Hi all,
I was just wondering if anyone had redness around the knee after a TKR. Also the knee area feels warmer than the other good knee. Currently 3 weeks post op. The X-rays and blood results shows everything is normal so unsure what it is but was given antibiotics for a week to take and also advised that if it spreads then to go back asap. What could this be? Could it be side affects from cocodomel or because of a lot of walking? Any responses would be greatly appreciated. Thank you.
Swelling, heat and redness is from trauma to the tissues of your knee, they respond by becoming inflamed and tender. I'm six weeks post-op and my knee is just beginning to get to the point where I can massage it without pain. It's still warm to the touch but getting better slowly. Keep an ice pack on it and put that leg up on a pillow. Take a medication that's an anti-inflammatory like tylenol, ibuprophen or Alleve. These will help reduce the swelling.
Thank you for your kind response.
At 3 weeks you should not do a lot of walking, there is a hell of a lot of healing going on. The more you walk the more the tendency to swell (specially lower leg). Concentrate on strengthening your muscles more than anything else. and yes, elevation (you can't do that when you are walking) and lots and lots of patience. It will not and can not be rushed, if you try, you will become disillusioned and be more aware of pain.
I too am 3 weeks post TKR. I have the same problem at night but not in the daytime. Have come to the conclusion that the operatedknee does not like being under the duvet so I now try to keep in uncovered and this helps. I was concerned about this and had to go for a routine blood test last Monday and got the nurse there to have a look.
It seems that there is a lot of variability in surgeries out there. Any advice I've offered has been based upon the approach used on me. And, apparently, it's a lot different than what's going on in general. So, what type of surgery did you have? Quad cut, minimal invasive, robotic assist, etc.
How long did you spend in hospital before going home?
Where was it done? Country/state kind of thing.
Did they recommend exercises immediately?
Did dr. recommend waiting for PT?
I think this has a lot of bearing on what happens to people on this forum. My stuff seems pretty benign compared to what I read here?
Hi elent
I posted this on behalf of my mum. Her surgery was in Yorkshire and spent 4 days in hospital.
The PT gave her exercises to do at hospital a day or two later and to continue these at home.
Yesterday was her first PT visit at the hospital as they said it would be 3 weeks after surgery.
I'm unsure about what type of surgery it was part from a TKR.
Thanks for your response.
Thank you for your response Angela.
Sorry elent, just realised this message wasn't for me!
A certain amt of warmth is the norm. It can least for quite a while.what you have to be concerned about is if it gets really hot, shows any drainage other the little bit around stitches/staples or if you start running any fever at all. After my 1st tkr I started running a fever in less than 36 hrs and turned out to be a global or systemic infection. After my reviision I fell and broke my leg resulting in a plate inserted next to the bone and 8 screws put in to hold it. 8 months later the plate was removed and 28 days to the date I had heat, drainage and was violently I'll. This time is was diagnosed as epi staph. Then I have 2 months infusion of clindamycin. And 900 mg daily orally for 10 months. That quit working and the knee had to be reopened, the prosthesis removed,, another 8 weeks of infusins, a total of 4 months immobilized and t hen the new prosthesis inserted. I was immobilized for another 3 weeks then started rehab. So you can see I have a little history of having a warm / hot knee and just a slightly elevated head is nothing to be concerned about. Con d inue excercising, elevating, ice.....ice....ice drink plenty of water and be very sensible about how much weight you are putting on it at this time. Be sure and stay on your prescribed doseage and schedule of pain meds. Be patient. Don't set yorself up f i r failure by expecting too much too soon
Yes there certainly are a lot of variables. Each surgeon has his preferred technique. I did a LOT of research before selecting both my doctor and the hospital. The surgeon I selected had an exceptional number of positive patient reviews as did the hospital.
I had a total knee replacement. My surgeon is only one of two in my State of Connecticut in the USA that does what he called 'minimally invasive'. He explained that that the procedure is the same except that he doesn't cut through muscle, he goes over or around muscles, tendons and nerves. It takes longer for the surgeon to do it this way, but he believes it's much better for the patient and I totally agree. He also uses computer navigation, called 'pinless navigation'. This means that he takes measurments with a computer guided light. This does away with the necessity for stabilizing the femur and tibia with a rod through the bone which may result in a fat embolism since the stabilizing rods go into the bone marrow. Again, it takes the surgeon a bit longer but reduces the incidence of fat emboli post operatively.
I had a femoral block inserted which was guided by ultrasound minutes prior to entering the operating room. This femoral block was left in my groin for two full days post operatively and reduced pain dramatically. Upon entering the operating room, I was sat up on the side of the table and a spinal block was administered. I didn't remember anything until I woke up fully in the recovery room.
I spent three days in the hospital. Immediately after surgery, my knee was wrapped with a continual cold water circulating pad and was elevated on a CPM machine (continuous passive motion). They gave me the controls for the machine and it raised and lowered the bottom half of my leg from knee to foot. I left the hospital at 90 degree bend and I give this machine most of the credit for that. I was using this machine for 10-12 hours each day that I was a patient in hospital.
