Total Knee Replacement: Swelling

Posted by mamndink @mamndink, Aug 11, 2019

7 weeks post tkr right knee. 0/120. Intermittent pain at top and bottom front knee when walking. Seems like the swelling never goes away. Icing 4x daily and resting in elevation. Out patient PT 2x week, gym for cycling and few stretching exercises 5x week. Shouldn’t the swelling go down?

@4russcoll

Gordy I will share my experience with swelling. Be patient.
While essentially pain free and mobile at 4 weeks I still had A lot of swelling despite regular icing and elevating. My flexibility was only 65 deg despite regular PT.
At that point my surgeon prescribed a course of prednisone and it made all the difference – dramatically reduced the swelling.
Over the next 4 weeks I gained an additional 50 – 55 deg of ROM. I think stretching with heat followed by MFR was the most helpful.
Now 5 months out and enjoying my new knee while gradually increasing endurance.

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I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

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@ginzy53

I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

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Glad to be encouraging. The swelling reduced over a week. The stretching w heat started about then and continued for the next 4 – 5 weeks after which I stopped formal PT.
Hot towel compress for 15 minutes and MFR during last 5 minutes.
My PT devised a technique that sat me a quad strength apparatus but had me use the equipment backwards applying pressure to flex my knee. After 5 minutes would shift to quad lifts and then back to stretching.
But remember what has been said – that everyone is different and we all heal in our own time.

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@ginzy53

I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

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Good afternoon @ginzy53. I was looking for your response today. Thank you.

Yes, I have also read that prednisone can be helpful with swelling. However, it is a form of cortisone and has quite a few side effects that worry me. That is why I choose the MFR and PT. And just to catch up with the fast train here, I owe you a couple of answers. 1. The MFR treatment session is one hour twice a week. During that time, one of the therapists works just on my surgery knee while the other one takes care of the small fiber neuropathy issues.

2. And I think I may have written the Heat recommendation incorrectly. The machine at the orthopedic center can be set to be only cold or to go back and forth from heat to cold. It lasts 15 minutes at the end of the exercises and all my effort. I love that last 15 minutes. Gives me time to catch my breath. I k
eep telling them as they make every exercise more challenging to remember that I am almost 80. They just chuckle.

May you be free of suffering from inner and outer harm.
Chris

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@ginzy53

I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

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Good for you @ginzy53, for staying ahead of the game. Sometimes we get out over our skies a bit but that is better than trying to beat it from somewhere behind the eight ball.

And you are quite right…..as soon as the swelling is reduced, the pain will also stat to
dissipate.

My knee was quite tight. It is now wrinkled and looks like it belongs to a 79 year old once again.

What are you going to challenge next? Good luck.
May you have happiness and the causes of happiness.

Chris

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@ginzy53

My PT person has given me a number of home substitutes for their equipment including the idea you suggested as well as using a cookie sheet underfoot to do leg slides while on carpeting. Clever!

I have my 2 week post op appointment with the surgeon this Tuesday. Apparently all staples and sutures will be removed and X-rays taken. I look forward to the visit, his assessment of my healing and the chance to get some questions answered. At the top of my list of concerns: controlling swelling, range of motion, scar tissue formation and the most effective plan to manage those 3 simultaneously.

Being this is my first TKR my observations for success up to this point are:
1. Eat healthy meals and get as much sleep as possible.
2. Do the rehab! It hurts but is the only way to improve.
3. Take all your meds as prescribed. Drink plenty of water.
4. Get into a daily routine including, meals, meds, rest, rehab, ice, repeat.
5. Maintain a social life whether online or in person. Have friends over, go for car rides (as a passenger) etc. it’s a great diversion and very physically and mentally stimulating. You’ll be surprised!

Lastly, this is a marathon not a sprint. Listen closely to your body. Go slow but DO push yourself. Remember, the mind and body are amazing instruments and are often capable of far more than we understand.

Gordy

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Good afternoon Gordy. That looks like a very good list. Sometimes it helps to make these lists and then we can rejoice when paying attention to your list means an easier rode to recovery.

