Knee Replacements

Bones, joints and muscles
1

Hi All

Well l just got told last week l need both knee's replaced. My 1st will be done in august. I just had both hips replaced one in dec lat year and one in feb. I was not recovering as fast as l hoped and when walking my knees were getting sore. I went back to hospital and its been confirmed l need both them done. My doctor says its more painful than hip replacements and the pain lasts longer.

Can anyone give me some advice is it very painful? How long am l in hospital for? And what the recovery like.

I am 43 and reasonably healthy and recovered well from my hip replacements if it was not for my knee's holding me back.

Thank you

Laura. Xx

2

Hi Laura

Firstly let me say that knee replacements are more trouble than hips because knees do heaps more work. I had my tkr's done together and it's been a hard slog. My knees are 14 weeks new and still give me pain, my balance is poor and the exercises required are often uncomfortable to do. BUT I am hopeful my new knees will deliver me better outcomes than my stuffed old ones, which were full of arthritis. It aint easy but nothing worthwhile has ever been for me. Best wishes from Sydney. Lyn

3

Had my right hip replaced in 2009.  Four days hospital then 6 days rehab facility.  Got home and started with a physical therapist, gym and therapy pool...six days a week, five hours a day.  Completely recovered and rehab'd in six weeks.  Done...back to work.  No cane, no drugs, no nothing.  I was 61 at the time.  I'm a rehab freak so I take it very seriously.  The therapy pool was the key...full range of motion with no weight in the water.  Gotta get your quads and glutes back to normal after they cut them.  Not easy but necessary.

Left total knee on March 10th of this year.  I was warned beforehand by the true experts (MDs, RNs, NPs) that the knee would be a whole different animal...they were absolutely right.  The pain is absolutely off the charts...and I've had four kidney stones...although, in my case, it was bad because I'm very resistant to opioids.  10mg Percocet plus 10mg Flexeril had little effect on the pain.  With a lot of effort, I got off the drugs in four weeks.

Starting probably in week 2 (after you see your doc for your post-op), you will begin physical therapy.  The goal is to achieve full range of motion defined as zero degrees when straight and at least 120 degrees when bent.  They will measure you when you start.  I was -14 / +84...lots of work to do.  After 9 weeks, I was -1 / +128...I'll finish this at the gym because, again, you have to rebuild your quad after they've cut it.  You will have very little strength in the leg and must put in the effort to rebuild the muscles around the knee.  Stationary bike, leg presses and curls, etc.  Gotta do the work or you will never fully recover.  Sometimes painful?  Yeah...suck it up.  No excuses.  Do the work.

Your knee will look more swollen than the other one for up to a year...maybe more.  You will hear pops and clicks...normal.  Gotta get your strength back.  Biggest friend? ICE!!!  ...and lots of it.  Plus you have to do all of this s..l..o..w..l..y.  Remember my six weeks for the hip?  Forget it.  Minimum three months to start feeling anywhere near normal again...and then you still have a way to go.  If the knee starts swelling, it means you pushed it too much.  Back off, ice, rest.  Don't push this...you cannot push a knee rehab.  It takes time and patience. 

Question...  Do you really need them replaced?  Right now?  I had four knee scopes (two each side) and did lots of SynVisc (like oiling your knee...lasts up to a year) before running out of options.  I'd get multiple opinions on whether you really need two TKRs at this moment in time.  If you're not fully recovered from your hip surgeries, I'd spend time in a therapy pool rehabbing those and getting your legs as strong as possible before taking this on.  Again...therapy pool.  Takes all the weight off your knees.  Get as strong as possible.  I had one knee done; I can't imagine what two would be like.

Again...  Very painful (way more than the hip)...long, slow, patient recovery...gotta do a lot of work in rehab both during and after PT...get to 0 / +120 and then work on leg strength...don't push it or the knee will swell and set you back...get off the meds ASAP but use them when needed.  When you feel like giving up, remember: "Never give up! Never surrender!" - Tim Allen, Galaxy Quest.

4

Knees are whole other ball game from hips.....hips are immediately liberating, small muscle op pain and you are on your way, it marvelous to have that ease of movement free of pain! Knees on the other hand are super rewarding when you finally get there because of all the hard work you have to do first. Nothing beats pain free joints but knees are not that to begin with and without the exercise regime you will not gain the rain gear of movement. Brace yourself knowing that it will be worth it. Good luck

5

Lol I don't check auto correct should read range of movement not rain gear!!!

