Miserable from TKR: What can I do to get better?

Good evening @tracy70. Oh my, oh my. I am trying to put my head around your situation. You must be shocked at the pain and discomfort you are having. May I welcome you to Connect? i just had my second TKR 7 weeks ago. I remember having some very tough times and feeling frightened. Did you have a nerve block? They are supposed to keep you quite comfortable and free of pain for a couple of post-surgery days. Another question...... did you have robotic surgery? That surgery is minimally invasive and also assures the patient and the surgeon that the surgery was done to plan without incident.

Two weeks is not a lot of time in what can be a full year of recuperation and when you are in pain it seems like forever. I don't think you are expected to have an adequate range of motion (ROM) at this point. Neither should you be so worried about the gap between your bed and the back of my knee. That measurement called an extension requires several weeks of stretching your leg.

What are you using for pain control right now? How are you sleeping? Have you ever heard of MFR....myofascial release therapy?
That sure might help. And most important.....are you icing your knee several times a day. Do you have a wedge to put your knee on so that it is elevated above your heart?

I am here for you and want to help you.
Chris

SO SORRY, 2WKS is not much time yet, you just went thru a very tough surgery, far tougher than doctors tell you. Keep pushing with the PT , take the meds, they help BUT YOU MUST BE YOUR OWN VOICE IF YOU DON'T SEE IMPROVEMENTS GET ON YOUR DOCTOR. Please keep trying with the PT if in 2 more wks you don't see things getting better I will tell you my story. BUT RIGHT NOW KEEP THE FAITH AND CLEAR YOUR MIND , TAKE THE MEDS AND WORK PT

Be careful with the narcotics.They can be very addictive as we know. I only took them at night.During the day I took Tylenol and Motrin.You can use them together as directed .Use a lot of ice and elevation.It’s still early.Follow the PT instructions.And yes this surgeons don’t ever describe how tough it is .Hang in there .It will get better.

Your pain with flexion and in general (2) weeks after a total knee replacement is to be expected. I have had (2) total knee replacements (first RT knee 7/9/2020 & second LT knee 9/19/2020). I'm 75 years old. The physical therapy for the first (6-8) weeks after the surgery is really really very painful, but you have to just push through it, otherwise you'll end up with a stiff knee that requires the surgeon to manipulate it for you under general anesthesia. If your knee isn't so stiff that the physician wants to manipulate it himself, your knee will NOT become more flexible on it's own without physical therapy. And you don't want your PT to end before you can sufficiently flex your knee to the extent required. Without sufficient flexion in your knee, your gait will be affected and you won't be able to walk normally as you should, which will eventually become a big problem and cause new problems & new pain in the long run. The really bad pain, in my case, lasted until the end of the physical therapy (after the 12 weeks of therapy). I found that BEFORE the physical therapist worked on my knee, I had to take a pain medication dose. When the physical therapist first started working on bending & straightening my knee joint, I screamed in pain often, but she knew enough to not stop and kept working on my knee. At the end of the PT, your bending knee flexion should be 120 degrees or better and your straight leg flexion should be close to zero. As far as pain medications, get ahead of the pain. In other words, don't wait until the pain is so bad that you then HAVE to take a dose. Stay on schedule taking the pain medications, since it's better to not have the pain set in than it is to tamp it down after it becomes unbearable. I can now bend both knees 127 degrees and straighten both knees down to zero. Good luck.

Tracy 70. I literally feel your pain. I am now 8 weeks pst left TKR. It got to the point were I fantasized how an above knee amputation would get me out of pain. I agree with all the above comments. A good PT is invaluable. They worked 30 min. Yesterday to release the tight soft tissues that remained after 2 previous such sessions. They are reassuring me my progress is ahead of schedule. Not being able to sleep without waking multiple times is the most challenging still. I am 2 mos from 75 and cannot take NSAID’s. That leaves Tylenol. They did prescribed Tramadol for the first 4 weeks. For me Tramadol was minimally effective as 3 per day did not allow me to stay ahead of the pain. I did have a nerve block, but not robotic surgery. I have changed my mind about having the other knee done which the doc would have done first if my left hadn’t been so painful. Concern over opioid addiction has changed the one time thought that good pain control decreased recovery time. In closing I want to assure you it does get better. Connect Mayo has been so helpful to me, knowing I wasn’t alone or crazy. Please keep posting.

Had TKR in May surgeon said when I see you in 2 weeks I expect you to go 0-60 degrees. I had physical therapy prior to surgery so my therapist gave specific instructions with exercises, etc and he wanted me in his office day after surgery which I was. Got the same instructions from in hospital pt and physician. Amazing they were all saying the exact same thing. Following their directions I was zero degrees extension and got to 62 degrees flexion one day post op. Having said that the worst was inability to sleep which went on for over two months, then it got better.
Had a former reverse total shoulder 2 years ago by the same surgeon and have the same physical therapist who is young and uses a kinds of things to get me back in shape. He has used dry needling, cupping and muscle stimulator. I am on a strict exercise plan for both knee and shoulder and apparently these exercises are for life. Anyhow I believe with a great surgeon and great physical therapist without any complications it just takes a lot of hard work. There can be setbacks, they say that’s normal. I am still in therapy once a month working on balance and going up n downstairs in the normal way. It’s hard hang in there

Also I do water aerobics really helps

Oh, for goodness sake. Am I niaeve? I expected TKR to go well and with PT be almost as good as new. Well....guess not. First TKR was perfect; not much discomfort, walking almost right away. 3 yrs. later, TKR by a different surgeon. This TKR was sort of OK, but not as perfect. AND I AM REALLY TIRED OF THIS FEELING OF IMBALANCE WHEN I WALK. I NEVER EVER HAD THIS PROBLEM IN MY LIFE. Something, I think, is wrong with the alignment. I work hard at PT to build core and leg muscles to help support my back (another issue). I can play sports (golf and picklball) - but limited to length of time. My problem is balance!! I do not walk smoothly. Is it too much to expect these surgeries to work perfectly?? (Do I expect too much.). But I want to go to a specialist (not my surgeon) to determine what can be done about walking with a smooth gait and not "pitched" forward. I still have numbness after 2 years, but much improved. People think surgeon clipped a nerve. Well, by gosh, what am I supposed to do about that?
Can someone tell me what type of specialist I should go to to become more balanced. My surgeon suggested using a "Dr. Scholl's" type of foot pad. C'mon. How about something more sophisticated? OK, sorry, enough tears and self pity. Can someone suggest what type of specialist can correct my walking gait? Shall I go to the same hospital, but ask for a different Dr. What type of Dr.? Or am I supposed to just be happy with this second-rate surgery from one of the best hospitals in the NY area? Surgeon has a great manner, but I want results. Sorry for sharing my frustration and lack of direction..............

I have numbness in my TKR that has expanded but originally have some numbness from a 2006 meniscus surgery. Have had balance issues which are getting better all in part to my great physical therapist.
In my experience with physical therapists over the years some just aren’t as good as others.

I had TKR done in 2013 at Mayo by just the greatest and most confident doctor I had ever been to. He told me straight out that this is probably the hardest surgery you will ever have bar none. He was honest outspoken and I had trust in him right away. They had exercises that I could do at home on my own. I never had PT. I know how hard this is but just remember why you did the surgery and all the things you want to do in life once you recover and you will. Your focus has to be on getting exercises done with a mission of recovery. You can do this so many already have.