How well is pain controlled after total knee replacement?

Hi @connie1559 - Welcome to Connect! Great bunch of people here with tons of experience and sharing hearts. I am 68 and I share your concern about pain & meds. I had my right knee replaced April 2017 and I'm having my left knee replaced the 29th of this month. Last time I was fine with the meds prescribed. This time, my surgeon said the law had changed and that while I'm in the hospital, they can only give a certain dosage UNLESS the patient is in pain and asks. So he told me once and then reminded me before he left to ASK. You can count on me asking. I do not suffer well in silence. LOL. Also, the nurse told me they could only prescribe 7 days at a time and they couldn't call it in - it had to be a paper prescription picked up and then taken to the pharmacy to fill. That is a real downer for me since we live about an hour away from the hospital. Fortunately I have a friend who lives near the hospital and I'm going to ask her to pick up my first refill.

In case it helps, here is what my progress looked like last time. This time I'm having robot-assisted surgery. My doctor says that gives more accuracy in the surgical precision and he's found that it cuts recovery time somewhat.

Last time, my surgeon kept me in the hospital (Mayo Jax) for 2 nights. In the hospital, I used the walker. I also had to learn to go up and down stairs since we have stairs front & back in my house. Right before I was released, I was at 105 degrees flexion.
– I started in-home PT once I was home. Also, iced my knee after exercise and kept it above my heart as much as possible. One week after I was home, I traded the walker for a cane. I could do 10 minutes on the stationery bike.
– 10 days after surgery, I could walk around outside with a cane. I'd gotten to 120 degrees flexion, but I still lacked about 5 degrees on total extension. Extension was the hardest for me.
– 2 weeks after surgery I could walk around anywhere in the house w/o a cane or any aids. At 2 weeks, I got the stitches out. It hurt. (Take some Tylenol before you go for stitch removal!)
– 3 weeks after surgery I got 100% full extension. I also got completely off pain pills during the day so I was allowed to drive. This meant I could start going to out patient PT. By this time I could walk outside w/o cane.
– By 5 weeks, I was walking 1 mile every morning. (Prior to surgery I walked 2 – 3 miles each morning.)
– By 6 weeks, I could walk 1.5 miles. I still limped noticeably when tired. Also, still occasionally needed to take pain meds at night in order to sleep
– By my 8 week check up, my right knee had become stronger than my left. So my operated knee was officially now my "good" knee. I had 125 flexion and 100% extension. I was released from PT the following week.
-By 12 weeks, I felt pretty much completely normal. I didn't limp anymore although there are things I still can't do comfortably including kneeling on my operated knee and twisting it sideways.
Hope this helps. As others have said, every surgery is different, but I'm keeping my fingers crossed that my left knee recovers as well as my right one did.
Good luck with your upcoming surgery. Please keep us posted.

@connie1559 Hi Connie, sorry for the late response. Your surgery is scheduled for today so obviously, you will be reading this after it.
I was in a great deal of pain after my second TKR surgery, less after my first TKR. My ortho is very conservative about narcotics so he gave me some but did not want to give me a lot. I have heard that ibuprofen is as helpful as the narcotics but the only OTC pain medication I can take Tylenol, and in a limited amount. More than likely you will NOT have extreme pain. After my first TKR I was doing all kinds of normal things within a brief amount of time. I have no idea why the second one was more painful, but ironically it's the better of the two now so it was worth it.

The good news is that the extreme pain lifted very suddenly about 6 weeks after my TKR and things have been great ever since.
Every surgeon has their own guidelines for their post TKR patients. My surgeon has an extremely high success rate but his guidelines are a bit different than typical. He does not want the patient icing for the first six weeks because icing prevents the healing blood from going to the site. Of course, after six weeks you probably do not need to ice anyway.
He is also opposed to vigorous PT. The in-house physical therapist had worked with patients of this doctor before and he was impressed with the doctor's success, so he was fine with that we did some very helpful exercises. When I started to go to outpatient PT that physical therapist was lost as to what to do so that was pretty useless.
I hope by the time you read this you are back in your bed and feeling fairly well. There is actually an ortho doctor about 45 minutes away from me who does TKRs as outpatient surgeries and he too is quite successful!
JK

@connie1559 - Just wanted to wish you well on the surgery today. Hope it went splendidly and that your pain is managed nicely. Please keep us posted. Wishing you the best!

I had my right TKR one week ago today, 1/21. I was taking pain meds as prescribed and doing really well. This morning I decided I didn’t need the prescription pain meds, so I only took 2 extra strength Tylenol. BIG mistake! I could barely get through PT, and I couldn’t get the ROM I got yesterday. You are absolutely right about staying ahead of the pain. Today’s pain was as bad as the pain I had when I woke up in the recovery room. I learned a lesson, and I will be smarter next time.

I did the same thing and had the same problem. I think we have all been brain washed into thinking if we take prescription pain meds we going to end up being junkies. I am calling BS on that. I set myself back and wish I had not done it. The chances of me getting hooked on prescription pain meds is close to zero as I don't get much out of them including pain relief. I think you have discovered that you should do what your doctor thinks best about pain meds and hopefully it will make you better sooner.

@connie1559 @bobnaquin Connie and Bob, if you want to try OTC pain meds, ibuprofen is much more effective than Tylenol because it has anti-inflammatory ingredients. I cannot take it, being a post-transplant patient, but Tylenol does not really help much at all. They are saying now that ibuprofen is often as effective as the prescription pain-killers.
JK

Ibuprofen kills stem cells along with aleve. Just saying you know.

@cobweb I did not know that. Generally, what is the importance of stem cells? I am wondering if that is the reason that I, being post-transplant, can not take those NSAIDs.
JK

i would advise you to look up the importance of stem cells. I was having steroid shots in my back and later found out the steroids were killing my stem cells. Had an injection of my own stem cells in the back and now i am good to go. Companies and Drs are making a fortune selling stem cells that are dead. They do you no good. Become knowledgeable t protect your body.

I have always had great results with Ibuprofen. However, I was told to stop taking it 10 days before the surgery and for an unspecified amount of time after the surgery, something to do with clotting issues. I’m with you: I get much better results with Ibuprofen than I get with Tylenol. Thank you for your reply.