Pain and stiffness 51/2 months after Total Knee Replacement

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Beginning to feel miserable! I have a pretty good range of movement in my knee - but the moment I sit for even a short period it gets stiff. If I stand for a while cooking or cleaning - that also causes pain. I can walk around the house fine, but outside it becomes painful very quickly and I have taken to using a stick and really can't walk far. It's still swollen up on the inside of my leg and shin just below my knee. I'm 51/2 months post op. When I am at rest there is little pain and it doesn't keep me awake at night - but other people I know have recovered much quicker. I do have to say that I was due to have the other knee replaced yesterday (4 May) obviously cancelled for now, and that might well be affecting the operated knee. Please can someone reassure me that still having more than what I would consider a reasonable amount of pain at this stage is normal?

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  • Edited

    You "feel miserable" because your expectations don't match your reality. You are also comparing your recovery to that of other people. Hint... NEVER do that. Recovering from a TKR usually takes a full year, give or take a bit, and is a very personal journey. Population statistics on TKR patients provide some insight but statistics pertain to mass numbers of people and not any individual. Some are faster, some are slower. You have no idea where you fall on that spectrum while you are going through it.

    The stiffness subsides very gradually over that time with virtually all of it gone in the 12-18 month range. Bad news... You have to keep the knee active the rest of your life to avoid recurring stiffness even years later. This requires a change in lifestyle to reflect your continuous use of the new knee. Swelling will occur when you push the knee too far any given day. Note your activity, back off, heal and resume gradually.

    It's good that your #2 was cancelled because right now, you have "no leg to stand on". I would recommend that you fully recover from #1 before getting #2 done. If that's not possible due to extreme pain, have your ortho give you a cortisone shot to span the time frame. Also, there is an FDA-approved procedure called COOLIEF that deadens the nerves causing the pain. The 15-minute procedure done under sedation takes a number of weeks to become effective but can last up to two years. Check their website to find a certified doc in your area. It could provide relief for #2 while your other knee fully heals.

    Click on my name, Discussions, See All. I have about 30 out there on all sorts of topics that you may find helpful. You're not alone...we all went through this. Long-term, it was the best decision I ever made. Short-term? I wish I had had another kidney stone.

    "Never give up. Never surrender." - Tim Allen, Galaxy Quest

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    • Edited

      Thank you - Some reassuring good bits of advice there! I'm pretty active normally (when I have knees!) so it won't be a problem keeping that way.

      Although I see what you're saying, although my operated knee is causing problems - I can certainly use it and I believe I wouldn't have had a problem having the second one done.

      Unfortunately, I am unable to have a cortisone shot in the knee - my husband had one - authorised by the same consultant and it has been brilliant. When I asked the consultant he said that given the condition of my knees it would actually have a negative effect when it came to the operation. They should have both been replaced well over 2 years ago - but I had a 'project' that I had to finish - and my consultant said that it would be impossible for me to have a knee replacement and finish that - as I would have to concentrate on the recovery exercises. The first knee was done as soon as possible after that (and he was right - I couldn't have done both!) but of course, the other knee is now seriously bad. I also know that the longer they are left, the more difficult the recovery - so that could also be an issue with the operated knee.

      With regard to your advice re COOLEF - Firstly, in UK - no elective operations or procedures are being carried out currently as, although I am a private patient, all our private hospitals have currently been given over to the NHS (and yes, little is happening in them - they are only dealing with emergencies, so my consultant has not done an operation since lockdown! So secondly, by the time I would be able to have a procedure - I will be able to have the knee replacement.

      Thank you so much for taking the time to reply.

  • Edited

    I'm less than a month out from a year post right TKA. It still gets pretty sore and swells, but it's a whole lot better than it was before. My left is well on its way to needing replaced, and I'm not looking forward to it for sure, but on balance i wouldn't be mobile by now if I hadn't done it.

  • Edited

    As Chico says, don't compare your knee with any other knee. I had my left done 15 months ago and the right 3 months ago. My first was pretty much as yours sounds and even now isn't as good as the second one after 3 months, which goes to show no 2 knees are the same even on the same person. In October the surgeon said he expected the first one to settle after 18 months and in January said they would scan it at 2 years if it hadn't improved.

    It is much improved, but I get some pain still going up and down stairs and it sometimes feels a little odd walking outside and stiffens if I stand for any length of time if I don't soften the knee slightly rather than keeping it dead straight. The second knee is absolutely brilliant though and, fingers crossed, causes me no problems at all so far.

    Keep icing and elevating when it causes pain and use a stick while you need it to walk if you have to. It's not a linear recovery by any means and there will be many backward steps along the way, so don't be disheartened. I was due to have mine done 4 months apart originally, but it wasn't until 8 months post op that I could even begin to consider it and 10 months before I made the decision to go ahead. Good luck. It will improve, it just takes time.

