knee replacement

My husband had knee replacement and his swelling lasted for a good four days . He used the ice packs all the time .

@kirtnichols Welcome to Mayo Connect where patients try to help one another through life's challenges.

Swelling after joint surgery is really variable - some have little, for others it can last for weeks or months. The most important things, especially in the first 6-8 weeks, are to elevate the leg (knee above hip level) whenever you are not walking or doing therapy and ICE...Ice...ice. 20 out of 24 hours is not too much at first, but at least 4-6 times per day until you have regained most of your activity.

Also, let me share a little secret. Doctor's often say "Oh you'll be healed in 6 weeks... or 2 months" What they really mean is, "the incision will be fully healed and the implants will be attaching to the bone." Complete recovery - full stabilization, regaining range of motion and full strength - can take from 4 months to a year. AND a lot of that is up to you - only the patient can do the "daily grind" of home PT 2-3 times a day for as long as it takes, even when it hurts, or you're tired, or too busy.

Where are you in your recovery from surgery?

I am 81 and had TKR4 months ago, and still have some small swelling. PT says this is a normal process of recovery and to ice and elevate. My scar tissue built up so I also had the manipulation under anesthesia done. I’ve got a bit more flexibility and I’m still working on that. So everyone’s different and just keep icing to keep the swelling at a low roar!

I am 11 months out and still have swelling. I have found that a knee sleeve gives me more support, increases blood flow and reduces swelling....I can do almost anything when I wear my knee sleeve. Make sure though your Dr. is ok with it because it cannot in anyway restrict your movement or bending. I'm hoping I do not have to wear it forever but it has greatly helped me. At night, though, when I take it off my muscles are really sore. I've heard for some it can take longer than year and think that might be me.

At about 1 year out from my knee replacement, I started to develop severe loss of range-of-motion. Previously I had about 115 deg and then about 1 year out, it was about 85 deg. I have continued to exercise and do daily activities, but I am not able to achieve more than 90 deg. My surgeon says it's mainly scar tissue. I am continuing with PT, but he has said that joint manipulation may be my next treatment. Is manipulation > 1 year dangerous or risky? The lack of motion is OK for running, but for cycling it is very frustrating. Or are there any other treatments?

Welcome to Connect. I hope someone here can answer your question. I have had hip replacements but still babying my knees.
@artscaping do you have anything to say about this?
Sue

Good evening, @pistons899004. Thanks, @sueinmn, for the introduction. I think I
I understand your message and have a good memory of my most recent TKR in 2022. MUA, "manipulation under anesthesia," may be a purposeful and effective solution. My Yoga teacher just had a post-surgery MUA for her right side TKR. She, too, had similar problems with range of motion. I also think she exercised too hard to be able to return to our Yoga sessions.

Another option would be MFR, Myofascial Release Therapy. My first TKR about ten years ago ended up the same way because of scar tissue. I lived on a 6,000-foot mountain with no medical support besides the firemen and a young lawyer with prior education in PT. After moving to flat sea level MN, I began MFR, and it took about 12 sessions to remove the scar tissue. Since then, I have had no pain or discomfort. Just for the record, my range of motion returned to 120. By the way, it is suggested that you have a non-invasive MUA about three months after your TKR.

Hopefully, your surgeon will be able to determine your best option for challeging that 90-degree level. I know it must be frustrating to faithfully continue exercises and daily activities without noticing increased post-surgery healing.

Would you please let us know what you decide to do in your pursuit of continued healing?
May you be safe, protected, and free from inner and outer harm.

Chris

I found that Phys Therapy after my hip replacement & spinal fusion made
ALL the difference. It may take awhile but every pain & stretch is worth it!
Kay

Thanks Kay. The best way to treat scar tissue is to never get it in the first place. As it relates to joint replacements, this requires the patient to start physical therapy immediately, or whenever the Dr. says to start, and continuing the exercises at home, usually 3x/day for at least 2 months.

I know after my TKR, and I think after every TKR, a PT will get you up and walking the hospital halls prior to your release, which is usually the same day. After that, patients usually attend sessions with a PT 2 to 3 times/week, and will need to do at home exercises 3x/day starting the day after surgery. (This may be different for shoulder replacements, but eventually PT is absolutely required.)

It hurts, of course it does, But it beats the pain pre-surgery, and the pain gets a little better every day. It's a good idea to take pan meds an hour or so before each therapy session.

Joe

Hi Chris - thanks for the kind words and valuable information. I didn't realize that MUA may be required for some patients and used as a preventive procedure. Being that I am one year out from my TKR, I was nervous about MUA and it's side-effects (muscle strain or damage). But sounds like my concern is a bit over-reactive. I definitely will look into MRT. This is exactly the effect I am experiencing and sounds like a good place to start to help with my range-of-motion issues.