder by higherproportion of ice to water). The machine also comes with barrier pads when you apply to skin.

Our suregons use pain catheters for knees that are good for at least 72 hours with slow delivery of ropivocaine or patients get Exparel injection that also provides contin pain relief for 72 hrs. Patients still expected to take oral pain meds narcotics and anti inflamatory to bridge pain control past 72.
I see you are at about 10 days post op, first two weeks it can be very uncomfortable. Many patients report after 2 weeks they start feeling like pain is becoming more manageble. Continue iceing and elevating. Swelling also contributes to pain. As long as incision looks normal to you (no oozing or redness), the knee is healing. Continue doing gentle heel slides to keep knee joint moving and work with your PT.

All the best !
Lena, PT

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Replies to "Try to stay on meloxicam for at least 30 days or celebrex 7-14 days (as long..."

Great advice on so much.
Forget the ice packs. Use the ice machine that delivers continuous pain relief that you can wear through the night.
The amount of differences in physical therapy & surgeon's opinions on PT is very disconcerting. You recommended gentle heel slides... my PT pushed me pretty hard 3x/wk. I'll never know if that is what contributed to my need of an MUA at 11 weeks, as I couldn't retain the numbers they got me in PT. My knee didn't look that swollen- but I would remain at 90* and couldn't flatten my knee past 7-8* by my 6th week checkup- a non-functional joint. I worked very hard at home as well. Ditched the crutches early on...
I utilized 5mg oxycontin an hour before PT for quite awhile as it was so painful when they would bend or flatten me.