Knee Replacement Recovery Tips

[Panik]

Hey folks, figured this would be a good place to post as I know from reading here for a 10+years that there are some people that muscle through recovering from surgeries and find work arounds to getting things accomplished despite impediments.

I'm 47 years old and am happily staring down the barrel of a total right knee replacement the Friday before Christmas. Between 3rd grade and age 26 I dislocated my knee 19 times before finding someone to do the corrective surgery necessary to stabilize my knee. (Was brought up in the era of waiting as long as possible for joint surgery). Causality was lax ligaments - likely genetic as my dad had similar issues.

In any case, I've had constant arthritic pain in that knee all my life and this summer it finally progressed enough that the pain moved passed being just background pain and started interfering with my ability to lead my life the way I want... instability on stairs/inclines, being barely able to walk when getting out of bed in the mornings due to swelling, severe daily limp simply walking, etc. Went and got evaluated by a local top surgeon and basically the prognosis was - bandaid the problem with cortisone injections with no guarantee if or for how long they would help or just but the bullet and get it done. Doc described the head of my femur as more resembling a mountain range than a joint..... So Santa is bringing me good drugs, a new knee for the holidays and a much needed 4 week break from work. Thankfully, while I don't actively work out, I lead a very active life and am not truly overweight (could probably drop 20lbs)

Having had knee surgery before and having been in and out of at least 20 full legs casts in my life I fully understand the need for re-hab & physical therapy - that's something I am fully committed to tackling with gusto. I've got too much stuff I want to accomplish to risk any issues. What I was hoping for is folks tips and tricks to manage recovery.... Things like:

- Thoughts on crutches/walker/cane/forearm braces for support in the first week or so?

- How long did the nerve block work after surgery? I'm a big believer in staying ahead in pain management after breaking bone in my foot in college and white knuckling the pain for 48hrs.

- Actual recovery time needed prior to returning to driving (right knee, automatic trans). I've driven many times with a full right leg cast before, but it was before big center consoles in vehicles became a standard thing. On the other hand that was also before cruise control really was a standard thing.

- Thoughts on which is better for getting into and out of vehicles - Higher entry vs lower entry? We have a Subaru forester, an outback and a 'yoga Sequoia with higher entry.

- Icing tips (should have a ice machine rented)

- Tricks for showering?

- Recovery time needed before being able to walk without a support device?

- Getting in and out of bed without assistance? (have a slightly raised bed)

- Brand/style recommendations for easy on/off sweat pants or PJ bottoms?

- Is it worth investing in a dedicated leg elevation pillow?

- Additional purchases that might be helpful? We don't have a recliner, but did just purchase one of those zero gravity padded beach chairs so that I can visit more comfortably with family.

- Brand/style recommendations for comfortable pj bottom/sweat pants that are easy on, easy off?

Thankfully, my wife is actually off for two weeks this Christmas and can help as necessary for that time, but I tend to be pretty independent in doing things & for the first week we will be at her mom's for the holidays.

 

[Mi-Troll]

Hey folks, figured this would be a good place to post as I know from reading here for a 10+years that there are some people that muscle through recovering from surgeries and find work arounds to getting things accomplished despite impediments.

I'm 47 years old and am happily staring down the barrel of a total right knee replacement the Friday before Christmas. Between 3rd grade and age 26 I dislocated my knee 19 times before finding someone to do the corrective surgery necessary to stabilize my knee. (Was brought up in the era of waiting as long as possible for joint surgery). Causality was lax ligaments - likely genetic as my dad had similar issues.

In any case, I've had constant arthritic pain in that knee all my life and this summer it finally progressed enough that the pain moved passed being just background pain and started interfering with my ability to lead my life the way I want... instability on stairs/inclines, being barely able to walk when getting out of bed in the mornings due to swelling, severe daily limp simply walking, etc. Went and got evaluated by a local top surgeon and basically the prognosis was - bandaid the problem with cortisone injections with no guarantee if or for how long they would help or just but the bullet and get it done. Doc described the head of my femur as more resembling a mountain range than a joint..... So Santa is bringing me good drugs, a new knee for the holidays and a much needed 4 week break from work. Thankfully, while I don't actively work out, I lead a very active life and am not truly overweight (could probably drop 20lbs)

Having had knee surgery before and having been in and out of at least 20 full legs casts in my life I fully understand the need for re-hab & physical therapy - that's something I am fully committed to tackling with gusto. I've got too much stuff I want to accomplish to risk any issues. What I was hoping for is folks tips and tricks to manage recovery.... Things like:

- Thoughts on crutches/walker/cane/forearm braces for support in the first week or so?

