Total Knee Replacement

Posted by adillen1 @adillen1, Dec 22, 2023

Just had a TKR on Friday
Lot of Burning when bending and lifting, still a little tingly and under knee cap hurts
Can someone also explain degrees of flexion
Is 80 degrees better then 90

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@heyjoe415

Well said. After a TKR, 120 degrees of flexion is considered good, and is really all that is needed for activities of daily life. A lot of that depends on the patient doing ALL the recommended therapy. It's a drag, most therapy is, but critical in the first few weeks after surgery.

In my opinion, most people who feel their TKRs weren't successful didn't do the required work. Not all, but most. Scar tissue builds quickly unless the knee is worked, and then flexion and even extension may be locked at unacceptable levels. And surgeons don't like to do a second procedure to remove scar tissue. First, it's not terribly effective and second, a patient who doesn't do required therapy the first time is unlikely to do it a second time. And scar tissue can't be stretched or massaged away.

So please, if you're getting a TKR, exercise as you can before the procedure, and even more after the surgery. The outcome can be wonderful if you do the work.

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Totally agree 👍

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@heyjoe415

Well said Cathyanne. Flexion at 150 plus is about as good as it gets. I'm at 130 but that's all I need. I can't sit on my heels but use a yoga block to sit on in yoga.

Pain/burning is the worst in the first week or two, then it starts to get better. That's a joy. And for some, please be patient. Swelling and stiffness in particular can persist for 6 months, maybe more. It truly does take one year for everything to finally settle down. A TKR is a safe but invasive procedure.

Best wishes to all for a healthy and pain-free 2024!

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Hey Joe! Thank you - it has been so nice to meet you in Mayo Connect. I can kneel in Mass - that was very important to me.

SO my second surgery is the 10th. Keep me in your prayers. This time I am well prepared. We are going to Europe for 26 days on October 15th (Budapest, a Viking Cruise up the Danube to Regensburg, Venice, Florence, Rome, Paris and London) so my goal will be to be all set! I asked my husband if we should postpone - he said NO! We can go to a museum and then just eat pastries and get fat lol. (We are both thin). We lost our last kitty in May (she was almost 18) and while we are still very, very sad, we will be able to travel. Buying new hiker type shoes at REI in August and I will spend lots of time in my garden - outside. It is so cold and damp here and I can't wait for warm weather. BUT not wanting to rush it so I have time to heal.

Happy 2024!

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@mabfp3

All of my very best wishes to all of you as you recover from knee replacement. I have posted here quite a while ago, but want to encourage you to keep up with in home and outside physical therapy. Unfortunately, for me, I could not take the pain medication that was prescribed. My doctor at the New England Baptist Hospital tried four different medications and I had an allergic reaction to all of them. I was “stuck” only taking Tylenol Extra Strength and my recovery was horrible, painful, and very long. This was three years ago. My TKR is just “okay”…….still can’t kneel down on it or do all of the exercises that I used to do. My other knee (the left one) is not good, but I go to my surgeon every three or four months and get a cortisone shot. It helps! I will never go through another knee replacement again…..I will just “live with it” the way that it is now. Like “heyjoe415 “ recommends, before you have the surgery, get in shape, strenthing your quads. I have to say that I did that, but after the surgery, I was told that those muscles were weak………even after all of the leg strengthening exercises that I did ahead of time!!! However, strengthening those muscles before surgery does help many people and that is very good advice! Waiting for stem cells to be the answer for knees and hips!!!! Best wishes to all who have to have TKR!

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Thanks Mab. Interesting comment on post op quad strength. I had a friend who did exactly what I did and got his quads and hamstrings as strong as possible pre surgery. After surgery, the quads on the operated leg looked like they had atrophied - I mean there was nothing, no muscle to see. And it happened quickly and this guy is a gym rat.

This happens to some people. I didn't experience it. If it does happen, patience is required and slow, steady work to rebuild the quads.

The surgeon has to make a small incision into one of the quad muscles to release the patella so it can be moved aside during surgery. I'm guessing it's possible this weakens the quad to the point that it can't be exercised for a while post op. I don't know what else could cause it.

Finally I hope you reconsider getting your other knee replaced. My suggestion - if it affects your gait and is painful everyday, get the surgery. Cortisone only works so well and for so long when the bones are touching. And stem cell solutions are promising to regrow cartilage, but probably a long way from reality.

All the best to you!

