Total Knee Replacement

Bobw235

Bobw235

Senior Member
Location
Massachusetts
My wife went in for a TKR a little over a week ago and had her right knee replaced. The arthritis that had made her active life so miserable the past two years finally won out and the knee had to go. We're in the initial stages of recovery and are fortunate that we can have physical therapy appointments (four in the first week, more this week) here at the house along with a visiting nurse each week.

Yesterday gave us cause for concern as my wife took a step with the walker and felt like the knee was going to go out on her. She screamed in pain. After a few minutes, she went out with the PT for a brief walk, but the knee is really tight and still very swollen. If there's no improvement tomorrow she's calling the doctor. She's feeling discouraged that there's not been more improvement and the PT didn't help yesterday by expressing concern about the lack of bend in her knee at this point. Everything we've read seems to suggest this is a long-term recovery.

Anyone here care to share their experiences, helpful tips, etc? We're using a wedge pillow to elevate the leg and have been icing it regularly. My wife is on a low dose of Oxycodone combined with Tylenol to keep the pain manageable. She's discovered that Benadryl works well for facilitating sleep, since the Oxycodone can cause insomnia.

I'll pass along a site we found which has been a great source of info. https://bonesmart.org/ It's focused on hip and knee replacement and has an active forum.

I'm please to say that we had a good experience with the hospital. Afterwards I wrote them a lengthy email to express our gratitude for the care shown my wife. That's led to a phone call from the president of the hospital as well as a writer from their outside public relations firm. He conducted an interview with my wife this morning. A little positive feedback went a long way.

On to recovery.
 

Well, I hate to tell you this story, but my 92 year-old mother is going in next month for her third replacement of the same knee since last spring. The first one got a bad hematoma behind the implant. They opened it up and cleaned it out and replaced a major part. Then a month later, bad inflammation set in. This time, they took out the whole joint mechanism and put in a temporary apparatus to hold everything together. They ended up having to put a pacemaker in, too. They wanted her to wait a few months before they tried again.

Now, she is having the whole thing done again next month, but by a different practice this time and at a different hospital. Each time means 4-5 days in the hospital and 3-4 weeks in rehab. I'll be going up there after I get back from Costa Rica and she gets out of rehab (my sister will be with her until then) and stay with her until she's doing OK. Last spring that was almost a month I was up there.

I hope and pray this time turns out better than the last two times.
 
jujube said:
Well, I hate to tell you this story, but my 92 year-old mother is going in next month for her third replacement of the same knee since last spring. The first one got a bad hematoma behind the implant. They opened it up and cleaned it out and replaced a major part. Then a month later, bad inflammation set in. This time, they took out the whole joint mechanism and put in a temporary apparatus to hold everything together. They ended up having to put a pacemaker in, too. They wanted her to wait a few months before they tried again.

Now, she is having the whole thing done again next month, but by a different practice this time and at a different hospital. Each time means 4-5 days in the hospital and 3-4 weeks in rehab. I'll be going up there after I get back from Costa Rica and she gets out of rehab (my sister will be with her until then) and stay with her until she's doing OK. Last spring that was almost a month I was up there.

I hope and pray this time turns out better than the last two times.
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Okay, that's just awful to hear knowing that my wife is just into her recovery. I hope it goes well for your mom. For every story we hear about how someone was up within weeks resuming relatively normal activities, we hear other stories saying what a long, arduous recovery this is. One of her PTs said that the knee is the toughest recovery in terms of returning to full functionality and flexibility. I had a shoulder done a few years ago and it was no picnic.
 
She had a rough time with the first one a few years ago and swore over and over again that she wasn't going to get the other one done. She claimed that nobody told her how bad it was going to be. Wrong......EVERYONE, including her doctor and her surgeon, told her how bad it was going to be but she didn't want to listen.

I reminded her of all that last spring when she was determined to have the other one done. She didn't want to listen then, either.
 
We did a ton of research beforehand, so went into this with our eyes open. Still, I think my wife is surprised at how uncomfortable this is a little over a week out. Just the same though, the pain she was having that led to her decision to have the operation has now disappeared. She couldn't walk or stand for more than 10 minutes without pain and needing to sit down.
 
Bobw235 said:
My wife went in for a TKR a little over a week ago and had her right knee replaced. The arthritis that had made her active life so miserable the past two years finally won out and the knee had to go. We're in the initial stages of recovery and are fortunate that we can have physical therapy appointments (four in the first week, more this week) here at the house along with a visiting nurse each week.