Physical therapy was not merely recommended, it was absolutely essential. I received physical therapy at my home three days a week starting day 2 of my discharge home. Home therapy continued for two weeks then I began going to outpatient physical therapy three days a week.
My pain control regime consisted of oxycodone which I took for severe pain and particularly one hour prior to any physical therapy. My surgeon also ordered Valium to be taken 'prn' or when needed. He explained to me that Valium would relax muscles and would be valuable prior to having physical therapy. He was absolutely right, it made it much more tolerable. I was also given several vitamins to take daily. OsCal, Zinc, Calcium and Iron. These essential vitamins aide in rebuilding strength and bone mass after surgery.
I have to say that this surgery was 100 times easier than my first total knee replacement in 2012. Different surgeon and different hospital. I literally had no pain at all while in the hospital and the most discomfort I felt was at the incision itself caused from the trauma and swelling. I went for my six week follow up today. I walk without a limp, no cane of course and I have no pain. I have 125 degrees of flexion and can comfortably walk stairs up and down. My physical therapy will continue for another few weeks but down to two days per week for strength training.
I am in the UK. I have had both knees replaced, after many other corrective surgeries. One surgical steel, the other titanium. Both times a week in hospital. First time round I behaved myself; taking the full 6 weeks off work. 2nd time, only 3 weeks, by this time I had changed my car from manual to automatic. Big difference. The first time was on the NHS, not a very nice experience, too gory for this forum. 2nd time went private, was like a 4star holiday by comparison. Both times out of bed on the second day, by the third day you are walking up and down stairs;a must if you want to leave. At home the first time visits from the district nurse to change dressings and administer anti clot injections, gentle exercises, then PT after a month. Second time, I had to do the injections myself, change dressings etc, no home visits. Gentle exercises for just under a month then full on PT. 2 years on, I go cycling when I can, work full time, but have to walk with a cane. Have most probably tried every form of pain relief, but the reality is my system have treated my replacements as foreign objects and have "rejected" them both. They will not fall off or crumble, have tested them to the fullest. I am in pain 24/7 with nothing left to try. Pain wise I have a good pain management team in place who cover a lot of different avenues. Been there, tried that, so to speak. Exercise is the key to sanity. When in a lot of pain and painkillers don't work, I go to the gym. Static bike, rowing machine and floating in the warm pool helps, both mentally & physically.
I hope I have answered your questions
Have you tried a very loose tubigrip. You don't want it tight, just as a cover for the skin, it helps keep the sensitivity to a minimum
Thanks, that explains a lot. My process was totally different and, unfortunately, nothing to offer but my best wishes for the pain to be relieved. Chronic pain is nothing to dismiss lightly.
The NHS and private options were an eye opener.
thanks
Thanks, very similar to mine in CA. I like the valium idea -- I'll keep that filed away in case I do a second TKR.
Mine was overnight and go home. Do most of the exercises in the first 10 days while under managed pain meds (oxy worked great) and up and walking, climbing, etc etc on day 16. So, the mini op and computer alignement were definite positives.
Congratulations.
No, it was for anybody. I'm interested in the types and variety of procedures -- I think it's important for everyone responding to understand the differences and the need for responses to be appropriate to the situation.
Mine was "easy" with no complications - poster child kind of thing. so, I'm cautious about offering suggestions -- 20 20 hindsight is alway annoying to me.
Hope your mom continues to do well. It's fortunate that you are there for her -- alone is really really tough!
90 plus percent are like yours. Its the 10% or less that wind up on a side like this looking for answers. You are correct that it's h a 3rd for those with "text book" cases to relate to most of the people on here who are really hurting.
Been through a couple of Drug resistant infections -- scary and nasty things.
You've certainly been put through some hell, I don't know how you managed to get through it all. The infection rates in hospitals is soaring and people need to be very diligent when it comes to hospital selections. I've been in hospitals that make me shudder at the lack of attention to infection control protocol. My husband was infected from surgery to put a graft in his femoral artery, he ended up with MRSA and it took 3 months in and out of hospitals then finally removing that graft and another 3 months if intravenous antibiotics which I gave to him at home. He was lucky to survive and I will never go back to that hospital. The rate of infections have doubled in the past couple of years and it's really scary to have to be admitted for surgery like a knee replacement. I implore people to check out the infection statistics of their hospital before placing their lives in the hands of a hospital with sloppy infection control. I'm hope you're doing better now. You sure deserve a good break.
I hope everybody reads these posts! It was my primary search criteria for surgeon and hospital! Incidence of nosocomal infection, re-admission for post surgical screw ups and infection -- hard info to get hold of, but worth the effort.
Any post operative infection -- even suspected -- should be investigated. Catch it early, treat it throughly, do the full course of meds, and keep watching it. Follow the warnings about dental work and the like (lifetime requirement to do propholactic antibiotics is no joke).