What is 'normal' when it comes to recovery after TKR?

Posted , 12 users are following.

I'm 23 days out from my total knee replacement and one of the most frustrating things is not having a solid timeline to refer to in order to get a sense of where I am and how I'm doing in my recovery. I'm getting so many conflicting opinions - at three weeks you should be almost pain free and not need meds vs. at three weeks you've barely begun healing and should take pain meds routinely - at three weeks you should be at 0 degrees extension vs. don't expect t more than 10 degrees extension at week 3 - etc etc. what IS normal and is there really a 'normal' at all?

0 likes, 14 replies

Report / Delete

14 Replies

  • Posted

    What is normal? Are you in UK? Are you having physio? Everyone is different. Royal college of surgeons says most people off pain killers by three months. Range of motion gets better when swelling reduces, generally. For me it went like this:

    My range of motion progressed a lot around ten to twelve weeks, but was around 90/95/100 for ages before that. It was 110 before the knee replacement, so I was relieved simply to get to 110, which happened around seven weeks. At 14 weeks it was 130, which I wasn't expecting or even aiming for to be honest. I was just glad to be able to walk without a limp. I used two crutches for any walking over ten minutes even at 12 weeks...My quadriceps were very weak and went on strike after the surgery. My personal feeling was I wanted to give the muscles a chance to build up first before putting more pressure on the joint and I found my gait better, and it possible to walk faster, with two crutches/sticks.

    I could only walk a tiny weeny bit in the house, literally a few minutes, with no stick or crutch at 8 weeks. I used one around the house for what seemed like ages. My physiotherapist urged me to stick with two crutches for as long as I felt I needed them, and I didn't see the point in causing myself needless pain. Instead I focused on improving range of motion and decreasing swelling more than dispensing with support. Then, after starting leg strengthening exercises at around 9 weeks, ie weights on legs, squats, I built up more strength, increased walking duration, and at 3 months things really turned a corner. But everyone is different.

    Report / Delete Reply
  • Posted

    Hi GianaNY

    from what I have seen in these forums there is no "normal" with regards to TKR. I had my right knee done on the 21st June and thought I was doing great until 10 days later when I overdid it by a small margin. I had a physio appt the day after who confirmed it's a fine line between overdoing it and doing enough. She also confirmed everyone is different and was surprised, after what I had been through in 12 months, to be as far on as I was. Having said that I'm not at the point where I was prior to the op. My extension and flexion are worse at the moment due to swelling. The swelling alone makes a massive difference and varies on the time it takes to go down.

    The best advice I've heard is listen to your body and take pain killers for as long as needed, get a good physio and listen to them.

    best of luck with it and post again if you want to.

    Martin

    Report / Delete Reply
    • Posted

      Hi Martin. I had myop on 19th June and was having a seriously bad morning until I found this forum!!Reassured that I'm not unique in struggling! Had tried reducing pain killers but don't think I ready despite what the books say! Gone back to cocodamol 30/500 4 times aday again today and feel a bit better this evening. Out for drive with husband and getting into car a bit easier.extension not bad but struggling with exercises as swelling and bruising limiting flexion going to try Voltarol gel on joint again tonight as 12_hour version helped this am.thanks to the forum membersfor the suggestion. Also got Bio oil but haven't used it yet.

      Report / Delete Reply
    • Posted

      Your not alone in the struggle. We all seem to in more or less ways. 

      I tried reducing pain killers like you but soon went back on them. Trust your body. It will tell you when it's ready. I also use arnica gel (as advised by others here) works great smile 

      Report / Delete Reply
  • Posted

    I think you only have to look around you and see the vast differences which exist between people to realise that there is NO "normal" which will cover everybody.  Very few people will be pain free at three weeks. . very few people will have 0 extension . . but there will be some who will achieve these two enviable goals.  You have to listen to your own body, what you can do and achieve, how far you can push yourself to the boundaries. . . Almost certainly, achieving a good bend and a really straight leg will involve a fair degree of pain.  I prefer to call it pain, than the mealy mouthed "discomfort" so often used on medical websites.  no, you do not wake up from the operation with a degree of discomfort.  It damn well hurts!  At three weeks for me, I was barely beginning to walk . .i felt shattered, my blood count was still low in spite of two transfusions, the pain was overpowering me (only had paracetamol to cope with it) and yet, at six weeks, I was walking two kilometres a day, and achieving a reasonable bend (probably about 90).  Now, I have a bend of 135 and a straight leg . . It took me quite a while . . more than for a lot of people. . . but try to forget normal . .and just be yourself!

