Left TKA recovery different from Right TKA recovery

Bones, joints and muscles
1

Hi I am 5 weeks post left TKA.  I am discouraged.  2.5 years ago I had my right knee replaced and by 5 weeks post op I was CRUISING.  This Left TKA is MISERABLE.  I had this left TKA done as a same day surgery, so surgery in the morning & I was home by 3:30 PM.  The stupid block that they used wore off at about 5PM.  The day after the surgery my leg turned BLACK from bruising and the entire leg was so swollen that you could have bounced a quarter off of it.  I am a surgical nurse, so I understood that I had one or 2 small vessells that were oozing and knew the bruising would resolve.  However, with this knee, I am in a tremendous amount of pain--all of the time.  I am going to therapy.  My range is great.  Within the first 3 days of surgery I had 110 degrees of flexion and 0 degrees extension.  At 14 days post op I had 135 degrees of flexion, still 0 degrees extension.  My orthopedic history is extensive and Ihad had over 25 arthrotomy procedures on my right knee prior to having it replaced 2.5 years ago.  So I am a veteran.  I could get range of motion in my knee standing on my head.  It is easy!!!  I did have a lot of swelling psot op this time, but I have had to get the range back in nmy right knee sooooo many times, that I simply pushed through the swelling and pain.  so my range is GREAT.  But the pain is not great.  And I wam walking with a LIMP, which is completely unaccaptable!!  With my right TKA I was walking with no limp, no crutch, cane or any assist device at 9 days post op.  This time I ditched the 1 canadian crutch, that I used immediately post op, at day 5 post op.  As I said, I have great range, I have been doin leg lifts since day 3 post op.  In physical therapy I have no issue with any of the excercises.  However, I am still in an incredible amount of pain and I LIMP.  My surgeon is an excellent technician, but has the personality and empathy of a bar of soap.  He is of the opinion that TKA's should be done outpatient (same day surgery) because you shouldn't be in the hospital unless you are sick and if you are a healthy patient going into your TKA, you are not a sick patient when it is done--so home you go.  I was up walking 300ft within 30 minutes of getting back to my room (doctor's orders :-)>wink.  I see my doc on the day after tomorrow and I know that when I describe the amount of pain that I am still having he will just look at me (or through me) & tell me that I am only 5 weeks post op.  I also am  100% sure that he will want me to kick up my PT and general excercise level.  

when I had my right knee replaced (different surgeon, whom I love & respect, but he moved out of state), he wanted me to  take things slower than I did.    For instance, he insisted that I wait 12 weeks post-op, before I started working my green broke wild mustang.  However, being a open knee surgery veteran I did not take it easy and pushed myself and had a GREAT result.

When I asked the surgeon that did this knee when I could start working my newly acquired green broke wild mustang he said: "why are you asking me that, when you feel like riding, ride."  As I said, this surgeon seems to have no empathy nor personality.  He is however, well known for his surgical skills and is considered "the revision guy" where I live.  I have refered 2 friends to him that needed their 4th revisions on their knees.  Both of my friends had infected femurs & tibias.  My friend's surgeons that did the 1st replacement and the revisions (different surgeons for primary tka & revision tka's--all of the surgeries were done in different states from where I live) told them that short of amputation, there was nothing that could be done.  They called me and I got them into see my surgeon "the revision guy".  My surgeon performed the 4th revision on both of my friends and they had AMAZING results.  My surgeon acted like these type of revisions were absolutely a piece of cake.  I relay these stories, because, this surgeon is a gifted "cutter".  However, I know that he will have no advice for me as far as me being discouraged at being 5 weeks post op and still having a ton of pain, still taking narcotics around the clock on a schedule and still LIMPING.  

Folks tell me that I have unreal expectations for myself.  But I do not believe that as I had the same expectations with my right TKA and pushed myself and had a GREAT result.  I am not one to sit on my butt and wait for things to happen.  I believe that I need to be pushing myself to make them happen.

As I said, PT is fine (very easy), I am icing, taking my narcotics (which I HATE).  I just cannot seem to get past the pain and the LIMP!.  My physical therapist wanted me to "chill and baby my leg this last week" (I did that as much as working full time, taking care of my parents, 5 horses, donkeys, goats, 6 dogs & cats allow.  It about drove me nuts as I am not one to baby injuries or rehabs).  I have therapy again tomorrow.  My therapist,  said he would evaluate things after my week of "chilling" and if things hadn't "turned around", he would crank things up and see if we can't "work "it" out of the joint".  I love & trust my therapist and he has YEARS of experience.  So we shall see what he says.  Personally, I do not believe that "chilling & babying my knee" is the right thing for me.  But I did it and will do whatever he thinks is best.  

