bad knees

DarkSkySeeker wrote:
Is it true? If you do more therapy right away after KR, you will increase your long term mobility in the long run?

ABSOLUTELY.

It's critical that the muscles supporting your knee get back to full strength. Otherwise some bad things can happen---the IT band will be overloaded, trying to keep the knee stable, and it will become painfully tight and inflamed. Also the knee joint will not track properly when it bends, and it will wear out a lot faster.

The main muscles that matter are the glutes, quads, and hamstrings. Many people go into surgery with these out of whack, due to favoring the bad knees and moving in abnormal ways. And the surgery really weakens the quads.

So PT is critical, and continuing to do the exercises afterwards for quite some time is very important.

With both of my knee replacements, the first 3 weeks pretty much sucked. You just gotta take the pain meds and get through it, don't let the pain get out of control. After that you start feeling better pretty fast. For the next 6 months or so you will know it when you make a step up in activity level, with a couple of days of soreness, but if you don't push a little you will never get anywhere. It takes a full year for the joint and muscles to be absolutely 100%, according to my physical therapists.

It's not a walk in the park, but it's not just awful either. The pain is finite and you will get better, as opposed to a lifetime of pain and disability.

You do want a surgeon who does a lot of knee replacements, and physical therapists who have a lot of experience with them. Don't go to any random ortho surgeon. If you are reasonably near the Nashville area, I can make some recommendations.

One of the potentially unpleasant side effects of pain meds is constipation. I recommend Miralax, which takes 2-3 days to work, so start taking it the first day home from the hospital. For faster relief, use Smooth Move herbal tea (after clearing it with your dr.) My NP recommended it and it works really well.

2 years out my left knee never ever hurts. 4 months out my right knee is very strong but still gives me twinges when I step up to a new level of activity. Nothing some ice and ibuprofen can't handle at this point.

It seems that each person's story of TKR is different. The human body is not like an automobile where you replace a component like a water pump and drive it off.

Make sure you get a orthopedic surgeon who specializes in knees and does scores every year. Mine operated a couple days a week doing at least four a day.

I had my right knee replaced in October of 2012. I was off all opioids in three days by using THC candy which is legal in Colorado. I used it only at night for sleeping for about 10 days. During the day I used Tylenol and ice. Get off the opioids as soon as possible. They make you stupid and constipated.

I was walking unaided in a few days. The key is physical therapy. You want a PT who pushes you not hold your hand. I made PT my full time "job". I was on a stationary bike in a little over a week working my knee a couple times of day and doing my exercises two or three times a day. Every few days I would take a rest day. Most people who have issues don't do the exercises as prescribed because they are afraid of pain. You're not going to get better without some pain.

I was dismissed by the doctor and rehab in seven weeks and hiking the Superstition Mountains in Arizona in ten weeks. I'm no elite athlete although I'm fit for my age and not overweight. My wife just says I'm a tough old bird.

My replaced knee quickly became my stronger one. After favoring it for several years I had to learn how to walk correctly again. I just had the other knee scoped and the doctor said I'll have to have it replaced in a couple of years. I'll not think twice about getting it done.

I don't really remember any pain after my first TKR, that is until the *&%#$)*@@! Physical Terrorist had some hair brained new way of using crutches. My surgeon contacted the head of his department and explained that if the idiot was ever assigned to another of his patients, it would be the department head's last day of breathing.

Two days of rest and I threw the crutches in the recycling and use a walker for two or three days.

The second TKR, when I got to my room, I rang for lunch and after lunch rang for someone to come and follow me while I went for a walk.

The pain of bone on bone crunching while I walked was severe and when the bad joint was replaced, there was nothing there to hurt. Just like the day after a root canal, the cause of the pain is removed, ergo, no pain.

Now if they could do the same thing for my lumbar vertebrae.

Rest with leg above your hips(heart if possible), use ice after walking or PT. Don't let the pain come back stay ahead of it. I never took any of the Hydrocodone either.

DarkSkySeeker wrote:
Is it true? If you do more therapy right away after KR, you will increase your long term mobility in the long run?

Yes, absolutely.

I had my right knee replaced August 2017. As soon as I came out of recovery I started working the leg. Everyone told me to take it easy. The Dr. said I can't hurt anything, the leg won't explode or anything like that.

It hurt a lot, felt like my leg was a gigantic rubber band stretched to the limit and one slight move and it would just snap. But I was determined to drive again within 2 weeks.

I went through surgery, and had no pain killers after surgery. I was 100 percent alert, no drugs. Hurt unbelievable. Worked that leg and fought like my life depended on it. I started walking on my own within a few hours and kept going.

Physical therapy was an absolute joke in my opinion. I did more, and much more aggressive than anything physical therapy had me do.

I would sit in our porch swing with my foot on the ground and start swinging back and forth. Each swing the knee moved to the point of total hurt, but I kept pushing it. I'd sit on my John Deere tractor and push the peddle with my foot over and over and over again. We got a 3 wheeled adult tricycle and I rode that thing for miles and miles.

I walked trails in campgrounds. I climbed on the playground equipment at the campground (we took advantage of that time was was home very little). I swung in swings, climbed hills, walked up steps and steps and steps. I hobbled with crutches at first, then a cane. I forced myself to start walking without a limp, which was very hard to do, considering I'd been walking with a limp for so long before the surgery. I finally put the cane away and forced myself to walk, walk, walk, swing, swing swing, climb, climb, clime.

