TKR #2..... Lessons I am learning

Chris, great suggestions, all! One of the hardest to follow is getting your knee up high enough when you ice, at least in the beginning when your leg is inflexible following surgery. I hope everyone gets sent home with that stiff "doggy walker loop" stick that helps you place your leg up into bed, as well as using it for various exercises. It takes a lot of pillows or cushions to get your knee to at or above heart level while in a recliner. I was given my stick/loop during first PT in the hospital following the surgery, and I used it a lot during the first three weeks, would have been hard to get in and out of bed without it.

I don't remember how many kinds of pre-surgery exercises I was given, but I continued to do two of them, right after surgery in the hospital, and many times at home when I couldn't sleep at night due to discomfort. I alternated doing the foot flex about 5 times, then the tighten and pull the back of the knee to the mattress 5 times, and I would keep it up until I got tired. I think it helped work the muscles and relieve inactivity and would relax my legs so I might be able to sleep a little. Finding a comfortable position in the first few weeks is a challenge.

For those who are having a first TKR, I suggest keeping a daily diary and jotting down progress and feelings and concerns as you heal. I wish I had. When I had my 2nd TKR, I kept wondering if I was healing at the same rate, and it seemed like I had more initial pain than with the first surgery. But no way to tell, since time diffuses memories, and since my first knee was a success, I could easily have pushed the more difficult moments out of my mind. You can either keep notes on your cell phone, use the dictation feature if you have it, or just get a cheap little notebook to keep by your usual resting place and make note of any good or bad things for the day.

Thank you Chris and DD. Using the toilet was incredibly painful. I purchased a bedside commode, took the pail off and then place the frame/seat over my toilet. What a blessing. I added a small foot stool, to rest my leg. BTW, I am 19 days post TKR. I have significant swelling, I sit in a recliner. Perhaps it’s not too late to try and get that leg more elevated? DD, can your loop gadget be purchased on-Line? I took Oxy the first week and now Tramadol. Doctor recommended taking it more frequently cause I was not sleeping and after PT pain was unbearable. Finally comfortable, nor pain free, but I can function. I exercise multiple times a day. I have good extension and 90 degree flexion. Mary

@artscaping I had my first TKR in 2013 and my second one in 2017.

I was not given a list of exercises to do prior to my TKRs, I never heard of that from any doctor, I wonder if that's something new, and if so it's a big step forward. My orthopedist was very happy that I was doing my recumbent bike and jogging in the pool before my second surgery. The first TKR was by a different surgeon and that was never even mentioned.

My second surgeon, who I think may be one of the best in the country, felt those two things were the best exercises for prehab and when able, for rehab. I asked him about prehab and he asked what I was doing for exercise. When I told him those two things he said I was all set.

The thing I would stress the most, is to really do the exercises faithfully after the TKR. I think that I probably did not keep up with them as well as I should have and wonder if I had, if I would have better flex now.
JK

@auntieoakley : I trust you are doing well with your second knee replacement. You are a veteran, both from personal experience, and so many other people adding their input. I had my right TKR 9/18, 85% happy with it. 100% functional. Just curious - if I would be faced with need to fix major knee pain in my other knee, I would -other than PT, etc. - try PRP, even stem cell injections, before TKR , perhaps even lowered expectations of activity, since I’m somehow getting older all the time. Again, my artificial knee works well, does not hurt, irritates the heck out of me because it clicks, and I can’t kneel, and it feels like about 5 degrees off perfect alignment, sort of screwed on lopsided........ so all those things would cause me to avoid a left TKR. Just wondering about your decision to go with TKR again. None of my beeswax, of course, Just curious if you had ever tried other options for either knee. Stay well, and go slay it. You know what to do - you can teach others what to do!

I am afraid the tag went to the wrong Person. I would send this forward to @contentandwell

Oops. my bad. I thought i had you and JK pretty much separated in my news feed. Of course I’m not savvy enough with an ancient iPad to easily get this moved over. Actually, I have no clue how to do this. I’ll check to see if there’s a forward option somewhere. Just for fun: first time I have seen black sweet potato vines flowering. Neat. ....... just an odd observation, but to me it was yeah? Finally something new, and good. Ignore otherwise in context of medical discussions.

No worries, I sent it on. 😁

I had my right knee done about ten years ago and my left knee done within the last five years. I have had a right shoulder replacement and carpal tunnel surgery on both wrists. I include that info as I have found commonalities in preparation and recovery.
Do the pre-exercises to the best of your ability. They gave me confidence.
Read and/or watch instructional videos. There are many on you tube produced by reputable universities and medical practices. Pre-surgery I learned what to expect. Post surgery taught me correct form, how to best negotiate sleeping, barriers in the home…tons of stuff.
I learned not to listen to horror stories or people who claimed to have no pain, etc. This is surgery to your body and relaxing, trusting your doctor, getting excited about benefits of the surgery, educating yourself and believing in yourself will make a world of difference.
Plan to need help and ask for it. Having a plan for someone to assist you for at least the first week to two weeks post op is comforting.
Use ice. I had the ice bucket thingy that forces ice water out and into a small mat that draped over my knees. Big blessing!
Be a good patient. Do your physical therapy.
Give time, time.
Any sacrifices I have made in modifying exercise, etc have been well worth it!
You can do it!

@marymelba - the leg lifter's are available online from Amazon, they run from $7 to $10. Mine are similar to the cheap blue $7 ones, the hospital staff gave me one each time I got my TKR's. Do a search for "leg lifter after knee surgery" It's just a long semi-rigid strap with a hand hold at one end, and a loop for your foot at the other. Along with helping you get into and out of bed, and elevating your leg on cushions on a recliner, it also is used for rehab exercises with leg lifts before you start getting your leg strength back.
It's possible a well stocked drug store might have them too. I got more use out of mine when I did rehab for a frozen shoulder last year, I could hang it over my shoulder to do behind the back arm pull ups. The foot loop was easier to hang onto than the towel they suggested.

I am sorry to hear you are still having so much pain. I wonder if it is aggravated by the swelling. I elevated most of the time I was in the recliner since I was captive there anyway. My PT guy said that icing for three times a day for 20 minutes is enough, but I iced for longer and more often in the early days, because it made it more bearable, even for sleeping (or trying to!) Also, the hospital sent me home with a large flexible ice pack with a soft removable cover with velcro straps to keep it in place. I think that ice pack was what kept me sane and as comfortable as I could expect to be.

@ellerbracke I guess your post was intended for me?

I am doing well. I exercise and walk a lot and as a result I do have discomfort at the end of the day. I didn't always and I believe a couple of medications I take now contribute to that.

Regarding why I never considered other options to a TKR, the only "permanent" option that I was really aware of was stem cell and from everything I read and heard the success rate with that was only somewhere around 50% I think, and it's not covered by insurance. That's a lot of money to risk and then not have your knee be better. My husband does know someone who went that route and it was not helpful at all. I did do PT but that can only help so much. I had cortisone and then Synvisc too. Synvisc helped for a while but eventually it stopped helping.

@anncgrl I agree with you, don't listen too much to others. One other thing that I think is important is to not think that a replaced knee is going to be exactly what your perfect, natural knee was like. It is not. There will at times be discomfort. People need to accept that.
JK