Thanks for sharing. What's for healthy dinner tonight? Just teasing.

Chris

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@suziet

Your words were/are amazing. Im 8 weeks out on my TKR. I only wish I had found this Mayo Clinic Connect before my surgery.
I feel Im in a good place with where I am. However I have worried about my incision sense i started squats 6 ot 7 weeks ago. I can only hope this too will pass. Again thank you for the great reply to the comment made by another fellow patient.

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Good afternoon, I so appreciate that you found my post of value. If you are only 8 weeks out…with what issues are you dealing? I also was worried about my incision. One of the PT folks suggested taking some X-rays and having my surgeon's PA take a look. That was a good idea and was quite reassuring to me. I am adding the images of my knee that were taken to check out the swelling. Everyone was happy with the result. This image has the front on the left and the back on the right.

May you have contentment and ease.

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@ginzy53

Thanks for the encouraging and thoughtful reply. I do elevate using pillows and have started twice a week orthopedic physical therapy. The sessions are very helpful but my range of motion is from 6 to 66 degrees at this point. Without their specialized equipment I find it much more difficult to incrementally increase the ROM especially given my swelling.

I am currently using a walker and am just beginning to take a few steps with a cane. My therapist said I am in the lower percentile for range of motion at this point but we all know everyone is different. He and I both I agree that my progress should be measured week to week against myself not others. We have discussed upping my visits from 2 to 3 per week but it is proving difficult as they are very busy.

I am aware of massage and it’s benefits. Does your PT person do this?

I guess my main issue is I have always been a very competitive and able athlete and it is very frustrating not to be able to steadily improve because the swelling prevents me from doing the exercises. It seems like if I exercise I swell and if I don’t exercise I swell. I’d hate to think how swollen I’d be had I not been using the ice machine hours per day.

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Good evening @ginzy53, I think you have said it succinctly. Everyone is different and you need to proceed as comfortably as you can. In answer to your question about massage, MFR is more of a treatment than a massage. Therapists in MFR have studied for several years and passed different levels of expertise. My MFR therapist has an "Expert" rating. She has been here for me for at least 5 years as I have progressed with the symptoms of small fiber neuropathy. I see her twice a week now so that my daily life can be more pain tolerable. I can predict that as the condition continues to progress, I may need to receive treatment 3 times a week.

I, too, have always been an athletic advocate…..tennis, golf, and an activity called Inn to Inn walking. We cover about 40-50 miles a week and have walked in many beautiful places. I have great memories. My walks right now while recovering are 1 mile or under. It has been hard for me to let go of the activities I so enjoyed. Several years ago, I replaced some of those adventuresome efforts with my volunteer role on Connect. That has been a wonderful choice on top of mindfulness, meditation, and yoga.

Have you discovered new activities?

May you have happiness and the causes of happiness.
Chris

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@debbraw

@mamndink – I'm agreeing with @johnbishop and @contentandwell – Even though it seems like forever, 7 weeks is kinda short. Things WILL get better. You can trust all of us who have had TKR's. I've had two – most recently January of this year. For me, 8 weeks was a real milestone, then at 12 weeks I felt like a new person. But even after that, I continued to improve. I applaud your ROM. Many people would be green with envy. Is swelling the main problem? Are you walking with or w/o aids – like a walker or cane?

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My thing is , Im 56 years old, had a left hip replacement 16 months ago, went back to work, I own a glass company and just do small repairs with me and my wife.I have been 14 days after total knee on the left side.The swollen parts is the front of the calf and back , the knee has pressure pain , from standing up and down. Does the Dr just cut the top femur bone and the bottom of the tabula. If that is the case how do we know he is cutting straight.I feel the right side is about a 1/2” longer, and my foot , or say from the knee down , my foot turns to the right, which I have been working on trying to correct..Two weeks before the TKR, I had 13 screws and two plates in my foot, which the knee Dr. did not look into what was being held and so on and so on .My whole question is what are the best ways to get the muscles straight ,working correctly, and strong. What I have found, the tabula connects to the top of the foot, were the screws and plates were on the top of my foot.Any feed back on it ? Please let me know .

