Four months post TKR and still difficult

I had a TKR on my left knee on May 7.  My surgeon said that everything is fine.  I completed my allotted post surgery physical therapy and they were able to get my range of motion to their target of 120 degrees.  I have been going to a gym for about 6 weeks and am exercising under the guidance of a physical trainer that has worked with knee replacements clients in the past.

I still have trouble sleeping and have difficulty walking immediately after sitting.  I am not taking pain medication other than Ibuprofen immediately following exercise.  When is this going to get better?  It is very frustrating and I'm very discouraged.  Are others having the same problems as I am?  Any suggestions 

 

I had a TKR in January and a manipulation end of March, I'm having terrible trouble sleeping still, I'm being referred back to PT as I'm still in pain, I also have problems going from sitting to standing my PT said it's weak muscles and she said it takes up to a year to recover, it's certai ly a journey xx

Natalie,

Thanks for replying to my post.  I agree that it certainly is a difficult journey and I suppose that it just takes a lot of time.  Did the manipulation help your range of motion ?  How much pain did you have following the procedure?

I hate to be Debbie Downer, but you have a long way to go to get better.....Im 7 months out and still hurting.  Seems like the more I do at the gym, the worse my knee gets.  I don't know what the answer is; Im getting a second opinion next month...

Hi Ed

You are doing well. Four months is still early, even though we don't think so! I have has 2 partial knees one last June and one in March this year. And although I was very active before the operations and am at the gym twice a week, I am in the same place as you. Moving after sleeping or sitting (even for as little as under an hour) is very painful and I need to walk for five minutes or get on the stationary bike to get past the pain.

It will get better (I too am told) as our muscles regain their strength and the knee doesn't have to take all the weight. It is very frustrating and discouraging and hard not to be. It is one area of my life that no matter how much input or gym work I do, the knee will only go at its own pace. Too slow!

Hang in there I am sure with all your effort it will get easier wit time.  Words I hope are true too.

I had my surgery in May 22/2018 and my range of motion is impeded by sciatica, l4 l5 on left. In physio since the surgery and still bend only at 90. No pain but sleeping is interrupted every 2 to 3 hours due to back. Still using a cane and my surgeon did discuss mua but we are waiting until 3 months and he is referring me to a pain management doctor who does injections for my lower back. My surgeon says to keep moving the knee and said physio is up to me. My pt has not recommended strengthening as yet until we can get more bend and straightening. I have diffuçulty walking after sitting also. I do home exercises for knee and back also. Very time consuming but does help.

Why don’t you ask dr if you can try 4hourlu paracetamol - take the ibuprofen in between ie 2 hours after it - or even paracetamol plus codeine ( separately or together as Co-codamol. I try not to take much codeine because of a bowel condition but I have tiny 20mg tabs which I can take as a top up when paracetamol not enough or I sometimes take cocodamol at night instead of paracetamol. Helps with the sleep so necessary for healing and your wellbeing! Don’t try tob be brave! My surgeon says reducing pain relief too soon is a classic mistake! 

Why don’t you ask dr if you can try 4hourlu paracetamol - take the ibuprofen in between ie 2 hours after it - or even paracetamol plus codeine ( separately or together as Co-codamol. I try not to take much codeine because of a bowel condition but I have tiny 20mg tabs which I can take as a top up when paracetamol not enough or I sometimes take cocodamol at night instead of paracetamol. Helps with the sleep so necessary for healing and your wellbeing! Don’t try tob be brave! My surgeon says reducing pain relief too soon is a classic mistake! 

Sorry I accidentally posted twice but I meant to say I’m just a month behind you and I certainly would not be ok on just ibuprofen as yet.  

I also use voltarol gel and still ice and elevate as needed and especially after exercise. 

Hi Ed

Yes i had hardly any bend, the surgeon got it to 135 but I'm at between 100/120 , so a lot better after the MUA. Yes i was in pain for about a week in my hips thighs , it was just where my leg was pulled about during the procedure I just took my pain meds after.

You are assuming Ed is in the UK or thereabouts. Most of those meds are not available in US, if he lives there. Maybe Tylenol would be about the same as paracetamol. And maybe Tylenol with codeine would be similar to Co-Codamol but I'd really have to look them up to figure it out.

The doctors here in the US are really shying away from narcotics and only giving them post surgery for a short time. My wife's doc says they re-wire the brain making it difficult to stop when you have been on them for a while.

 

Sounds perfectly on track.  It is GREAT that you're doing the muscle rebuild which will take the pressure off the knee and put it back on the once-dead musculature where it belongs.  That will take time.  Typically, people report "feeling more like themselves" around nine months.  At your pace, you may achieve that in less time.

You have to understand and accept that the whole thing usually takes about a year.  Very few avoid that fate.  Your tools are time, work and patience.

Try these ideas for sleep...

https://patient.info/forums/discuss/trouble-sleeping-post-tkr--539591

 

You are doing okay , this is all normal or even better than a lot of people  

Hi I'm 5 months ltkr and feel I'm doing well. Still not sleeping through but I was like that before op so no change there. Not taking Any meds knee feels stiff initially on waking up and sitting for awhile but then it's OK. Have the occasional quick stabbing pain right of knee this area appears to be where the pain is situated but as Chico says it takes a year to recover so stick on and you'll get there. I do weights on leg and bike but walk a lot

I try to go to the gym 4-5 days/week and use the stationary bicycle and one day/week I have a trainer to help with strengthening my legs.  I'm going back to my surgeon this week to get his advice.  Sometimes, I think that I'm doing too much exercise but I'll admit that I'm very discouraged at this point and hope for some breakthroughs soon

I would like to add Swimming or walk-in the pool. Most of all swimming: freestyle and backstroke. Minimum three x week! This was recommended by my PT in Sweden. Jogging prohibited, of course.  Exercise Bike (stationary bike) YES provided you have enough flexion “bend”. My case 60 degrees.  Not enuff!

Walking  if I can walk on a long sandy beach OK. But rather not on the busy, hard and uneven sidewalks (footpaths) here in Bangkok. 

You are doing great...

It is hard with the sleeping....I found mindfulness and full lung breathing (as done in yoga) helpful. I think the body can hold a lot of trauma in it post surgery...

You need to be really patient.

Improvements happen for ages... I am 18 months post op and there are still improvement happening with respect to the strength of my leg.

Decide how you feel more decisively at the one year mark, not before. And even then, things still continue to improve!

You may like to go to my profile by clicking on the image next to my name/my name. Then if you copy and paste you can get to the relevant page of my artist's blog. I kept a journal of my own knee replacement experience, right from before the surgery right to the one year mark..may be worth a skim through. It has a lot of useful suggestions and information. Hopefully it might be useful to you.