6

Hi Lors!

Knee replacements ARE pretty involved because there is A LOT of fixin'going on during surgery! In my opinion they are AMAZING because they DO get rid of terrible pain!

Mine were last June and last October. Each surgery was different even though both were done in the same hospital by the same surgeon.

In a nutshell knee replacement surgery is two to three days in the hospital. You will be standing probably that evening of surgery and walking a bit in the morning with nurse's help and a walker, of course. You will probably be given blood thinner shots and might have a nerve block to help with pain. There probably will be additional pain meds given as needed. You may have stitches or staples.

Your leg(s) will feel heavy and cumbersome, and swelling is common. There is a lot of healing going on as your body gets busy dealing with the trauma that just took place in surgery. You will probably be instructed to drink lots of water to rid your body of toxins from pain meds and anesthesia.

Keeping a positive attitude helped me A LOT! If you are a believer I think prayer really helps, too! Thinking about HEALING and PATIENCE with yourself allows you to see progress each day.

Taking needed pain meds allows you to be able to move which increases circulation and also helps you get stronger. I had six MONTHS of PT between my two TKRs, but every situation is different, and different countries and different insurance companies handle things in different ways.

You will be instructed to ice and elevate your surgical leg(s). Both of these are important. It takes some getting used to, but walkers are helpful in getting you moving. You may graduate to crutches or a cane in a few weeks. Some hospitals provide things like a walker, and some organizations provide you with other things like a raised toilet seat etc. Again, each situation varies.

I walked around the house frequently then iced and elevated my legs. I tried to do as many exercises as I could and worked hard at Physical therapy sessions. You will probably learn about proper walking techniques and practice them in PT sessions. Exercises given will target muscles and probably will provide practice with balance, too.

You may feel that you are moving at a snail's pace and may get frustrated with yourself. You may have swelling that prevents you from bending g and straightening your leg(s). This is all VERY NORMAL!

Be patient with yourself!

Look for small gains, and congratulate yourself often!

Sleep at night may not come too often. Try to nap throughout the day. Drink plenty of water and eat well. You will get stronger as you do your exercises and as your body heals.

Around six weeks I felt pretty good and felt stronger. Around nine weeks I began to sleep better at night. I drove at about eight weeks post surgery.

Having my TKR surgeries gave me back my life. I can now stand in line for an hour and a half at a political rally without pain. I can shop, walk, garden, shovel snow, and play with our granddaughter without wincing in pain. I can keep up with my long-legged husband as we go from parking lot to restaurant door, and I no longer need to plan sit-down times as I go about my day.

I think you will be VERY glad you decided to have surgery! It is work dealing with all the recovery, but the benefits of knee replacement surgery, in my opinion, far outweigh the work required!

Wishing you much success on your journey!😊

7

Laura, I've not had a hip replacement, but I did have both my knees replaced on the same day. I don't know that having them done at the same time made it any more difficult or not - I think having one at a time would have left a great deal of strain on an already crumbling knee. I was 50 when it was done, and it's now 20 months later. My aunt has had both and it does seem like the knee was a quicker recovery. But you seem like a fighter and one determined to do the work, which will help. At 6 months I was using a cane and able to manuever stairs. I was in India working and navigated the trains for a 4-hour ride to visit friends in Delhi. There was still considerable swelling, actually, nearly a year later I was still known for putting ice packs on it.

The pain is real and it's constant. Sleep is seriously reduced because of it. Somewhere by the third week, I could feel it decreasing and sleep was getting easier at night, but it was still some time down the road before it was good.

Mo

8

I know your reply is to Cheryl but thanks as it's helped me too I'm 6 weeks post op just the one knee, it's a slow process I want to run before I can walk so I'm very impatient and frustrated, but your post have helped I've told myself off and will get there in the end. Good luck Cheryl 

9

Sorry to have to tell you but yes it is more painful and recovery is longer. Some of course are better than others and you are young so probably stronger than most.The key thing I think I picked up on is to get things like thighs and upper body strength as strong as you can.hopefully unlike me you are able to have anti inflammatory meds and the spinal meds whilst under.

I wish you well C

10

Hi. Think you'll get the gist of the way this thread is going!! I had Hip replacement 8 years ago, recovery fairly quick. Apart from 2 dislocations at 4 and 6 month, OMG the pain!! I never even knew I could scream!!!

