I am scheduled for a TKR procedure one week from today.
I would be interested in opinions and advice as concerns recovery from the procedure.
My understanding is it's a stone Bitch.
In my favor perhaps is that I had a donor ligament put in my leg a few years ago.
I cringe at the idea that this will be a more difficult recovery than that.
Can ya help a guy out?

My brother in law just had a knee replacement 3-4 weeks ago. He was hurting a bit for a few days, but tolerated it. I took him to PT 3 times a week, but now down to twice. He had a walker to get around for a week or so, but now using a cane.
Think about the bright side, you will be a new man when it’s all said and done just in time for summer.
Good luck. Bet it won’t be as bad as you anticipate.
QM

I'd ask for a schitload of painkillers, but that's just because I could.

You'll be fine.

Make sure you go to PT, had a friend that didn't and he walks stiff legged, goes down steps backwards.

Best thing I have ever done for myself. Will have you walking next day. Don't cheat yourself by cheating on therapy. Was hunting mule deer in northern Colorado exactly 6 weeks later.
George

What gemby said.

I had two total knee replacements about 5 years ago (same year, different months). Yeah, it hurts like a sumbitch, but power through and do your PT. I went to an actual PT place following my first replacement, where I learned the specific exercises to do. After my second knee replacement, however, I simply went to the gym on my own to do the PT.

My knee replacements were the smartest thing I've ever done.

How's the hunting in the wheelchair accessible units anyway? LOL

Ain't so bad.

Start doing pre-therapy now. Not too late.

Start taking stool softeners yesterday and drink as much water as you can tolerate. Pain killers will lock you up. And make sure you can tolerate codeine cause they will only give you 10 days of Oxy. And Tramadol is useless. The Tylenol Advil rotation is better.

Mix up some 60-40 90 percent isopropyl alcohol cold packs - about half a dozen in double gallon baggies. Keep them in the freezer. The little cooler and pump they give you ain't gonna cut it.

And hit the PT with a vengeance. Yeah it hurts a little but the pain is worth it.

My wife has had TKR both knees, done about 1 year apart in the last 3 years. She had a very good surgeon, did PT religously and is very active. She can now hike 7 miles in the mountains, she is a little slow and careful on the downhills but climbs like a sherpa. After each surgery and completion of PT we went to Wyoming and spent a month hiking. At first she would walk out and back short distances as she built strength and confidence
w/ short rests in between. I then hung a Helinox chair on my pack and we took longer hikes. In late October of 2020 we hiked the closed FS road to the top Of Signal mountain in Gd. Teton NP. 11mile round trip w/ > 1k feet of climbing. She never finished the opiate pain medication that she was given.

Good luck.


mike r

It was way easier than either of the two rotator cuff surgeries I had.

Mine was done in March I think. By October I was hunting elk. Climbing that hill about a mile away (by foot) in the background. With a 20lb day pack and 10 lb rifle. At medicare age.



a pic from the top of the hill looking back toward camp. An old homemade ranch antenna up there.



Do the PT religiously. Actually, if you're just a go to church on Sunday type, do it like the little old Italian lady that gets up at 0630 to go to Mass EVERY morning.

If the PT lady (or dude) says ride the bike for 10 minutes.................do it for 12.

If they say walk 1/4 mile, walk a 1/4 mile + 10 steps.

do like I did and have them tell you "you're doing better than 95% of our patients your age". In other words, try to be the 100% person.

Be aware, I'm one of the lucky ones that still has some residual pain. Doc said it's normal in some patients. But it's nowhere like the bone on bone pain I had that required massive doses of "advil" just to live with. Or cortisone shots, or Synvisc. And they all stopped working.

Or don't read my post.

Read Mikes!

Alot of pain levels depends on the doctor and what he does. I had my TKR October of 2018.

Ask about a nerve block. This goes into your knee before surgery and essentially kills pains receptors for up to 2-3 days! Your body may vary, but it could very well get you past that first 36-48 hours which is key.

Things to expect:
- BRUISES, they will have a tourniquet on your thigh, it will leave bruises, don't worry, they go away!
- Sleep that first week isn't going to be easy, very hard to get comfy.
- They will have you on your feet FAST. Most likely within 24 hours at most. I had a drain in my knee for the first afternoon, that kept me in the bed.
- Your leg will be essentially dead, at least quads will. you will sit there and simply try to lift your foot up, nope, not happening, won't move. It will come back.
- Early PT SUCKS. I had in home for a week, that SUCKED. forcing it straight, forcing it to bend, all while your quads are dead. Trust me, the joy you feel that first time you can lift up your own foot is amazing!
- I actually didn't even take the Oxy, until the in home PT told me to just before she got there to make PT more effective. I did for a couple days then didn't.

