Post TKR Leg strength and walker usage questions

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Hi everyone, thanks again for all your help.  This forum is a GOLD MINE of tips, encouragement and information.  Here are my questions for today smile

Post TKR Leg Strength?

I've seen references to people using a belt or strap to lift their leg, for example, when getting out of bed.  Does everyone do this, and if so, how long does it last?  And when people list a number to describe how far they can bend their knee after surgery, that makes me nervous...!!  And it sounds quite painful. cry  With about four weeks left before my surgery, I'm trying to wrap my brain around what life will be like when I return home (I live alone with two very demanding Pomeranians.)  Yes, I'm still deciding what to do with them...yikes..!!  So are you walking around like "Igor", dragging your TKR leg, after surgery?  question

Postop Walker Usage

Is it true that post TKR you can only use  the type of walker that has two wheels in the front only and straight legs in back?  My walker has four wheels and brakes.  And a seat and basket I've rigged up so I can move things from kitchen to table, etc.  Gotta get real creative here, I guess..!!

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  • Posted

    Mary Ellen, good luck with your upcoming surgery. I am just 2 weeks out from left TKR and thrilled with what I'm already able to do with my new knee. Some things I've found:

    Lifting your leg. I have lifted it by hand since the beginning. You won't have the leg strength to swing it up onto a couch or bed without helping it. The handle of a cane works too.

    Bending your knee. If you sit in a chair and put your feet on the floor you have a 90 degree bend. My first measurement in the hospital had me at 64 degrees. So not able to hang my leg off the side of the bed. As you do your exercises your bend gets better, mine was 78 at discharge. You should look around the forum for numbers from other people.

    Walker. I would have been very nervous with a walker with wheels. Can you set the brake so it stays locked? That might work. I found that if I wanted to go up and down stairs by myself I needed 2 walkers, one at the top and bottom as you don't take the walker up and down the stairs.

    Are you going to rehab or are you going home by yourself? I could never have gotten through the first week without someone with me. I have 2 dogs also and just taking care of them would have wiped me out. Don't underestimate how hard it will be to get moving and how tired you will be.

    Set yourself up on a couch with risers in a room with a tv and close to the bathroom and kitchen. ( don't forget the toilet riser ). That couch will be your base of operations for a while. Take good care of yourself, be patient and do your exercises, you'll be so happy you did this.

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    • Posted

      Hi Deborah, thank you for all this great info..!!  And it is so encouraging to hear how well you are doing at 2 wks post left TKR.  I'm also starting with my left knee.

      Luckily, my house is all one level.  I have two very low rise steps from the kitchen to the garage/laundry area.  Risers -- what a great idea for elevating my couch (pillows aren't working that well).  The couch has a built-in lazyboy on each end.  And my bathroom and kitchen are close by.  My only  concern is that there aren't two arms, just one since it's the end of the couch.  Might have to rig up something solid to act as an arm I can push up on for the right side when getting up.

      I am planning to discharge to a rehab facility after surgery and should be there about a week.  My insurance may or may not cover it, but for me it's not an option to go directly home from the hospital (just ain't gonna do it, no way no how..!!) lol

      Yes, I can leave my brakes on and still move my walker.  I'm just not sure how I'll be transporting food, drinks, etc. from the kitchen to my couch using a two-wheeled walker.  

      My older dog is related to "Grumpy Cat"... very demanding, he is..!!  It will be interesting to see how things work once I'm home from the rehab facility.

      I'm so happy you are doing so well, Deborah!  Thanks again for the practical suggestions and the encouraging words - much appreciated..!!

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  • Posted

    Generally speaking a dog's energy is inversely proportional to its size isn't it?!

    my big old mastiff just wanted to lie in front of the fire and get the occasional fuss... 

    Perhaps tie the Pomeranians to the four wheeled walker and use their leg strength to tow you around razz!

    sorry sure someone who knows more than me will give you a more sensible answer soon!

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    • Posted

      LOLOL...!!! lol

      Of course, now I will have to "stage" a picture of my little Poms hauling my walker and post it here for all to enjoy..!!