- How long did the nerve block work after surgery? I'm a big believer in staying ahead in pain management after breaking bone in my foot in college and white knuckling the pain for 48hrs.

- Actual recovery time needed prior to returning to driving (right knee, automatic trans). I've driven many times with a full right leg cast before, but it was before big center consoles in vehicles became a standard thing. On the other hand that was also before cruise control really was a standard thing.

- Thoughts on which is better for getting into and out of vehicles - Higher entry vs lower entry? We have a Subaru forester, an outback and a 'yoga Sequoia with higher entry.

- Icing tips (should have a ice machine rented)

- Tricks for showering?

- Recovery time needed before being able to walk without a support device?

- Getting in and out of bed without assistance? (have a slightly raised bed)

- Brand/style recommendations for easy on/off sweat pants or PJ bottoms?

- Is it worth investing in a dedicated leg elevation pillow?
View attachment 1930137

- Additional purchases that might be helpful? We don't have a recliner, but did just purchase one of those zero gravity padded beach chairs so that I can visit more comfortably with family.

View attachment 1930140

- Brand/style recommendations for comfortable pj bottom/sweat pants that are easy on, easy off?

Thankfully, my wife is actually off for two weeks this Christmas and can help as necessary for that time, but I tend to be pretty independent in doing things & for the first week we will be at her mom's for the holidays.

I'm looking to have a total knee replacement soon as well, looking forward to answers myself.

 

[Gee Ray]

My wife had to have knee surgery. They gave her one of those pumps to pump ice water around her knee thank goodness it was a godsend for her. It was a mess for me until I realized I could freeze water bottles and swap them out a few at a time and keep the water in the pump cold. It worked well for her and several of her friends as we haven’t seen the Pump back to us for three or four years it keeps getting used. you can buy them relatively inexpensively on Amazon.

 

[WM75Guy]

I wish you good luck. My experience wasn't bad when I had my knee replaced. I used a walker for 2 weeks, a cane for 2 weeks, and then carried the cane occasionally, especially when walking across the yard to the barn or shop. Elevation is your friend, along with ice packs. Get some re-usable gel ice packs that go in the freezer. I experienced occasional swelling for about a year after surgery. Also forget about getting down on that knee after surgery, it is painful even with knee pads or cushioning.

Physical therapy is important. Keeping ahead of pain is good. Take pain meds one hour ahead of physical therapy or going to bed. I learned that in nursing school and it helps a lot.

You can get toilet rails relatively cheap. I bought these for mine off Amazon. Also get a second inexpensive walker without wheels to leave in the shower. It won't slip and you don't have water dripping everywhere. Afterwards keep everything in a closet, you never know when you might need them again.

 

[Panik]

I'm looking to have a total knee replacement soon as well, looking forward to answers myself.

Do you have a date yet? I was surprised when we went in for the consult about how quickly arrangements could be made. Given that its the end of the year my wife and I figured that all surgery slots between now and the end of the year would be taken due to people taking advantage of having met their deductible. Surgeon actually had a bunch of dates available and we were able to snag one that fit our schedule perfectly. With kids and work if we hadn't been able to sneak it in over the holiday the next time-frame that would work for us would have been at the end of the school year and over the summer.

I'd much rather be laid up after surgery during the cooler months than in the middle of summer heat.

 

[Panik]

My wife had to have knee surgery. They gave her one of those pumps to pump ice water around her knee thank goodness it was a godsend for her. It was a mess for me until I realized I could freeze water bottles and swap them out a few at a time and keep the water in the pump cold. It worked well for her and several of her friends as we haven’t seen the Pump back to us for three or four years it keeps getting used. you can buy them relatively inexpensively on Amazon.