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This is a very good thread … I am 59 had tkr aug 12 right now I am at 75 degrees I can relate to most all that is said ….. I start Aqua therapy on November 1 hoping it will help ….. I started measuring my knee to see what is swollen and just tight because sometimes they feel same last night at bed was 16 1/2 I use cryotherapy at night I switch my front to back of my knee during night when I woke up was little less than 16 .,, but soon as I start moving goes right back up …. My dr not very helpful he gave up at 8 weeks I have been researching on my own and through this site so thank you all for sharing it helps so when I don’t know what else to do read another article where someone tried something else …. Because let’s face it all trial and error at this point ..,,I just hoping something or everything I am doing finally works ….. so thank you again god bless

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Can’t say enough a great physical therapist and hard work on our part I believe is success as long as surgeon has done their part. I’ve have reverse total shoulder, and TKR. My TKR in May I was at zero degrees and 62 degrees 2 days post op at pt (physical therapy) my surgeon wanted me to attain those numbers at 6 weeks but was able to get there 2 days post op. Pt has used dry needling, massage, taping,cupping and all kinds of exercises.within a few months I reached 126 degrees. It’s a lot of work and I’m doing exercises everyday and will need to keep them up even after therapy is over. I still have exercise weighs regimen for my reverse total shoulder I do
Also at 8 weeks post op do water aerobics at a rec center. There were times I felt like having a set back but found that everyone said that’s normal. It doesn’t happen overnight.wish everyone the best! My life is better after these joint replacements though not perfect. Still get dry needled on my shoulder when I overdue as I do have limitations with that replacement.

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@ezas123

This is a very good thread … I am 59 had tkr aug 12 right now I am at 75 degrees I can relate to most all that is said ….. I start Aqua therapy on November 1 hoping it will help ….. I started measuring my knee to see what is swollen and just tight because sometimes they feel same last night at bed was 16 1/2 I use cryotherapy at night I switch my front to back of my knee during night when I woke up was little less than 16 .,, but soon as I start moving goes right back up …. My dr not very helpful he gave up at 8 weeks I have been researching on my own and through this site so thank you all for sharing it helps so when I don’t know what else to do read another article where someone tried something else …. Because let’s face it all trial and error at this point ..,,I just hoping something or everything I am doing finally works ….. so thank you again god bless

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Hmm, are you still icing regularly? It is a really good strategy at the end of your day to elevate and ice to alleviate the stress of getting around all day. When I had one of my hip replacements, and ongoing swelling, I also got my leg up and iced at lunch time (kept a big ice pack in the office freezer.) That continued for over 4 months.
Sue

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@ezas123

This is a very good thread … I am 59 had tkr aug 12 right now I am at 75 degrees I can relate to most all that is said ….. I start Aqua therapy on November 1 hoping it will help ….. I started measuring my knee to see what is swollen and just tight because sometimes they feel same last night at bed was 16 1/2 I use cryotherapy at night I switch my front to back of my knee during night when I woke up was little less than 16 .,, but soon as I start moving goes right back up …. My dr not very helpful he gave up at 8 weeks I have been researching on my own and through this site so thank you all for sharing it helps so when I don’t know what else to do read another article where someone tried something else …. Because let’s face it all trial and error at this point ..,,I just hoping something or everything I am doing finally works ….. so thank you again god bless

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Good afternoon ezas123. I am going to add a bit to Sue's advice about icing and elevating because I took the question to my MFR therapist yesterday. She has kept my swelling down while I waited about a year for my recent TKR. When the area fills with fluid that is generated by our body to try to fight the infected knee area, it needs to be pushed out as part of the MFR treatments. What you may have noticed is that your calf on the surgery foot has shrunken at the same time that the knee has swollen. And that is from muscle atrophy because we tend to use that leg less the closer we get to surgery.

So….we need to keep the fluid calm and the muscles active. How is your pain level?

May you be safe and protected from inner and outer harm.

Chris

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