My Experience: Total Knee Replacement

This post has nothing to do with quilting, but I have information to share. I thought I was prepared for Total Knee Replacement but there were several things that caught me offguard. There were other things I did well since we have had numerous knee surgeries in our household. Here are some insights from me that may or may not be helpful to you..

A Bit About Total Knee Replacement

I knew for years that a Total Knee Replacement (TKR) was in my future. My knee woes began with a fall down 16 stairs in 1994 which resulted in a knee surgery. It didn’t go well and I was on crutches for almost 6 months and then a cane for a few months. It was bad and I was only 25. Over the years I have had issues and talked to different doctors. I tried Synvisk in 2014 and had a Pseudo Septic reaction to the last shot in the series that put me on crutches for over a month. In January of this year I tried some new exercises and ended up with so much pain I could barely function. Physical Therapy and cortisone shots did nothing. I didn’t understand it at the time, but each failure brought me one step closer to being approved for a Total Knee Replacement. Failures could be:

• Physical Therapy
• Cortizone or Synvisk Shots
• Medications not being helpful

You become a candidate for TKR when the pain is so severe that it interferes with normal activity. If you are reading this, you are probably already at this stage. . .even if you don’t want to admit it to yourself or others. It took me a few months after a recent injury to realize that I was missing out on all sorts of things because of my knee pain.

Just for the record TKR may not mean what it sounds like. They don’t take out your knee and give you a whole new joint. Each of the knee’s surfaces are supposed to be covered with cartilage which provides cushioning and lubrication. In those of us with problems, the cartilage has been damaged in some way and the person may not have any cushion left at all and is now bone-on-bone. The top surfaces of the tibia and fibula, the bottom surface of the femur, and the back side of the kneecap (patella) are covered with metal and plastic to give those parts new surfaces.

Choosing the Doctor

First of all you better have a good doctor. Ask around. People will gladly talk about the docs that they like. . . and don’t. It is absolutely OK to get a second opinion and you should ask all the questions that pop into your head. My first doctor was well-regarded and worked at the most prestigious hospital in the area. He decided I needed TKR based on a really crappy X-Ray. He never looked at my knee or touched it. I scheduled surgery several months in the future and then I started paying attention. I went in for a second appointment and they took a few more X-rays. . . but still wouldn’t look at my knee (turns out I had a Quadrilateral muscle tear) or order an MRI.

Then one of my friends had surgery with this same doctor and it was a disaster. I wouldn’t have blamed an infection or an allergy to the material used for the stitches to the doctor- these things happen. The thing that bothered me was that my friend was getting no response from the office and got septic. I still didn’t cancel my surgery.

I did decide it was time for a second opinion. I asked a woman I know whose husband sells “joints” to orthopedic doctors in the area and asked for his top three. I picked the first one on the list and made an appointment. Yep. . . it was a pain because it was a different group and I had to do all the paperwork, but it turned out to be well worth the effort.

At my appointment with the second doctor, the PA walked in, looked at my knee and acknowledged that something was definitely wrong since it didn’t look like my other knee. The doctor looked and touched my knee when he came in. He immediately sent me for an MRI and at my next appointment a few days later he looked at the MRI and wanted more X-rays so we did that immediately. Together we made the decision that I had exhausted all other avenues to relieve my issues and that it was time for a TKR. I scheduled the surgery- for the next week- and had a CT scan and an EKG that afternoon. A day or two later I had all my blood work done.

Getting Ready for the Big Day

The day before my surgery was busy because we cleaned the house and made sure there were no tripping hazards for me. We washed and sanitized the bedding, mopped floors and wiped down all the hard surfaces. Throw rugs were moved or removed.

The night before my surgery I showered and washed my leg thoroughly with a Hibiclens sponge. I did NOT shave my leg- I’ll explain that in a minute. I put on clean pajamas that covered the area and slept in a clean bed. The next morning before I went to the hospital, I showered again and scrubbed with a Hibiclens sponge. I put on clean and easy to put on/off clothes that covered the area.

One of the things to know before surgery is that they don’t want you to have any open wounds that would invite infection. If you shave your legs, you may scrape or cut them and that is not an infection risk. You need to make sure that you don’t have any ingrown toenails, open sores, or dental issues before surgery.

Surgery Day

My surgery was at a local hospital that has a robot that works with Striker knee joints. I didn’t get to the hospital until around noon so I made it to the hospital room around 4:30. By the time I got settled the Physical Therapist had left for the day. It took a couple hours for me to feel my legs again from the nerve block to my back (epidural?) and they won’t let you leave until you can use the bathroom.

I chose to stay overnight since I already had the room. This was not something I expected and I was not really prepared to stay overnight, but I didn’t really need anything and the nurses offered to get me a phone charger if I needed one. Sleeping in a hospital is not all that easy- I was setting off alarms all night! I did receive two doses of anti-biotics that I would NOT have received had I left. That’s a strong bonus in my mind.