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@mabfp3

All of my very best wishes to all of you as you recover from knee replacement. I have posted here quite a while ago, but want to encourage you to keep up with in home and outside physical therapy. Unfortunately, for me, I could not take the pain medication that was prescribed. My doctor at the New England Baptist Hospital tried four different medications and I had an allergic reaction to all of them. I was “stuck” only taking Tylenol Extra Strength and my recovery was horrible, painful, and very long. This was three years ago. My TKR is just “okay”…….still can’t kneel down on it or do all of the exercises that I used to do. My other knee (the left one) is not good, but I go to my surgeon every three or four months and get a cortisone shot. It helps! I will never go through another knee replacement again…..I will just “live with it” the way that it is now. Like “heyjoe415 “ recommends, before you have the surgery, get in shape, strenthing your quads. I have to say that I did that, but after the surgery, I was told that those muscles were weak………even after all of the leg strengthening exercises that I did ahead of time!!! However, strengthening those muscles before surgery does help many people and that is very good advice! Waiting for stem cells to be the answer for knees and hips!!!! Best wishes to all who have to have TKR!

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I can't imagine doing my other knee! I never thought I'd be so long in rehabilitation mode...12 weeks out, right knee. Hoping to walk without cane, but so afraid, although did at pt last week! Will practice driving today around neighborhood, but, yes nervous! Hate all this psychological fear! Have noticed improvements like graduating from walker to cane, some walking without cane! Hate step up/down at pt, so afraid of hyperextension even though has not happened for a few weeks now! It's been a few years that I've avoided stairs, doing one at a time, and not walking much...hard to break those habits. Also hesitate reading here, some good, some BAD!

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Hello,
I'm almost 9 months out on my right knee and 7 months out on my left knee( done 7 weeks apart). I'm 54 years old and have had 4 joint replacements 2 hip and 2 knee in 3 years. (Darn osteoarthritis)I had burning after both surgeries in my knees ,I actually had to buy Capri cotton bottoms pajamas or leggings to wear all the time even to bed, this helped with the incision pain and burning, I know it sounds weird but it helped me. Also when my legs started to ache I used a lotion called: muscle moisturizing shea butter lotion by village naturals therapy off of Amazon. I actually still use it for my knees and other parts of my body that hurt. I still have stiffness some days but it's getting better day by day. Just don't expect a real speedy recovery, but I hope you do have one but make sure you do your exercises and stretches. I went back to work after 13 weeks on my right tkr and 6 weeks after my left tkr that was a struggle since I am a table games dealer and I'm on my feet all day but every day it's gotten a little better. I can see why they say it takes a full year and that's totally true if not longer because it took my hips about a year and a half to two years to feel better. I hope this helps.

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@heyjoe415

Thanks Mab. Interesting comment on post op quad strength. I had a friend who did exactly what I did and got his quads and hamstrings as strong as possible pre surgery. After surgery, the quads on the operated leg looked like they had atrophied - I mean there was nothing, no muscle to see. And it happened quickly and this guy is a gym rat.

This happens to some people. I didn't experience it. If it does happen, patience is required and slow, steady work to rebuild the quads.

The surgeon has to make a small incision into one of the quad muscles to release the patella so it can be moved aside during surgery. I'm guessing it's possible this weakens the quad to the point that it can't be exercised for a while post op. I don't know what else could cause it.

Finally I hope you reconsider getting your other knee replaced. My suggestion - if it affects your gait and is painful everyday, get the surgery. Cortisone only works so well and for so long when the bones are touching. And stem cell solutions are promising to regrow cartilage, but probably a long way from reality.

All the best to you!

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Hi heyjoe415, Thank you for your very helpful reply! I am trying to exercise my quads (when I remember to do it) using the exercises that I was taught at PT after the surgery. My husband and I do go to Planet Fitness twice a week and I get on the stationery bike for a few miles. You really did the right thing by getting in shape before your surgery! I am sure that it made all of the difference in your recovery. I appreciate your advice on my left knee being done in the future, but knowing what I know now, especially because none of the pills for pain agreed with me, I can’t see myself going through it again. For now, I will continue with the cortisone shots every three months and do what I can to strengthen the left quad in particular. All the best to you!

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@kneenee

I can't imagine doing my other knee! I never thought I'd be so long in rehabilitation mode...12 weeks out, right knee. Hoping to walk without cane, but so afraid, although did at pt last week! Will practice driving today around neighborhood, but, yes nervous! Hate all this psychological fear! Have noticed improvements like graduating from walker to cane, some walking without cane! Hate step up/down at pt, so afraid of hyperextension even though has not happened for a few weeks now! It's been a few years that I've avoided stairs, doing one at a time, and not walking much...hard to break those habits. Also hesitate reading here, some good, some BAD!