Do PT, work on bend and straighten. Different people have harder time with one over the other. I had a bitch of a time getting it straight, but no real issues bending. Do what PT tells you, they will KNOW if you are doing your home PT, do it, but don't over do it. Push the pain limits, that's all up to you, but don't over do it. You just need to make steady progress. If you don't bend/straighten it with steady progress, the PT will, and you don't want that.

If you make it through the first 1-2 weeks, it's all easy from there. Progress speeds up, pain goes away.

Oh, and don't expect to take a crap anytime soon :-)

you're [bleep]....can I have your stereo?

I had bilateral total knee replacement surgery in August of 2018. As others have said, it is painful and rehab is tough. I'm glad I had it done. PT is key!

I had it some years ago. It is really tough. Very painful.
Very tough for 3 months.

Do your physical therapy. Get a bicycle, or else an exercise bike.

Had the same procedure Feb14,’20. Best outcome imaginable. PT is the key. Once home health pt starts, make certain you use the meds for pain mgt to enable best results for workouts. By then you’ll likely be down to only tramadol which is like stronger Tylenol IMO. I did not experience any of the horror stories that circulate among your network. Most of that comes from a friend of a neighbors cousin type nonsense. Getup and walk. You’ll have a good knee under you and a bionic knee too. You will not be fragile. It’s hard to remember that. You’ll do fine and feel 1000x better in 30days. It’s a quick initial recovery but about a year to be totally confident and wo fear.
Good luck!

I'm told there's a great market for unused painkillers.

I had both of mine done at the same time in 2014.
My only limitations from the Doc were no running and jumping.
Take your pain meds and do the therapy !
I`m including the obligatory x-ray that you can show your friends

Yeah you wish

I had a TKR one year ago, yesterday. In fact I see my surgeon for a one year follow-up tomorrow. My recovery has been OK but I am still prone to soreness. I was up the day of surgery. The kept me an extra day. The home PT lasted about a month and then I went to outpatient PT for about 2 months. I started walking a few weeks after I started outpatient PT. I suggest that you do the PT and do not stop doing it when it formally ends It was not difficult but it was boring and at time seemed pointless. I have always been and continue to be a gym rat so the discomfort was no big deal. It was frustrating more than anything else. Last Fall's hunting was tough but I managed to get my share of bids and drag a deer out of the woods. Anyway, good luck.

One thing I can tell you, from the experience of a co-worker, you'll like it even less if you don't keep up the therapy as directed. He wanted to get back to work, not take afternoons off for the later stages of PT when he was back to work.

His knee wouldn't straighten or bend correctly and he had to go back in to the surgeon. They had to put him under again and "manipulate" his knee rather forcefully.

He told us at work he'd rather have just had the surgery again.

Another thing that helps. A good dog to get you through it. This guy kept me company, every day:

3 days post surgery.


3 weeks post surgery:



you have a dog, right?

Not my xray !
I had both replaced !

I don’t know where you are — small facility or large medical center— and what’s available for anesthesia techniques, but the type available or that they will offer is the numero uno thing right off the bat that will determine the first several days and beyond.

That nerve block thing was certainly helpful the first day or so.

after that, my high tolerance for drugs seemed to bother the nurses. Bothers the dentists too when they give me novacaine and get to work and say "you can STILL feel that?".

Had both knees replaced at 48 years old. Don't have the same range of motion as I did with original equipment,but I don't have unbearable pain now. My advice is to not skimp on the physical rehad or you will regret it.

Some centers have the patient already doing a couple to a few weeks of PRE surgical PT.

Had both replaced in 2009. Left one in July. Right one three days before Thanksgiving. Was out of bed with crutches and walker the morning after. Home in three days, walking with a cane. PT is good. Pain killers with the first one for several days. With the second one did Tylenol when I got home and a pain killer every third or fourth night. All good until about three years ago. Left knee started giving trouble. Could barely bend it to put my left shoe on. Back to the doc in Sept 2019. Knee was swollen. X-rays, tried to get fluid out. No dice. January of last year back in to replace the plastic. Just an overnight stay. Also cleaned it out. Doc said there was so much scar tissue he was surprised it even worked. Right one has been fine.

I have a wide selection available. Ten to be precise.

