8 weeks TKR with regrets Advice pls

Bones, joints and muscles
1

I'm a 49yr old male of a large 20st stature and 8 weeks on Tuesday I had a TKR on my left knee.

If I knew that the past 7.5 weeks was going to be this painful & uncomfortable I would never have had this done. All I was ever given & advised was success stories, I wish I had researched it in more detail as I would rather have suffered the knee problems I had compared to the ones I have now.

Although my PT is happy with my progress regarding leg bend of 115 & extension of -1, I come away full of smiles BUT the smile is very short lived. I still cant get comfortable, still cant sleep at night, cant sleep on my side and the pain during the night is ridiculous (I've tried the pillow in-between my legs), I have totally had enough, I'm still taking Tramadol to try & ease but now it's having little effect.

I've been walking unaided for almost 4 weeks now (by advice of my PT) but the problem I have is the swelling, the swelling just does not go down, I elevate my leg at least every 2 - 3 hours for 30mins at a time and still wear my cyrocuff for the icing at the same time. I have a sharp pain in my knee at times even while I'm just sitting still, my surgeon says there is nothing to be concerned about, again he is happy.

I do 3 x 1hr of home exercise & stretching which was advised by my surgeon and PT everyday without fail & try to push myself further each time.

I seem to have a fold across the centre of the knee which fills with swelling & then overhangs the bottom half of my knee which then makes my leg feel very stiff and heavy. My knee for pretty much 90% of the time feels stiff especially when I clench my thigh muscle. The left hand side of my knee is completely numb and the right hand side is so sensitive to touch or have any material on it, which again don't help me whilst in bed keeping me awake.

Am I doing something wrong? Will the pain ever ease? Will I be able to sleep again properly? When will this swelling ever come down? How long before I stop regretting having this procedure done? I am constantly feeling down & depressed that all that's on my mind is this bloody knee & if it will ever be "Normal"

Sorry for the long winded story and the whining, I need to know if others have gone through the same, as I know 2 people who have had the procedure done one was fully recovered in 6 weeks and the other in 8 weeks, so that's why I'm feeling so cheesed off and full of regret. It's also easier to talk to others who have gone or going through the same than ask my surgeon or PT.

Your advice would be greatly appreciated, Thanks in advance.

 

2

Forgot to add, the throbbing that is there all the time, and when in bed my leg is so restless.

3

Hate to say it, but its a helluva surgery.  Wish I had never had it done either.  Im 5 months out and still ice everyday, it still swells everyday and I still have pain everyday.  Oh, and yeah, my ortho doc says, All of it is normal. BS.

4

I am almost the twin of you! The swelling is so bad I am going for acupuncture on Monday... will let you know if it helps.

5

I was in your shoes until I found this site...at six weeks I didn't think I would ever be able to tell people that this was worth it because I would hear about people who recovered in 6 weeks after this surgery...and it can happen but....not for everyone.  

Read the posts by Chico Marx, OldFatGuy, and jenny80029...three of my favorite but there are plenty more on this site with great advice.  

I am 6 months post TKR, still have swelling, still have some problems sleeping and still have some stiffness.  But not as bad as a month ago or 2 weeks ago..and not the incredible pain I was in before the surgery.  I can now say thought it was worth it.  I am kicking up my exercise routine like I haven't been able to do for years.  It kicks me back later in the evening but I am happy.  

Have you looked at the videos of what is involved in in a TKR....this is one bad surgery.  It really does take time for most people.   I am taking the advice of the folks on this site that have been there and done it and I assume it will take a year for things to get back to "normal".  This is a tough recovery.  As Chico Marx likes to say your knee will heal when it heals, don't compare yourself to others.  

Hang in there!!!

6

I'm thinking of doing the same, also looking into cupping as well, I'll try anything. Please let me know how it goes.

7

I knew I wasn't the only one who's had bad experiences. But 5 months? Oh no, 8 weeks and I'm at the end of my teather.

8

You're not whining.  This is a HORRIFIC surgery.  Tramadol gave me restless legs at night.  Maybe you could get a mild sleeping pill or tranquilizer to help you relax and sleep?  Once I started sleeping more than 3 hrs. at night (with the help of Valium) I felt better.

I'm almost 2 years out from my right TKR and am finally glad I had it done.  Even vaguely considering doing the left knee, which I SWORE I would never do.

 

9

What you're feeling right now IS NORMAL!!!  What?  You thought this would be over and done with in 8 weeks?  Wow...you really were listening to all the wrong people.  A full recovery from a TKR takes a year...accept it...own it.

We have ALL been where you are now...all of us....well, there was that one guy who went back to mountain climbing at 13 weeks post op...never heard from him again...I hope someone used a metal detector to find the body...

Really...  The first three months absolutely suck...period...no getting around it.  Your -1 / +115 is excellent for 8 weeks.  Took me 12 weeks to get to -1 / +123.  While everyone is different, you seem to be on the good side of the curve.  The really bad pain is usually gone within 90 days; the swelling also decreases noticeably in the 3-6 month range.  However, there is always the danger of "balloon knee" on any day you push the knee too far.  It's not about distance or time...it's about the number of steps in a day.  Get a cheap fit bit...track your steps...chart your progress.

Swelling decreases very gradually over time.  You might even find that the new knee still looks a tiny bit bigger at one year...this goes away.  Clicking, popping and clunking noises are also normal.  At 2 1/2 years post-op, I don't hear them anymore.  Pain when kneeling on hard surfaces is a nerve issue that gets better looooong term but may never go away.  Has nothing to do with the knee itself.

Ice, elevate, do your exercises.  A great topical anti-inflammatory and pain reliever is Voltaren Gel (RX in the US; generic diclofenac elsewhere).  OTC pain killers include BioFreeze, Lidocaine patches and Aspercream with 4% Lidocaine...the last two are good for nerve pain.