Those things are amazing! I still have the old one from my first knee surgery back in 2006. Like you it's been used pretty extensively by friends and family. I'd just plan on using it for this surgery, but I'm unsure if the cooling pad configuration will suit this surgery. Plus, the one my wife rented after her hip surgery was much much more advanced.

I wish you good luck. My experience wasn't bad when I had my knee replaced. I used a walker for 2 weeks, a cane for 2 weeks, and then carried the cane occasionally, especially when walking across the yard to the barn or shop. Elevation is your friend, along with ice packs. Get some re-usable gel ice packs that go in the freezer. I experienced occasional swelling for about a year after surgery. Also forget about getting down on that knee after surgery, it is painful even with knee pads or cushioning.

Physical therapy is important. Keeping ahead of pain is good. Take pain meds one hour ahead of physical therapy or going to bed. I learned that in nursing school and it helps a lot.

You can get toilet rails relatively cheap. I bought these for mine off Amazon. Also get a second inexpensive walker without wheels to leave in the shower. It won't slip and you don't have water dripping everywhere. Afterwards keep everything in a closet, you never know when you might need them again.

View attachment 1930180

Thanks for the data point regarding assistive devices. I've normally used crutches in the past, but hate how they bruise up my armpits no matter how I pad/modify them. Out of curiosity at the start of recovery - how much of your walker use was to bear weight vs using it for stability? I've heard that you should try and be weight bearing on the affected leg as much as you are capable.

And I'm definitely with you regarding pain management. I've been witness to the swings in the medical community regarding over and under medicating for pain. I'm a firm believer in better living through chemistry within reason... and have had to get on my wife about pain management a number of times during her hip surgeries and c-sections.

I am a little concerned about getting on and off the toiled - especially for the first week because where we are staying have those stupid, midget height toilets. That toilet safety frame looks perfect for both the toilet and a stable support device for showering. Mom has mobility issues so it would get additional use after I'm done.

 

[ponytug]

Those things are amazing! I still have the old one from my first knee surgery back in 2006. Like you it's been used pretty extensively by friends and family. I'd just plan on using it for this surgery, but I'm unsure if the cooling pad configuration will suit this surgery. Plus, the one my wife rented after her hip surgery was much much more advanced.



Thanks for the data point regarding assistive devices. I've normally used crutches in the past, but hate how they bruise up my armpits no matter how I pad/modify them. Out of curiosity at the start of recovery - how much of your walker use was to bear weight vs using it for stability? I've heard that you should try and be weight bearing on the affected leg as much as you are capable.

And I'm definitely with you regarding pain management. I've been witness to the swings in the medical community regarding over and under medicating for pain. I'm a firm believer in better living through chemistry within reason... and have had to get on my wife about pain management a number of times during her hip surgeries and c-sections.

I am a little concerned about getting on and off the toiled - especially for the first week because where we are staying have those stupid, midget height toilets. That toilet safety frame looks perfect for both the toilet and a stable support device for showering. Mom has mobility issues so it would get additional use after I'm done.

Good luck! I hope that your surgery and recovery go well.

If you have a genetic predisposition toward loose/lax ligaments, I think that you can expect rehabilitation to take longer than average, but it sounds like you are up to speed on that already. Not that it will speed your recovery, but you might want to look into connective tissue disorders, e.g. Ehlers-Danlos as it is now known to cover a wide range of symptoms, not just "double-jointed" that may be helpful.

The Ehlers-Danlos Support UK

Our vision is that nobody should be left to fight on their own. Every person with EDS or HSD should have access to the appropriate medical services and care.

www.ehlers-danlos.org

In addition to toilet seat frames, you can get toilet lift rings as an alternative and it both.

If you have upper body strength, I highly recommend forearm grip style crutches (aka Lofstran / elbow / forearm support crutches). No underarm issues and I think it gives one much better mobility. If you want to go down the walker path, there are hands free version and upright versions; e.g. LifeGlider - LifeGlider
But I would check with your doctor about them.

I would also vote for an icing machine.

Have you looked at lift recliners that support you to near vertical?

All the best,

Peter

 

[Panik]

Good luck! I hope that your surgery and recovery go well.

