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10 mons post-TKR and still stiff and swollen at times

Posted , 6 users are following.

dode
dode

Hi all. I haven't posted on here for several months now but I just wanted to share an update with you. I had my TKR on 19th May 2015 so 10 months on now. The knee is still stiff (I think the flexion is maybe 85 - seeing my surgeon again next month) but the knee regularly swells up. My physio plan let me down post-op and in the end I do my own daily exercises stretching and bending and I walk every day for at least 40 minutes. There is no pain whatsoever in my new knee when walking which is great. I still find going downstairs very difficult, at least to try and do so normally and getting in a car on the left side is awkward if the footwell is tight. I was driving 5 weeks after the op and have been abroad twice since my op so it isn't stopping me getting about but I don't understand why the knee still swells up so regularly. I use rose oil and black pepper oil to massage into the knee daily. To complicate things my right knee is just about to give up (very sore) and I have spondylosis which means I've to be careful with my back so this doesn't help when trying things like going down stairs. Generally, the new knee is stiff after sitting for a while and is sore when I stand up but then the pain goes within 30 seconds of starting to walk about. Just wondered what any thoughts might be on this subject? Cheers!

1 like, 19 replies

19 Replies

  • sueisobel
    sueisobel dode

    Posted

    Well done to get this far without issue. You still have a little healing time to go. The swelling / fluid is a sign that somewhere you are doing too much and not elevating. Cut back on your walking. If you need to go out and about, use a bike.  Walking (and driving) is an impact that resonates against your knee joint (driving does the same, even is the road appears smooth). Massaging is good as it desensitises your still healing nerve-ends.  Try coming down backwards every now and then, exaggerate the bend in your new knee ie slow and try to keep your weight on it as long as possible. Might be easier for your back.  Pill wise, ask your doctor for anti inflammatory meds (get her/him to check you out first). Work on your muscles more, with nothing that uses impact.
    • dode
      dode sueisobel

      Posted

      Thanks sueisobel. I take Naproxen, usually only one a day and that if I'm planning to go out. I have to take Lansoprazole each morning to protect my stomach. I was taking Co-codamol 4 times (x 2) a day but weaned myself off and the withdrawal process was horrendous! I now take maximum of 2 of these tablets twice per day. I'll take your advice on the stair descent technique and maybe I should buy a bike, but my flexion is still not great. I can't use our exercise bike at home as it is too upright. Again, many thanks!
    • sueisobel
      sueisobel dode

      Posted

      On your bike at home raise the saddle until just the tip of your toes are touching the pedals and the gear on the lightest one.. With your "good" leg push down on the pedal and see how your new knee copes. If it is just half way round, don't panic, just go back and forward until you can do an entire revolution, the more you do the easier it becomes.  Gradually increase pressure, when that is comfortable, try lowering your seat.  Do everything at slow speed and you should, hopefully, find that your knee moves easier
    • dode
      dode sueisobel

      Posted

      Thanks sueisobel. I'll give that a try and ease back on the walking. I can walk for 90 minutes but I suppose that is why the knee then swells up when I get home. Maybe 30 minute walks and 30 minutes on the bike would be better. I tried hydrotherapy briefly but as a non-swimmer I was uneasy in the pool with water up to my chest so gave that up. Spanish sunshine helps and I'm looking forward to going there next month for a week! Cheers.
    • sueisobel
      sueisobel dode

      Posted

      The hydrotheraphy pool is graded, for all abilities and sponge bars and floats for non/ess able swimmers.  If you are active, it really is the best way to get your knees working with minimum effort.  Getting ready for Spain should be a good incentive for you.  Can I suggest you wear surgical stockings on your flight, you may find your knee will not swell up so much. Don't stress so much about your bend, it will happen. Most probably when you start relaxing
    • dode
      dode sueisobel

      Posted

      Thanks for that. One of the issues I had with the hydrotherapy was that they cancelled the sessions twice in four weeks which was a bit annoying. My wife has offered to take me to the local swimming pool to start walking initially but hopefully to learn to swim. Erk! My post-op physio has been a bit of a let down really. I've just been for a 45 minute walk today and my knee has swollen up again so I'm about to ice and elevate. Thanks again for your tips.
    • sueisobel
      sueisobel dode

      Posted

      I was just out to feel sorry for you.  Hydropools are great. If I were you, don't even consider a normal pool unless you have the skin of a rhino.  The water temperature is too cold for a start, it will aggravate your knee even more, als you are going to be limited to what strokes you can do in the pool,no sideways twisting, your knees are not strong enough.  If you do have a really thick skin, then straight forward walking in the water or pushing yourself of the bottom of the pool (jumping in other words) will work as you will be working your muscles against the resistance of the water without the impact.

      Then you had to go for a walk, was it a nice slow and gentle stroll???????  Did you have support?? I know it’s a beautiful day (as I sit looking out of the office window!)  and I know you are eager to get going, but….

      You have been fortunate to do a lot of things; driving and travelling, but right now, you have to take things a little slower. That way your recovery will be quicker. Nag over!!