I had double TKR's in Summer of 2017. My experience mirrors Bob H in NH's so I won't repeat it. I was off of the Narco after a week because I can see how people get hooked on that stuff. Used a walker for 5 days, a cane for another 3, then walked and limped around as much as I could stand, then iced down.....ice is your friend. PT sucks for 2 weeks, but you'll get better quickly. Can't explain how good they feel today.

Had mine in 2017 and to me the worse part was wanting it to hurry up and heal so I could go about my business. I never used a walker just a couple days with a cane, mainly to scoot the dogs out of my way when walking. They sent me home with a ice machine that worked great, think it's called iceman. Mine has limited me to some things and my surgeon said everything looks good in xray and his moving it around felt right. A couple weeks ago I had an independent exam through the VA as they paid for the surgery, they found I was missing a 4 centimeter muscle that runs from knee cap to the thigh. Then they ask me what happened to it and I told them it probably went in the bone bucket with the old knee. It kinda explains why I seem to not pick my foot up quite high enough at times when walking. But still much better than the bone on bone pain. Cold weather stiffens it up to where it'll throb and ache.

I had both of mine replaced 4 years ago. Right knee 1-4-17, and left knee 3-14-17. Although it can be rough at first, its the best medical decision I ever made. I'm in the gym 3-4 days a week now with no pain. I can walk all I want up and down hills hunting. My advice is to take your meds to control pain, and give your best effort at physical therapy. The elliptical machine helped with strength and range of motion once the Dr. approved it. Do your best to bend and straighten your knee while rehabbing it. You'll be glad you did it!

Ron

It has been mentioned above but don't blow off the physical therapy. It is important that you work hard at that.

I have had several friends that have had their knees replaced. All of them took rehab seriously except one. That one hard head is having a very hard time.

Best synopsis that I relate with.

Find whatever food or pill that makes your colon regular & stay with it for the duration of the opiates if you take them. I tried about three days worth post-op & they were quite useless. Ironbender & I had ours done same week & he suggested Ibuprofen as an alternative to the opiates. That stuff was magic. I never had any pain relief with my old joint using Ibuprofen, ever. But, that all changed with the new one. My doctor said not to take more than 800 mg’s per day for more than 3 days a week. So, I started at 400 mg’s & that worked great.

Weather changes will cause you pain, but, only due to the cutting off of your old parts. Not, because of the new parts. Expect soft tissue pain for months after. That does not equate to damaging the joint.

I pushed hard thru therapy & realized afterwards, 4 months post-op, while trying to climb stairs at work that my leg muscles were atrophied from years of limping. So, expect that if you’ve been babying it pre-op.

I was put on a lifetime directive of antibiotics prior to ANY dental work, including simple cleaning. And, no pivoting with your foot planted. And, absolutely NO running.

Mine was done in 2018 at 58.

Uncle Alvah: I had my total knee replacement just 2 years ago and it was THE best decision I have made since I married the VarmintWife 45 years ago.
I tried to deal with the pains, inability to do certain things and the inability to sleep well for way to many years (8 - 9 years)!
After the knee replacement and after the physical therapy I was like a new man - all the old and varied pains were gone and I became much more mobile.
Now I will relay this (quoting my expert knee surgeon!) "it's gonna hurt and be uncomfortable for some time (IIRC he said two weeks) but once that is over you WILL be better and much improved"!
That Doctor was right.
One thing I was not aware of is even a few "narcotic" pain relief pills WILL cause "constipation"!
Sounds benign enough but try to have a bowel movement with serious constipation and a leg that won't work or support you - it's an experience "I" never want to repeat!
I quit taking pain pills the second day after the operation for this very reason. I had been receiving intravenous pain killers for two previous days while I was in the hospital recovering.
So I became REAL constipated.
And secondly and perhaps more importantly - ABSOLUTELY keep up with the recommended exercises and never miss a physical therapy session!
I will NOT relay the consequences that befell a close friend of ours when SHE did not keep up with the exercises and therapy!
The thought of my having to go through what she went through to have her poor recovery (due to not keeping up with the exercises and P.T.!) are to excruciating for me to relay.
I am so happy I had my injured knee replaced and even happier my other knee does NOT have a thing wrong with it.
Best of luck to you.
Hold into the wind
VarmintGuy

While in rehab I had a kindly female PA in the clinic tell me that 2 extra strength Tylenol and 3 Motrin were equal in pain relief to the Vicodin.
After 2 weeks I started getting hooked on the Vicodin.

I did learn that, one 10 mg Vicodin and a double gin and tonic made my knee quit hurting*

I didn't want to get hooked on the Vicodin so I flushed it down the toilet. I did try the Motrin and Tylenol and it works.
If you have liver problems or kidney problems you don't want to load up on these meds, but I took them a-plenty for two years and they worked well for me with no side effects. The three Motrin and the two Tylenol, do not take more than twice a day.




