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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index

Hopefully the surgeon's office will set him up with what is called a Continuous Passive Motion machine (CPM)which is used in the hospital and at home to keep the knee moving (key to recovery) and prevent the build of up scar tissue. The second common machine used at the hospital and at home is a cooling device for the knee. There are a few different kinds and they function to limit swelling.

I was discharged home with the CPM and the ice machine. I used the CPM 6 hours a day minimum and then the ice machine whenever I was not in the CPM.

In most cases he will be put on blood thinners and in the first two weeks home a home health care nurse is sent to check the wound and do a blood test to see if he's on the right dosage of blood thinners. In addition a home health care Physical Therapist comes to the home for 2-4 weeks (for your dad it sounds like maybe 2 as he'll likely graduate to outpatient Physical Therapy quickly given his type of work history).

The more he can push through to knee flexion (bending) the better he will do. This requires physical therapy. The worst thing he can do is resist either PT or the machinery. Using them appropriately and with enthusiasm (which can be hard to muster based on pain) will lead to a better recovery.

In the 1-2 weeks prior to my TKR I had calls from the CPM company and the ice company. Then upon waking in the hospital a representative from the home health care company introduced himself (I could choose any company I wanted but my doctor recommended their company and I've not had experience with any other). When I was discharged I called the Home Health Care company the next day (i was discharged late at night)and they set up my nurse and PT visits. I then graduated to PT outside the home at 2 weeks. Mine was the right knee and in order to do PT I took strong pain meds so my husband drove me to and from PT for the first 8 weeks. After that I drove myself (but it's only one mile away).

Best items I had for home were handles for the toilet to ease me up and down. I bought mine online at Overstock but you can buy them in the big pharmacy chains. I also had a shower chair from prior surgery that made it more comfortable to shower.
While your Dad is still in the hospital post-surgery, encourage him all you can, to do everything the surgeon and physical therapists tell him to - exercises in bed and walking with walker as far as is tolerable the first couple of days post surgery. Very important for him to get that prosthetic moving as quickly as possible to increase range of motion. Whether your dad goes to a rehab inpatient facility after the hospital or straight home, just keep motivating him to work at the rehab. Trust me, it DOES get better as long as he does everything he's asked to in order to have a great outcome.

I had my right knee total replacement in April of 2011 and 4 months later, my range of motion was 135 - 140 degrees and the majority of the post-surgery soreness was gone. I ditched my cane in mid-August and only have mild, occasional soreness in the muscles surrounding the prosthetic knee. That should be gone by my one year mark in April. (I had a left knee arthroscope during the same surgery due to a meniscal tear, and will need that knee replaced in about another year or so.)

His surgeon will tell him and you (his family) what limitations with normal activities he will have post-surgery and for how long. NO DRIVING for six weeks post-surgery, especially if it's his driving leg. (and even if it's the other leg, he may not be able to drive either. The concern would be if he had to brake suddenly, the new knee could get damaged by hitting the dashboard. The surgeon would be concerned about reaction time.) Other restrictions include no climbing of ladders and no more weight lifted than 10 or 15 lbs at a time. I only had MY weight lift restriction increased to 50 lbs in October.

When your dad sleeps the first six weeks post surgery, it will have to be on his back with the leg absolutely straight and a towel under his ankle (NOT the knee). The reason for this is that they don't want the prosthetic knee to lock up and heal in the bent position. If that happens, the surgeon would have to go back in and straighten out the prosthesis. (Immediately post-surgery, his new knee will be placed in a continuous passive motion - CPM machine that will gently bend and straighten the knee while he's in bed. They usually just do that while he's sleeping or just lying in bed.) The day after surgery, they will get him both up in a chair and on a walker.

As far as the surgery itself, have your dad ask for a spinal with sedation as far as anesthesia. It's just safer than general anesthesia and believe me, he won't feel them working on the knee. Also, I note that you say both knees are bad. Your dad should try NOT to have both done at the same time. Not generally recommended because there's more chance for complications that way. Have him get the second replacement done at least six months to a year later depending on how well the first surgery and rehab goes. (I have two relatives who had to have both done at the same time and had major complications because of it. An aunt who had both done a month after me, is now having such problems with swelling and inflammation that I think she didn't have a very good surgeon performing the procedure. And she had hers done at a hospital in NYC where MY orthopedic surgeon has privileges. He's one of the top knee and hip replacement surgeons in the country and if he had done my aunt's surgery, I don't think she'd be having these problems! Besides, he might not have agreed to do both of her knees during the same surgery which would have lessened her chances for the complications she's experiencing now!)

If your dad is generally in good health otherwise, complete recovery should take about a year.

I hope all of this advice helps. Good luck to your dad. I know he'll do well!

