Swelling and ROM with Knee Replacement

Bones, joints and muscles
1

Hi everyone. 46 y.o male here who just had a total right knee replacement on Monday. Tuesday I did really well. ROM was measured at 0 degrees and 90 degree and I went home to recover. Today (Wednesday) I really feel like I regressed. Only able to get to 5 degrees and 60 and the knee to me feels significantly tighter than yesterday. My PT said that this can happen and to not worry to much about it. 

Just curious if others have had the same experience and if this sounds normal. Its kinda frustrating because I really felt like I was doing very well and feel like I took a step back. Thank you in advance.

2

I got the straight poop on this....You get an injection "cocktail" prior to leaving the OR which lasts for 2/3 days - local anesthetic.  When that wears off you will know it - Dont be shy with your pain management cause it will be significant pain and tightness.  Do your best to get full extention and 90degrees flexon for 8 weeks minimum......its a long road be diligent and you will reap benefits

3

Forgot to mention I am day 10 myself.....

4

Thanks for the response. I kinda figured that was the case but it was kind of a letdown even if an expected one. I wish you the best luck with your recovery also. Sounds like your coming along well. 

5

Long road ahead. Hang in there. Consider swelling from surgery...perhaps in 2 months, eight weeks you will have a better range of motion. Give your knee and leg some time to heal. It just had major, major surgery. Tightness may be there with the surgery. Am I clear.....You are only one day out of surgery?

6

You certainly haven't taken a step back - you've simply joined the real world. To have a 0 degree extension so early is brilliant, but both that & a good bend can be great one day, not so great another. Don't be too hard on yourself, read some of the other tkr discussions on this forum, and you'll understand that what you've experienced is perfectly normal.

The tightness may hang around for weeks or months, so stay focused, take your meds before the pain gets bad (& especially before excercise), hydrate & ice. Follow your excercise regime and expect it to take as long as it takes. Not everyone's the same, but you've had major surgery, and when you consider what's been done to your knee, you shouldn't be surprised that it needs a long time to heal.

Best of luck,

Denise from Oz

7

Don't panic, this is perfectly normal. This happens to everyone as the anaesthetic is still in your system so it makes the first day feel quite good. As it wears off and the trauma from the surgery shows itself and swelling appears, it becomes tougher. I would say with some confidence, that if you were able to achieve that ROM straight away, that you will easily get back to that and surpass it with physio.

You may not feel like it yet but you are actually very lucky to have that sort of ROM. I've never had that so further surgery is in my immediate future.

Stay positive.

8

Hi im 2 weeks post tkr and at 85 degree bend and struggling to lift the leg,the tightness is a killer as you feel you cant do the exercises when its like that and the swelling too..sometimes we expect far too much of ourselves in these early days,and tend to beat ourselves up alot..it will get better as my physio says,remember to exercise,rest,ice and keep hydrated..keep up the good work 

9

Hi 26 weeks Pos left tKR - same as other replies - physio is key to recovery especially in the first 3-6 months so make that you focus. Progess will be stop start but you will get there if you stick at it and drink plenty of water, take meds regularly and manage pain so you are not prevented from mobilising or resting. Good luck.

10

Sounds very normal . .the leg is probably even mor swollen today than it was yesterday . . and by the way, your initial 0 and 90 was spectacular the day after the op!  You will find that recovery is very much like that. . two steps forward, one step back , , but you have made such a brilliant start that it's looking good for you!  don't let this dampen your spirits. . .Just insist on the exercises so that scar tissue doesn't build up and impede movement and be patient!  good luck. . but don't expect this to be a short recovery period

11

Wow, none of those injections given to me! paracetamol from day 3 . . .and not much else before.  Are you in the USA MarK???

12

Right now you are too early in the process to even be looking for benchmarks. For the 1st few days just try to get comfortable, get pain managed, eat what you feel up to and try and do all the hospital staff requests. Sleep as much as possible and be slow and steady. No need to rush or push too hard at this stage, that will come soon enough.

13

Hi!

I had TKR on my left knee three weeks ago. I have found that my range of motion is almost always completely dependent on the level of swelling/tightness that I am experiencing at the time.

I was VERY fortunate to get home health care and have a PT come here to my home just five days after my surgery and two days after I was discharged from the hospital. An added bonus was that my PT had had her DOUBLE TKR just four years before at age 42. She KNEW FIRSTHAND what it was like!

When I expressed difficulty achieving good range of motion on this one particular day, she said, " Cheryl, of COURSE your range of motion isn't as good today! Your whole leg is much more swollen, AND don't forget all the RAIN! Weather is a BIG FACTOR in the process."

I felt relieved and I started to look at the swelling issue more closely.

At my follow-up appt.a couple days ago, I asked my surgeon about swelling. He said to EXPECT swelling for up to a YEAR. After all, there was a lot of trauma to the tissues with all that was happening during my three-hour surgery!

I am trying to follow the exercises, walk frequently, rest as much as is possible, ice, elevate, and above all STAY POSITIVE! I am learning that I pay the price of overdoing things, and that only sets me back further.

Each TKR experience seems to have similarities, but each also has differences. Pain tolerance varies as well.

I would say just evaluate yourself each day based on whether you slept well, if your swelling is better or worse, whether it MIGHT be a day to spend icing and resting or whether it might be a day to push a bit harder. As many have said, a TKR is NOT a sprint. It isn't even a MARATHON. It is a bonified ULTRAMARATHON!!!!

Wishing you well!

Let's promise to be patient with ourselves.

We will each do this...in our own time!