Average level of pain after TKR?

Posted by ellerbracke @ellerbracke, Mar 17, 2019

I had right knee TKR 6 months ago. Perfect ROM and extension (after hard work), functioning very well. However, I am fluctuating between what I would call “awareness” of the artificial joint - just a little sore - to aching, to moderate pain. Depends a little on activity level, weather, who knows, but it is always present, and I resent it. Some (many?) people are pain free at this stage. Should I be concerned, or will the magical 1-year mark fix this?

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@pam61

I had a tkr done a year and a half ago. Things were going good and then I fell on it at work landing directly on a concrete floor. That was 7- 8 mo after the surgery. Workmans comp hasn’t wanted to address it. I have had a tight band feel around it ever since. I don’t know what to think. I did secure an attorney for all of this since I did actually land on both knees. Should I still be feeling like this after this long??

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It's possible the tight band feeling is not from the fall. It's fairly common with TKR because of all the muscles and nerves that are cut to get to the knee. I am four years out from TKR and still have that sensation and expect I will forever. It actually helps if I use a strip of KT tape over the knee (like a bandaid) 😉

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@cisconurse

Can’t take Tylenol and have tried Lyrica in the past with poor effectiveness. My pain is muscle/nerve and like others have mentioned it’s the length of standing time and endurance that are still not up to par (and sleeping! God how I wish I wasn’t a side sleeper!) I still work with my PT, but going to the pool has been the ticket for me. I mostly just walk and do ROM but it has been amazing (physically and mentally). When I need to take RX pain meds it’s not the operative pain so much but rather the pain in the other knee and my hands. I already take ibuprofen routinely and as you know, you can only take so much. I have the will most days to go farther, but limitations with my right knee prevent that. I’m scheduled to have a left hand CMC arthroplasty on March 2 and then will decide, depending on recovery, what next steps are. Right knee or right hand? 2023 is going to be as challenging as 2022 but I try to keep my eye on the prize! Fortunately (? Or not) arthritis is my only health issue.
I stayed away from the internet for the most part, but I will say that although my surgeon is well known and the best around here, I feel their attention to post op education ( weeks and months, not immediate) is lacking, I’m a nurse and know that there are so many variables associated with individual recovery and rehab that you cannot expect a one-size fits all response. Still, I never worked ortho and don’t personally know anyone who has had a TKR and found the posts on this board to be most helpful and reassuring.
Thank you.

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You might try a nerve ablation for your knee. Unfortunately my first did not give a lot of relief but am getting another after 6 months from the first. It’s relatively non invasive and used both before and after surgery. I am 17 post op and still struggling especially if I do any kind of physical activity.

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@continentalred

I am 4 1/2 months from having a total knee replacement, and still have the symptoms you are explaining. I really thought that I would be further along at that this point, but I suppose I was a little naive. I go to PT, do muscle strengthening exercises attend aquafit classes, ride my walking bike outside and my stationary bike inside but walking long distances can give me grief. And that I resent because the main reason for having the surgery was so I could walk without limping after half an hour.
I still have inflammation around the knee and a Bakers Cyst behind the knee so I know the swelling is making it difficult to weight bear. I started to wear an elasticized knee brace which helps and yesterday I got fitted for a compression stocking
But what I wanted to mention is that when I had extreme pain in the first 2 months the opioid I was prescribed did not bring me any relief. The only thing that helped was Lyrica, which focusses more on nerve pain. I can tell you it was a game changer for me and I don’t know why more orthopaedic surgeons do not prescribe it regularly. At the height of my pain I took 150 mg twice a day and then weaned myself down to 50 mg twice a day. Occasionally I might take one but I highly suggest that the people who are having extreme pain to ask their doctor for this medication rather than an opioid. The doctor might be more willing to prescribe this as well as opposed to an opioid.
Another consideration is to take Calcium and Vit D supplements for bone strengthening. Here is an article that supports the use of the supplements
https://www.lancasterortho.com/news/calcium-vitamin-d-your-new-knee.html

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May I ask how long did it take for the Lyrica to take effect?

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The Lyrica worked almost immediately.
I was at physio on a Thursday morning and couldn’t lift my leg or do a rotation on the bike. I got the script filled that day and by Sunday I could lift my leg and do rotations on the bike.
My PT couldn’t believe it
That was at a dose of 150 mg twice a day

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@vpuchstoeke

May I ask how long did it take for the Lyrica to take effect?