If you have a genetic predisposition toward loose/lax ligaments, I think that you can expect rehabilitation to take longer than average, but it sounds like you are up to speed on that already. Not that it will speed your recovery, but you might want to look into connective tissue disorders, e.g. Ehlers-Danlos as it is now known to cover a wide range of symptoms, not just "double-jointed" that may be helpful.

The Ehlers-Danlos Support UK

Our vision is that nobody should be left to fight on their own. Every person with EDS or HSD should have access to the appropriate medical services and care.

www.ehlers-danlos.org

In addition to toilet seat frames, you can get toilet lift rings as an alternative and it both.

If you have upper body strength, I highly recommend forearm grip style crutches (aka Lofstran / elbow / forearm support crutches). No underarm issues and I think it gives one much better mobility. If you want to go down the walker path, there are hands free version and upright versions; e.g. LifeGlider - LifeGlider
But I would check with your doctor about them.

I would also vote for an icing machine.

Have you looked at lift recliners that support you to near vertical?

All the best,

Peter

Funny you mention looking into connective tissue disorders… well not funny but interesting coincidence…..

I’d be willing to bet I don’t have Ehilers Danlos - that knee has been the only thing that’s ever been an issue and I don’t seem to have any of the other associated symptoms. That said I have an appointment with my primary care physician and I’ll bring it up for conversation and see where it goes.

On the other hand we’ve been in the slow train with my wife’s care team to diagnose her issues - ankylosing spondylitis (autoimmune degenerative joint disease) and in the last month we’ve been trying to get a differential diagnosis between myasthenia gravis and although less likely - possibly multiple sclerosis. Your comment about forearm crutches brought the comparison up because she has a pretty slick pair of purple forearm braces she used from time to time.

I had been already thinking about it - with your suggestion I am going to go ahead and get a pair for myself. I really hate the old school style crutches and would rather the increased weight bearing and balance required of the forearm crutches.

The other thing I’ve been contemplating is getting a cheap stationary mount for my bicycle. bike mount. It’s a nicer single track bike that’s very comfortable. It seems like it would be an easy way to get in more passive joint flexibility work initially and then more active muscle rehab at home. I haven’t used it much in the last 10 years but my orthopedist as a kid was always big on getting me on a bike for rehab and I seem to remember it being a huge benefit.

Out of curiosity… I understand Ehlers Danlos often has a chronic pain component. Have you tried CBD & its related compounds for pain relief? (If it’s something that you don’t ethically endorse or don’t feel comfortable sharing about I completely understand & respect that… if that’s the case please ignore this part of my post with apologies)

My wife’s been dealing with at times debilitating pain and we’ve been searching for non-prescription non-narcotic solutions - she doesn’t tolerate the side effects of prescription narcotics very well. NSAIDS, muscle relaxers, curcumin, CBD and the like don’t really provide any relief.

On the other hand the stronger relative compounds of CBD really DO provide her significant relief from both pain and inflammation. However, while she tolerates the side effects of those compounds MUCH better than prescription narcotic pain relievers, she is still very sensitive to the side effects.

It’s been very difficult finding something that provided her relief with minimal negative impacts.

Back on track to the conversation at hand… I think I’ll pass on the life glider for my recovery but it’s an excellent idea. Mom lives with us and has significant mobility issues (neuropathy, arthritis and a severe case of not exercising/stretching) I do think your recommendation would be a great next step for her in terms of assistive devices.

I’m any case Peter, sincere thanks for sharing and helping with some decisions!

 

[Mi-Troll]

Do you have a date yet? I was surprised when we went in for the consult about how quickly arrangements could be made. Given that its the end of the year my wife and I figured that all surgery slots between now and the end of the year would be taken due to people taking advantage of having met their deductible. Surgeon actually had a bunch of dates available and we were able to snag one that fit our schedule perfectly. With kids and work if we hadn't been able to sneak it in over the holiday the next time-frame that would work for us would have been at the end of the school year and over the summer.

I'd much rather be laid up after surgery during the cooler months than in the middle of summer heat.

I retired last year but still working, If I retire now my wife will be uninsured until next March when she can get insurance, just waiting until then. You're correct, the Dr said he can schedule me right away.

 

[ponytug]

Funny you mention looking into connective tissue disorders… well not funny but interesting coincidence…..