     

    Report / Delete Reply
  • Posted

    There is no timeline...there is no normal...there is no "should be"...EVERYONE IS DIFFERENT!!!!

    You are asking for statistics that you can compare yourself against.  The problem with statistics is that while they apply to a large "general population", they NEVER apply to a specific individual.  That said...

    https://patient.info/forums/discuss/the-tkr-recovery-bell-curve--563756

    You have to get all expectations and comparisons out of your head...they only lead to "the Dark Side" where they have GREAT cookies but not much else.  The other thing is that you will not know where you fell under the statistical bell curve until you are completely done with your recovery.  Only then can you look back and discover you "place".  Can't happen while you're going through it.

    You have to see this as a long-term recovery (likely a year or more), where there will be pain and a lot of effort on your part to completely recover.  You have to make a choice between strength and endurance or passivity and victimization.  All up to you.  I'm at 16 months post-op and it was all worth it.

     

    Report / Delete Reply
    • Posted

      You have to make a choice between strength and endurance or passivity and victimization. ...indeed, so true. And maybe I could add, you don't need to do it alone. Expect and receive all the help and support you can, and devote yourself to the healing process by putting yourself first. Helplessness can be combated by getting all the support you are able. While self determination is vital, this is not the time to struggle forwards insisting on independence.

      Report / Delete Reply
  • Posted

    Surrender. Just know it'll probably be a long recovery. Or it mightn't be. Don't try to put a timeline on it. Just take each day as it comes. Seek help when necessary. I am 16 months post op for a "doubler," both knees together, and they are still not perfect, but I'm on my way to total recovery. Good luck.

    Report / Delete Reply
  • Posted

    There really is no normal. You are you, then they broke the mold. Certain things have to happen to heal and but they don't happen on a timeline. You are now going through the "process" and it isn't a lineal affair. You will hear the phrase " its a marathon, not a sprint", words to live by.

    Just do the exercises, stay on your pain meds, hydrate and rest.....especially rest and eat as much nutrition as your system allows. Sleep and water are great healers. Plenty of hydration and rest. I've been through 11 surgeries and 5 complete rehab...no 2 exactly alike.

    You will find frustration, tears, depression and many highs and lows. Things will even out eventually. Stay with this forum, great group who have borne the scars of this surgery and will offer great advice and wisdom you only get when you've been tempered with high heat.

    You will heal....time is your friend, patience your ally.

    Report / Delete Reply
  • Posted

    Basically Gina, nothing is normal - the recovery and healing process is all very much highly individalised.

    ?I did not have a TKR but a partial. My timeline was - 6 Nov 2015, surgery PT started same day as soon as I was back in my room. In hospital for 3 days, not allowed home until I'd got a 90 degree bend and a fairly straight knee - did that by 3rd day. 19 November - dressing removed. 24 Nov review by PT Department at hospital. 1st sugeon review 29 December, off crutches, back to driving my car (a manual, not auto) and back to work driving a tourist bus on 26 January 2016.

    I certainly wasn't pain free, nor meds free at 3 weeks.

    ?All my PT was at home at least 5 times a day as prescribed by PT Dept. Was given a booklet showing the exercises to be done and the frequency. I supplemented this by getting on to youTube and checked out PT after knee surgery.

    ?Anyhow, that was my experience.

    ?I my opinion the most important thing to do after your dressing is off and its confirmed you have no infection is to massage the incision line and surrounding area to keep all the tissue, muscles etc as supple as possible so as to prevent scar tissue forming - this is the worst possible scenario - that scar tissue forms. It will make your PT exercises just about unmanageable and will slow up your recovery and healing considerably.

    ?I was not walking normally until I had got to arounf 130 + degree bend in my knee.

    ?Do not hurry things make every step a gentle, positive forward step. No rushing things, causing damage and then have a set back - effectively having to start again. Keep up your pain relief EXACTLY as prescribed - no short cuts. Why ????? 'cos you have just been butchered - thats why !

    May the force be with you.

    John

     

    Report / Delete Reply
  • Posted

    Hi

    If you work on 12 weeks timeline, the majority we be over the majority of the pain in this period.

    Good healing

    Report / Delete Reply
  • Posted

    There is definitely no such thing as normal.  We are all different.  I am fit and active but definitely took a long time to recover.  Did water aerobics two months after and did come off strong painkillers after about 6 weeks, just used ibuprofen.

    liz

    Report / Delete Reply
  • Posted

    I think if there was a set time for recovery we wouldnt need these forums, everyone is different love, some are up and off in weeks, some it takes months, unforunately we are all different xx
    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up