Are there any knee veterans out there (multiple open surgeries and rehabs) that would have advice other than what I am doing.

Thanks

Personally, I think things need to be "cranked up".

2

Wow, I am amazed. It sounds like you are doing great! Even breaking records!! I'm 3 weeks out and can't get past 80 degrees on my flexion!! You have been through this before so had an idea what to expect, although I know every surgery is different. I still have a lot of pain when I walk with very little bend to my knee. I also have a huge ant of swelling. I'm just encouraged by your post that you have done do well in the past. I hope to do so well!!

3

Medical professionals are the worst patients? To me, your doing mighty fine! You were fortunate with your first tkr so niw you're not so fortunate. Just do what you do and take the painkillers, rest and eat clean. And maybe try to manage your expectations! The recovery process is not a race! X

4

I have only had a right TKR , but today, I did talk to a man that had two TKR's and he said the left knee repaired just fine, but the right knee (2nd TKR) never quite healed right. It doesn't have the bend that the left knee has, and his pain comes and goes. I think each surgery is unique in its own way. I hope this helped, and maybe you are limping because of a hip and not necessarily your knee.

5

Lisa, I am sure you will get there. The bend is gradual and will increase with therapy every day. Hang in there and do your exercises. I am 7 weeks into it, and no longer use a cane. Walking very normal with no limp at all.

6

Desert Rat - first I'm really curious where you are located, I'm in the Vegas desert.

Here are my thoughts, based on what you've shared and my own experience. The recovery from your first surgery is nothing short of unheard of. You were very fortunate. Your second one, is also relatively remarkable. Having the bend you have and being able to straighten it so well is something a lot of people on here would rejoice about. The pain is something that most of us still have to some degree.

I hada a bilateral TKR while I was living in India, and my doctor didn't have much more bedside manner than yours. But they had me stay in the hospital 6 days after my surgery. I was still using a cane (mostly because of stability and to let people in the crowds know I was not your normal white gal walking around. It also served me well to stop people from getting in my way). My left leg healed up really nicely (this was the one that was in the greatest dires before the surgery). I am still, at 22 months post op, having problems with my right knee. But that's more because the knee cap is bad.

-Mo

7

Wow! what a frenetic post.

You can't have it all, do what you are told if you want a good Longterm result.

What on earth is the rush rush rush.

Slow down for God's sake, you might think you are Superman, I can assure you, you are not.

300 ft within 30 mins of getting back to your room? Now that is just plain silly.

please be a sensible grown up,mand do what you are told, rest the poor knee and give it a chance.

There are no medals for being a stoical idiot.

Sorry, but knee surgery is too important to ruin by not doing what you are told.

8

Hi my first tkr left leg was a nightmare as far as pain levels go,I get it under control and I limped. I even put a long mirror up and walked up and down the room watching myself trying to walk without a limp!!! It took me about 5 months. Pain wise It still bothers me sometlmes 12 mths later, ligaments tendons muscles all need gentle regular exercise, note the Gentle!!!!!! My second tkr 6 wks ago has been great ,I don't have the pain or limp with this one. I don't understand why your going at it like a bull in a China shop,do you not realise its major surgery!!! You can't rush the body's healing process, you'll have a far better outcome practising patience and tolerence

9

Good answer, chrishappy. I agree . The doctor and my family said "take your time healing." It is well worth it. The body heals itself slowly.

10

Take your time. Dont rush it.

11

actually this message was for desertrat5. I must have pressed the wrong button.

12

Boy o boy.... Pain is a real challenge.  My therapist helped with breathing and focusing exercises.  It seemed to help.  I hope you got a lot of your frustrations out by writing your post, yes, you've been thru a lot, but to me it also sounds like your doing preset darn good at your stage of recovery.  Breath breathe breathe, I'm 4 1/2 po, bend is 104 n stretch is 4 .  I'm still working at it, still have pain, know I will get there, I've learned a whole knew respect for the word " patience ".   Best of good health to you