      Hare and Tortoise

    • dode
      dode sueisobel

      Posted

      Nag away, by all means! Walk was nice along the beach down here in sunny Sussex. I can't walk that fast due to my failing right knee but I'm hoping the other benefits to your body of walking will help, i.e. heart, circulation, etc. I'll speak with my surgeon about the hydrotherapy when I see him again 3 weeks time and I'm thinking about the gym where I could use various bikes that might suit. I'll have a week in Spain moving slowly, sipping my glass of Spanish plonk! Thanks again
    • sueisobel
      sueisobel dode

      Posted

      You are a terrible terrible person, you never mentioned the beach before.  I can now understand why you want to walk.  Invest in a mountain/trail bike, you can still go out and about, sometimes for hours at a time.  The good thing is there is no impact (unless you fall off, like I do! Mind you I cycle in the woods) plus you have the added bonus of the ozones, that in itself is invigorating.  Go and enjoy Spain, wear those awful socks. remember that when you go through the barriers at the airport, the alarms may go off.  And keep working the muscles, if you can't get to a warm water pool, find somewhere that has a jacuzzi.

      Take care

  • debz13
    debz13 dode

    Posted

    Thanks for your post dode. I'm at 7 months post tkr and frustrated with the continual stiffness and swelling.

    I read on another post here that I should still be elevating my leg, which I have not been doing. Possibly that may help you, too.

    I am able to get a bit over 100 degrees flex, but it's been at that for a few months now.

    Good luck to you!

    • dode
      dode debz13

      Posted

      Hi debz13. I'm sorry to hear you are having similar trouble. I do elevate my leg every night when I sit down to watch TV. I have a footstool and I constantly move my leg as well. I use ice occasionally but I'm not sure how much good that does (as I need the ice for my whisky!). I guess we need to grit our teeth and hang in there. One thing is for sure - the arthritis pain disappeared immediately after the TKR and that was worse! Good luck to you too.
  • patricia67962
    patricia67962 dode

    Posted

    Hi, thank you for sharing your update. I was reading your last post when you said your ROM was poor after you had MUA. 

    It's almost 6 months since my tkr. I also had MUA but the stiffness returned despite exercising. My ROM was just under 80 deg the last time it was measured. I'm still persevering with the stretching and bending and using a static bike.

    It's encouraging to see how well you are doing now. I will have to try the massage oils you are using.

     

  • ziggy1231
    ziggy1231 dode

    Posted

    Hi Dode,

    I'm about 10 months as well and having the same issues.  My knee is still very stiff and swells.  My flexion is a little better than yours at 115, but that's after I stretch out a lot.  I do have a stationary bike at home and try to use it every night along with stretches.  Then ice for about 20 minutes which helps, but goes back to stiff the next day.  I see my doctor again in May which will be a year, so hopefully things will be better.  I do not want anymore surgery.  Stairs are very difficult for me as well and going down is harder than going up.  I'm not in a lot of pain, so that's good.  My biggest problem is driving for a long period of time.  My hip starts to hurt and goes down my leg to my knee.  

    Just thought I would let you know that it's true what most people have said about it being a year before it is healed.  We'll see in May how things are.

    • dode
      dode ziggy1231

      Posted

      Hi Ziggy. Sorry to hear you too are suffering but it is reassuring in one respect in that it isn't just me! The pain from your hip to your leg must be your sciatic nerve. I suffered badly from this before the TKR but it went away afterwards, apart from occasionally at night when I have to move off my left side. Let's compare notes in May and hopefully we can both move on. Take care
    • sueisobel
      sueisobel ziggy1231

      Posted

      Until you are complete healed you should not be driving for long periods of time... Unless you make a few stops along the way.  Try walking down stairs backwards
    • ziggy1231
      ziggy1231 sueisobel

      Posted

      I usually drive about an hour and a half on Monday mornings and then back home on Thursday nights.  I am a contractor and work away from home during the week.   That's about the longest I can drive.  I'll try the walking down stairs backwards.  Thanks for the tip.
    • sueisobel
      sueisobel ziggy1231

      Posted

      An hour and a half is a long time to be in pain and drive +  not good for the nerves in your leg either.  If your vehicle is automatic and it is your good leg operating the pedals, try putting your bad leg out in front of you and push hard so that the muscles in your thigh contract, hold for a a good count of 20 (or more if you are feeling brave), relax, then do again.  Another way is to bend your knee as much as you can and press down (as if you are about to stand), you should feel pressure across your knee cap and calf as well as your thigh.  Even if you are driving on a smooth road there is still a certain amount of vibration going through your joint.  Try raising your leg up every now and then. If it is manual, move your foot, so that a different part of your foot is on the pedal (at some point your toes will be pointing towards your, other times pointing away, sounds weird but try it).

      When you walk down the stairs backward, makes sure you bend your knee, it is not as painful as front facing and works if you are in a hurry to get down those stairs with a minimum of pain.

      Works for me, hope it does for you

    • dode
      dode sueisobel

      Posted

      I agree about the driving. After that length of time stiffness and possible sciatic pain could kick in. Farthest I drive is about an hour. On flights at least I can constantly wiggle my feet and ankles and stretch my legs back and forth and get up and walk too! I've flown three times in the last six months and it has been fine and I do wear a flight stocking.I find inactivity for any length of time makes my leg stiffer but as soon as I get up and about it eases considerably.
    • sueisobel
      sueisobel dode

      Posted

      For some reason that is the hardest part of rehab to clear up.  I wonder if the vibrations on the road (even smooth ones) set  up some sort of resonance with the metal in ones leg. Like a tuning fork. That would certainly make the newly mended nerves complain...Just a theory.  I drive a lot to the South West Uk and sometimes by the time I've reached my destination I can barely walk (even on the knee that was done years ago)
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