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Pain and Stiffness 6 months out from TKR

Posted by afladland @afladland, May 8, 2023

I have a lot of pain getting up from a sitting position but subsides after a few steps. Wondering if this is normal. Also, it is very painful to go both up and down stairs. Its almost worse than before my surgery. any ideas?

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Justin McClanahan, Moderator | @JustinMcClanahan | Oct 11, 2023
In reply to @knighthawk11 "I am 6 months post TKR today but still not happy with results. Yes I can..." + (show)
@knighthawk11

I am 6 months post TKR today but still not happy with results. Yes I can walk about 1 mile a day but have constant pain on outside of my knee. Worse when walking down stairs feels like pulling stabbing pain so I tend to walk one step at a time instead of foot over foot. Also burning pain above knee. I have done Physio up until a month ago but am still doing daily excercises . I really thought at 6 months I would not have constant pain. Still taking OTC pain meds. My surgeon told me at 3 months everything was okay with X-ray so not sure what to do. Any advice would be greatly appreciated.

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Hi, @knighthawk11. I combined your discussion with an existing discussion titled "Pain and Stiffness 6 months out from TKR" - https://connect.mayoclinic.org/discussion/pain-and-stiffness-6-months-out-from-tkr. You can read other experiences similar to yours from members @mrnomad, @cindymattern, and @afladland who are in varying stages of their recovery.

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mrnomad | @mrnomad | Oct 11, 2023

It's been 16 months since my right knee TKR and the only thing I am glad about is that I didn't do both knees. I still cannot bend more than 90 degrees, cannot ride a bicycle (a life-long love), and the pain & imflammation never ends unless I don't use the knee. I am not overweight, exercise 3-4x per week at a gym and active other days.

The most recent "remedy" was using Ultrasound to identify massive scar tissue and long needles to break it up. After 4 painful treatments, I gained 1 degree of bend and the loud click is quieter.

One thing I'd like to pass along is not all cortisone shots or doctors are alike in their skill. When my GP administered cortisone to my left (unmolested) knee, it lasted 2 months but when the sports doc administered cortisone, it lasted longer than 4 months. I assume the sports doc's trajectory is better and his mixture more effective. After all, he does this 50x per week whereas the GP does it less often.

My best non medical advice is to wait until technology improves and make sure your surgeon will "tuck the saphenous nerve", NOT cut tendons too short, and basically gives a damn versus rushing to get more procedures in 1 day.

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leahcece | @leahcece | Mar 26 2:16pm
In reply to @mrnomad "I'm nine months past TKR and I had lots of difficulty with stairs so I tackled..." + (show)
@mrnomad

I'm nine months past TKR and I had lots of difficulty with stairs so I tackled the problem three ways. First, and perhaps most important, I lost weight. There is a multiple I've read that claims for every lb of weight u lose the reduction in impact to the knee is 6-7lb. I was amazed how much easier stairs were with as little as 3 lbs lost. Second, I eliminated the consumption of any food that exacerbates inflammation. The internet is rife with ideas. Third, weight training. When I go up or down stairs, both hands are on the rails making the most of the gym exercises which built my calf muscles, hand strength and arm strength. In essence, other parts are used to assist the TKR knee and don't forget about the non TKR knee. Build it as well.

I regret my TKR surgery every single day, but regret only lead me to anger and depression. Basically, I had to figure a solution and then find the determination to stick with it. For the record, I recently climbed 3 floors using the stairs, non stop, hands holding the rails and calves doing most of the work. My HCM caused me to become winded at the top, but I climbed those stairs and believe I can do it again and again. My knee was definitely inflamed but it calmed overnite.

Hope this helps.

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Thank you for sharing. This is so helpful! All of the above was exactly what I was dealing with and I kept thinking it would be beneficial to lose some weight and take a healthier approach. I am totally on board with the physically therapy but was concerned about the 6 months progress that seem very slow - stiffness and intimating pain.

