TKR at 10 weeks

Posted , 4 users are following.

I had a total knee replacement about 10 weeks ago. Everything was going well at the end of week 4, I could do an 30 minutes twice daily on the bike and walk a couple of kilometers. But, I also suffered a blood clot around the same time, which cost me a week on the bicycle do to the pain and uncertainty about my condition.

After about a week I was back on the bike, but the knee was not as fluid as before and it would stiffen up with exercise. The physiotherapist was not much help with this issue, as she was obsessed with straightening my knee. This just made the knee painful for days afterwards and was not helping my stiffness. The stiffness has gotten worse and I am lucky to do two bike sessions a day now, as the knee stiffens too much.

I had discussed getting an ultrasound with the physiotherapist, but when I asked, she declined. She said my knee felt fine to her. LOL. I went back to my sports physiotherapist (previous life) to get the ultrasound. The ultrasound was inconclusive, but the doctor forwarded it to my surgeon and I got my follow-up bumped up.

The other odd thing is that my knee makes noises when I bend it. It sounds rustling leaves and originates from the ligament that passes the outer edge of the kneecap. It's so loud that other people can hear it. It is not painful, but is likely contributing to my swelling. This is the same ligament that experienced pain when the physiotherapist was trying to straighten the leg.

Any ideas? I assume it is related to my exercise break due to the blood clot or even a side effect of the Xarelto. It could even be the phase of the moon and I'm sure the surgeon won't have much to add.

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  • Posted

    I'm at 15 months and still with varying degrees of stiffness and pain. I have been told and read that healing is different for each of us. Now you have me wondering about an ultrasound as I am very frustrated. I do the bike and walk daily, I stretch. Not sure what I am missing. will follow this to see what others have to add.

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    • Posted

      You're missing the muscle rebuild. Biking is a good warm-up plus helps with the ROM (if the seat height is set to give you a full leg extension). It does nothing to strengthen the dead muscles. Also, walking only works if you kick your leg out straight as you take your next step with the TKR leg. Feels very funny at the beginning but works.

      Also, walking distance and/or time is irrelevant...it's the STEPS that count as that's when the load is put on your knee. Get a pedometer and chart your steps every day. Current devices will allow you to download the data and chart your progress over time. Increase gradually; set a goal of 10,000 per day. YOU CANNOT PUSH THIS as the knee will swell. If that happens, back off, recover and resume...GRADUALLY.

      You are absolutely correct that everyone is different but the vast majority of stories reported on this Forum (I've been on over 3 1/2 years) all point to a typical year-long recovery with any remaining issues gone by 18 months. Again, some people take shorter or longer.

      Personally, I went from -14 / +84 to -1 / +123 in twelve weeks of tough, painful PT. Currently at 0 / +133 which I will maintain. Got stuck at -4 for weeks...that plateau was very frustrating but you have to push through it. Had my "balloon knee" event at 5 weeks when I did 8,200 steps one day. I was never that stupid again. I was up to 11,000 steps by 8 months. The muscle rebuild took many months of hard work. The payoff was being able to go up steps two at a time without holding onto anything at 14 months. Do the work...get the results.

      Long term? You will probably always experience pain when you try to kneel directly on concrete, tile, hardwood floors, etc. without any padding. It's not the knee...it's the damaged nerves. This may or may not ever resolve. Accept it. Also, stiffness will absolutely return if you don't keep the knee active. Become a couch potato at your own risk.

      Check out the links I posted in this thread for the ROM work plus the muscle rebuild.

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    • Posted

      Thanks,

      ROM has never been an issue, except for the +5 I was stuck at for a while. I was +115 at day 10 and at 125 a few weeks ago.

      Thanks for the pedometer advice, but I was previously a fitness freak with a gadget fetish. I am currently using the Garmin Fenix.

      I was walking up to 20,000 steps a day pre-surgery and 30,000 if I was being particularly OC that day. Yes this would bother me some and more on the days I overdid it. I had to weigh getting this done while I'm young-er and the company will pay vs. later when I have to pay and it will take longer to heal. The surgeon said I was bone on bone, but I would only notice this if I ran (not far!) or twisted the leg a certain way.

      Yeah, the knee swells now at the least provocation now, so I see this requiring patience. LOL.