We have lots of people saying that they regret the op in the first few months and then completely change their tune by their one year anniversary.  A very common tale.  First step is to finish the ROM work.  These will help at home...#3 is a killer!!!

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

Next, you have to take all the pressure off your knee and put it back on your dead quads, glutes and core.  The muscle rebuild is mandatory so you can walk correctly, regain your balance and then be able to do stairs...

https://patient.info/forums/discuss/post-tkr-exercising-565527

Finally, stairs...

https://patient.info/forums/discuss/mastering-post-tkr-stairs-552728

Your PT may have you doing stairs in the reverse manner to my discussion; no big deal...that's the way I was taught by my PT and I was climbing stairs two at a time without holding onto anything at 14 months.  Whatever works.

If you want to know how I felt right after my op, this was the first discussion I posted...

https://patient.info/forums/discuss/the-tkr-experience-or-wish-i-had-another-kidney-stone--524499

Yeah...rude awakening.  I thought that I would just breeze right through like my hip replacement, two shoulder impingements and more.  Boy, was I wrong...  Click on my name and then "See All Discussions" for a lot more helpful topics.

Also, print this out and hang it on your fridge...

https://patient.info/forums/discuss/the-reality-of-a-tkr-recovery-in-one-picture-626038

Welcome to the real world...yeah...I should have taken the blue pill too... 

10

I think people push themselves too much and this causes the swelling and pain , I didn’t and I can get my leg straight and bend it , my advise is to cut down on your physio , I did very little , and at 7 months I have full movement , little pain and haven’t had much swelling since about 6 weeks , but I didn’t overexercise it , also no one is over op in 6-8 wks they may have less pain than you but it takes a year . Go to a pool and do stuff gently . I was sleeping fine by 8 wks and off opioids , I found pain level suddenly decreased from awful to not too bad . Good luck , oh another thing I was told by a surgeon is that the people who have the worst pain are men in their 40’ S  and  fifties , 

11

Your doing far too much exercise, cut it down to half hour each day.

And rest more, elevating your knee with ice.

Hope this helps.

Sue

12

That is everything I needed to hear, thank you so much in describing in detail what to expect and the reality check. I appreciate the time & effort you went through to give me all this information. Thank you.

13

Try and lower your expectations based on other people's stories. You will improve. Is it better today than it was , say, 4 weeks ago? I agree to cut down on walking and exercise. If you are a heavy guy you will be putting far more pressure on the joint. It's probably not linear either. If you are twice the weight of somebody else it's likely to be 2 squared i.e 4x the pressure. In the early stages you are exercising to try and get the ROM going. Yours is fantastic at this stage and if you are getting swelling exercises are the worst thing you can do early on in my humble opinion. You can get the strength back later.

As far as sleep goes I think everyone struggles with this. I'm down to a dull ache i don't even notice by day but still haven't had a totally peaceful night's sleep. In fact the doctor gave me drug called amitriptylene which I believe is a mild sleeping/antidepressant which also helps pain in nerve endings. Seemed to help a bit.

The other issue is that you can get conflicting advice on here, from other good sites like Bonesmart and from your and other professionals. Not very helpful is it and it can leave you confused. My suggestion would be to enjoy the kindness and empathy on here and read all of the advice and decide yourself what might help, probably by trial and error. You will get better and when you do you will be better off  as I'm sure your medics would have spotted any serious problems. I reckon after three months you will notice improvements. 

I found it helpful to keep a daily diary because you tend to forget how bad it was and don't notice the slow improvements but when you look back at what you wrote about how you felt 2 weeks before you will be surprised that things have actually changed  and it gives you a boost.

Good luck my friend and we will be hoping for your improvements soon.

Dave

14

Thanks for the great advice, I most certainly have been speaking to the wrong people and I completely agree with the weight situation.

15

Hello I am 57 290lbs ( no idea what 20stone means??? I am also 6'4". Since you have never been thru this before it stinks there is absolutely nothing nice to say about how you feel after the surgery. Your situation is bad but this is my 6th time only difference between what your going thru vs what I am going thru the more surgeries you have the longer the recovery and more pain. You are doing all the right things and it may not help but patience plays a part in this as well. What you wrote is right on Monday will be 4 weeks PO. Based on my last revision ( all my surgeries have been on the L knee )at the end of the 1st month I was anxious to get out of the house go for short walks get in my car in general just wanted to be somewhat active now I hurt constantly 24/7 the best way for me to sleep is on my back sometimes the pillow just doesnt do the trick.Since this is your first ( hopefully your last ) based on my averages by the 3 month time frame you should be feeling better. If your still in too much pain I would tell the Dr. as far as what you should be doing when they are pointless all of us heal differently. If its an option a stronger pain med might help. I can relate trust me going thru this once is no fun now I am at # 6.

16

What you are feeling is normal. TKR is the worst surgery ever. I am 5 months post op and doing so much better, with very little pain. I sleep with a pillow or blanket under my knee which allows me to sleep and not be in pain. The jury is out to know if it was worth it and I will probably not have my other knee done as originally planned, having this site to ask questions and know that you are not alone has been a blessing.

Good Luck on your healing, you will get there.

17

Hang in there.. I'm 6 months out and just this week finally had a great week at work. 2 great days and 1 ok day. Thankful for the 3 days. I too was really upset,. What did I do!.. but it seems to be turning around. Hang in there. Slow down on the workouts. You got this! We got this! Try the tramadol and few hours later advail. Works for me most of the time.

18

Thank you for your advice, 290lb equates to almost 21st so we're very similar.

19

Already only finding this site this morning I know I'm on track and the advice is extremely comforting. Thank you

20

That's great news, thank you for your reply.