In the morning before I left I had to take all the medicines that my doctor had prescribed to make sure I wouldn’t be sick. This included 5mg of Oxycodone. It didn’t make me sick but I was crazy and dizzy which made me concerned that I might fall. That feeling lasted for over 8 hours so I have not taken any more of that med. I am using Celebrex for inflammation, Lyrica for nerve pain, and Tylenol when I need it.

Being at Home

Getting home was a little tricky. My leg was wrapped pretty securely which inhibited bending, so I had a challenge getting in and out of the car. We chose to bring our lowest car so I wouldn’t have to climb up and in and I definitely think that was the right decision. BTW. . . this surgery was on my right knee so there is no way that I can drive.

I am using a walker. Not a fancy buffet wagon (my friend loaned me his but it moves too fast for me right now) just an old fashioned walker. I really like it because I feel secure. I did make a cool quilted bag to hold my iPad and other items and that has turned out to be a really valuable piece of equipment. My friends made sure I had a cup holder and a bell to call my husband.

Most of my pain in the first couple days after surgery was in the mid thigh. This is normal because they use a tourniquet to stop your blood flow to the knee area during surgery. I did not know this and I was not prepared for how sore that area would be. The Tylenol really helped with that pain as well as some gentle massaging.

On day 3-4 after surgery (not counting surgery day) the block that they put in my thigh to cover the pain in the front of my knee wore off. Some people have that wear off much sooner than I did- so I count myself as lucky!

I am currently one week after surgery and I am still managing the pain with Tylenol BUT Physical Therapy and doing the exercises is more painful now. I am stiff and sore but my knee looks great. i am having some pretty significant hip pain which the Physical Therapist is attributing to my use of new muscles and a new gait when I am walking, He said that often the hip or the ankle is affected.

Keeping your leg dry is a MAJOR component in avoiding infection. I will not be taking a shower until cleared by the doctor. One good trick to keep your body clean is baby wipes and some rubbing alcohol. Use it everywhere- but don’t flush the wipes. Just throw them away. I am using these rinse-free wipes and I really like them. My skin has not been dry or sticky.

Here is a link to the bath sponges. It is an affiliate link and I will receive a small commission if you use the link:

Physical Therapy

PT is an important component of TKR. If you talk to anyone who has had surgery they will stress to you how important it is to attend Physical Therapy and to do the exercises at home. Movement is painful but is the only way to get the knee back to full range of motion.

My surgery was on my right knee so I cannot drive. That makes me homebound so I qualify to have a therapist come to my home for the first two weeks. I was assessed on day 2 and have already had appointments on Day 4 and Day 6. I am supposed to do the exercises on my own on the off days. I have been diligent in doing the exercises more than recommended because that is just the kinds of person I am. . . always trying to get an A+!

Just getting up and moving on a regular basis is really important because I get stiffer the longer I sit. I have been using my phone as a timer so that I remember to get up at least every 90 minutes. I am trying to do all the right things.

Lessons Learned (in no particular order):

• Stay overnight if it is covered. I didn’t sleep all that well but I got excellent care, two doses of antibiotics that I would not have received and a lot of confidence from working with the Physical Therapist. It was nice to not feel rushed.
• The medical team is going to put a tourniquet on your leg during surgery. This will cause pain in your thing for many days after surgery.
• You will need a walker. You may also need crutches or hiking sticks or a cane down the road. It’s good to have these assistive devices lined up BEFORE you need them.
• You will want a bag or basket or something on your walker to carry things so that you will be safe while transporting items you need.
• You will want a comfortable chair that reclines. We have recliners built into our couch so I can either use the leg lift or just lay flat on the couch- both of which I enjoy! One of my crazy friends had both knees done at the same time and she rented a lifting recliner for a couple of weeks. She said it was a lifesaver.
• If you choose to not shower like me, you will want to make sure that your shampoo/conditioner and a towel are near the sink you will use to wash your hair. Early on you may need help but you will soon feel confident to stand and lean against the sink.
• Let people help. If people offer to bring you a meal, let them! You need to take it easy and tryin to navigate a kitchen with a walker is tricky. Don’t be afraid to ask for help.
• Clean your house before surgery. You in your compromised state should come home to a clean and sterile as possible home. You should wash and sanitize your bedding the day before surgery.
• Don’t shave your legs before surgery. Let them handle it.
• Buy some oversized exercise shorts. You will want them for Physical Therapy. You need to wear shorts so they can massage, use the tens machine, etc.***
• You can’t have dental issues before surgery and you aren’t supposed to have dental work done for at least 3 months AFTER surgery, so take care of those teeth.
• You may want to gather a few pair of “grippy” socks to wear around the house- my feet are cold a lot of the time! I tend to wear shoes when I am really walking because I stubbed my toe on the walker and I really didn’t need that extra pain.
• Move your shampoo and conditioner to a sink BEFORE surgery.
• Don’t mess around. Trust your gut. If something feels wrong, call the doctor.