I had a total knee replacement 10 days ago and I am still in pain, my knee sometime slips.

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I still use a walker, hard to walk. What time frame should I be looking at to walk normal? Any advice?

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  • Posted

    It can take weeks. Everyone is different. Keep taking your meds and do your exercises. Time heals it all be patient.
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  • Posted

    Hi everyone is different. I used a walker for a few weeks then a cane for around a week.

    As for pain take your meds when you are scheduled don't wait for the pain to start. Playing catch up with pain does no good. And ice ice ice ice and elevate.

    Take care

    Tom

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  • Posted

    Rob, 10 days is still early. I know my doctor challenged me that when I came in to have my stitches removed to try to not use my walker. I had both knees replaced at the same time, so I thought he was crazy. But I'm also a tad bit competitive and the challenge was good for me. If I wasn't ready, I wouldn't have been able to do it. My biggest hurdle was confidence. My quads still felt a little wobbly and when my knees would buckle, I would freak out a little and didn't want to leave the walker. But slowly, moving around my apartment, I gained confidence while my muscles streangthened. Just to be clear, I went from a walker to a cane, and that I had with me until nearly 3 months post op. But I was doing a lot of traveling (internationally) and it helped people realize that I wasn't so stable and might not respond well to being bumped - at least that was my hope. smile

    -Mo

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  • Posted

    Most Important...  Everyone heals at their own pace.  Don't judge yourself by anyone else's progress.  This is between you, your PT and your doc.

    That being said...here are some "ballpark" estimates...

    1. Medication...  Take you pain meds.  This is not a test of endurance.  Need 'em?  Take 'em.  Ballpark: Most people are off the the opioids in 4-6 weeks; some need them longer  800mg Ibuprophin or Tramadol after that if you need it.

    2. Pain... It's really, really painful...no getting around it...especially the first month.  Don't measure your pain levels daily...monthly is better as you'll see dramatic changes  from the longer time span.  Ballpark:  The worst of the pain will probably be gone within 90 days...but again, everyone's different.   

    3. Assistance...  Crutches, walker, cane...whatever you need for as long as you need it.  Ballpark... Most people are off of all those items within 90 days.  Gotta start to learn how to walk on your own again. (NOTE: This may not apply to people with previous hip/knee/leg problems or to the elderly.)

    4. PT...  Gotta do it.  Your therapist will work with you to both straighten and bend your knee.  Full range of motion is zero degrees straight and greater than 120 degrees bent ( 0 / +120 ).  I started at -14 / +84 and finished 9 weeks of PT at -1 / +128.  Ballpark...  Depending on age, previous conditions, individual circumstances, you should shoot for the full range of motion goal.  If you can't get there at PT (I was still one degree from straight), finish the work in the gym or therapy pool.  The closer you get the better...but again, everyone's different.  You should consult with your doc and PT.

    5. Exercise...  After PT, ya gotta rebuild the muscles in your leg, especially the quad.  Walking, swimming, stairs, whatever.  Have to rebuild your strength to support the knee.  Ballpark...  Since it's during and after PT, this work usually falls within the 3 to 6-month range for most people.  My daughter has been an ACSM- and ACE-certified personal trainer and graduate nutritionist for the past 16 years.  Her recommendation: Build endurance before strength.  Start with NO weight but perform four (4) sets of 12-15 reps each until you are at ease with every exercise and are not tired out by them.  Do not use your good leg to fake the exercise.  The idea is to get the bad leg as strong as the good one before you exercise them together again.  Once comfortable, start adding weight...slowly....like 5 pounds at a time.  Any pain, strain or swelling means you did too much too fast.  Back off...you'll eventually have equal strength in both legs.  PS: I guess people with BTKRs can do both legs together...I'd have to ask her.

    6. Swelling...  This is the knee's way of telling you that you overdid it.  Back off, ice, elevation, rest.  Ballpark...  Everyone does this at one point or another.  Listen to and learn from your body.  Avoid pushing it too far.

    7. Sensations...  There will be numbness at the incision site.  Nerves have been cut.  Ballpark...  Crapshoot; normal feeling may come back or it may not.  Some people have an uncomfortable sensation of the knee rubbing against clothing or sheets.  Hint: Wrap the knee loosely with an Ace Bandage or buy a "knee sleeve" and slide it on over the knee.  Easy Fix.