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It probably kicked in after 48 hours

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@cisconurse

Can’t take Tylenol and have tried Lyrica in the past with poor effectiveness. My pain is muscle/nerve and like others have mentioned it’s the length of standing time and endurance that are still not up to par (and sleeping! God how I wish I wasn’t a side sleeper!) I still work with my PT, but going to the pool has been the ticket for me. I mostly just walk and do ROM but it has been amazing (physically and mentally). When I need to take RX pain meds it’s not the operative pain so much but rather the pain in the other knee and my hands. I already take ibuprofen routinely and as you know, you can only take so much. I have the will most days to go farther, but limitations with my right knee prevent that. I’m scheduled to have a left hand CMC arthroplasty on March 2 and then will decide, depending on recovery, what next steps are. Right knee or right hand? 2023 is going to be as challenging as 2022 but I try to keep my eye on the prize! Fortunately (? Or not) arthritis is my only health issue.
I stayed away from the internet for the most part, but I will say that although my surgeon is well known and the best around here, I feel their attention to post op education ( weeks and months, not immediate) is lacking, I’m a nurse and know that there are so many variables associated with individual recovery and rehab that you cannot expect a one-size fits all response. Still, I never worked ortho and don’t personally know anyone who has had a TKR and found the posts on this board to be most helpful and reassuring.
Thank you.

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I had TKR on Jan 30,2022 I am slowly getting better. If I am on my feet shopping and doing regular activities I pay for it that night. The pain usually is behind and the side of my knee. I also have pain down the top of my foot. The pain in the foot is so terrible that it keeps me awake. I don't think I have had a good nights sleep since my surgery. I am on 300mg of gabapentin that I can take twice a day, but I usually try and just take at bedtime. It seems to help some but nothing helps much even vicodin or percocet. I don't take the hard drugs anymore because they don't seem to help that much. I really don't understand why doctors don't try and get you ready for all the pain that you experience with TKR.

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@jeaninking

I had TKR on Jan 30,2022 I am slowly getting better. If I am on my feet shopping and doing regular activities I pay for it that night. The pain usually is behind and the side of my knee. I also have pain down the top of my foot. The pain in the foot is so terrible that it keeps me awake. I don't think I have had a good nights sleep since my surgery. I am on 300mg of gabapentin that I can take twice a day, but I usually try and just take at bedtime. It seems to help some but nothing helps much even vicodin or percocet. I don't take the hard drugs anymore because they don't seem to help that much. I really don't understand why doctors don't try and get you ready for all the pain that you experience with TKR.

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I had a TKR on Feb 14, I have had almost no pain due to the surgery. What I do have is may be arthritis on the inside of the right knee. That flairs during rehab and sometimes at night.
Use Voltaren and tylenol and that it.

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Everyone recovers at their own pace. I don't think it's unusual to have pain 6 months out from your surgery. My TKR was 9 months ago and while the range of motion is good, the muscles and nerves around the knee are still healing. Some days that area around the knee aches, some days it's a little stiff, some days it feels almost normal again. It's a process that can take up to a year or more. Don't panic. Be patient. Improvement is often gradual. It takes time.

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Hi all true we all recover at are own pace …. I found it’s what I do in that time my first tkr pain from time I woke up…. I took Percocet for however long dr gives you …. Than took tramadol which I liked better not to sedative to get through therapy …. I never did get through therapy I continued going for a year did not get anywhere ….. long story short I went for revision within year of tkr with new dr…. I understand pain …. I found ways and therapies to help first is mfr that has been my saving grace , I had great chiropractor that performed graston technique …. Helped me through pain, swelling … so I have not had to take these other pain meds like many others have had to…..now I am 7 months out I still continue with mfr no more pain for many months Tylenol once and a while …..so my two cents if you can try myofascial release therapy I think definitely benefit you …. Good luck

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@boosaw

I had a TKR on Feb 14, I have had almost no pain due to the surgery. What I do have is may be arthritis on the inside of the right knee. That flairs during rehab and sometimes at night.
Use Voltaren and tylenol and that it.

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Voltaren? I’m gonna see if I can use that because that’s when mines is worse at night. I heard my PCP mentioned that name but said I can’t use it because I’m on blood thinners.But he knows I hadn’t been on blood thinners since 2/7/2023. I was told I had hemotoma and still haven’t gotten back on it because none of the doctors want to step up and say when it’s safe to start back up on my Warfarin. 😒

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