Yesterday gave us cause for concern as my wife took a step with the walker and felt like the knee was going to go out on her. She screamed in pain. After a few minutes, she went out with the PT for a brief walk, but the knee is really tight and still very swollen. If there's no improvement tomorrow she's calling the doctor. She's feeling discouraged that there's not been more improvement and the PT didn't help yesterday by expressing concern about the lack of bend in her knee at this point. Everything we've read seems to suggest this is a long-term recovery.

Anyone here care to share their experiences, helpful tips, etc? We're using a wedge pillow to elevate the leg and have been icing it regularly. My wife is on a low dose of Oxycodone combined with Tylenol to keep the pain manageable. She's discovered that Benadryl works well for facilitating sleep, since the Oxycodone can cause insomnia.

I'll pass along a site we found which has been a great source of info. https://bonesmart.org/ It's focused on hip and knee replacement and has an active forum.

I'm please to say that we had a good experience with the hospital. Afterwards I wrote them a lengthy email to express our gratitude for the care shown my wife. That's led to a phone call from the president of the hospital as well as a writer from their outside public relations firm. He conducted an interview with my wife this morning. A little positive feedback went a long way.

On to recovery.
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Bob, I'm glad you discovered bonesmart.org. I found that website to be extremely helpful during and before my hip replacements. One of the good things about that site is that it is medically monitored so you don't get people posting a lot of crap. I hope you've "talked" with others on that site who have had knee replacements about their experience.

I've only personally known two people with knee replacements, and both of them said it was a long and difficult and frustrating recovery. From what they've shared with me about it, a week or so out is a bit soon to be expecting real relief. Hips, on the other hand, are pretty much a piece of cake, in my experience. When they got me out of bed in the hospital the morning after the first replacement, I already experienced a huge lessening of pain from before the surgery, and had very little pain the whole way through recovery. My ortho surgeon told me (when I was frustrated about my iffy knee) that knee replacements are a whole lot more complicated and recovery much longer and more difficult than it is for hips.

I hope your wife does well, and I'm glad she has good pain control. I hope you're taking the advice of bonesmart's Josephine to be proactive about pain and not to let it get way out of control before taking pain meds.

I hope your wife sees some improvement soon.
 
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Bob, I hope your wife is out of pain soon and has a complete recovery. One man I used to see at work had one that caused him great pain, he had trouble walking and working and was close to retirement. He said he went back to the doctor and they told him it was put in crooked, at an angle, and he needed surgery to correct it. After that I didn't see him, so I assume he retired, don't know what happened with him, but I was hopeful that they resolved the problem.
 
Bob, a few observations.

First, ice is your wife's best friend. Apply frequently, especially after any exertion. It doesn't reduce swelling, it prevents it and with it, a lot of pain.

She needs to keep her leg elevated as much as possible to assist with the swelling. At this early stage she should not over do the exercises. I wouldn't worry too much about the knee flexibility yet because this will improve as the swelling subsides. It will take a good six weeks for healing to take place and another six to recover strength in the legs.

If her pain is intense you may need to have some scans to make sure she isn't bleeding. If that is the case she may need a drain. Keep in touch with the hospital. Any elevation of her temperature should be taken very seriously too.

Hubby's last knee replacement was not right and he needed a second operation. He is very heavy and the original prosthesis was just not sturdy enough. After the second operation it was all plain sailing.

One other thought. It is vital that your wife avoid falling, which is another good reason to rest with her feet up.
 
Thanks everyone for the replies; they are much appreciated and I'll share them with her later this morning. We have a PT appointment for her at noon and I'm sure we'll be discussing her recent scare. To Warrigal's point above, we are definitely icing the joint regularly and keeping it elevated whether in bed or on the couch. And, as Butterfly noted above, the Bonesmart.org website has been a big help. I believe my wife will be registering so that she can talk with others and share her thoughts in the member forum. We're also following the advice from that site and also at the hospital about staying out ahead of the pain. As someone told her, don't be a hero in this and try to "tough it out". You're not doing yourself any favors. That said, she's been able to take the minimum dosage of the pain medicine, albeit on a pretty regular basis during the day. Ah the joys of growing older. Thanks again everyone. I'll report back in this thread to let others know how her knee progresses and how this impacts our lives.
 