Had knee replaced ten weeks ago and I'm nowhere near recovered. I cried with pain, frustration and despondency every day for 3 weeks. At night I couldn't get comfortable, couldn't stand even the weight of the duvet on my foot as it would just tip it one side or another and that would pass right up to the knee. But, at 4 weeks I just started to turn the corner. You have to do a huge amount of work to rehab yourself. But, it does get better. I see improvements every single day.

I wish someone had told me the truth about the knee replacement before I'd had it done, not to put me off but to prepare myself, as I immediately equated the intense pain with the fact that something had gone terribly wrong.

Best wishes to you in your journey.

11

Hi

Yes l definatley do need them replaced right away l am with bupa and the hip and knee specialist is an expert in his field. I saw the xrays and he showed me how bad they really were. He said l have no other option as they are to damaged especially the left one. He kept saying sorry l wish there was something we could do to prolong it but its to late and right now l have no quality of life l can harldly walk a small amount without ending up in agony. So yes l need them and would rather they were done so l could get on with rehab and get a normal life back.

Could not have came at a worse time as we just found out my mum has cancer in her lung a mass and another lump and we are un the process of finding out what treatment she can get snd a pet scan will be done this week to find out if its anywhere else. I have had a terrible 6 years with my life and just getting better after my 2 hip repllacements which l had 8 weeks apart. He said he is going to do one at a time as its to much for me to get 2 done at same time especially when l am still recovering from my hips.

Thanks for your information it sounds really scary if the pain is off the charts. I feel like l have been in constant pain for about a year. I am tired of being like this and to face it all again seems so much. Its ok saying suck it up l am trying to but right now l am worried to death about it and more so my mum. I will just have to get on with it l guess.

Thanks

12

Thanks for all your help still teally scared but l an brave thats one thing with what l jave been through all my life l am used to hospitals but l was in total agony the days after my thr's l just could not imagine anything being worse pain as l was crying in agony and hyperventilating until they gsve me a morphine shot. And l was on morphine tablets. I still take tramadol and codine hust now and 1 oxy if needed. I feel exausted being in pain snd knowing there is worse to come pits the fear of death in me. I need to be there for my mum too which is worrying xx

13

Tkr is nothing like hip replacement. The pain and the recovery time is a lot longer. But the pain killers,icing, pt,and elevating are a help. Just don't get discouraged and compare it to your hips.it's a whole new ball park. A good year before everything is back to normal.

14

@lors23. I had a BTKR in October and spent 3 nights in the hospital. They wouldn't let me go home because my house has all the bedrooms and full bathrooms on the second floor. I was sent to a rehab facility for 8 days where I had physical therapy for 4 hours every day. After I got home I went to out patient PT for 2 hours a day 3 days a week for about 6-8 weeks. The PT would have only been 1 hour if it was 1 knee.

I scheduled my pain meds and followed my schedule to keep ahead of the pain so I didn't find the pain to get all that bad. If you let the schedule get away from you, then you'll be really hurting. If the meds say every 4 hours, you need to set your alarm or watch the clock. If the meds don't work, you need to call your surgeon and ask for different meds. My surgeon ended up giving me a fentanyl patch that worked wonders and I even asked him to wean me off 2 weeks early. 

I would advise you to maintain or increase your upper body strength prior to surgery. I wish I had before my surgery just to make it easier to move around. I have a hip replacement coming up in September and I'm doing a lot of circuit training and even some Silver Sneakers (even though it hurts) to build up my muscles.

15

Great point about upper body strength. I too had a bilateral and the strain on my arms and abdomen caused issues I hadn't forseen - including an umbilical hernia and my hands were going numb [caused concern about needing carpal tunnel surgery again, so I revised my movements].

16

Understand that it was "off the charts" for me because I am resistant to all the normal opioids (Vicodin, Percocet, Oxycontin, etc.) that work very well for others.  If you had success with certain pain killers for your hip, try them first...for this you may just need to have the doc bump up the dose.  Again. pain killers are very effective for the knee in the vast majority of cases...just not for me, so that shouldn't scare you.

"Suck it up..."  Unfortunately, there are days where that will apply.  After a while, It just was do depressed over the fact that I was sleeping so much.  My doc told me that it was normal...body is using all its energy to heal itself.  Believe me, it's really tough to get out of bed sometimes.  Find a phrase or an image in your mind that motivates you to stay the course.  Because it's not a quick recovery, the pain and the length of this can wear you down.  Don't let it.  Eat healthy!!!  Stay strong.  Do the work.

