The aftermath of knee replacement surgery

In My Humble Opinion
1

Spousal unit had his left knee replaced on Sep 3, and the right will be replaced on Dec 3. As I write this, we’re a week from his hospital release (they kept him overnight because of another recent surgery - apparently this doc normally does knees as day surgery.) I’m wondering how our experience compares to others.

He expected the pain - both of his parents had both knees replaced, so he’s gotten lots of anecdotal feedback. But I don’t think he expected the therapy to be as painful as it is. He’s done his best to stay on top of the pain, but he’s avoiding opioids as much as possible because of the constipation side-effect. Ice packs help.

What surprised both of us is the bruising. His leg - especially the inner thigh - looks like he was beaten with a sledge hammer. Shades of purple, red, and yellow one rarely sees together. The reaction of his therapists and the nurse was pretty much “Yep, you’ll see some colorful bruises.” I don’t know why we didn’t expect this.

His biggest problem is getting sleep. He’ll get comfortable, fall asleep, then wake in an hour or so in pain - sometimes he gets up and goes to sit in his recliner a bit. I can’t recall the last solid sleep he got. And, unfortunately, the same goes for me. Even if he was sleeping thru, we’ve got alarms set for his meds every 6 hours which means if I’m lucky, I might get 5 hours straight. So far, the best is 4.

Follow-up appointment with the surgeon is Thursday - just shy of 2 weeks after the replacement. Not sure what to expect, but I know my husband is itching to drive again. So far, I refuse to let him, mostly because of the drugs, but also because even tho his right leg still mostly works, he can’t walk but a few steps without his walker, so what’s the point of driving anywhere? OK, it’s boredom.

Tell me it gets better fast! I need something to cling to!! And I need sleep. :yawning_face:

2

Sorry to hear that. My wife had her knee replaced the end of last year. She was in the hospital 3 days (it was supposed to be 2 but her nurse coached her on the magic words to say to get to stay another day.) They had her exercise right away, and she exercised when she came home also. She’s 68, by the way. She was up and about long before she expected to be, and the pain was much less after the surgery. It doesn’t hurt at all anymore, in fact. She is having her hip replaced next month - they hoped the knee would fix all her problems, but it didn’t.
I don’t remember when she started to drive again, it’s not like we go anywhere anyhow, but it was not a problem.
She’d do it again in a second. We’ll see how the hip goes.

3

My husband is closing in on 65. He’s been good about doing his exercises even tho I know he hates it. I’m wondering if his weight adds to the pain - he really needs to shed some poundage, but one thing at a time.

I think he got false hopes in the hospital - he felt really good and was up and walking shortly after the surgery. Then the nerve block wore off…

4

I had one knee replaced in January and got the full therapy treatment. 3 days in the hospital followed by a week at a nursing/recovery home with therapy twice a day. Then 2 weeks of at home therapy by the Visiting Nurses Association. Then several weeks visiting the orthopedic center gym with a trainer.

Yeah the therapy hurts but you need it. Stretching the knee through all those motions helps to make sure you don’t end up with limited motion or need to have the scar tissue cut back. The worst for me was compressing the leg straight. Weights are placed on the straightened knee while the heel is raised a bit. Felt like my leg was going to snap! The therapists smile and encourage, “One more degree!”

I didn’t drive for almost 2 months.

5

I had my right knee replaced three years ago. Due to my age and other health problems I had to stay in the hospital a full week, then a week in a nursing home. Before my release I told them I didn’t need any home health care, because my daily activities would be enough exercise. Foolishly, they agreed, so I went without any further healthcare.

I was able to drive as soon as I got home, but getting in/out of the car was a little difficult. In PT they had me getting in/out of the passenger side, but not the driver’s side.

All went well for about 9-10 months, then the pain started coming back. Before long it was almost as bad as pre-surgery. I saw the surgeon, and he told me to take Tylenol [!].

Now my left knee is needing replacement, and both knees are hurting about the same. I’m taking Glucosamine Chondroitin, and it helps.

6

My 75 year old mother had both knees replaced August 9. She was moved to inpatient rehab that Thursday and released home (where she lives alone) the following Thursday - we all really expected her to be in a least a week longer in part because she does live alone, but I drove up (she’s about 2 hours away) and did the training they required family to do and all the PT and OT folks told me it was really a formality because of how well she was doing.

I was back up last weekend to check in. She is driving, since 3 weeks out IIRC - her doctor told her she had to be fully off the opiods for 2 days before she could drive, so she stopped taking those . Took her to costco last Saturday where she walked all around the edges of the store. She’s still on a walker and outpatient PT is working to transition her to a cane. She’s really good about doing her exercises. Like others have said, night is hard because she stiffens up while sleeping, so wakes up partway through the night.

