Total knee replacement recovery requires time, patience, and consistency.
We’ve arrived at the third installment of our case study. (Pt 1) (Pt 2)
We’re going to look at the challenges during Royce’s left and right total knee replacement recovery.
Deciding on a second total knee replacement
Both knees were pretty much worn out. The left knee was the worst which is why I had surgery. I knew the right one was bad because I had seen the x-rays. So, I chose to go ahead and do it. I wanted to make sure to have the same knee prosthetics. The hospital was phasing out my particular model. So, that’s why I decided to go ahead and get my right knee done. And the surgery approached, I kept thinking, this is just not a good time to do it. Finally, I realized there’s never a good time.
How the second knee replacement surgery differed from the first
After the second surgery on my right knee, I developed an infection. We think the infection had something to do with the adhesive strip. I started oral antibiotics, cleaned the wound, and applied Neosporin. When I bend the knee, the skin hurts and burns when I stand. It’s an unfortunate side reaction similar to the rash I developed after the first surgery. Other than the infection, my right knee feels pretty good.
In a rush to get active again, I overworked my left knee and developed a hematoma. Unfortunately, this prolonged the recovery an additional three to four weeks.
After knee replacement pain
The surprising part with the left knee was the pain in the glute, buttock area. The pain radiated down my IT band which makes sleeping and riding in a car difficult. Basically, I developed an annoying ache that would wake me up because I couldn’t get comfortable.
I definitely had knee pain, especially in the morning. The knee was stiff and painful. There was a significant amount of popping and clicking in the left knee. Sometimes with pain, sometimes not.
Again, I pushed recovery on the left knee. I experienced feeling as though my knee wanted to hyperextend followed by sharp pain.
Over the years of treating thousands of knee surgery patients, I’ve only had a handful that said they had no pain after surgery. Most people need to expect pain post-surgery.
You need to be prepared and have your accessory items like:
- an elevated toilet seat.
- something to grab ahold of to help push yourself up and out of a chair or couch.
- a walker. I used a walker for the left knee for two and a half weeks. For the right knee, it was four or five days.
- a wedge or a lot of pillows to elevate the leg above your heart.
- a means of applying ice to the knee
The emotional side of knee replacement recovery
First, what I want to say leads to emotions.
After the second knee surgery, I noticed the hydrocodone affected me in a different way, a worse way. I had very little to no appetite and felt somewhat nauseated. I had zero energy and slept 10-11 hours a night. When I would wake up, I’d have a cup of coffee and want to go back to bed. Once I stopped the hydrocodone, the fatigue cleared up.
You worry about issues like constipation which your surgeon takes very seriously. Nobody wants to go back to the hospital to deal with that issue.
In terms of emotions, you almost feel like you’re in a depression.
Depending on the feeling’s longevity, you can alter the neural chemicals in your brain. In turn, this leads to depression and tiredness. For me, I felt like I was being left out of my daily life and the ability to run my business.
Fighting boredom during recovery
I’m in a business that is 100% treating patients. When I’m not at work, I’m idle. You’re idle because you’re not very mobile. You stay inside with your leg elevated and ice on your knee. Not only can you not conduct your business, but your daily routines of life are limited. Of course, boredom sets in.
From my perspective, as a business owner, I felt anxiety and worry which comes from not being at work.
I didn’t anticipate how much I would be affected by the downtime. I take my patient relationships seriously. You see a patient and they install their trust in you helping them heal. Then, you’re gone for 3-4 weeks which really bothers me.
After the first surgery, I returned to work in 2 1/2 weeks which was too soon. I could start off good, but then within a few hours, I could feel myself running low on energy. While you’re trying to regain your stamina, focus becomes an issue. Keep in mind, most people take off six weeks of work during their knee replacement recovery time. With the second surgery, I’m seeing patients on a limited basis.
As everyone in Houston knows, in February, cold weather burst a lot of pipes. The Friendswood clinic’s pipes burst which became a major anxiety moment right after the first knee replacement. Plus, I was going through a home negotiation. This affected my physical therapy regimen and slowed my recovery.
Fortunately, I’ve got great support people. Even so, I felt anxiety wondering if everything was running as smoothly as if I were there at work.
Knee swelling is a big problem. A knee joint has a cavity filled with synovial fluid. The fluid helps reduce friction around the knee.
After your knee replacement, the cavity balloons up and fills with the fluid. When you bend your knee, it’s like squeezing a water balloon in a large nutcracker.
The problem exists, in vitro, or inside the body. The pressure of the fluid being squeezed puts pressure on the nerves, blood vessels, and soft tissues. This creates pain. The knee’s mobility gets restricted by the amount of fluid within the joint that slowly attenuates over time.
During the first two or three weeks, knee surgery physical therapy should play a vital role in reducing inflammation and swelling.
Keeping your knee elevated and iced makes a huge difference.
I’m not using a cane or walker right now. I’m still walking with a pretty serious limp. Some of the limp is due to pain, some of it’s due to the swelling.
Improvements in range of motion in knee
With functional activities of daily living, you need 117 to 120 degrees to be able to bend over, tie your shoe or navigate stairs up and down, foot over foot. That’s why we set a goal minimum of 120 degrees after a knee replacement. You can’t bend over and tie your shoe easily if you have only 95 degrees in your range of motion.
My left knee range of motion post-surgery has improved from 122 degrees to 127 degrees of bend.
How my knee replacement changed the way I interact with patients
My two knee replacement surgeries bring a beneficial understanding of what patients go through. Before my surgeries, like most therapists, it’s more about push and push harder. I’m going to ease off that and say “let pain be your guide”. I definitely feel more empathy towards people who come in with a knee replacement. I feel like I’m one of the group.