Stairs after TKR (1 side, 72 yrs old)

Posted by persia @persia, Nov 12, 2023

Hi. I am bone on bone, one spur, arthritis in one knee for yrs. Stairs are hard for me. Going up is easier than going down and can only do good leg down/bad leg up.
We are staying at a house that is raised up with parking, etc. underneath. (Post hurricane sandy construction).
13-14 exterior steps to entrance of house.
The place (a rental) has a full bath on the main floor with all bedrooms up a flight. We’re bringing a bed down to main floor for post-surgery.
Questions:
1. How painful/hard to climb the outside stairs when I leave the hospital?
2. Would it be better to extend hospital stay to 2-3 days?
3. How long before I should be able to navigate the outside stairs for rehab/walks/outings as a passenger?
4. How long before I can sleep upstairs in a bedroom (there’s a second bathroom upstairs)
Am anxious about pain/strength/getting around.
Thanks

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@janieben

I had right knee replaced in 2009 and left done in January 2023. Right knee became painful a couple of years ago and has not gotten better, so it hurts to walk up and down stairs with it. Left knee is still somewhat stiff, so going up and down is always a challenge. Both knees hurt a bit when rising from a chair. I do a lot of outdoor activities, like walking, gardening, landscaping, so am kind of active. I have to go up and down steep stairs every am and pm to bedroom; I just put up with it, going up one step at a time, using rail to pull myself up or hang on to go down. Even stepping up and down from a street curb is a bit painful still. I am hoping that over time, things will improve. It is a slow process.

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Thanks

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@ddsack

@persia
I started trying the stairs at least once a day after the first couple of resting days at home. It was a slow struggle, but I figured I needed the exercise, and there was cat litter box duty, as well as laundry and freezer food storage down there to get at. I also had three sessions a week of PT to travel to, so had to go up and down our stairs for that. It became easier as the swelling went down.
I remember going in for my ??14?? day removal of staples. I'd just missed the elevator going up to the Ortho office, so I climbed the long staircase which included a switchback landing half way up. The desk nurse was surprised to see me hobble up with my cane, because they had been watching the elevator for me. It wasn't painful, or I wouldn't have done it, just still awkward because of the stiffness. I went to PT faithfully and did my home exercises, and was pretty much back to full function and no pain by 3 months.

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Thanks for sharing all this! It’s a big help.

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I am now about a year out from a right TKR. Both my surgeon and PT guy told me that steps would be the most difficult to do and the last thing to return to normal. It takes both patience and persistence to get there. After my surgery, I had at-home PT 3X a week for two weeks, then went to outpt PT. The second week of home PT, the therapist had me try some steps, one at a time, and said I should do that once daily. I'd say it was about 6-8 weeks until I felt comfortable going up and down the stairs the "normal" way, and by the six month mark, I was pretty much okay with it. Improvement still continued after that. Now, I don't even think about it most times, except for a little stiffness if I've been using the knee a lot that day. Hang in there!

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@nursefran68

I am now about a year out from a right TKR. Both my surgeon and PT guy told me that steps would be the most difficult to do and the last thing to return to normal. It takes both patience and persistence to get there. After my surgery, I had at-home PT 3X a week for two weeks, then went to outpt PT. The second week of home PT, the therapist had me try some steps, one at a time, and said I should do that once daily. I'd say it was about 6-8 weeks until I felt comfortable going up and down the stairs the "normal" way, and by the six month mark, I was pretty much okay with it. Improvement still continued after that. Now, I don't even think about it most times, except for a little stiffness if I've been using the knee a lot that day. Hang in there!

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Thanks. Very helpful. Appreciate it!

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@persia

Thanks. Very helpful. Appreciate it!

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You are very welcome, and hope all goes well for you!

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@nursefran68

You are very welcome, and hope all goes well for you!

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Thanks!

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Hey Persia as far as the correct leg order for stairs when you have bad knees, it should be bad knee down, good knee up. If you step up with your bad knee, you're putting pressure on that joint. Going down with the good knee is the same thing, the bad knee takes the stress of your body weight as you step down.

It's easy to mix these up so I hope you just mixed up the words. Again, bad knee down, good knee up.

