Very slow progress following TKR

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I had a left total knee replacement 11 weeks ago. I spent 7 days in hospital whilst everyone else with the same op went home after 3 or 4 and seemed to sail through those first few days. I had a lot of swelling and a lot of pain. I still need to take OxyContin twice a day.  I can’t bend my knee past 60 degrees and still need a crutch to aid my walking. I do all of the excercises I should. 

The things that concern me are 1) I haven’t had my 6 week post op check with the surgeon yet. I rang the hospital about this to be told my name is in the book but there are too many patients and not enough appts and 2) I haven’t had any physio yet. I also queried this to be told not enough appts available and to just wait. I just feel like I’ve had my op and now I’m on my own doing the best I can but it doesn’t seem enough. It seems like the opportunity for maximum recovery has been missed. Anyone else In the same situation? 

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  • Posted

    I don’t know where your from but here in Tasmania Australia that type of service doesn’t happen .

    I’ve had my tkr 15 days ago and have my first Physio next Monday and an appt for my surgeon at 4 wks then 6 wks perhaps you should move to my beautiful island 

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  • Posted

    Sorry Caroline that this is what you have experiencedsad don’t despair keep working on your own I am certain not all is lost. Very important to see physio though so be that squeaky wheel and keep at them to get you in. Best wishes 
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  • Posted

    Caroline,something is not adding up for me:

    1 . Why did you have to stay 7 days in the hospital? Did you ask your surgeon? 

    2 . At 11 weeks a 60 flexion is not quite enough and I would just show up at the surgeon’s office if you can’t get a app. because at this point he has some explanation to do for you.

    3. Do not give up on moving your knee as much as you can,worst comes to worst you can google exercises for TKR and do as much as you can.Ice should help you too

    But the most important!try to get in touch with your surgeon and ask a lot of questions! He is the one to take care of you since he did replace your knee....

    Be patient,this is not a easy surgery,but be vigilant and demanding! It is your right to know all about your body! Good luck to you!!

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    • Posted

      Did you have your Xray in hospital? Post op...

      As Chico says, that checks out if it's all nicely in place.

      Make some phone calls , NHS is very stretched. I had my post op appointment just over the 3 month mark.

      Physio provision varies from area to area. If you are not getting any on NHS it is worth getting just one or two appointments privately.

      Chico has posted good information on rehab at home, also Google exercises, there is a lot of information to be found, good videos on you tube etc.

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  • Posted

    Forget about the days in the hospital...

    Some rules:

    - Never compare your recovery to that of anyone else...we all heal differently.

    - Give up all your expectations and time schedules.  Your knee will be better when it's better.

    - Eliminate the word "should" from your vocabulary.  Messes with your brain.

    - Be strong, eat healthy, hydrate a lot, do your ROM work/PT...most of all: Endure.

    Your 6-week...or so...appointment is for your alignment x-ray.  Doc draws a straight line from hip to ankle...should go straight through the center of the knee.  That shows the doc that everything is OK.  It will happen...

    Start your own ROM work...

    https://patient.info/forums/discuss/tkr-rom-work-at-home-620053

    Have fun...and don't worry...it does get better...

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  • Posted

    Hi Caroline,

    My case three years post op. Stiffness and pain still main issues. Sandbags and stretching, my home ‘physio’. Stretching to increase the extension. This will improve my walking i.e. less limping. Swimming is also recommended. Regarding you pain medication. OxyContin or Oxycodone aka “Hillbilly Heroin” highly addictive. My recommendation ask you physician to switch to Tramal or Tramadol. Less addictive and cheaper. But be careful with the dosage. 50 mg per day. Or 25 mg half a capsule with 300 mg Paracetamol. This works for me. My advice home physio and switch to Tramadol if your your pain issues will continue. Good Luck Bangkok-Johnny

     

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  • Posted

    How old are you I'm 67 still working a ft job o7/18/2017

    Had a bilateral back to w/o 09/11/2017 went bowling Fri night all I can say everyone HEALS different if you have to much distress just be more assertive over the phone you will get seen

    Good luck

    Mitch

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  • Posted

    Hi Caroline, i have not had my knee done yet, having to put off as long as i can due to being under 60. however. I would go through the hospital complaints procedure.  In the UK we have PALS, if not complain to the chief execs office. They should not be doing operations if they cannot fit in all the patients they operate on with a follow up in good time. , within the specified time. Agree with others don't compare yourself to them. When I had my hip done, I was in 5 days to everyone elses 2/3 days. But then I had an unexplained infection and urine retention. 

