Help with pain after 3 months of TKR

Posted by fran102 @fran102, Mar 8, 2023

It has been 3 months since I had TKR and still have terrible pain behind my knee. I finally got my ROM up to 115 and can bend my knee when walking although I still have to use a walker. I’m going to get a second opinion because my surgeon has been totally unhelpful. Does anyone have any recommendations on coping with the pain and is this normal? I feel so frustrated and scared I might be this way for the rest of my life. It’s pretty much nonstop pain. I go to PT 3x a week for 2 hour sessions and they have helped me with ROM and knee strengthening but have so far to go. They are trying to get me a Dynasplint. Has anyone ever used one and does it help? Thank you so much for any advice you can give me. I’m so depressed! I had no idea it would be like this.

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@heyjoe415

It can be a slow process, up to a year. Riding the bike is great for the knee after TKR surgery. Keep doing that.

I would NOT apply heat to a painful knee. I'd stick with ice. The reason? Heat increases blood flow which increases inflammation which increases swelling and pain. IMO that's bad advice. Heat is very rarely helpful to treat anything as it increases inflammation.

Speaking of inflammation - if you eat a lot of sugar (you may to even be aware), that also increases inflammation. Just check what you eat. And dried fruits are notoriously high in sugar.

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Appreciate your thoughts! It’s so hard to know what to do! I will not use heat and will cut out the sugar. Don’t eat a lot of sugar except for dried fruit. A day at a time… Thanks for the tips!

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@knighthawk11

Thanks for your advice I will take that to heart 😊

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I was surprised by the high sugar content of raisins, and I love em. I changed out for blackberries with a much lower sugar content.

And my comment on icing - I got that from a chiropractor, a very good one, years ago. His philosophy was to NEVER apply heat, not even to tight muscles. The damage from increased inflammation wan't worth the short term relief. I will make an exception for an occassional sauna, but that's it. And all has been well. I recovered from my TKRs very quickly. All the best.

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@fran102

Appreciate your thoughts! It’s so hard to know what to do! I will not use heat and will cut out the sugar. Don’t eat a lot of sugar except for dried fruit. A day at a time… Thanks for the tips!

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I think you'll find it will help. Ice is absolutely magical. People tend not to use it because it doesn't feel very good to apply, but it works. And dried fruit is still better than eating processed sugar products. I mean, we have to be reasonable! All the best to you.

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@knighthawk11

Thanks for your advice I will take that to heart 😊

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Ask your doctor/surgeon but once the initial swelling from surgery has resolved, as is the case for you, most PTs and orthos DO recommend alternating heat and ice. Heat warms up your muscles and increases blood flow which promotes healing. Ice AFTER exercise to reduce the inflammation.

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I am wondering if you have a Bakers Cyst which what occurs when the popliteal fossa fills with fluid. It is located behind the knee.
My doctor did an ultrasound on me because I had significant pain behind my knee and down my calf and he wanted to check for blood clots. No blood clots found just this annoying Bakers Cyst.
It has still not gone away but as the surgical swelling has decreased overtime there is not as much pressure on the back of my knee.
I really to feel it when I bend my knee back.
I am 11 months. post TKR and have been told it will eventually go away. I have spoken to other knee replacement people, and they have experience the same thing

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@continentalred

I am wondering if you have a Bakers Cyst which what occurs when the popliteal fossa fills with fluid. It is located behind the knee.
My doctor did an ultrasound on me because I had significant pain behind my knee and down my calf and he wanted to check for blood clots. No blood clots found just this annoying Bakers Cyst.
It has still not gone away but as the surgical swelling has decreased overtime there is not as much pressure on the back of my knee.
I really to feel it when I bend my knee back.
I am 11 months. post TKR and have been told it will eventually go away. I have spoken to other knee replacement people, and they have experience the same thing

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Hello,
I had a Baker's cyst prior to my knee replacement and they drained it a couple times. I'm just wondering if they could drain it to give you some relief, or maybe a cortisone shot to dissolve it.

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Drainage is not recommended post op due to infection so I would wait

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@knighthawk11

Thanks for your advice I will take that to heart 😊

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You're very welcome. It amazes me how many different outcomes I've seen from people with TKRs. For the people who don't do the required prehab and rehab, it's gonna be a rough ride and likely not get better.

And yet I've seen people do everything right, even athletic people, and their recovery can be long. That's why the surgeons say expect a one year recovery, and hope it gets better sooner than that.

I have a friend, 8 years younger than me (he's 61) and he was in the gym everyday. He went into the surgery in great shape and did everything right post op. Right now he's at 8 weeks, his knee is still swollen and painful and his quads have atrophied. Unreal, and with no good explanation. X-rays show the prostheses is perfectly in place.

So I feel very lucky for my results. It always takes hard work to recover well, but hard work doesn't guarantee an immediate recovery. I guess just be prepared for everything, and be prepared to be resilient.

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