Redness and feeling hot around the knee

Thank you for your kind response.

It seems that there is a lot of variability in surgeries out there.  Any advice I've offered has been based upon the approach used on me.  And, apparently, it's a lot different than what's going on in general.  So, what type of surgery did you have?  Quad cut, minimal invasive, robotic assist, etc.

How long did you spend in hospital before going home?

Where was it done?  Country/state kind of thing.

Did they recommend exercises immediately?  

Did dr. recommend waiting for PT?

I think this has a lot of bearing on what happens to people on this forum.  My stuff seems pretty benign compared to what I read here?

Hi elent

I posted this on behalf of my mum. Her surgery was in Yorkshire and spent 4 days in hospital.

The PT gave her exercises to do at hospital a day or two later and to continue these at home.

Yesterday was her first PT visit at the hospital as they said it would be 3 weeks after surgery.

I'm unsure about what type of surgery it was part from a TKR.

Thanks for your response.

Sorry elent, just realised this message wasn't for me!

Yes there certainly are a lot of variables. Each surgeon has his preferred technique. I did a LOT of research before selecting both my doctor and the hospital. The surgeon I selected had an exceptional number of positive patient reviews as did the hospital.

I had a total knee replacement. My surgeon is only one of two in my State of Connecticut in the USA that does what he called 'minimally invasive'. He explained that that the procedure is the same except that he doesn't cut through muscle, he goes over or around muscles, tendons and nerves. It takes longer for the surgeon to do it this way, but he believes it's much better for the patient and I totally agree. He also uses computer navigation, called 'pinless navigation'. This means that he takes measurments with a computer guided light. This does away with the necessity for stabilizing the femur and tibia with a rod through the bone which may result in a fat embolism since the stabilizing rods go into the bone marrow. Again, it takes the surgeon a bit longer but reduces the incidence of fat emboli post operatively.

I had a femoral block inserted which was guided by ultrasound minutes prior to entering the operating room. This femoral block was left in my groin for two full days post operatively and reduced pain dramatically. Upon entering the operating room, I was sat up on the side of the table and a spinal block was administered. I didn't remember anything until I woke up fully in the recovery room.

I spent three days in the hospital. Immediately after surgery, my knee was wrapped with a continual cold water circulating pad and was elevated on a CPM machine (continuous passive motion). They gave me the controls for the machine and it raised and lowered the bottom half of my leg from knee to foot. I left the hospital at 90 degree bend and I give this machine most of the credit for that. I was using this machine for 10-12 hours each day that I was a patient in hospital.

Physical therapy was not merely recommended, it was absolutely essential. I received physical therapy at my home three days a week starting day 2 of my discharge home. Home therapy continued for two weeks then I began going to outpatient physical therapy three days a week.

My pain control regime consisted of oxycodone which I took for severe pain and particularly one hour prior to any physical therapy. My surgeon also ordered Valium to be taken 'prn' or when needed. He explained to me that Valium would relax muscles and would be valuable prior to having physical therapy. He was absolutely right, it made it much more tolerable. I was also given several vitamins to take daily. OsCal, Zinc, Calcium and Iron. These essential vitamins aide in rebuilding strength and bone mass after surgery.

I have to say that this surgery was 100 times easier than my first total knee replacement in 2012. Different surgeon and different hospital. I literally had no pain at all while in the hospital and the most discomfort I felt was at the incision itself caused from the trauma and swelling. I went for my six week follow up today. I walk without a limp, no cane of course and I have no pain. I have 125 degrees of flexion and can comfortably walk stairs up and down. My physical therapy will continue for another few weeks but down to two days per week for strength training.