*not recommended by physician

A friend of mine got the nerve block and he had horrible migraine headaches for 2 weeks. I told the anesthetist I wanted total anesthetic, that is what I had.

Former talk show host Neal Boortz had TKR, he got the nerve block and he had them set up the pillows and he watched the operation! Good God not for me I didn't want to see them sawing off my femur with a Sawzall. After that, they saw off the top if the tibia.
No thanks I didn't want to see that I wanted to be out like a light.

Simonk , there is too much misinformation behind your response to answer fully, but the “nerve block” you are referring to is probably the SAB or “spinal” which do have an incidence of headache post-procedure.

But, there are other forms of nerve block that won’t result in a headache, and, will give tremendous pain relief post-op. And they can be combined with “going to sleep.”

From my experience most patients are not apprised of them if the anesthesia providers even do them. They take increased skill, more time, thus creased cost.

Pain management after a TKA is still not satisfactory for most patients. Not that everything can be pain free.

Misinformation behind my response. No, I don't think so. I gave an exact recounting of my experience.
Vicodin will get you hooked and Motrin and Tylenol are great pain relievers following TKR.

Yes, my buddy got a spinal block.
If there are other forms of nerve block that are more effective than spinal block, I am not knowledgable about them and I must plead ignorance to other forms of nerve block.
And, of course, not everyone who has spinal block gets the bad side effects.

Be very nice to your anesthesiologist and get the nerve block. IIRC it is injected into the thigh. You'll enjoy the best two or three days after that with minimum of drugs. And it really helps you get started on PT. I had Oxy left over but I'm not real pain sensitive. It's only pain.

BTW I was taught early on in my athletic career to learn the difference between pain and injury. I did and it has served me well. Motivation helps way more than drugs.

Best wishes.

This! Mine TKR was bi-lateral so I had a nerve block in each thigh. Poly type needles that you self remove when pump runs dry. It sets you on the right path for pt and really knocks the edge off the pain initially, when you need it most. Really just worked hard in pt and flexion was125 when I started outpatient therapy. You can do this and be great!

Yep, a femoral nerve block with a catheter placed near the nerve before surgery but for a continual infusion during surgery and for 2-3 days. We had great results with them.

But they require a little extra time with ultrasound, or a nerve stimulator to place, and more skill — the nerve can be hard to locate especially in those with a little extra weight, and then infusion strength must walk the line between making the quads too weak so the patient can’t walk or even stand — not good — or not giving enough pain relief.

But, when all these demands can be met, the pain relief is the best.

https://youtu.be/tMy978ZwaDU

If I remember right, my nerve block was 2 really big needles, one went in the back of my knee, don't remember the other, but might have been spinal. They put fall risk bracelet on then as well.

Do PT.

Enjoy the pain.

If it was easy, everyone would do it.

Go to a good rehab facility. My guy has experience with pro, collegiate and Olympic athletes. He was hard core. I worked hard, like come home and crash for 2 hours hard. He was 5' 4" and 140# but when he approached my table to manipulate my knee my palms would sweat. Knee rehab therapy is true sweat equity. If you aren't breaking a sweat you ain't gettin' anywhere. I had my TKR on 5-9-18 at 61 years old. I got back on the motocross track in September. When I told my PT I wanted to ride, He said no, I'd like to get your leg a little stronger. I thought that was pretty cool.

I 've had both knees replaced,do the P.T. as directed,thats the most important thing.It will determine how well you move later on.First couple of days are a little rough,after that you ll be fine.

I 've had both knees replaced,do the P.T. as directed,thats the most important thing.It will determine how well you move later on.First couple of days are a little rough,after that you ll be fine.

You should recover nicely then!

Although Uncle Alvah asked for Y'alls advice, I wish to thank you for sharing your stories. I too am in the market for TKR......was just at my OS office two weeks ago to tell him I finally agree to the surgery....and he said he couldn't do it.....said he is retiring in May so wouldn't perform the surgery since he couldn't perform the aftercare. Now I have an appointment with a new Surgeon on April 14.....hopefully we can still make this happen in May sometime so that I can heal up enough before Storm season arrives.

I am told I need both knees done, but will start with the most painful one first.....and then as soon as practical, have the other knee operated on. Plan is to take my Son, Brother and Nephew on a Father/Son Elk hunt in the Fall of 2022......I want to be able to hike the mountains and enjoy it. Just turned 60 in December.....hopefully there's some life in me yet!