(her reasons for asking for both at once was that she’s 75 and doesn’t want to spend a huge amount of time in the hospital/rehab. And she’s said now that if she had only had one done she might not have gone back for the other because it hurt. That said, she’s moving better than she did before surgery, even just a month out)

7

My husband was saying the same thing about not getting the right knee done, but he will. He had arthritis in both of them and even before the surgery, he was hobbling around on a cane. At least we know what’s ahead of us in December. And by then, we’ll have a new grandbaby to help distract him!

8

Yeah, I got surgery last week…I hear six weeks at least before normal sleep returns.

Make sure he isn’t dehydrated. I came out of surgery with a wicked case of drymouth. I’ve noticed other symptoms as well, so I drank some gatorade. At first, it was like “I’m exhausted…I can hardly think straight.” Add electrolytes…I’m still exhausted but it’s a better form.

The combination of exhaustion and opiods isn’t conducive to driving.

My bruising is mostly gone, in under two weeks. I’d keep the bruising in place of insomnia, for sure.

I think for me it’s the term "therapy,’ like it’s totally benign, no tears, etc.

They say the more you push therapy, the more you’ll regain of your range of motion etc. So it’s a strange line to walk…if therapy doesn’t hurt, is it working? Mine hasn’t been bad but maybe I won’t have a good outcome.

Yep. Been there done that.

9

Good thought about the Gatorade - I’ll get him some. He tends to drink mostly diet Coke and occasionally OJ or lemonade. Dehydration never occurred to me. Thanks!

10

Sure. I too was pretty constipated…if you’re dehydrated, that’ss another problem. I don’t get a lot of headaches but I started having them, so there’s another hit.

Add to this the fact that you’re not supposed to drink fluid before surgery so you’re starting from a low level.

11

A few more thoughts for you, OP…

Background: I didn’t really wake up in a terrible amount of pain once initial swelling subsided a day later, but the first couple days I used painkillers. I was already the kind of sleeper who wakes up in he night 2-3x. And Tylenol has never worked well for me, but I guess that’s what the medical establishment likes to use. The toxic dose is close to the usual amount given, so don’t OD if you want a healthy liver.

Not sure which painkiller he’s on, but AIUI many of them disrupt deep sleep.

They’ll block pain so you can sleep, but you won’t sleep deeply. I called doc about insomnia, they called in new Rx for heavier opioid, but pain wasn’t the issue. I gather that insomnia’s common, but there is no easy solution.

A few minutes ago I tried to lie down and see if I could nod off. I breathed very slowly and tried not to think of anything. I didn’t sleep—but I got that little “kiss” your brain sometimes gives you right as you’re waking up from good rest. I’ll take what I can get.

  1. I tried melatonin. I haven’t figured out if it helps…but it might be worth a try.

  2. One to ask your MD about: CBD or marijuana (if legal in your locale).

One of my nurses fought my ignorance: I was telling her that my mom had hip replacement and came through it like a trouper…twice. She said, “Knee replacement is major surgery, though.” I would have thought hip replacement was major-er. Butter my butt and call me a biscuit!

With 9-11 passing, I’m reminded of prisoners at Abu-Ghraib being subjected to tortured with sleep deprivation. I’d jump off a building or something.

The other question I would raise is the Diet Coke. I am the poster child for that stuff. Get up in the morning, pour one, get ready for work…refill, hit the commute.
Drink it through out the day. Well now that I’m home, the routine went out the window. I have actually gone a couple days without any at all…it’s a sign of the apocalypse.

If your body is used to that and you stop, then are you always kinda groggy? Instead of “I want a nap” sometimes it should be “Time to wake up! Open a Diet Coke!”

And years ago, my doctor mentioned that “Exercise triggers sleep.” I’m doing stretches etc. with physical therapy but that isn’t very aerobic. If the knee doesn’t allow exercise for the time being…I guess you could try some upper body.

Good luck!

12

He’s been taking a time-release melatonin and it helps a little. The issue is the pain that wakes him every few hours. This has been going on for months - I didn’t mention, but in April, he had his 10th spinal surgery, so between that pain and the arthritis in both knees, he’s been a mess for months.

As for marijuana products, they do nothing for him. At least the edibles don’t. He won’t smoke or vape it or whatever one does.

We do have a recumbent exercise bike and the therapist had him on one last week. When we go tomorrow, I’m going to ask if/how much he can do at home. I’m reluctant to make that decision for him.

We just took a walk down our driveway and back - maybe 150 feet? I figured that would be better for him than doing laps in the house - fresh air and sunshine and all that. He’s napping now, or trying to - I shut the door and the house is quiet, so we shall see.

At least we know what to expect in December when the right knee gets done.