I don't know where you live but please research "tincture of m.......ana".  My daughter had Stage 3 (advanced), Type 3 (aggressive), BRCA-1 (mutated gene) breast cancer at age 35.  Chemo doubled its size.  Started on the tincture and titrated up to 8 drops a day (a "drop" is the size of a grain of rice)...in four weeks, it was gone...totally gone.  Double mastectomy pathology showed zero cells and zero lymph nodes.  Just had her big set of scans yesterday...almost 3 years since onset.  Zero.  She's still on one drop a day as a prophylactic.  We personally know of six other people on the tincture who are either in full remission or totally cured.  Do the research; consider your choices.

17

Ahh yeah l see l am allergic to NSAID's but am fine with opioids l can take morphine and tramadol and strong codine. But l understand you know. I did all my pt for my hips everyday and recovered fairly quick apart from when l started pushing my body to walk long distances my knee's would end up in agony l thought it was somnething with hips at first now l know so the walking has stopped for the moment. I can drive fine and live in Scotland and drove to england for a small break in York with my hubby but lasted a day as my sleeping is all to pot. And l can only sleep in my own bed for so long them move to couch half way through night. And when l got to the hotel l could not sleep at all which made me to tired to do anything so just frove the 350 miles home.

I have a month to go to learn about it and reas some of your stoties. As well as look after my mum who is 75 and l need to take her for her pet scan on 4th july and then back for outcome

Thanks for your advice though l will look into it. She is a healthy 75 and does not smoke and still works part time think thsts whybiys came as such a shock her having cancer as l.just never expected her to get ill. But l know the circle of life well enough l have had my fair share of hard tests myself. I was really ill in 2004-2005 l spent a year nearly in hospital on deaths door because of a blood condition and my orgins started sgutting down. Its a miracle l am here. And have a great husband as well that has been there all the way after that year later we wanted a family but tht was not to be either after 3 failied attempts at ivf and thn finally a posative one and fell pregnant but lost it at 7 weeks got 2 years to get over that and find acceptance that l was nit gonna have a family to get told l need new hips. Thats dine now and niw onto knees. So i would say l am a strong person and everything bad thats happened has mafe me stronger. I can deal with me being ill but you always rgink yiur mums gonna be there and thats ny weak spot.

I have been a member of the hip forum for about a year and thank god as it was brilliant so much support and l made closes friends there. I hope the knee one is just as good as l am gonna have more questions and things as l am really scared at the moment. I still have a job as a bank manager but have been off since nobember last year. I hope to one day go back as it was a good job and they have been great with me but l have worked there 13 years.

I look forward to getting to know you all and hopefully getting your help.

Xx

18

Hi chicory I know what you mean ,I too really want to rehab and start the bending process but the pain from the swelling after doing very simple bending and straightening exercises just stop me in my tracks , swelling comes back and ice and couch are my only options,cannot bend to 90 degrees yet, thought I was doing OK then the swelling comes back I'm 3 weeks post op with the my knee minimal invasive op any thoughts Rick

19

Hi Cheryl I'm 3 weeks out from TKR and have struggled with swelling I try to do the exercises and only can bend to 80 maybe almost 90 but then the swelling and pain comes back so the next day I cannot do anything but ice did you have a similar experience ???? RICK

20

Hi Rick!

I had REALLY BAD swelling with my left TKR and hardly any with my right TKR several months later! I was surprised because my RIGHT KNEE had always been my worst knee and one that caused me pain years before my left one.

Try this: put both legs straight up on your bed headboard as you lay on your bed. You can also do this up a wall if you lay on the floor. ( It is hard for many people to get up and down from the floor, so the on-the-bef technique works better for them and ME!)

Our son is an elite athlete who runs Ultramarathons, does Crossfit and Ironman Competitions, and he REGULARLY does this following workouts.

Compression hose that reach up your thighs help, too. Our son wears them to bed most nights following races and long workouts.

Swelling is a very elusive thing. It can come back after many weeks or months. Elevating and icing help, but the two things I mentioned help me the most with swelling.

Some other things to try is drinking more water, watching salt intake, and eating bananas! Our son does all of these, too!

Athletes put great strain on their bodies. Those who have had knee surgery have had lots of trauma with surgery. BOTH groups can benefit from these additional methods!

Eventually healing takes place and body tissues quit swelling so much. Until this happens we all just need to keep finding things that work.

Wishing you much success as your recover!