    8. Sciatica...  If you've never experienced this intense pain from your back, through your hip and then running down your leg, be thankful...be very, very thankful.  On occasion, the sacroiliac (SI) joint on one or both sides of your hip will lock up and pinch/inflame the sciatic nerve.  This happens because we change our gait to compensate for the knee pain.  In layman's terms, "you threw your back out."  Ballpark...  Some people get it, some don't...another crapshoot.  Possible solutions: steroid injections, Celebrex, Lyrica, 800mg Ibuprophin, chiropractic, therapy pool, accupuncture.  Whatever works; talk to your doc.  It's temporary but painful; cross your fingers and toes that you don't experience it.

    9. Long Recovery...  That "swollen look", popping and clicking sounds, stiffness...all normal.  Ballpark...  All of this should resolve in 12-18 months.

    Hope this helps.

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    • Posted

      Dear Chico et al:

      Thank you all for your great advice. Chico, I am so thankful for all the questions you answered and advice given. It was more than the doctor and PT's offered and you have been spot on with every answer.

      I just had my 6 week post op at Hospital for Special Surger and doc was very pleased. I'm not familiar with all these numbers given .. All remember is when he bent it he said 100 and told me that I have to work on the bend. I am still swollen and he said it was from the Coumedin which I am now OFF. This is what he recommends for the next 6 weeks.

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    • Posted

      It's amazing how little doctors really know about the healing process. You'd think they'd take to heart some of what their patience say. This group is definitely crucial to anyone going through the surgery. It's so helpful to know that you really are normal, even if that normal isn't what a doctor told you to expect. smile

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    • Posted

      Sorry, I am writing on my phone and hit wrong key, 6 weeks post op recommendation.

      For next 6 weeks:

      PT 3 X week

      Ice, rest, elevate

      Tramadol for pain

      Walk one mile daily

      Work on bending

      Continue with Votarin for swelling

      Doc said swelling should go down in the next six weeks. He also said, it should take about 3 months till I feel comfortable with TKR

      Im still concerned about the swelling. I don't take Antiinflammatory meds. I also have that feeling of a tight band around my knee and tightness in calf. i missed a few days of OT because of traveling. I recuperated at daughters house 4 hrs by car from my home. Am lucky my son in law flew me home .. One hour flight and did fine climbing up and down.

      Reminder: I'm 73 y.o. Lady who had been active and miss my 3 mile walks daily. Mostly concerned about swelling and bending.

      Thank you again.. With much gratitude..

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    • Posted

      Great Post Chico !!

      I'm soon to have my right knee replacement replaced very soon, apparently the prothesis is too small 

      I will find your notes very useful as it was November 2014 when I had my initial TKR so my memory is a bit blank until I get there again and thing OMG I remember now, 

      I suppose its like having a second/third baby LOL

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    • Posted

      Thanks for the detailed feedback. I am now seven weeks out and feel a lot better.

      I realized that this is not a race. If it takes me 7 months then that's  how long it takes.

       I still have a lot of pain in the back of my knee. I purchased a heating pad and that seems to do the trick I also do a lot of stretching. 

       

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  • Posted

    Hi Rob!

    If your legs were pretty straight and you walked fairly well before your surgery, you will probably walk normally as soon as your swelling goes down.

    If you walked with bent knees due to pain PRIOR to your surgery, it may take a bit longer to get those legs straight. Straight legs help you to take a more normal stride and walk with a more normal gait.

    I have had both knees replaced. I lived with painful bent legs for a number of years, so my therapist reminded me that I was undoing YEARS of walking in an unusual way and I needed to BE PATIENT!

    I used a looped belt to get my first replaced knee up onto the ottoman. At first I could only tolerate the position for about a minute. I worked on this every hour or so, and slowly the leg got straighter. As I would do this I would engage my quad muscle in my thigh. Together, this helped me get MUCH straighter legs.

    By the time of my second surgery three and a half months later, my first leg was pretty straight. Surgery on my right leg went easier than my left, and the PT with #1 helped #2.

    By about four months post op with #2 I could walk A LOT more normally because I then had TWO GOOD KNEES!????????

    I can now keep up with my family of long-legged tall people (even though I have to take extra steps due to my short little legs!)

    Stretching helps A LOT, too. I stretch often throughout the day and night. I still do my "ottoman training" to maintain my straight legs.

    It will come. Be patient. Stretch, practice straightening, strengthen your quads, walk by touching your heel first then rolling your foot as you step, and practice balance exercises to add stability. It is like learning how to walk again, but it IS worth the hard work!

    You can do it!????????

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