Thanks again!


Frog---OUT!

I’m at one year on mine (50 now ) and I’ve got constant swelling in my knee, but I was not a typical replacement . I had 3 orthos tell me they’ve never seen a knee as bad as mine. They had to take a wedge and ran it between my ligaments and bone and scrape them to get proper tension on the implant because one had gotten shorter than the other.

I tore my ligaments playing football and the staple’s you see in the X-ray’s is how they reattached it when I was 16. I can straighten and bend my knee slightly past 90 deg, I know I could do more if the dam swelling would go away. I will say my knee pain is gone and I use to have a lot of back problems but that all gone to now that I’m straight now ( my left leg was 7/8 ‘s of a inch shorter than my right) But my docs said it can easily take a full year or longer go get back to 100%.

The nerve block is awesome but after it wore off I was in some pain and tolerated the pain meds for a few days then ditched them as I’d rather put up with the pain than feeling loopy on them . Best of luck

Best bud had both his replaced at thanksgiving, he's back to golfing now.

Good luck. Do the PT religiously and get on a stationary recumbent bike ASAP. The recumbent bike gave helped me get a better range of motion faster than walking.

The PT was painful on my knee replacement but very helpful.

frogman,

good to see a post from you. Hope all is well. I don't visit the good conversation thread much anymore and I probably miss your posts on other stuff in passing.

60? get them things done and go hunt elk with the family! Then post pics for sure! If you're like the majority of TKR patients, your going to be quite a happy man, especially if you've been living with knee pain for years like I did. The relief is amazing.

Just be aware, you'll now feel all the other things that weren't as obvious!

Like "why do my knuckles hurt so much now? And my feet?)

Nah, you''ll do fine.

Great advice

Takes the weight off and specifically works those knees. Just have one’s PT adjust the seat for the right range.

I had the left knee done about 2 years ago and like everyone else has said it hurt, but now it's great, No pain I walk normal and don't have to worry about the knee giving out on me and dumping me on the ground, Do the PT. I would recommend going to the clinic instead of at home. I had a good at home PT nurse but I didn't push myself like I think I would have had I not been at my house.

I had both of mine done about four years ago. They said it was a life changing surgery and they were right. Other than no jogging or jumping off of things I can walk, hike, climb ladders, and all that stuff like I did when I was a kid. Reading through all the posts on this thread you have all the good advice there is about what to do. Just be sure to do it...... all the way to the very end of PT and whatever else they tell you to do.

If the PT lady is really cute, it helps immensely if you're sitting in the seat while she adjusts it. Especially those seats with the lever between your legs.

I should have gotten a knee replacement years ago, but I didn't and won't now since it doesn't hurt any more or go out of joint. It's been bone on bone for over 40 years. I don't try to run but can walk up and down hills for exercise for an hour with no ill effects.

Truthfully.....i've been existing only by the grace of modern chemistry. Thankfully, the Opioids do their job and relieve my pain so that I can function and at least work, albeit I have to be wise about what I tackle. Finally made up my mind that it's time to do the surgery and then my Surgeon decides to retire, so I have to meet with a New Surgeon in April and go through the process again. Was hoping to have the Surgery in May and get it done before Storm season....

You should stop on down for a visit and say hello! LOL

I went to see my knee doc today. I have been bone on bone for a long time, but now my right knee makes 3 clicking noises because things are popping off my knee cap.
Anyway he said he could put in a new one next week. So now I have to get the pre-op stuff done like cardio tests etc, and get ready for the PT time.
I guess now is a good time, it will give me time to get back in shape for hunting the fall.
Kinda getting real right now. Have to get a stationary bike, get some mulch down, and get the garden tilled before next week.
Thanks to all those that contributed, great to hear experiences.

I will time after arrowhead season, after the corn gets knee high, and during the hottest part of the summer just after my 144 determinate tomatoes blow their wad. That should leave me several weeks for rehab, skip bow season cause bow season sucks anyway. Be mostly ready to go by Nov 1

So....August 1st would be a good date for myself.

Im pretty busy. 👍😎

Do your PT.

I have a friend who didn't do his PT, he has the pain threshold of a 3 year old, and had to be put under general anesthesia so the surgeon could manipulate his leg and break the adhesions loose. He said that it hurt worse than the actual knee replacement and powered through the PT after that.

Anyone that's going to have a TNR. Needs a Cold Therapy System, Check amazon .
It's more than worth the money.
I have had both knees replaced.
Works great for shoulders also.