Night Pain: Using a knee wedge after total knee replacement?

Posted by connie1559 @connie1559, Jan 30, 2019

I had a right TKR on 1/21. Even in the hospital I couldn’t sleep at night because of knee pain.

Multiple sources, including a hospital issued post TKR book and my discharge instructions, warn against putting a pillow under the knee.

Does anyone know if a knee wedge would fall into the category of a pillow? Has anyone used a wedge with good results? Has anyone had their doctor or physical therapist tell them to not use a knee wedge?

I will ask my joint care coordinator tomorrow, but as I have been awake for the last 2-1/2 hours, I’ve had plenty of time to think about possible solutions to night pain. BTW, I am taking Rx pain meds, but pain still wakes me up every night. A knee wedge sounds good to me right now.

Thank you for any input.

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Thanks for suggestion of custom knee. I will certainly as about that for my second knee

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@glasgow46

Thanks for suggestion of custom knee. I will certainly as about that for my second knee

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@glasgow46 If you google "Conformis" their website will guide you to orthopedic surgeons who use the Conforms knee. As I commented, the MAKO surgery seems highly successful also.
Two people on here who have had MAKOplasty surgery are @debbraw and @saeternes. They have both been happy with that also.
JK

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@jud

If you don't mind my asking, how do you feel about the whole TKR procedure now that you are 15 months post surgery? Was it worth it?

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I had my procedure in March and it was the best decision I ever made because I couldn’t stand and walk. The pain was unbearable. It is almost a year and I am experiencing no pain but just discomfort from the tight band. When I exercise too much I get a pain on the inside of the knee. I am able to walk a couple of laps in the mall. Still have difficulty getting out of a car due to knee flexion. I still get odd sensations and some clicking occasionally. I do exercises at the Y and have a home therapy program. My main complaint is that they do not prepare you mentally for the procedure and the first 6 months are awful. But on the flip side, if they did reveal expectations, no one would get it done! The key to successful surgery is a good doctor, mako robotic arm, and a good therapist. But I would not be in a hurry to do the other knee.

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I was a physical therapist for 40 years and have two totl knees. I agree with you. They are the most painful after surgery situations. I was in good shape for my surgeries, so I can imagine the struggle for some who were not. The average patient of mine needed more exercise to build up the leg ahead of time. Most had an incident that prevented that preperation. Using a pillow after surgery is because the kinee is swollen and restricted and you need sime support for the knee to relax, Your knee was done in January and you are talking about favoring your nee more with a wedge. Yhis, of course lead to more problems of not being able to extend your knee fullu. Let be be blunt! You most probablely can not extend your knee fully. Almost a year afterwards, you have a unstable total knee. My strong suggest, with in finances, is to resume physical theraoy with a sports Medicine group. If you hyave used up medicare, have the doctor use a di8fferent code, such as exascerbtion to,qualify you for a 2nd series. Sometimes you have to get into electrical stimulation under heatm followed with massage and special contact under restriction ans relax hamstring excisie and quadriceps re- education and proper knee alignment in gait with outsinking to get ypur useful leg back. Your may need to go back to a walker during re-ed until you yoe pulling up- on your knee correctly. Thank you for posting. You have a hard decision to make and it do

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I got cut off. Your decision should now be made with your contact with a referral for home health PT. I would prefer you go again tp out patient therapy. Do not hesitate to talk to me about this. I a frank and to the point. You should not need knee support after 6 months, generally. Bill

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@sjot4u I completely agree that the post-TRK is something of a shock - for me not so much continuing pain, but the effort I have to put in to move forward, and the toll on my stamina. I am still sleeping more, although it has improved. I did a lot of pre-hab so that is not it; in decent shape for my age. But I wonder how long I will have to keep doing these exercises. Good luck.

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@saeternes

@sjot4u I completely agree that the post-TRK is something of a shock - for me not so much continuing pain, but the effort I have to put in to move forward, and the toll on my stamina. I am still sleeping more, although it has improved. I did a lot of pre-hab so that is not it; in decent shape for my age. But I wonder how long I will have to keep doing these exercises. Good luck.

