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Knee replacement

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  • Knee replacement

    I would really appreciate any insight into what kind of help I will need when I come home from the hospital. Will I be able to take care of myself...do the minimum...get out of the car and in to the house??? Stupid stuff like that....I want to be prepared for it ahead of time. And also, what should I respect with rehab?? How much, how many times a week, for how long? thanks for any experiences you could share.
    "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt

  • #2
    Are you going to any type of inpatient rehab from the hospital to home? most people I know went inpatient for about five to seven days, learning how to get in an out of the car, shower, and most important how to begin to move the knee. Know several people that eventually went back to riding but it was a while. Outpatient rehab is usualy three days a week.


    • #3
      I've had 3 knee replacements so far --- one to replace a failed replacement, and I'm setting up for replacing the other original replacement in December.
      I go into the hospital on Monday morning, leave Wednesday. I go home to my house, BY MYSELF, and take care of everything myself. A PT came to the house 2-3x a week for about 3 or 4 weeks. I drove myself to the doctor's office at the 2 week point to have the stitches removed. Was back to work FT in 6 weeks. You go home with a walker, switch over to a cane, then to nothing.
      Ice packs are your best friend. Don't forget to have your house stocked with things like extra dog food for the dogs (if you have them; I have 3 large hungry ones), chocolate, extra toilet paper, and Nacho Cheese Doritos. :-) Assuming you can let dogs go out into a fenced in yard, have a very good friend or a poop-scooping service come by and clean up once a week. It's a hell of a lot easier if you have someone around to help, but you can do it alone.


      • #4
        My first knee replacement I went home alone as you are planning on doing. They sent a person to do PT 3 days a week. I won't lie to you, it was very rough. Just trying to make food and carry it to the table was very difficult with a walker. Lost 17 pounds trying to take care of myself.

        The next knee replacement I knew better and insisted that I go to a rehab facility for 5 days. They gave you PT twice a day there and had the proper equipment and people to help you. Meals were served and ice bags brought to you after PT. I healed a lot faster with that knee than the first one. Rode for the first time after 4 weeks.

        If at all possible, check with your insurance company and try to get into a rehab facility even if only for a few days.


        • #5
          I had my first TKR at 51. I spent 3 days in the hospital, the third day was a extra because a conscientiouis nurse sent me to nuclear medicine in the middle of the night to check for an embolism and I was worn out. I went directly to my home, and climbed the flight of steps to my front porch with the help of a cane.

          I did have my husband to help me with all of this.

          I spent the first night in a recliner on the first floor, and was able to get back and forth to the bathroom, kitchen, etc., without difficulty. (I have the ADA tall potty, it's a big help. I also have a shower stall with a seat and a hand held shower attachment.) I got to the second floor and slept in my own bed the second night home from the hospital.

          I had a visiting nurse come and change my dressing and check my blood every couple of days. I started at home PT immediately, and was discharged to out patient PT early. The therapist felt that if when she arrived, she had to search the farm for me because I was running the dog from the golf cart or was out in the horse pastures or get me off of the tractor, it was a little silly to make me go inside, get my cane and sit down to do PT. :-)

          I rode at 4 weeks post op, was back at work full time 6 weeks post op.

          Of course, your mileage may vary, but I'd be happy to answer any questions about my experience for you.
          The plural of anecdote is not data.


          • #6
            My insurance would never go for sending me to a rehab place, and that's fine with me. I'd miss my dogs too much! Heck, I'm lucky they don't send me home the same day as the surgery! My last surgery, and my next, are 2nd time around replacements, and sad to say it's a lot more painful than the first time, but the rehab and recovery is the same. I don't ride anymore, haven't for a few years, but was volunteering at all day robotics competitions within 8 weeks, showing dogs again in about 3 months, and now I'm running alongside one of them working on conformation. (Don't tell my surgeon that I'm running!)

