Total Knee Replacement: Swelling

Thanks for the reply. My surgeon has nothing to say about it. He implied that it's just the way it is. He did prescribe me some Prednisone which I haven't taken yet. I think I'll try the Prednisone combined with ice for ba week and see if it improves.

I have consistent swelling after 10 months. No pain and range of motion is good. I'm very active. My doc just says that's the way it is. He offered me a Prednisone prescription to see if that helped. I don't ice because I don't want to be doing this the rest of my life. Doc said they don't aspirate (drain fluid) because they don't like to put a needle in where there is metal. Anybody have thoughts?

I still have swelling from a LTKR done in December 2019. No pain, just swelling. It has gone down a little bit and I've learned to live with it. My thoughts on the Prednisone... I thought that drug was used to calm down inflammation plus it's a steroid. Is there inflammation somewhere causing the swelling? Did the doc take x-rays to determine the cause of the swelling? I would opt out of the Prednisone. If the swelling isn't causing any pain that's good! Recovery from TKR can take up to a full year, more for some folks. Hang in there.

This is spot on John. Especially at 10 months, any over activity could definitely contribute to the swelling. Ice and elevate for 20 minutes could be the cure!

Thanks for your reply. Doc did not take x-rays. He says Prednisone may help. I don't have any inflammation other than the swelling. He really just said I had to live with it. I have no pain and good range of motion.

I've learned to live with my swelling.

I’m 10 days out from replacement and have a lot of swelling. How can you improve ROM if swelling prevents moving? I elevate, ice and compress multiple hours a day using the NICE iceless machine?

Good afternoon @ginzy53. Welcome to Connect. I am just one of a group of mentors who share their experiences with members. We are all patients or former patients and caregivers or providers. We believe that knowledge is power and will try our best to understand your concerns and respond appropriately so that you can make informed choices.

First of all....I think that for 10 days. you are right where you should be in terms of the road to recovery from a TKR. Swelling is a build-up of fluids that your body creates to help you heal. And I believe there is some inflammation going on.

Do you use a wedge to elevate your knee? I looked at some of the NICE machines and didn't see an "elevator" for that knee.

Have you started Physical Therapy at a special Orthopedic facility? I have been very impressed with the attention given to me and the manner in which they PTs reassure me that I am on the right path to recovery. They facilitate healing and increased use of the knee by changing up the difficulty, e.g. learning to get out of a chair without holding on. You first start with a seat at 16 inches. When you master that, they move the seat down to 12 inches which makes your knee work harder and get stronger. They ask you to learn balance and strength by standing on your surgery leg for 20 seconds at first. Now I do 3 sets of 20 seconds. This really improves the security I feel. Squats both in repose and from a standing position are also very helpful.

In reference to the angle measurements and your knee being too swollen...the PT folks understand. I have a set of 6 exercises that I do at home to keep the leg stretched out so that I can reach the extension goal of "0". Currently, I am at 137 ROM and I owe that success to this set of exercises. It's a lot.....30 repetitions twice a day. They also had me do the same exercises twice a day starting one month before surgery and they began post-surgery exercises 1 day after. Of course, they didn't expect me to do very many at that time. I graduated back up to 30.

And finally, have you heard of or tried MFR, Myofascial Release Therapy. I go for two sessions a week. They work on the swelling and any pain you may be experiencing. The swelling is reduced by moving the fluid up your leg where it can find its way to your bladder and be released when you urinate.

So at 5 weeks or 35 days, I am working on stairs. Last week, I just climbed up the stairs one foot after another. This week, I start going down the stairs one foot after the other. That requires more stability. I do this 3 times a day. And this was the week I started driving after passing my life partner's driving test. I practiced on our frontage road until I felt secure.

One of the things they don't encourage is moving too fast. They yanked me back from walking more than 1/2 mile at this point. And they said no Yoga practice yet because some of the poses may not be knee-friendly.

Please relax and do only what is appropriate for your recovery stage at this time. Be grateful for and excited about your new knee.

May you have happiness and the causes of happiness.
Chris

Thanks for the encouraging and thoughtful reply. I do elevate using pillows and have started twice a week orthopedic physical therapy. The sessions are very helpful but my range of motion is from 6 to 66 degrees at this point. Without their specialized equipment I find it much more difficult to incrementally increase the ROM especially given my swelling.

I am currently using a walker and am just beginning to take a few steps with a cane. My therapist said I am in the lower percentile for range of motion at this point but we all know everyone is different. He and I both I agree that my progress should be measured week to week against myself not others. We have discussed upping my visits from 2 to 3 per week but it is proving difficult as they are very busy.

I am aware of massage and it’s benefits. Does your PT person do this?

I guess my main issue is I have always been a very competitive and able athlete and it is very frustrating not to be able to steadily improve because the swelling prevents me from doing the exercises. It seems like if I exercise I swell and if I don’t exercise I swell. I’d hate to think how swollen I’d be had I not been using the ice machine hours per day.

Hello, I am sorry to hear that you are having a lot of swelling, but wow, 10 days is really early in the recovery process.

You have a wise therapist. I wish all of them would acknowledge that every body is different, and entitled to individual an individual treatment schedule. Ask the PT to show you strategies for increasing range of motion without their equipment. Most are very willing to show you how to improvise.

The hardest thing for me to believe, when I had my first hip replacement, was how many things were affected by "one little incision" - then I realized that my bones had been cut and hammered, muscles and ligaments moved and bruised, nerves cut and damaged, and blood lost - my body was in distress. For some people there is pain, swelling, numbness, weakness, muscle spasms, or all of these.
Everyone heals at their own rate, and it can be different with every surgery.

Apparently, your body has decided to slow you down by swelling, you just have to respect that and keep doing what you can. Just find that fine line between exercise/rest/ice and overdoing it.

One of the beautiful things about connect is that we are all walking the path back to health, and can encourage one another.

I'm wishing you lessmswelling and more range of motion in the coming week.
Sue