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Old 05-14-2012, 09:08 PM   #1
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Lucy56 HB User
Unhappy 8 wks post TKR & still no improvement

I am 8 weeks post TKR & so discouraged. The first 4 weeks were painful, but my Dr & physical therapist said that I was right on track. In fact at 4 weeks, I was doing so well, I didn't need a cane or walker, could walk around the block & no longer needed pain meds. I was so encouraged! Then at one therapy apppointment, I over-did & accidently bent my knee too far while I was on a stationary bike. The pain was excruciating! The therapist said that I probably didn't do any damage & continued with therapy. The next week, I was still in so much pain that I went in to see my Dr. He did not see a problem by visually checking the knee, but said that he would take xrays at 10 weeks. He told me to continue with therapy, but not to exert myself too much like before. Each therapy session since has been very painful, but with pressure, I can finally get a 109 ROM, & can straighten my leg completely. Last week, I developed an agonizing "ache" on the top of the same foot that I had the surgery on - along with terrible pain in the knee & down my calf. It is like a nerve pain on the top of my foot & the knee/calf pain feels like a toothache! After calling the Dr AGAIN, he told me to go back to using my cane & put me back on the same dosage of pain meds that I was on when I left the hospital!! I seem to be going backwards! I have been having so much pain with my TKR, that I wish I'd never had it! Has anyone else had pain this bad 8 weeks out and on the top of the foot as well??

Needs encouragement,
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Last edited by Lucy56; 05-14-2012 at 09:23 PM.

 
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Old 05-16-2012, 12:00 AM   #2
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Re: 8 wks post TKR & still no improvement

Hi Lucy Lou -- I

Apart from the pain, do you have any other symptoms? There's a little known condition called complex regional pain syndrome (the health condition board here is called reflex sympathethic dystrophy). You might want to check the stickies on that board to see if you have any of the corresponding symptoms. CRPS can develop after a surgery if a nerve was damaged. Or, you could have "regular" nerve damage or just ongoing troubles from overdoing PT. Remember that ice can be a girl's best friend...

Last edited by Administrator; 05-17-2012 at 02:17 PM.

 
Old 05-16-2012, 11:29 AM   #3
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Re: 8 wks post TKR & still no improvement

Thanks Sweetpea... I will have to check into CRPS. As far as I know, I don't have any other symptoms, but suffer from chronic back pain and also wear a permanent ankle brace due to valgus & neuropathy, which occured after I had surgery for a torn ligament. I am hoping that I am not going through the same thing as I did with my ankle surgery. For some reason, I haven't healed right after any one of my surgeries, causing even more problems than when I started out with. Again thanks! Getting ready to put an ice pack on as soon as I log off!
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Old 05-16-2012, 03:21 PM   #4
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Re: 8 wks post TKR & still no improvement

Hi Lucy56,

Don't get discouraged!! Your surgeon and therapist are right - you were pretty much on track 8 weeks post surgery before you attempted to intensify your bike exercise and you just did overdo it. Everybody heals at different rates, so don't worry if you have to dial things back for a little bit - I am also 8 weeks post left TKR and doing quite well. (Minimal use of the cane and walking the stairs normally one foot after the other, etc.)

However, I just had a little setback this morning. For the third time since Saturday, I got this sharp pain in my right hip while sitting in my car driving. Very painful. Since I've been relying on my right TKR that was done April of 2011 so much, as my left TKR heals, it's apparently putting extra pressure on the muscles and bursar of my right hip causing the pain. I'm going to my Ortho surgeon in the morning to see what he can do for me therapy-wise and to find out for sure if this is what caused the flare-up. (I actually saw one of his physician assistants this morning, and he told me to have my therapist do therapy on my hip and knee both this afternoon. The P.A. also said that he thinks it is the bursar of the hip being inflamed, and that my surgeon will figure it out tomorrow morning. He told me to take my muscle relaxant medicine the rest of today - I had that medicine in January when I had a bad back spasm and had plenty of pills left over. - the P.A. said it should help until tomorrow.)

Sooooo.......I was a bit upset because I had to "dial back" MY PT workout today!