13

Bumping the thread to check in.

I’ve been mending pretty well. I did get a nasty case of hives, not sure why. Finally got past some of the sleep issues, and I’m down 6 hours at a time now.

How’s everybody holding up?

14

One anecdotal point for the OP here. My buddy had a knee replaced several years ago in his early 50s (arthritic, I think). Recovered, then injured the same knee again in a work accident 2 years ago. Evidently, they had to replace only the lower part of the knee this time. He is very athletic, so I am sure he took the PT seriously. Anyway, he’s an animal on a bicycle, and this year we completed a bicycle tour of the California coast. His “bionic” knee was never an issue - he’s such a strong rider we joked he was really Steve Austin.

I am sure it’s rough right now, but it will get better and he can be stronger than before. Hang in there!

15

It’s nearly 5 weeks since my husband got his new knee, and he’s been pretty faithful with his therapy. Almost from the start, he’s had great bend and straightening numbers.

Unfortunately, he’s dealing with some hard-core neuropathy, not from the knee surgery, but from the spinal surgery he had in April. As a result, some of the therapy exercises are difficult and even dangerous - his balance is a real issue. On the plus side, his neurologist just set him up to be evaluated for some sort of device to be implanted in his spine to deal with this. He compared it to a pacemaker - I don’t understand the details, but I’m hoping it’ll help. We’ve got an appointment next week, so back to Baltimore we go.

In the meantime, my SIL tore his ACL and is seeing his surgeon on Monday. Oh yes, and my daughter is nearly 8 months pregnant. and they have a 3-y/o who SIL takes to school. Something tells me my grandmotherly duties will include taking the toddler to school while SIL recovers from his surgery. Sure hope Baby 2.0 doesn’t decide to come early. And did I mention my husband’s second knee replacement scheduled for Dec 3? To quote Danny Glover in Lethal Weapon: I’m too old for this $#!+!!

16

Sorry to hear about all of that!!

I missed the thread earlier, but I’m not surprised at all at the bruising - any broken bone produces some spectacular discoloration. And yeah, pain not too bad until the nerve block wore off… I haven’t had knee replacement surgery (yet) but I remember the same syndrome when I had my wrist surgery. It was rather like someone had replaced my arm with one of those huge pork loins.

A friend of mine was dealing with knee pain for years. She finally had first one, then the other, replaced within a few months. at about the same time I was dealing with knee pain from a different cause. I remember telling my doctor about the friend, and said “She’s kicking herself… or would be, if she could, for not having it done earlier”.

How does the neuropathy etc. affect the plans for knee #2? Might they need to delay that?

17

My strength has been pretty good, as are flexibility and range of motion. Balance is iffy at times in PT. Some of the problem is “trusting” the new joint but it’s improving. It has only buckled twice. I remember to take my cane with me half the time, but I don’t really need it.

One day not long after surgery, I was lying in bed and rolled on my right side. I felt like a big lego was trapped under my right knee. Nope, that’s the new knee. Now the bits and pieces are settling more into place. Doc says feeling completely normal takes six months.

I was looking at the billing on line. If you had no insurance? About $34K. That doesn’t include physical therapy, of course.

18

He’s got a appt next week to discuss implanting some sort of stimulator in his spine to deal with the neuropathy. The timing of that may affect the knee surgery - we don’t know yet.

Yeah, that sounds about right. We’re so lucky that I was able to carry my insurance into retirement. Especially in Maryland, where, for some reason, all the cool Medicare options you hear about on TV aren’t valid. I talked with an advisor some time back, and when I told her what our insurance was and what it cost, she said to hold on to it and don’t bother with any of the supplementals. So much as I choke over the monthly premiums, they’re a pittance compared to what we might be paying otherwise.

19

My uncle (by marriage) got a bad infection. His body rejected the metal implant. It eventually had to come out and his knee fused.

Don’t want to scare anyone. This was my uncles second knee replacement (same leg). He messed up the first one in a motorcycle wreck. His first operation had been quite successful. Maybe too successful because my uncle tried riding his sons motorcycle. He hadn’t ridden in 20 years. Didn’t make it around the block

20

As I said, I got a wicked case of hives about two weeks after surgery and ended up on prednisone. The incision had been healing fine but the prednisone suppressed the immune system, making the hives go away. So my body couldn’t quite completey heal the incision. I ended up back in the doc’s office yesterday because it was bleeding and oozing a little, and the red was spreading. Surgery was six weeks ago…

But I just finished prednisone and he said there were no abcesses, gave me oral antibiotics, said to keep it clean and covered and it should be ok.

I have 120 degrees of bend, which I guess is max for the prosthetic. I lack about 4 degrees in the other direction (vertical) though.