            Your mileage may vary, quite true, and attitude is a whole lot of it. And we all know you can't keep a horseperson down!


            • #7
              Not to hijack, but for everyone that has had a(or more!) TNR how old were you at the time and how long has it been since then? I know I'll have to have my knees done and am just trying to get a feel for what impact age/fitness has to do with recovery.
              You can't fix stupid.... but you can breed it!


              • #8
                Based on my own experience, and threads similiar to this one that I've started and particpated in here and on other horse boards, here's some generalizations:

                You are going to need help the first couple of days at home. Not constant round the clock help, but help. I was able to get out the car and up the steps into the house without help, but of course, I had the reassurance of someone standing right there watching, and someone to fetch and carry for me. The real risk is if you fall with the new knee. Have the house set up before you go to the hospital - clear paths to the important stuff, pick up area rugs or other leg catchers, put a grab rail in the bathroom, get a shower seat if you need one, figure out where you're going to sleep, etc.

                They sent me home with a walker, which I hated and didn't use. I was most comfortable with a cane, on the side of the replaced knee. You do need SOMETHING to give a some support as you get used to the new knee, but do what works/feels comfortable for you - walker, crutch, cane, whatever.

                Take the pain meds. I ALWAYS make the mistake of waiting till I'm hurting to take the meds; take them BEFORE you start hurting. I had a spinal block as part of my anesthesia, and that was wonderful; it meant the bad knee and ankle on the other side from the TKR didn't hurt. :-) But you have to be comforable enough to do the PT, that's key. Take meds 1 hr. before the therapist arrives or before you go to outpatient PT.

                The biggest predictor of success or speed of rehab is fitness before the surgery and adherence to the PT routine. But the "fitness" component is not necessarily aerobic fitness, it has more to do with your quads and hamstrings and the other structures supporting your knee. Start doing leg lifts and calf raises now, and keep doing them.

                The plural of anecdote is not data.


                • Original Poster

                  Thanks SO much..

                  to all of you who have taken the time and made the effort to reply!!! I really needed to hear these things and know they will help me to organize myself for this surgery and PT. Did any of you change your own dressings?? I did for my ankle surgery, and would buy materials to do it for this if it seems practical. Wound healing is something I really liked when I was in the horse business and find it very natural to do the same for myself. Again....thank you!!
                  "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt


                  • #10
                    I agree with almost everything that McGurk says --- all that stuff putting away throw rugs, having everything set up, having a place to sleep arranged --- yep. Cane vs walker? Depends on you.

                    I had my first partial knee replacements in my late 40's (48, I think), and now, at 56, I've had one of those replaced and the other one is soon to be replaced. The second time around is MUCH harder because they have to take out all the old hardware to put in the new stuff, so the surgery is longer, there's more blood loss, a bigger incision, etc. When this second knee is redone, I plan to ask for bigger, badder pain meds for the first week home.

                    I never had to change my own dressings --- the PT or the visiting nurse did that. (You'll most likely be on Coumadin for a few weeks, and they have to check your blood once a week so a nurse comes by.) And after two weeks, the stitches/staples are out and then you don't cover it anyway.

                    A full replacement should last 20 years or so if you don't do anything stupid. :-)

                    I suggest having a couple of pairs of comfy gym shorts to wear rather than long pants --- makes PT easier, doesn't irritate the wound. When getting dressed, put the bad leg into your pants first --- much easier that way.

                    I'm more than glad to answer any question you may have, so don't hesitate to PM me.