And yes, going downstairs is more painful than going up.

As for your situation....... Stairs were one of the last things I could do without pain, discomfort. I know that doesn't help much. You could use a cane, or if possible a walker to navigate stairs - but that's very tricky and risky.

Can you stay with someone for two or three months while you're rehabbing - where stairs aren't an issue?

All the best. BTW I'm a 69 y/o male, had both knees replaced in 2022. Best thing I ever did for my health, and it took a lot of work on my part with a lot of help and support from my wife. The surgery itself is the easiest part!

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@heyjoe415

Hey Persia as far as the correct leg order for stairs when you have bad knees, it should be bad knee down, good knee up. If you step up with your bad knee, you're putting pressure on that joint. Going down with the good knee is the same thing, the bad knee takes the stress of your body weight as you step down.

It's easy to mix these up so I hope you just mixed up the words. Again, bad knee down, good knee up.

And yes, going downstairs is more painful than going up.

As for your situation....... Stairs were one of the last things I could do without pain, discomfort. I know that doesn't help much. You could use a cane, or if possible a walker to navigate stairs - but that's very tricky and risky.

Can you stay with someone for two or three months while you're rehabbing - where stairs aren't an issue?

All the best. BTW I'm a 69 y/o male, had both knees replaced in 2022. Best thing I ever did for my health, and it took a lot of work on my part with a lot of help and support from my wife. The surgery itself is the easiest part!

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Hi. No, I didn’t mix them up, just found it more comfortable to do this way.
Can’t live elsewhere. Currently (post covid) are living in Canada at our cottage. (Still legally a nj resident.)
We rented a place in nj for 3mos (presurgery to rehab). It has the flight to get into the house.
So, arrival after surgery is my biggest concern. And 2 weeks after as I want to get out for rehab, etc.
Thanks

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@artscaping

Good evening Persia. You are really being challenged with the stairs in your home. I understand. Are you still in the hospital tonight? I see your post was created 13 hours ago which was early morning. Since you are already in the hospital, have you talked with your surgeon? Is there a physical therapy area where you are or close by?

I have had two TKRs. For the first one 10 years ago, I was fortunate to have an elevator in my home so the 16 steps up to the front door was not a problem. I was 71 then and lived in a small village at the top of the mountains. I remember that the increased altitude of 6,000 feet made a difference. My PT was also my trust attorney. (Many of the residents had multiple specialties.)
As I recall....it was more difficult to walk up a slope than climb up the stairs. I also remember that my surgeon told me that walking uphill was not as hard on your TKR knee as going downhill. There is greater pressure on your knee. He estimated my TKR would only last about 5 years if I chose to walk downhill excessively.

My second TKR was entirely different. I was 80 years old this time and yet it was much easier to get around post-surgery. There were 3 factors which made it different.
1. I was only in the surgery center for 3 hours. And, the surgery was a robotic procedure with much less damage to surrounding tissues.
2. I began PT within 24 hours in combination with MFR (myofascial release therapy) to alleviate any pain and discomfort. Have you talked with your surgeon about post-surgery treatments? I continued the PT for three weeks and met most if not all of the goals that had been established. Completing the sit-to-stand exercises was my greatest challenge.
3. The stairs were also a challenge. However, my PT taught me how to manage the range of motion issues. My insurance also funded a walker which I used just to walk around the house or outside.
4. I also purchased a cane which came in handy at times. Be careful that you don't offset your stance because you are favoring only one side.
5. You are wondering how long this will take. That is really up to you and your therapists. I am very pleased with the quality of my treatment and my knee's positive response.

What have I left out? If questions arise as your recovery begins please send them along to Connect. I will be waiting for you to check-in.

May you be safe, protected, and free of inner and outer harm.
Chris

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Thanks. My surgery isn’t until late Jan.
Appreciate the advice.

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The way I was told to remember the correct stair order is the "bad" lef, foot, ankle, or knee stays down in hell while the good leg goes up to heaven.

I stayed overnight at the hospital after my TKR and the next day the PT had me going up and down stairs one step at a time. It was not a problem after that though I did camp out on the living room sofa for 2 or 3 weeks just in case some emergency arose and I had to get out of the house quickly.

Good luck.

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