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I got cut off. I have a small computer and numb hands. More to the Point. Exercise the rest of your life and keep mobile and walk daily.. If your insurance covers Home Health , get a physical therapist for the maximum. Follow up with the maximum Out patient Pysical therspy and if needed, occupational Therapy and Psychologist. Then, health spas are $45-50 a month .If you are 65 yrs or older, think about selling your home and moving to a Senior Center(not Nursing home)You have gym activities, swimming pools, social activities, meals paid for and transportation to shopping and social events. They have all the conveniences of kitchen living rooms, bedrooms. some casitas, etc. Usually they cost about $4500-5000. a monthy married. ( add up your monthly expenses sometime) Visit 5-10 of them to get the right fit. MAKE SURE they have "Assistive Living Programs", If you are getting older with other problems, they have smaller apartments but evaluate you for additional help, such as bathing or dressing. My observation in visiting these facilities is this. Look for Assistive living quarters that have a walk in closet and a stove and frig as well as a living room and Wi-fi in all the rooms. Possible also, 2 bath rooms with walk in showers and i bath tub. (Google--"A Place for Mom") to get a list in your area. Or, think of moving to warmer climates. Arizona. Thnk lower elevations and big cities with small city surrounding of gardens and outside locations. Doesn't this open up a lot of excitment? Of course, the most logical thing is to get services in the home. But, don't wait too long to think about these opportunities. They are not nursing homes but privately run businesses that have to have staff to deal with you. I know, because I too am in the planning stage. How much more economically I could have been living under a full array of services and sociability. We don'[t live forever and end of live needs planning. Just think. Job and Solomon lived to 140 yrs. old. With good living,why can't you....Me too. bi8ll54321.

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@bill54321

I got cut off. I have a small computer and numb hands. More to the Point. Exercise the rest of your life and keep mobile and walk daily.. If your insurance covers Home Health , get a physical therapist for the maximum. Follow up with the maximum Out patient Pysical therspy and if needed, occupational Therapy and Psychologist. Then, health spas are $45-50 a month .If you are 65 yrs or older, think about selling your home and moving to a Senior Center(not Nursing home)You have gym activities, swimming pools, social activities, meals paid for and transportation to shopping and social events. They have all the conveniences of kitchen living rooms, bedrooms. some casitas, etc. Usually they cost about $4500-5000. a monthy married. ( add up your monthly expenses sometime) Visit 5-10 of them to get the right fit. MAKE SURE they have "Assistive Living Programs", If you are getting older with other problems, they have smaller apartments but evaluate you for additional help, such as bathing or dressing. My observation in visiting these facilities is this. Look for Assistive living quarters that have a walk in closet and a stove and frig as well as a living room and Wi-fi in all the rooms. Possible also, 2 bath rooms with walk in showers and i bath tub. (Google--"A Place for Mom") to get a list in your area. Or, think of moving to warmer climates. Arizona. Thnk lower elevations and big cities with small city surrounding of gardens and outside locations. Doesn't this open up a lot of excitment? Of course, the most logical thing is to get services in the home. But, don't wait too long to think about these opportunities. They are not nursing homes but privately run businesses that have to have staff to deal with you. I know, because I too am in the planning stage. How much more economically I could have been living under a full array of services and sociability. We don'[t live forever and end of live needs planning. Just think. Job and Solomon lived to 140 yrs. old. With good living,why can't you....Me too. bi8ll54321.

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@bill54321 I didn't clearly explain. I have always exercised, a lot, and enjoy living in my house, so that won't change. What I was referring to was the specific knee exercises, not general exercise (I lift weights, walk, and bike...daily). I just had my final therapy session and will post an update soon. Thanks again.

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@saeternes : I think I addressed this before. I sort of remember that I continued to do some of the knee exercises for a total of about 6 months, mostly because it took me forever (about 4 months) to get full extension. Mostly, I did the flex and extension exercises, squats, and bridges. With daily walking or swimming the leg itself got plenty of exercise in general. I recently checked my extension when sitting on the floor with legs extended straight out, and it seems like the TKR leg is now marginally straighter, or definitely as straight, as the other one.

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I put a pillow between my knees when sleeping. It helped with sleeping on my side.

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