I’d be willing to bet I don’t have Ehilers Danlos - that knee has been the only thing that’s ever been an issue and I don’t seem to have any of the other associated symptoms. That said I have an appointment with my primary care physician and I’ll bring it up for conversation and see where it goes.

On the other hand we’ve been in the slow train with my wife’s care team to diagnose her issues - ankylosing spondylitis (autoimmune degenerative joint disease) and in the last month we’ve been trying to get a differential diagnosis between myasthenia gravis and although less likely - possibly multiple sclerosis. Your comment about forearm crutches brought the comparison up because she has a pretty slick pair of purple forearm braces she used from time to time.

I had been already thinking about it - with your suggestion I am going to go ahead and get a pair for myself. I really hate the old school style crutches and would rather the increased weight bearing and balance required of the forearm crutches.

The other thing I’ve been contemplating is getting a cheap stationary mount for my bicycle. bike mount. It’s a nicer single track bike that’s very comfortable. It seems like it would be an easy way to get in more passive joint flexibility work initially and then more active muscle rehab at home. I haven’t used it much in the last 10 years but my orthopedist as a kid was always big on getting me on a bike for rehab and I seem to remember it being a huge benefit.

Out of curiosity… I understand Ehlers Danlos often has a chronic pain component. Have you tried CBD & its related compounds for pain relief? (If it’s something that you don’t ethically endorse or don’t feel comfortable sharing about I completely understand & respect that… if that’s the case please ignore this part of my post with apologies)

My wife’s been dealing with at times debilitating pain and we’ve been searching for non-prescription non-narcotic solutions - she doesn’t tolerate the side effects of prescription narcotics very well. NSAIDS, muscle relaxers, curcumin, CBD and the like don’t really provide any relief.

On the other hand the stronger relative compounds of CBD really DO provide her significant relief from both pain and inflammation. However, while she tolerates the side effects of those compounds MUCH better than prescription narcotic pain relievers, she is still very sensitive to the side effects.

It’s been very difficult finding something that provided her relief with minimal negative impacts.

Back on track to the conversation at hand… I think I’ll pass on the life glider for my recovery but it’s an excellent idea. Mom lives with us and has significant mobility issues (neuropathy, arthritis and a severe case of not exercising/stretching) I do think your recommendation would be a great next step for her in terms of assistive devices.

I’m any case Peter, sincere thanks for sharing and helping with some decisions!

Good luck with your wife and I do hope that whatever she has responds to treatment sooner rather than later. Finding effective therapies for chronic pain is, in my opinion, very challenging, and often takes longer than anyone would like. My sympathies to her. I suspect that there is a much higher diversity of causes than most folks consider. Vis-à-vis CBD, I'm on the page that there are lots of medically active chemicals out there, some approved by the FDA, some not, but if someone finds a therapy that works for them, that's fine by me. I think that many chemicals can, and do, have effects in many ways in the body. That makes many treatments not universal treatments, but treatments for certain groups of individuals. It is my experience that the current method to find effective treatments is often largely trial and error.

I don't have Ehler-Delos myself, either. The British seem to be farther along in understand the web of diseases that have similarities, which is why I posted that website. I brought it up because I think more doctors are starting to see Ehler-Danlos as one particular point on a spectrum of related and associated connective tissue disorders, but that also strongly associated with with things like migraines, chronic pain, orthostatic hypotension, hives, mast cell activation and more. As I understand it, connective tissue disorders aren't treatable yet, but many of the associated diseases have therapies, e.g. antihistamines.

I agree that stationary bikes certainly have lots of advantages for sure. Personally, I do try to always include my doctors in those sorts of conversations. I had some extremity pain many moons ago, and while under going treatment for it, I double checked that continuing to swim over lunch time would be ok. They said yes. Many, many months of treatment went by, without much of any improvement, before I thought to double checked with them that the actual amount of swimming I was doing (3,000 plus meters) was ok. Their response was "gosh no! We thought you were just paddling around in the shallow end." With that misunderstanding cleared up, I got better. As they say, "the dose makes the poison..."

On the LifeGlider, I bought one for an older relative, who loved it.

All the best,

Peter