  • Edited

    I am 18 months in from a RTKR and I can only walk with the aid of a Walker so I reckon you are doing pretty good. No matter how bad it feels it dos slowly (in some cases VERY slowly) get better.

    It's a bit of a lottery how the recovery goes. Don't loose hope it will come good in its own sweet time!

  • Edited

    I'm going on 7 months I had mine done end of October 2019. Mine still swells up. Sitting and then getting up it stays stiff till I move around. cant really stand for long periods then have to sit. I still have alot of pain going up stairs vs coming down. Today I have therapy and get measured so we will see. 4 weeks ago I was about 110 ROM. Sleeping is another story really dont sleep very well. Well so I think you are doing the right thing.😊😊.

    • Posted

      Thank you for your reply - although I am sorry you are still in pain - it is reassuring. I'm not too bad standing for while - eg cooking. Cleaning on the other hand is very difficult! Going up and down stairs I am very aware of the knee and if I've overdone things - its very difficult. I can't do either without the stair rails. I have not had physio for weeks now - however, I do the exercises every day at home. The last time I was measured was over a month ago and it was at 105 degrees. I think a lot has to do with the way it is measured too. This is sitting up on a bed with my leg outstretched on the bed and then I bend it. This is the most difficult and my friends who have been measured on a step, for instance, have a much greater bend. My other knee only does 105 - so the physio wasn't worried about it. When I can get fitter and lose weight - it will bend more! So sorry you are not sleeping because of it - that is awful. I wish you well and hope it improves quickly for you.

    • Edited

      A few things...

      Everything you say is normal. Most people report "feeling more like their old self" at about 9 months while the one year mark usually has you dancing in the street again...although some stiffness and clunking sounds can last to 18 months. Freeing yourself of everything remaining is gradual, cannot be rushed (hence the swelling), and goes away imperceptibly. You measure your progress month to month...never day to day.

      This is for your ROM...

      ROM at Home

      ...and this will get you your muscle strength back so you can do stairs again...

      Muscle Rebuild

      By following this course, I was doing 11,000 steps a day without any pain or swelling at 8 months and able to climb stairs two at a time alternately without holding onto anything at 14 months. You MUST do the muscle work for your atrophied quad, glutes and core to regain all your previous functionality. This takes time, commitment and patience...

      Get rid of all your expectations and timetables...they only screw with your head. You will absolutely see the benefits of all this down the road. I am 4+ years post-op and doing great...because of the work I put in. You can do the same...

    • Posted

      Thank you again for your detailed reply There is only one exercise there that i am able to do and have not tried. I will certainly try it. I only have one working knee - and that is the one that has been operated on. So I do one legged squats as i cant bend the other knee. I totally agree with you and I do my exercises religiously every day. Our gyms are closed so we bought an exercise bike! I've also bought bungees that i use like a leg press.

  • Edited

    I too am n the same boat. It has been 7 months since my op, I am ok around the house but still need a stick to walk further. Mine also feels sore and swollen most days, wether I am sitting or walking to be honest. I am fine sitting and sleeping but it still isn't right. I too am on the list for my other knee to be done but am quite grateful for the delay as I don't feel I could cope just yet.

    Quite honestly it is a relief to feel I am not alone!

    • Edited

      thank you. Your reply is a relief to me too! Sounds as if we are in a similar situation. I have been working very hard at making my operated leg be the workhorse so that I would be ready for the other! It is painful - but I do feel that it would be able to support me once the other one is done. I'm sure the delay is probably good for it - but I honestly don't think it will fully recover until the other one is done! I'm still religiously doing exercises and I know it's getting stronger...I'm probably just impatient!

    • Posted

      I am just glad I'm not the only one in this situation. I'm at doctor now. Hope I can stay off work longer especially with this covid because I work in retail grocery. My ROM is only at 110 and 6 1/2 months out is this unusual well we will see what doctor says. I hope my other knee isnt in trouble now. Because that started hurting.

    • Edited

      I've not been bothered about my bend. There are so many different ways to measure. Mine was 105 at 4 months and that was the same as the other knee. I'm overweight which doesn't help the bend. Neither the physio nor my consultant were bothered and said it was fine. I'm doing all the exercises so when I lose weight that will get better. Fortunately I don't work - but doing my own cleaning is taking its toll!

    • Posted

      Well that is good. Went to doctor today he said I coming along really well. Now he took xray of opposite knee when its basically all arthritis so he is trying a steroid but if that doesnt work in 4 weeks I have to get a shot or have the surgery and get it replaced. Didnt expect this.

    • Posted

      So pleased that your operated knee is doing well. But I am sorry to hear that about the other. A steroid injection wasn't going to work for me as the arthritis was so advanced..in that case it can do more harm than good. My husband had one though and it worked well. All it does though is postpone the inevitable...so sooner or later it will need replacing Im afraid. let me know what you decide.

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