                    • Original Poster

                      I thought I would post an update. Just finished week three. In home PT was working great....the measurements of my straightening and bending were way ahead of schedule....a 5 straightening, and I am at 116 bending. Ice, Delaudin, and Tylenol taking care of the pain, Aspirin for blood thinning. I walk with nothing or a walker if I get light headed. I mow my pastures. Take walks with th edogs.
                      THEN I went to the out patient Rehab on Monday. The deep muscle massage did me in and I became nauseous and remained so for three days....also the exercises were painful. She had done the measurements and said how good they were. But what a shock..I am just now starting to feel better and will resume on Monday....but I will not try as hard and will pass on the deep muscle massage. I will not ride until I am no longer light headed....and I know I have to get off the Delaudin. I hope the Tylenol will hold me. The ice is amazingly effective. If it hurts too much at night for me to sleep, I go down stairs and ice and fall asleep. This has only b een necessary since the PT appt.
                      "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt


                      • #12
                        Claudius, glad to hear you are doing better. I had knee surgery a few years ago due to a riding accident and I have to say, those PT people are masochists! To straighten my knee, they used to make me sit in a chair with my foot resting on another chair and weights hanging from my thigh and shin. Ouch! (but it worked!)

                        My doc told me I'll eventually need a knee replacement so I asked when...and he said 'when you can't stand the pain anymore'. Great.

                        For those of you with TKR's, how did you decide when it was time?
                        ~ Citizens for a Kinder, Gentler COTH...our mantra: Be nice. ~


                        • #13
                          My mom is on week 4 of a TKR. Her doc reccomended tyenol PM for nights when it's hard to sleep but she doesn't want to take the stronger stuff. You may want to talk to your doc about that.
                          For the horse color genetics junky


                          • Original Poster

                            Snaffle635....exactly when your Dr. said. When you can not stand it any more. I finally realized how much of my life was about AVOIDING doing things that hurt, and recognizing how MUCH of life was hurting to much for me to participate!!! Kind of when denial just doesn't cut it any more~~!!
                            "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt


                            • #15
                              knee replacement

                              in 2007, I had both knees replaced - spent 3 days in hospital (pt was very painful - could not lift either leg off the bed but got inspired watching dog agiliyt on ESPN so started exercises in the hospital). Went to rehab for 19 days (with both knees done and good insurance plus living with 2 corgis, I needed it!), then went outpatient. Took pain meds BEFORE PT, iced a LOT, worked hard. I got a lot of the equipment mentioned, a grabber for socks and other things, raised toilet seat, shower chair. Came home on no walker but was in wheel chair in rehab then went to walker. Managed to be able to put dogs outside in yard - had friends grocery shop. Went back to dog agility at about 3 months, did ride at about 9 months on VERY safe horse. Have not competed nor jumped since the surgery - no problems with either knee.
                              You will know when it is time - I have never looked back nor second guessed myself - both horse and dog friends were very helpful and supportive - you just have to ask for help! While I choose not to ride a lot now, I do some judging, show up at shows and do miss it - I could if I really wanted to - my doc said he could put me back together if I fell off and messed up his work!!! Good luck!
                              \"Let me become the person my dog thinks I am\"


                              • #16
                                I highly reccomend a TKR.I went about 15 yrs while being a full time groom,wearing a brace,constant pain and finally had TKR and cant believe the change.It helps if you are fairly fit and active to start with makes recovery so much easier.For sure it is painful.but well worth it I only wish I had done it earlier.Good Luck


                                • Original Poster

                                  Having a bad day.

                                  Coming up on week four. Tylenol isn't holding. Hurts all the time. How long does this cconstant pain last??? It exhausts me. I can only do one "event" a day...like going to the grocery store.....then I am bushed and in pain. for those of you who have had this, how many more weeks of solid pain can I expect???
                                  "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt


                                  • #18
                                    Is there any reason you can't take vicodin? You can cut them in half. You still get the pain relief without the other side affects.

                                    I have pain from other causes, not related to my knees, but I was miserable until I decided to just take more and better drugs for pain.

                                    I have read a lot of your threads and I sympathize with you, Claudius. I hope you get better soon!

                                    ETA check over on the riders with disabilities thread for more experience with TKR.
                                    2012 goal: learn to ride like a Barn Rat

                                    A helmet saved my life.