Sounds like your Dad is all ready for his surgery. And that's what I meant by movable shower head - the flexible hose that's attached at both ends. I'm surprised they're keeping the bandages on till he gets the staples out - they normally remove the bandages the day of discharge from the hospital and make you promise to cover the knee completely with plastic bags and tape them to the surrounding skin to keep the moisture out. Maybe his surgeon does it differently - you'll find out soon enough! The reason for the removal of the bandages at discharge is so the surgical site can breathe and start healing in the open air. That's good that you have a built in shower seat. Definitely ask for one of those grabber poles and maybe a long shoe horn to make it easier for him to dress. (The rehab place I was in offered me a long grabber to help me put socks on, but I ended up not needing it because my range of motion by the time I was ready to get dressed to go home was good enough that I was able to bend the knee long enough to put my sock on that foot.) Same with the elongated shoe horn. Didn't need it. By the way, get a bottle of Vitamin E Oil to put on the scar when they tell you he can, after the staples are removed. It will lessen the visibility of the surgical scar over time. It works - trust me.

I'm going to be doing volunteer work in the Ortho unit of the hospital where I had my TKR done. I wanted to be supportive of my surgeon's new TKR patients to help them get past the hospital portion of recovery. It's kind of to "repay" him for all he's done for me so far. He's thrilled I offered and will have the nurse care coordinator for the Unit get in touch with me after the New Year to set this up.

I specifically joined this Message Board because I had such a good TKR surgery experience and wanted to share that with others who might be nervous about it. (As I previously noted, I will need my left knee replaced in about another year at the earliest and I'm sure I won't be freaking out beforehand since now I know what to expect. I think when that time comes, I'll just say to my surgeon, "Okay -Let's roll on this!")

Glad I could be of help and again, good luck to your dad next week! I'm sure he do just fine.

Hi thrutime!

I agree with you that having your knees replaced within a year of each other is the best thing - I'm really looking forward to getting MY left knee replaced this spring. (My surgeon had repaired a minor meniscal tear during last April's right knee replacement surgery - I'd been compensating with my left leg and developed the tear about a month before the replacement surgery. He, at first, optimistically thought he'd bought me about 4 to 5 years before I would need the left knee done.) Unfortunately, in early December, the knee started bothering me again and I had my first cortisone shot. The surgeon looked at the x-rays and said that I had a little room left, but he was downgrading his optimism to 2 to 3 years or less. This month, I've already been to him 3 times and had my second cortisone shot in the left knee on Monday. He had sent me to get EMG testing on both legs (electro conductivity tests). After the right leg test back on Wednesday, I developed bad back pain. He had me come in Thursday to evaluate what was going on. I told the surgeon that my pain tolerance threshold was shot to heck and I can't function like this with the knee pain and back pain, and could I PLEASE have the knee replaced this spring. He agreed it is time. First, though, he wants to get my back pain issue squared away and resolved - I'm going Monday for a spinal MRI, and to a pain management doctor on Wednesday. Then it's back to my surgeon on the 30th to see the whole picture of what is going on. He's 99.99% sure that he'll do the surgery in late April, because he told me to get any other medical procedures done by the end of February. I would have to start all my pre-surg testing and clearance appointments by mid-March at the earliest. The surgeon's physician assistant told me Monday that if he does it this spring, we're catching this BEFORE the knee is as far gone as the right one was when I came to him in October of 2010, and thus, he'll probably have to cut less bone to fit the prosthetic knee in. Also, that should make for an easier and shorter recovery period. (I HOPE!) My surgeon knows I'm a real trouper and that I rarely complain unless things are as bad as they've now gotten. Last year, I did EVERYTHING they asked of me post surgery and, as I approach the one year mark on my right replacement, have very little residual soreness in that knee. They tell you it takes about a year for the soreness from being worked on in surgery, to completely go away. I told the surgeon Thursday that I'm willing to put up with that soreness again for the first 3 months post surgery because I know that there's a light at the end of the tunnel and my left knee replacement will turn out as great as the right one did. (I'm 56, so, since I'm not an uber athlete, I figure the knee replacements should last me the rest of my life!)

I have complete trust in my surgeon who is considered the top Orthopedic surgeon for knee and hip replacements in the county where I live. He's been named to the Top Doctors in the U.S. list for 11 YEARS RUNNING! He also has a Ph.D. and has patents on two or three replacement models! And he has the most AWESOME bedside manner on top of that! Of all the surgeons I've had to deal with in the last 30 years for one thing or another, he is the kindest, most caring surgeon I've had the pleasure to be under the care of! They broke the mold when they made this guy!!! He was MEANT to do this!

As for the insomnia, I didn't have that problem. You were probably just uncomfortable having to sleep on your back with your surgery leg kept straight while sleeping, for about six weeks, so the knee would not heal in the bent position (NOT a good thing to have happen!) I admit it was tough, because I usually sleep on my side, but I toughed it out and it paid off.
(I didn't have to wait six weeks for my range of motion to increase. My ROM at my first PT session at the rehab place was 110 degrees - not too shabby for one week out from surgery! As the weeks went by and I had frequent PT sessions at home, my range of motion increased to a final level of 135 degrees!! MORE than I'll ever need and 10 degrees ROM above the average person's ROM WITHOUT surgery!)

If you're still taking the benadryl and NSAIDS, try and cut back so you don't get addicted. They can have a harmful synergistic effect (heightened effects on the body) that can be potentially dangerous. Hopefully, since you had your surgeries in '08 and '09, you've gotten past the insomnia because of discomfort and don't have to take those meds anymore. BE CAREFUL!

I cannot WAIT to be in your company of having both knees replaced and finally getting my mobility back WITHOUT PAIN!!!

Gotta run.


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