I am in the UK. I have had both knees replaced, after many other corrective surgeries. One surgical steel, the other titanium. Both times a week in hospital.  First time round I behaved myself; taking the full 6 weeks off work. 2nd time, only 3 weeks, by this time I had changed my car from manual to automatic. Big difference.  The first time was on the NHS, not a very nice experience, too gory for this forum. 2nd time went private, was like a 4star holiday by comparison.  Both times out of bed on the second day, by the third day you are walking up and down stairs;a must if you want to leave. At home the first time visits from the district nurse to change dressings and administer anti clot injections, gentle exercises, then PT after a month. Second time, I had to do the injections myself, change dressings etc, no home visits. Gentle exercises for just under a month then full on PT. 2 years on, I go cycling when I can, work full time, but have to walk with a cane. Have most probably tried every form of pain relief, but the reality is my system have treated my replacements as foreign objects and have "rejected" them both. They will not fall off or crumble, have tested them to the fullest. I am in pain 24/7 with nothing left to try.  Pain wise I have a good pain management team in place who cover a lot of different avenues. Been there, tried that, so to speak. Exercise is the key to sanity.  When in a lot of pain and painkillers don't work, I go to the gym. Static bike, rowing machine and floating in the warm pool helps, both mentally & physically.

I hope I have answered your questions

Thanks, that explains a lot.  My process was totally different and, unfortunately, nothing to offer but my best wishes for the pain to be relieved.  Chronic pain is nothing to dismiss lightly.  

The NHS and private options were an eye opener.

thanks

Thanks, very similar to mine in CA.  I like the valium idea -- I'll keep that filed away in case I do a second TKR.  

Mine was overnight and go home.  Do most of the exercises in the first 10 days while under managed pain meds (oxy worked great) and up and walking, climbing, etc etc on day 16.  So, the mini op and computer alignement were definite positives.

Congratulations.

No, it was for anybody.  I'm interested in the types and variety of procedures  -- I think it's important for everyone responding to understand the differences and the need for responses to be appropriate to the situation.  

Mine was "easy" with no complications - poster child kind of thing.  so, I'm cautious about offering suggestions -- 20 20 hindsight is alway annoying to me.  

Hope your mom continues to do well.  It's fortunate that you are there for her  -- alone is really really tough!

90 plus percent are like yours. Its the 10% or less that wind up on a side like this looking for answers. You are correct that it's h a 3rd for those with "text book" cases to relate to most of the people on here who are really hurting.

You are very welcome, it is nice to hear about those that work. On the other hand the good ones have no need for forums.  The upside being that 98% of TKR's are successful.  The other 2% are the ones that do not take for one reason of the other.  That is without taking into account all the outlying issues that can delay the healing process (That is the main reason a lot of surgeons are not interested in what happens after your operation and thereafter.  They have done their job; replaced your joint.  Everything that happens after that is not their department, so to speak).  Sounds brutal, I know, but knees are mechanical and the mechanic has done his job !!

My word so different from NHS UK but I've done well.

Would you be willing to share the name of your CT surge Ron wth me?

thanks

Lois Adams 

Hi Jemma33320,  I recently had a kneecap Replacement and it is six weeks later and my knee is still red, hot with a lot of pain and I am still using a cane. My doctor did not cut the tendons or the ligaments, he pushed them to the side but I am not doing too well at this moment. My next surgery is my right ankle because I have two torn ligaments. I live in  Westchester County in New York & I would love to know the name of the doctor that you used and who is he’s affiliated with. 

I live in CT also, and I had my first knee replacement on July 26, 2017 on my left knee.   Now, almost 4 months post surgery, my Right knee is giving me more pain then the left knee prior to surgery.   I feel I am heading back to the  table again    I am very interested in who your surgeon was.  Would you be able to share the POC for the Surgeon.   Please email me at    thank you so much

Moderator comment: I have removed the email address as we do not publish these in the forums. If users wish to exchange contact details please use the Private Message service.

This isn't uncommon. Before surgery most of us walk anyway we can to avoid pain, then p.o. we try to tighten the ship plus we use the good leg do everything that require strength and stability. This puts lots of pressure on a part of the body that can't handle it. This also happens to the back and can cause severe sciatica pain. I've been through rehab 5 times and something always seems to pop up creating a new pain. Possibly an injection of one of several drugs can take the sting out of it long enough for you body to get back upeight. One of the biggest flaws in rehab is the mental aspect. We get to feeling so good because the knee pain has eased that we think we need to start running to get caught up with everything. If you slow down, go back to the basic s low stride hitting the heel, then the ball of the foot, toe and then bend as far as comfortable. This isn't going to win you any awards for style but you're not in it for gold stars anyway. Slow and steady is the way to go. Hope you get along better in the coming weeks.