At home I used a ladder and climbed up to the roof of the house, over and over and over again. I forced myself to start crawling on that knee (which was ... and still is ... very weird), I pushed, and pushed, and pushed. Everyone thought I was nuts, crazy, insane. I was determined.

The day I came home from the hospital, I watered the grass, finished a wood project I had going on in the garage, and got the garbage out to the road.

I was mowing the lawn on that John Deere 3 days after I came home (5 days after surgery), and using the push mower to trim. At 5 days I drove the car for the first time again. I kept pushing. At 7 days we went camping my wife towed the trailer there. I towed the trailer home. Went camping again about 3 days after that for about 5 days, came home for a couple days and took off again.

Leg got stronger and stronger and stronger. Still hurt, still swollen, still felt like a rubber band ready to break, but kept pushing through the pain.

Doctor said the swelling would start retracting at 3 months. Ha! It did not. Said it would at 6 months. By about 9 months the heat from the knee started cooling down, and the leg was mobile as it could be.

After 1 year, it still throbs at night, but walking and standing is wonderful now. I'd rather stand than sit now. But now it's been 16 months since surgery and if I sit still very long, the muscles in the leg begin to seize up again. They begin to ache. Movement, even the slightest releases the discomfort. Sleeping at night, my knee us up against my chest. I wake and the leg is aching. I'll stretch out the leg and hang my foot over the end of the bed on my stomach. The leg is hyper extended now. Feels wonderful. Back to sleep. Wake up again and aching. Back to my chest. Movement, movement, movement, day and night and everything is good. Stop movement and ache returns.

Yes ... DarkSkySeeker .... early aggressive, almost insane exercise and movement of the leg, working that knee and those muscles is absolutely crucial to longevity.

Doctor said, no matter what I do naturally to the leg, it will never hurt the knee. Muscles may ache, but nothing will hurt the knee as long as I don't fall or break a leg or something.

So, with absolutely every step, forever and ever, it's constantly in the forefront of my mind ... walk careful ... every step, solid footing, and no horseplay... ever.

I'm riding bicycles again, climbing flights of stairs, and more active now than I've ever been. But.... when the leg become still for 30 minutes, I begin to feel it.

Exercise, move it, force yourself to climb steps and start doing shallow knee squats, going deeper and deeper each time. It may take you 10 months, but you will eventually get there.

One thing I cannot do is cross my legs Indian style any more. The side pressure of the artificial joint against my muscles makes it impossible to get into that position. I miss that, because I use to sit cross legged all the time.

Movement ... do it and the more it hurts, the quicker it will stop hurting. Folks have a tendency to stop when it hurts.... no, no, no. If it hurts you are doing good! It's getting better. If you only make movements that do not hurt, the movements will get less and less and less until eventually even the slightest movement will hurt like He!!. I know, I've had my lazy streaks too. But never again.

My wife has instructions that if I'm ever in a coma, to put my leg on a machine that will keep it in constant motion!

Well ... I hope that answers your question.

My husband was in pain for a least 8 weeks after his knee replacement. He got off pain pills early and started taking Advil. He couldn't stand Oxycontin so the doctor prescribed Tramadol. They also give Tramadol to dogs for pain. LOL. What helped him a lot was ice packs. He would ice his knee 4 or 5 times a day and that seemed to helped out a lot.

Listen to your physical terrorists... oops, therapists.

The harder you work the sooner you will be pain free unless...

You turn out to be the one guy in 10,000 that is deathly allergic to the knee they put in. BTDT, I am severely allergic to cobalt(as in a cobalt chromium knee). After 6 months of hell on earth and 17 days at the VA hospital I convinced my “new” surgeon there was something seriously wrong.

They did a “revision” which is Dr speak for we have to do it over...Another 14 days at the VA hospital.
The new “Oxinium” ceramic knee works well but it will never be completely right.

Fortunately I had no withdrawal issues with all of the opioids I was on for a year.

I do not blame the VA, just my VERY bad luck.

:S

Is it true? If you do more therapy right away after KR, you will increase your long term mobility in the long run?

My wife is 4 weeks post op on her second TKR. We knew what to expect having done the first one in July, but it's tough. PT is going well, movement is great, everything in the surgery went real well, but the pain is real. It's now time to come down off the meds, I'm not looking forward to the next few weeks :)

The pain seems extremely person dependent. Some say they are up and pain free (relatively) in a few weeks. Others much longer and more pain. Wife's first was probably 3 months to pain free (though it was hard to tell because the other knee still hurt so much). We're hopeful to get back to going for walks sometime after the new year.

If you're overweight, losing 50 pounds would be a kindness to your knees, back and hips.

Happytraveler wrote:
My husband had two knee replacements. Physical Therapy is very important. He was in the hospital one night and two day later I drove him to physical Therapy. I believe it was 3 days a week for two months.
Knee replacements are very painful, my husband thought back surgery was a breeze compared to a knee replacement. Good Luck and hoping for a speedy recovery.

I've heard similar (very painful) regarding knee replacement. One of my friends had both done at the same time. He told me he is glad he made the decision to have them both done because given the pain he wouldn't have done the second one after the first had he know how painful it would be. That said he is very happy with the long term results.

I've been managing my worn out knees (bone on bone) via the gel or hyaluronic acid injections. Both types have worked for me and I get one or the other done every year or so for the last three years when knee pain starts to really slow me know.