      Maybe I can get them harnessed up to little wagons to transport food, etc. from the kitchen to my perch in the living room...lol

       

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  • Posted

    From last to 1st. 4 wheel walkers are dangerous and generally prohibited. If all those wheels start going it can take off on you ....walker to the left, you to the right....you get the picture, the floor wins and you lose. Just relax as far as the ROM. That's why you have therapists analyzing your movement. Don't set the bar to some unachieveable level before knowing from where you are starting. As far as the leg lifting. Work on strengthening your quads as much as possible prior to surgery. Strong quads will help. 1st 4 S urgeries I had to use my hands to lift my leg for several weeks. This last surgery....bingo.....I lifted it on its own strength the evening of surgery. A little of it is the psychological aspect of the brain not working to tell the leg to move. Don't live in fear of the unknown.......as they say in sports......let the game come to you......just try to take it as it comes. You'll do just fine.
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    • Posted

      Thanks for the headsup on 4-wheeled walkers, OFG, sounds like it will be "off limits" for awhile.  Any suggestions on what to use to move things from one room to the other?  As for quad strength, I have a long, long ways to go.  I have been using a walker at home for the last two months.  The pain in my left knee increased dramatically, plus I began experiencing weakness, pain and some numbness in both legs.  I saw my doctor about it recently and she just tripled my pain meds so I could tolerate doing the exercises better.  As weak as my legs are now, I dread what it will be like after the surgery.  Thanks for your encouragement and (as usual) helpful, wise words.  Much appreciated, kind sir...biggrin
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    • Posted

      Hi Mary Ellen!

      My favorite way to transport books, my Kindle, pens, etc. when you are using a walker is to put them in a plastic bag with handles like you get at the grocery store. Easy to keep track of everything. Easy to hold onto WHILE you are also holding onto the walker.

      Drinks work in a plastic bag, too, if you get ones with secure screwtop lids and tie the bag up close to the top of the drink container.

      I got pretty good at carrying plates by holding onto my kitchen counter with one hand and holding into the plate with my other hand. My dining room is right next to the kitchen. I never was very good with a walker and ditched it after a couple weeks. A cane made things easier around that time.

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  • Posted

    It is 9 weeks since i had a full knee replacement for the first three weeks i needed help lifting my leg then after that i could lift ot on my own without holding on to it i can lift ot quite high now and i am walking with sicks i am getting out a bit more now i am not one for sitting about xx
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  • Posted

    Hi,

    I'm nearly 5 weeks post op. Not used anything to lift the leg except the good leg for the first few days as I couldn't lift it at all. Now I can lift it very well..

    I was told I needed a 90 degree bend for discharge and achieved this on day 4.

    the physios prescribed me a walker with two trays, a blessing for making a brew! It also had 4 wheels, so can't see why yours won't work.

    i too have two dogs, Yorkies, biggest problem is that I needed others to walk them, but I can now go short walks with one crutch and both dogs. 

    You are much better prepared than I was, well done. As everyone has said keep the pain meds going, last night I took strong meds and night before just paracetamol so levels of pain vary day to day.

    good luck with your op x

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    • Posted

      It's really interesting how decisions are made and what's allowable in some areas and completely taboo in others. As i mentioned earlier, the 4 wheeled walkers are not an option around here as they aren't as easily controlled especially when one is on pa I n meds. My wife who has Parkinson's disease is on the 4 wheel kind with hand brakes and a seat so she can use it as a chair and for balance if she gets tired. You just have to be flexible and isten to the professionals' instructions and trust them that everything is being done for the good of the patient.
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    • Posted

      I'm in the central part of the US. Generally speaking, the 1st line of post op treatment is pain management, then rehab. Home health is the initial 2x's a week is standard therapy with oupatient therapy 2 or 3 x's weekly depending on all of the circumstances. Rarely are crutches used, a walker is the safest assistive device then to a cane. I have never heard of a Dr telling anyone the had to meet a certain level of ROM or they can't go home. The main goal of getting a patient out of The hospital soon as possible is to get them in a more favorable infection free enviornment. In the hospital, therapy is a 2 x's a day thing. Part of it is the actual work and part of it is the education. 1st time I went through this my therapi s t laid out the program......he stated 15% of this is on me, 85% is on your........I want you to work and be tired but i dont want you to work and increase your pain level. Not to say over the years I haven't had to remind him of that a few times. Unfortunately, this being 5 times rebuilding this knee, there's s always something different.
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    • Posted

      Lynne....I to to a teaching hospital....a university medical center. Things can be a little different as there are fewer budget restrictions and a greater abundance of professors (instructors), medical, nursing and therapy students and Dr's in their residency programs. I get them all as i have a very rare tumor that started all this and everyone wants a piece of my time as I'm the c rarity they may never see again in their career.
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    • Posted

      Thanks. My computer died on me so just back on line. Hope 5th time is good for you. You seem to get much better therapy

      support than UK. Not that I am complaining its just interesting to read all the different advice we have all rec'd.

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    • Posted

      I'm on medicare and we are allowed a certain $ amount annually and this is adjusted upward with each incident that calls for special treatments. Th e n you have to work with the provider to make sure you maximize the time spent with him and the time you do work on your own. I do all of my own post therapy icing to save money and also do my own warm up time pre therapy for the same reason. I've been at it so long they trust my judgement in both areas
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