I'm surprised that your range of motion is only 109 degrees at this point. Mine is 132 now, but still with some soreness. But then again, everyone does regain full ROM at different speeds.

I've never heard of the foot problem you describe. The only TKR surgery related foot problem I had was the first full day I was home from the hospital and the foot swelled up really badly. Saw my surgeon the next day, and he reassured me that was completely normal and would go away once the staples were removed two weeks post surgery which is exactly what happened. Your current foot problem is a puzzle to me.
Hope you get the answers and treatment you need soon! Just DON'T GET DISCOURAGED! YOU WILL GET BACK TO "NORMAL" IN TIME! It may just take a bit longer, that's all.

Hope this helps.

Regards,
******* (Carol)

Last edited by ldy12; 05-16-2012 at 03:25 PM. Reason: grammar correction

 
Old 05-16-2012, 04:04 PM   #5
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Re: 8 wks post TKR & still no improvement

Oooh... I am so sorry to hear about your setback this morning Carol. That sounds painful! I have been having pain lately in my hip too, but I figured that it will go away. I had the same hip pain when I had therapy for my ACL replacement (same knee). It was definitely inflamed, but the therapist showed me some stretching exercises that seemed to help.

My foot also swelled after surgery, but the swelling went down eventually. I am going to have to see my podiatrist if this pain persists. I am definitely going to look up CRPS, to see if that is what I have. From what I read about RSP, it includes osteoperosis, which I don't have.

I cannot believe that your ROM is 132. That's amazing!!! With the way mine feels, I will be surprised if I reach 110 by the time I see my surgeon on the 29th. They have been pressing on it at therapy & I have tried to press it at home, but it only goes to a certain point & stops. Since I over-did it several weeks ago, I have not done any home exercises except to stretch it. Since I haven't over-done it for a few weeks now, I thought it would be better, but it's not.

Thanks for your encouraging words. I'll keep you informed to what my Dr. says in a couple of weeks.
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Old 05-19-2012, 12:05 AM   #6
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Re: 8 wks post TKR & still no improvement

109 is good range of motion. I had my replacement on 7/30/12. The pain was agonizing for a long time. Don't feel bad about increasing the pain meds. I don't believe the surgeons that operate have ever had one done. I would have never had mine done either. It's such an invasive procedure. Patience is what I constantly read. I'll start replying more to posts. thanks...Wildbill

 
Old 05-20-2012, 03:24 PM   #7
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Re: 8 wks post TKR & still no improvement

Hi Wildbill,

Don't you mean 7/30/11? July 30 of this year hasn't arrived yet! Wishful thinking on your part perhaps?

As for whether any of the Orthopedic surgeons who perform TKRs have ever had one done on themselves is something we will probably never know, unless they choose to tell us! I have an AWESOME Orthopedic surgeon who has both the amazing skills AND compassionate bedside manner who performed both of my TKRs within a year of each other and I healed really well and fairly quickly! He did an incredible job on both considering how bad my knees were going into each surgery! (right one - 4/5/11 and left one 3/23/12). I am forever grateful to him for giving me back full mobility without all that pain!!!! (I'm almost done re-habbing my left knee, which actually healed faster than the right one did, which is ironic because it was actually in WORSE shape than the right one was at the time of surgery!)

Friends and family are so amazed at the job he did on both my knees that I've been inundated with requests for a referral to my Ortho surgeon for themselves or a family member or friend!!!

Yes, patience is one key to getting through rehab, but the more important component is to do EVERYTHING you are asked to do in re-hab post surgery to get a good outcome.

Even realizing that everyone heals at their body's own pace, a 109 range of motion at 8 weeks post surgery is kind of way below normal. It SHOULD BE AT THE MINIMUM about 120 or more. I'm at 130+ (depending on the day and how much soreness I still have, which isn't much). By the time I finished with rehab on my right TKR last summer, my range of motion went all the way to 140 where it remains to this day!!!!

As I say, everyone heals at a different rate, but as long as you stay motivated with your therapy, you WILL eventually get there to complete ROM with NO MORE PAIN!!!!

Regards,
******* (Carol)

 
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