My wife had another PT session today and the therapist was pretty blunt, saying "this is going to hurt." She didn't pull any punches, telling my wife that she had to work at this every day, even if it hurts. She was crying on the massage table we have set up in our office for her rehab. A discouraging day, in that her range of motion was measured at only 65%. I can see that I'm going to need to be tougher on her on those days that the therapist isn't here.
 
Alls I know is that it takes quite a bit of time for the knee to bend with having to be on it and all. I wish the best possible recovery for your wife.
 
Bobw235 said:
My wife had another PT session today and the therapist was pretty blunt, saying "this is going to hurt." She didn't pull any punches, telling my wife that she had to work at this every day, even if it hurts. She was crying on the massage table we have set up in our office for her rehab. A discouraging day, in that her range of motion was measured at only 65%. I can see that I'm going to need to be tougher on her on those days that the therapist isn't here.
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I don't like the sound of that therapist. My program never involved pain like that.

Do you have access to a heated pool? I really loved those sessions and was able to move much more freely in the warm water.
Another useful device was the bicycle. At first just a rocking motion on the pedals, later 5 - 10 minutes of cycling.
 
Warrigal said:
I don't like the sound of that therapist. My program never involved pain like that.

Do you have access to a heated pool? I really loved those sessions and was able to move much more freely in the warm water.
Another useful device was the bicycle. At first just a rocking motion on the pedals, later 5 - 10 minutes of cycling.
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We do have a bike and she's done a bit of back and forth on it, but no way she can do a full cycle yet. Doctor said no water for a few weeks. Staples come out on Friday.
I worked with my wife a bit tonight. We have a massage table and I supported her knee as I lifted it as much as she could take. It's so tight right now. Will keep at this from here on a few times a day, followed by ice and elevation.
 
My wife had a real dose of reality today in her talk with the orthopedics nurse from the hospital where she had the surgery. The message basically was "you're not where you need to be and you need to fight through the pain. We know it's tough, but you have to do it. Take more Oxycodone before rehabbing the knee, but you need to do this."

She burst into tears afterwards, frustrated and scared. But, it got her doing more in the aftermath. The nurse kept stressing you need to work through the pain and get the flexibility back in the knee.

This is going to be a long process. Stitches come out tomorrow.
 
Bob - So sorry to hear about your wife's rehab issues. All of us on here are pulling for a complete recovery for her. In the mean time, just give her our love.

Hoot
 
Hoot N Annie said:
Bob - So sorry to hear about your wife's rehab issues. All of us on here are pulling for a complete recovery for her. In the mean time, just give her our love.

Hoot
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Thanks, I'll do that. For all the research she did beforehand, I think this really caught her by surprise. Just a few minutes ago however, she was able to dangle her leg off the bed. This was something she'd not been able to do previously, but after talking to the nurse she took another dose of the oxycodone and maybe it made a difference. I knew the pain of shoulder rehab, and believe me some sessions brought tears, but this seems worse.
 
Bobw235 said:
My wife had another PT session today and the therapist was pretty blunt, saying "this is going to hurt." She didn't pull any punches, telling my wife that she had to work at this every day, even if it hurts. She was crying on the massage table we have set up in our office for her rehab. A discouraging day, in that her range of motion was measured at only 65%. I can see that I'm going to need to be tougher on her on those days that the therapist isn't here.
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Bob, I would check with your doc about this. As Warri said above, a week out is too early to be worrying about ROM, and PT isn't meant to be the Spanish Inquisition. I would ask the doc if this treatment is in accordance with his wishes. In my experience, many PT people are way overzealous. PT should not make her cry in pain -- ever. With my hips, my doc was VERY clear that in the first weeks, movement was to be gentle and not stress the new joint. I was supposed to walk, but not very much at a time. I was also clearly told that if something hurt much to do, I should STOP doing it. I was also told that the tissues have to heal and that can be a slow process. I can't imagine that anything causing her that much pain at this early stage can be good.
 