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Hi Kneenee, I am so sorry to read about all that you are going through. You sound a lot like me. I was in PT twice a week for six months. After the surgery, I felt so depressed. I was in a lot of pain and didn’t have an appetite. I lost 18 pounds at that time! I used a walker for quite a while, then went to a cane. I found the cane very helpful. My orthopedic surgeon did tell me that knee surgery is the roughest surgery anyone can have. Like you, I can never imagine getting my other knee done! Psychologically I just don’t think that I put myself through it again. All my best to you as you continue to heal. You *will* heal but it just takes a long time!

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@kneenee

I can't imagine doing my other knee! I never thought I'd be so long in rehabilitation mode...12 weeks out, right knee. Hoping to walk without cane, but so afraid, although did at pt last week! Will practice driving today around neighborhood, but, yes nervous! Hate all this psychological fear! Have noticed improvements like graduating from walker to cane, some walking without cane! Hate step up/down at pt, so afraid of hyperextension even though has not happened for a few weeks now! It's been a few years that I've avoided stairs, doing one at a time, and not walking much...hard to break those habits. Also hesitate reading here, some good, some BAD!

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Good morning Kneenee. I had to reply because my last name is Nonini. And now I have a new last name. NewKneeNonini. Try that! Don't be afraid. Discuss this with your PT. Trust that your surgeon did the right thing and you WILL get better. I am now at almost 4 months and FINALLY notice a considerable improvement. I live in Northern Idaho and it is very cold here so that affects my knee. However, I have 150+ flexion - every day in the shower I work on bending my knee, while it is warm. And at night, after icing (I still ice every day) I use my heating pad and then bend some more. I do my exercises at home every day. Well, I took yesterday off but just did more stairs.

I am not going to PT for two weeks as I have my second surgery on the 10th. This time I will be prepared for the pain and loss of appetite. Plus I have PRUNES and Peri-Colace! So all set there. I did struggle with some serious depression for a few days after the first surgery. Not this time as I know I can't die from the pain.

I hope you will get past the fear - that is truly the worst. Everyone tells me it will take at least 6 months to feel somewhat normal. My surgeon reminded me to look forward to how well I am doing. Not to focus on the pain/stiffness etc. That helped me a lot.

Do you have some support at home? My husband has been stellar and so very encouraging.

Wishing you a Healthy and Gentle 2024.

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@cathyanne

Good morning Kneenee. I had to reply because my last name is Nonini. And now I have a new last name. NewKneeNonini. Try that! Don't be afraid. Discuss this with your PT. Trust that your surgeon did the right thing and you WILL get better. I am now at almost 4 months and FINALLY notice a considerable improvement. I live in Northern Idaho and it is very cold here so that affects my knee. However, I have 150+ flexion - every day in the shower I work on bending my knee, while it is warm. And at night, after icing (I still ice every day) I use my heating pad and then bend some more. I do my exercises at home every day. Well, I took yesterday off but just did more stairs.

I am not going to PT for two weeks as I have my second surgery on the 10th. This time I will be prepared for the pain and loss of appetite. Plus I have PRUNES and Peri-Colace! So all set there. I did struggle with some serious depression for a few days after the first surgery. Not this time as I know I can't die from the pain.

I hope you will get past the fear - that is truly the worst. Everyone tells me it will take at least 6 months to feel somewhat normal. My surgeon reminded me to look forward to how well I am doing. Not to focus on the pain/stiffness etc. That helped me a lot.

Do you have some support at home? My husband has been stellar and so very encouraging.

Wishing you a Healthy and Gentle 2024.

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Good luck. Well I can drive now and do walking without cane, but need to be more confident! Some stories on here are frightening!

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@mabfp3

Hi Kneenee, I am so sorry to read about all that you are going through. You sound a lot like me. I was in PT twice a week for six months. After the surgery, I felt so depressed. I was in a lot of pain and didn’t have an appetite. I lost 18 pounds at that time! I used a walker for quite a while, then went to a cane. I found the cane very helpful. My orthopedic surgeon did tell me that knee surgery is the roughest surgery anyone can have. Like you, I can never imagine getting my other knee done! Psychologically I just don’t think that I put myself through it again. All my best to you as you continue to heal. You *will* heal but it just takes a long time!

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Hello! I also went through some depression - I asked my husband if a person can die of pain. SO I called the surgeon and they increased my oxycodone dosage. HOWEVER, I was able to stop it after two weeks. I am scheduled for my next knee on the 10th and so will take an increased dosage for the first week and be certain to take my anti-depressant. All the best for your continued healing - Cathyanne.

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