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    • Posted

      Hi, I should have said that I am in the Uk and aged 56. Like you I put off having my knee done as long as possible but the pain was so bad and interfering with my job and activity in general. I had no choice in the end but to go ahead with surgery as my knee was bone on bone. My right knee also needs replacing but can’t go ahead with that until this one is at its best. 

      I think you are right in saying I should follow the complaints procedure but I’m interested to know if mine is a unique case or this delay in follow up care is commonplace.

      Thank you for your reply 

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    • Posted

      Not unusual, as per my other post!

      NHS is wonderful, but very overstretched!

      I wouldn't waste energy complaining personally, it is no one person's "fault" as such. But give them...the hospital were you had surgery... a ring to get your follow up appointment and discuss lack of physio with surgeon. .he or she will get it sorted!

      Mean time do what you can.

      In UK physio is organised via your area CCG, not the hospital normally. IF you were meant to have it, then physiotherapy at hospital would have called relevant physiotherapy provider. Maybe there has been a communication error? But as said provision varies from area to area.

      I got a lot of physio, but others in UK on this forum have had just a booklet.

      Did you get a booklet to take home?

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  • Posted

    I had my RTKR in March and was in 5 days instead of 3-4 due to a redness on my leg being observed. After discharge I had problems with pain control, swelling and stiffness in the knee, leaving me with about 65 deg flexion at several weeks on. Physio was not helping the flexion and movement only caused swelling to increase.

    ​I did not get any follow up apt and had to phone and ask to be seen. This was at 9 weeks and I was seen at 10 and booked in for manipulation within days as they like to do the manipulations sooner than later for best outcome. I am in the UK too.

    ​Anyway, the MUA did help the flexion a lot and I had some extra physio and eventually discharged from that to continue at home. I still have problems with knee, am told it can take a year or more by GP. I awaited a further follow up at 6 months but never received one. I phoned and have been given apt in a few weeks. Everything seems to have been an uphill struggle!

    ​So, I think you also need to call up and ask to be seen urgently tell the clinic you only have 60 degrees and may need some intervention to get things moving. You also could call the physio dept - I dealt with them direct as sounds like you are being overlooked. We are told here you need over 90 degrees to do everyday basic things. You can keep improving your range of movement, apparently it is a myth that you cannot, but the early days are important for maximising mobility.

    Good luck and let us know how you get on, take care.

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    • Posted

      Cynthia, I did not even think about a six month follow up...I haven't been told about anything, as my surgeon discharged me.

      You had various complexities with yours, and I would like yourself definately wanted six month review in your position.

      I am thinking I may have an annual review, but it is something I need to ask about I think!

      The poor but precious NHS is struggling to stand on its own two feet!

      The government needs to put more money into it..

      Have you been told about what you should expect with longer term follow up appointments at all?

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    • Posted

      Hi Jenny,

      ​Not sure what they will do with the later appointment.

      ​The one I requested which was about 10 weeks post op, I saw the consultant who asked me how things were and looked at my knee bend (not very closely, just from across the room) and he said, no that is not enough, had a bit of a closer look at knee and booked me in for the MUA.

      ​I then had to go along for an x ray of the knee, standing up front and sideways.

      ​That was about all there was to it, then I got a date for the MUA in the post.

      ​Yes, the NHS is really stressed. I worked for them at different times of my life and there were always staff shortages, but I think the advances in treatment and fast turnover are pressures as well as funding now.

      ​Everyone with TKR seems to have different treatment and advice!

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