Butterfly said:
Bob, I would check with your doc about this. As Warri said above, a week out is too early to be worrying about ROM, and PT isn't meant to be the Spanish Inquisition. I would ask the doc if this treatment is in accordance with his wishes. In my experience, many PT people are way overzealous. PT should not make her cry in pain -- ever. With my hips, my doc was VERY clear that in the first weeks, movement was to be gentle and not stress the new joint. I was supposed to walk, but not very much at a time. I was also clearly told that if something hurt much to do, I should STOP doing it. I was also told that the tissues have to heal and that can be a slow process. I can't imagine that anything causing her that much pain at this early stage can be good.
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I think this is what's so difficult about the recovery, conflicting advice. Online advice from Bonesmart.org seems to suggest what you and Warri have said, namely that it shouldn't hurt this much. Then she had a call from the orthopedics nurse today that left her in tears. The nurse essentially told her to increase her pain meds as a way to fight through the pain of rehab, stressing that it's crucial for the knee to not develop adhesions. The nurse told her she needs to fight through the pain, and that the Oxycodone is there for that reason. This is nothing like her spine surgery two years ago.
 
Bobw235 said:
My wife had a real dose of reality today in her talk with the orthopedics nurse from the hospital where she had the surgery. The message basically was "you're not where you need to be and you need to fight through the pain. We know it's tough, but you have to do it. Take more Oxycodone before rehabbing the knee, but you need to do this."

She burst into tears afterwards, frustrated and scared. But, it got her doing more in the aftermath. The nurse kept stressing you need to work through the pain and get the flexibility back in the knee.

This is going to be a long process. Stitches come out tomorrow.
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Sad to hear she's having such trouble and pain Bob, hope the medication helps and she can lower the dose quickly. I'd be in tears too, hope she feels better soon and is not in too much pain from the stitch removal. Hugs and best wishes. :love_heart:
 
Hi Bob,my situation was different from your wife,but wanted to tell you what I went thru
I had partial right knee surgery in '04 because I couldn't bend my knee all the way back,was in a lot of pain. My surgeon suggested I buy a cane before surgery to get use to it,which I did.I had surgery at local hospital where I worked,was out of bed the following day for my 1st PT session.The first thing I had to do, put a sheet around my knee&pull to see if I could move it back,that was painful.
I went to rehab for a week,I was very determined to keep a positive attitude, do the exercises my therapists asked me to do. I remember seeing other patients giving up&not doing their exercises because it was too hard or painful.
After rehab,I did out patient therapy at the hospital,my therapist gave me exercises, which I still do every morning. As a life long walker,the exercises help limber up the knee before I go on my 1st walk of the day. I continue to elevate&ice the knee sometime when it gets sore. 13yrs later,I have no regrets having the surgery
You mentioned your wife is taking Oxycodone,its a VERY ADDICTING DRUG. I hope her doctor has prescribed the right dosage for her. I say this because I was a pharm tech at the hospital,knew people who became addicted to it. I only took it twice during my recovery Sue
 
moviequeen1 said:
Hi Bob,my situation was different from your wife,but wanted to tell you what I went thru
I had partial right knee surgery in '04 because I couldn't bend my knee all the way back,was in a lot of pain. My surgeon suggested I buy a cane before surgery to get use to it,which I did.I had surgery at local hospital where I worked,was out of bed the following day for my 1st PT session.The first thing I had to do, put a sheet around my knee&pull to see if I could move it back,that was painful.
I went to rehab for a week,I was very determined to keep a positive attitude, do the exercises my therapists asked me to do. I remember seeing other patients giving up&not doing their exercises because it was too hard or painful.
After rehab,I did out patient therapy at the hospital,my therapist gave me exercises, which I still do every morning. As a life long walker,the exercises help limber up the knee before I go on my 1st walk of the day. I continue to elevate&ice the knee sometime when it gets sore. 13yrs later,I have no regrets having the surgery
You mentioned your wife is taking Oxycodone,its a VERY ADDICTING DRUG. I hope her doctor has prescribed the right dosage for her. I say this because I was a pharm tech at the hospital,knew people who became addicted to it. I only took it twice during my recovery Sue
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Thanks Sue. The Oxycodone does is 5mg, but she's allowed to take one to three tablets every four hours. She's been primarily on one tablet and doesn't need them at night. Because she's having so much pain/stiffness right now, the nurse suggested she take two or even three tablets before her sessions with the PT. She's going to try two for her session this morning and see if that gets her through the pain. She was stretching this morning and I thought she made some progress, but the knee is still swollen after two weeks post-surgery. The nurse yesterday also told her to start taking an anti-inflammatory to help with the tissues. Staples come out this morning. That may also help.

We're fighting through this, but have come to realize that this is going to be a protracted process. I think it's good that the nurse was so blunt with her yesterday.

Appreciate your words of advice.
 

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