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mrnomad | @mrnomad | Mar 26 3:44pm

I'm 2 years and 8 months since my TKR. I exercise almost daily, Planet Fitness for 90 min, cardio and strength. I cannot bend the knee any more than 92 degrees so my 10 speed has not been used since the TKR (disaster). Pain is daily and standing/walking for any length of time causes pain level 10. Weight loss definitely helps bec it lightens the load. Inflammation is my other culprit. My replacement doc refuses to MUA the knee bec the return of inflammation could reduce the ROM to 40 degrees. Voltaren, ibuprofen, and anti inflammatory foods help. Build up your arms to help you rise off the ground and go down stairs. Going down stairs is much more painful than going up. I stopped playing pickleball bec of the pain.

The two huge mistakes were not fully testing to see if I was an inflammation machine and the surgeon's failure to tuck the Saphenous nerve. My anger has subsided... somewhat. Will I do the other knee?? Not in this lifetime.

Best of luck. Write again if I can help.

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mrnomad | @mrnomad | Apr 11 9:24am
In reply to @mrnomad "When I walk stairs, my stronger/newly developed arms, hands, calves and non TKR knee work in..." + (show)
@mrnomad

When I walk stairs, my stronger/newly developed arms, hands, calves and non TKR knee work in unison to lift my 170lbs, 5'10" frame up the stairs. It's a team effort. When I was 165lbs, it was even easier so the goal is 165. The "means" is Planet Fitness 3-4x per week and exercise every other day. My knees don't lift me, my calves do most of the work. My feet are never flat foot on the steps, my calves are constantly working to lift me. There is no easy way, but my life is worth living (despite the pain) after I refused to capitulate to pain and the dysfunction the TKR caused.

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Unfortunately, 3 years after surgery, my TKR knee STILL will not bend beyond 92 degrees which means my 10 speed bike is never used. Pickleball is out, long walks, jogging, and hiking a faint memory. I've tried all different types of PT and medical procedures to increase the ROM to no avail. 5x per week I work out at Planet Fitness and for 90 minutes endure pain level 10 when I use the leg press and stationary bike. I reject a sedentary life, I'd sooner live with the pain.

Words cannot describe my remorse for agreeing to this procedure. I urge people to think long and hard before proceeding.

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1 reply
kalawthamee | @kalawthamee | Apr 12 12:29pm

Very sorry to hear about your situation. My surgery for TKR is scheduled in two weeks and I cannot decide if I should go through with it because at the moment I can walk and drive. I have not tried to alleviate my pain withmedications, my pain only goes up to about a seven or eight on occasion, especially if I do a lot of standing or lifting heavy objects. Hearing about what you’re going through adds to my concern about going ahead with this surgery. I also have osteoporosis, which means that my bones are going to deteriorate in any case and therefore my left knee, which I’ll be using to support me while my right knee heals, will probably require me to have surgery on that knee as well shortly after and my hips are also showing signs of the same wear and tear and would mean that I would have to go for more surgery on those. I am in my mid 80s right now and that itself is another concern to me. Thank you so much for putting that out there for us to see that some do not benefit from this TKR and land up with more problems than before.

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jdth | @jdth | Apr 13 12:53pm
In reply to @mrnomad "Unfortunately, 3 years after surgery, my TKR knee STILL will not bend beyond 92 degrees which..." + (show)
@mrnomad

Unfortunately, 3 years after surgery, my TKR knee STILL will not bend beyond 92 degrees which means my 10 speed bike is never used. Pickleball is out, long walks, jogging, and hiking a faint memory. I've tried all different types of PT and medical procedures to increase the ROM to no avail. 5x per week I work out at Planet Fitness and for 90 minutes endure pain level 10 when I use the leg press and stationary bike. I reject a sedentary life, I'd sooner live with the pain.

Words cannot describe my remorse for agreeing to this procedure. I urge people to think long and hard before proceeding.

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I am so sorry about your situation. I had my TKR 3 months ago. My bend was 90 in 4 days. It is now 130. My knee still aches and I ice some evenings. I’m 75 and while my knee hurt really badly for 2 months, I’m much better now. I hope you can find some relief.

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