Hi Jan,
I did not have a TKR, only a partial knee replacement - but the principles of recovery are the same - even though we are all different in how we recover.
Understand one thing - this is butchery - 1st order butchery !
Mine was right knee, medial compartment. I had a general anesthetic. I have a pre-existing medical condition, a heart arrythmia. I am on Warfarin (Coumadin) for life. I was operated on and cared for by a surgeon as an NHS patient in a private hospital. I just give you this background as an outline to show the challenge I presented my medical team.
I was operated on on 6 Nov 2015, home after 3 days, stitches were the staple self disolving type. Dressing removed on 19 Nov 2015, return to hospital for PT review on 21 Nov 2015. Driving my car again on 29 Dec 2015 and on 26 Jan 2016 back at work driving a bus.
The only PT I had was during the 3 days in hospital and that was intensive - it was more like (boot camp) training in all the exercises I'd have to do at home. At discharge I was given a booklet explaining what had happened and what exercises had to be done, when, and their frequency. Surgical and hospital policy was that the patient had to achieve a 90 bend in the knee before discharge.
The most significant thing you can do as an act of self help is what I did - get the leg muscles strengthened, lower and upper leg, prior to surgery. In other words present to the surgeoan a leg with the best possible strength in it as you can - all ready for him to butcher. YOU WILL need those strong leg muscles to work for you during recovery and rehab. I went once a week to my sports injury massage therapist for her to work on my leg.
NEXT - as soon as you have the dressing off and it is confirmed there is no infection I went back to my massage therapist for her to start breaking up the scar tissue. She did this by gently massaging the incision line itself and all around it. THIS IS VITAL. She showed me what to do myself at home and recommended I use an Aloe Vera Gel.
The point is this - if the scar tissue forms it will make your exercise program very painful and maybe even nearly impossible for you to get the bends and flexion you need to walk properly again.
I decided to dedicate myself time at home exclusively to exercises and rehab. I did all my exercises exactly as instructed every day - WITHOUT FAIL - you have plenty of time as I'm sure you will realise. I was at it 5 times a day. I was on crutches continuously up until 29 December, very, very gradually weaning myself down to one crutch and then none. Then as soon as I could drive I tested myself along the (I live in Cornwall) South West Coastal path, hilly, rugged and very uneven. Very tiring, very uncomfortable and mildly painful but good exercise.
I am one of those who likes to know things, yes, I knew why I was doing exercises and rehab PT but I wanted to know what it was doing to the inside of my leg. I went onto YouTube, and typed in the search box something like " exercises after knee replacement". there were shedloads of short videos which explained it all and gave me much more confidence in what I was doing.
Yes, always adopt the RICE practice - Rest, Ice, Compression and Elevate, . Make sure your leg is raised, I went 2 pillows high and just used large packs of frozen peas. I never put a pillow under my knee, rather my heel on a pillow (or cushion), that way the knee joint stretches. Sleeping for me - I slept when I could, which wasn't often - not so much from pain but the toxins inside me from the GA made me continuously dizzy. Every time I put my head back I became dizzy. It wore off eventually. Because of the Warfarin I am severly restricted as to painkillers I can take - in hospital morphine and tramadol didn't do it for me - I ended up staying with CoCodomol 30/500. Plenty of constipation so a good fruit diet is advisable if you are that way inclined.
Your exercises will all be different, all aimed at producing a different result. I found that sitting on a dining table chair (I have one with arms on ) and used that to practice my heel slides was excellent. also, from that position I was able to rest my heel on the arm of a lounge and press down on my knee just above the knee cap, and keep pressing it this helps you get flexion. ( a straight knee). Heel slides are illustrated on You tube and are vital to help you get the bend. to get anywhere near normal you have to aim for 130 degrees bend in your knee. Try it now, sit on a dining table chair, firstly sit with your bum right back then slide your leg back under the chair. Then sit in the middle and do it again and then sit at the front of the chair and do it again. Notice how in each seated position will give you a different bend in the knee. Another trick to help straighten your leg is to get a large towel roll it up, length wise, put your leg out straight, put the rolled towel under your foot and pull it back. This should have the effect of straightening your leg.
These explanations are probably not very good - do go to Youtube.
Can't think of anything else Jan - except - may the force be with you.
Let me know how you go !
John
I will come often! xx
- not just on my knees, just unlucky - this is about number 20 - and I am just so tired of the whole thing, but I've got this one, and then the other knee- and even a few more needed after that, so , hey ho. Here we go! lol