      I have no delusions of kneeling, as one side of the knee feels numb and the other side feels like it's on fire. I can't wait to try though. 😃

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    • Posted

      Thanks JRS11,

      I tried the TENS today to see if it would help with stiffness, but it did not help and seemed to make the swelling worse. Both PTs have used EMS/NMS on that quad, which stiffened up the knee for two days. I need to buy some ankle weights and get back at my angled leg raises.

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    • Posted

      20-30,000??? That's my daughter who doesn't even work up a sweat with P90X at age 41. Graduate nutritionist and personal trainer certified by the American College of Sports Medicine. She's the one who wrote up the exercise routine.

      Me? Those numbers are unattainable with metal in my knee, hip and spine. It will be a total of 5 pounds in January when I finish my third fusion. That way, even when I'm dead and turned to ash, I'LL STILL WEIGH FIVE FREAKING POUNDS!!!!!!!!!!

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    • Posted

      Sadly, I sweat at the drop of a hat. I think it's related to my breathing issues, so summer steps are sometimes a challenge. The one good thing about the blood thinners is that they make me cooler.

      I have Ankylosing Spondylitis, but up until about five years ago it only really fused my lower back. Then it moved into my middle back and started to bug my knees and shoulders. I finally fell down the stairs about three years ago and finished off the cartilage in that knee. An MRI said I had crushed the honeycomb inside the bone (fracture). The knee was swollen for about 6 months, but finally recovered enough to walk without limping.

      Before my body gave out, I did cardio 4 days a week (twice on Sunday) and my weights 4 days a week. I got stopped going through the airport once, because they thought I was smuggling drugs in my pants. "What do you have in your pants Sir?" "Just my ass I replied." I got sent to the body scanner after that. Now, I just have old man ass. LOL.

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  • Posted

    The noises are normal and can persist 12-18 months.

    You must accept the fact that a TKR recovery is NOT a linear process. There are advances, setbacks and plateaus. All are normal. Post this on your fridge...

    Reality

    A complete recovery usually takes a full year and includes a good ROM (0 / +120) plus a rebuild of all the supporting musculature (quads, glutes, core and more). These will help...

    ROM Work

    Muscle Rebuild

    Get rid of all your expectations and timetables. Listen to the knee not your brain. Your tools are time, work and patience...you will need them all. Mostly...

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

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  • Posted

    I got the ultrasound report finally and there is a lot of medicalese, but the highlights are as follows:

    Thickening ,

    - Patellar tendon

    - distal quadricep tendon

    - fatty tissue anterior to the quadriceps tendon

    - collateral ligament

    - distal biceps

    - distal IT band

    Tendinosis and enthesopathy (bony protrusions) of the distal quadriceps tendon at the insertion into the patella

    Soft tissue edema of the subcutaneous fatty tissue anterior to the quadriceps tendon due to hematoma or an abscess. Grade 1 strain of the medial collateral ligament - likely pre-existing. Suprapatellar bursal effusion - water on the knee.

    The technician suggested a possible infection, but I don't think so based on the fact I have no other symptoms, other than the upset knee. The technician also suggested an MRI to diagnose other possible issues.

    I saw the surgeon yesterday (before I saw the above) and they blew me off for 9 months, despite my complaints of stiffness and worsening condition. They also received the above a couple of weeks ago (Assuming anyone read it). They told me the knee was not swollen; gee why is it twice the size of the other knee and that does not jive with the above. Also, when the sports physiotherapist used the Game Ready (cryo cuff) on the knee the reduction in the size of the knee was astounding, but it did not last of course.

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  • Posted

    Hi there,

    I had my knee replacement about 4 and a half years ago and had a very successful recovery.

    About 9 weeks ago I went out for the day wearing a pair of shoes that were not particularly supportive. I think basically they were too wide and too big. As a result my muscles around my knee became very stiff and sore. Sometimes they were quite painful. I was extremely concerned. I was told that there was nothing wrong with the joint and that I needed to exercise more and find a good physio. I was back to using ice packs and heat.

    So I found a new physio and she has done two sessions of massage and stretching the muscle in my leg. I also had some acupuncture and I have been amazed at how much things have improved.

    I think that time is a great healer as well. I try to go to the gym 3 times a week to ride a bike, use the leg press and hop abductors machine.

    The treatment from the physio has been particularly helpful not sure whether it may help you.

    I think that you are still in the early stages of your recovery and there are many set backs along this road. It is difficult to be patient when you have these setbacks.

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