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Help Preparing for Knee Replacement

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Help Preparing for Knee Replacement

Old 10-17-23, 02:42 PM
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Help Preparing for Knee Replacement

Folks,
I am 70 years old, ride a road bike and a tandem, and I am going to have my right knee replaced November 3rd. I diligently followed the thread "Has Anyone had knee replacement" and have gone back and read it multiple times. I found some good info and wanted to ask a few questions from those who have been there. I read a recommendation from the hospital to have a comfortable chair where you plan to spend most of your time during the first weeks. A nurse on the "ortho care team" (with the hospital) said many patients find use of a recliner helpful to elevate the knee. Then on the web I read, from a medical institution, "Recliners and sofas are not recommended after your knee or hip replacement because they are not supportive, difficult to get out of and can limit range of motion."
What chair did you use as your main place to sit/relax and elevate? I do not have a recliner but am willing to get one if it aids in recovery, ease, and or comfort.
Anyone else a side sleeper? Is it possible to sleep on your side post-op, or should I try to stay on my back only?


I will have a walker, bedside commode (that I plan to only use the frame installed over a toilet to aid getting on and off), a shower chair and an ice machine. Our house only has one step up to enter and no stairs inside that I’ll need to navigate. Any other equipment you recommend?

Any other recommendations, advice? I am all ears. My goal is to be an A+ student and do everything the doctor and staff say, for I want the best outcome and to get back to Europe on a bike tour.

Tailwinds,
Charlie

Last edited by Chancy; 10-17-23 at 02:45 PM. Reason: correction
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Old 10-17-23, 05:12 PM
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Originally Posted by Chancy
Folks,
I am 70 years old, ride a road bike and a tandem, and I am going to have my right knee replaced November 3rd. I diligently followed the thread "Has Anyone had knee replacement" and have gone back and read it multiple times. I found some good info and wanted to ask a few questions from those who have been there. I read a recommendation from the hospital to have a comfortable chair where you plan to spend most of your time during the first weeks. A nurse on the "ortho care team" (with the hospital) said many patients find use of a recliner helpful to elevate the knee. Then on the web I read, from a medical institution, "Recliners and sofas are not recommended after your knee or hip replacement because they are not supportive, difficult to get out of and can limit range of motion."
What chair did you use as your main place to sit/relax and elevate? I do not have a recliner but am willing to get one if it aids in recovery, ease, and or comfort.
Anyone else a side sleeper? Is it possible to sleep on your side post-op, or should I try to stay on my back only?


I will have a walker, bedside commode (that I plan to only use the frame installed over a toilet to aid getting on and off), a shower chair and an ice machine. Our house only has one step up to enter and no stairs inside that I’ll need to navigate. Any other equipment you recommend?

Any other recommendations, advice? I am all ears. My goal is to be an A+ student and do everything the doctor and staff say, for I want the best outcome and to get back to Europe on a bike tour.

Tailwinds,
Charlie
Good luck on your knee replacement. My wife has had two. I have had none. Our experience with an ice machine is that they drive you nuts refilling them keeping ice etc. A really good ice bag can be just as effective how much less trouble. We have two or three. We like the ones that are filled with some sort of liquid, and can bend but stay very cold good luck again
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Old 10-17-23, 05:27 PM
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Originally Posted by gobicycling
Good luck on your knee replacement. My wife has had two. I have had none. Our experience with an ice machine is that they drive you nuts refilling them keeping ice etc. A really good ice bag can be just as effective how much less trouble. We have two or three. We like the ones that are filled with some sort of liquid, and can bend but stay very cold good luck again
For the ice machine, one can fit 4 soda bottles into it. I don't remember the exact brand or size. I seem to think it was Dr. pepper, 16 oz that we had, but it may not matter. Add soda bottles, then fill with adequate water.

Get at least a dozen of the bottles filled 3/4 full of water. Loosen the cap, and freeze.

Thus, an ice change simply is retrieve 4 bottles from the freezer, pull the warm bottles out and put the frozen ones in. Put the bottles back into the freezer. The change can be done by one's helper wherever the ice chest is.
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Old 10-17-23, 05:27 PM
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My first thoughts as an 81 year old.:
a] Set-up a pre-op physical therapy session. The doctors will talk about at home physical therapy but if someone can drive you, at their center is much better.
b] The bandage will be huge! (over 2 pounds of padding and elastic wrap) so wear extra large slacks.
c] Take your walker to surgery. I took my old crutches. They put me in a wheelchair as my wife got the crutches and I left the building on the crutches.
procedure started at 9AM after surgery waited for the surgeon to do another patient, then left the building a 2PM.
d] Next day I walked around the block on crutches with my wife.
e] 2nd day, walked a 1/2 mile.
f] 3rd day, removed the huge bandage.
g] small Range of Motion my make cycling a problem.
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Old 10-17-23, 05:31 PM
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My father had a simultaneous double knee replacement which was generally fine for his strength and condition. Early 60's, I think.

However, before the surgery he couldn't fully straighten his knees. After the surgery, he had significant rehab to lengthen the shrunken tendons. Mom made sure he did his exercises, but it was hard work to get the tendons stretched.
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Old 10-17-23, 05:56 PM
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More thoughts:
h] install hand rails in stairways and shower.
j] when going down stairs with crutches, it might be easier to go down backwards.
k] The nearby park has a set of steps down to the lake. I do a down/up set then loop the park and repeat. Total 360 steps. I do all the steps leading with the new knee.

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Old 10-17-23, 08:42 PM
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Originally Posted by gobicycling
Our experience with an ice machine is that they drive you nuts refilling them keeping ice etc. A really good ice bag can be just as effective how much less trouble. We have two or three. We like the ones that are filled with some sort of liquid, and can bend but stay very cold good luck again
I like the reusable ice packs also. We have about 7 bags that are ~4"x10" and they do not harden either and are fairly flexible. The doctor's nurse said they will send me home with a couple more. I plan to use them to keep the water cold. If I don't have enough to rotate I'll freeze some water bottles per CliffordK.

Tailwinds,
Charlie

Last edited by Chancy; 10-17-23 at 08:43 PM. Reason: spelling
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Old 10-17-23, 08:51 PM
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Originally Posted by Speedskater
My first thoughts as an 81 year old.:
a] Set-up a pre-op physical therapy session. The doctors will talk about at home physical therapy but if someone can drive you, at their center is much better.
b] The bandage will be huge! (over 2 pounds of padding and elastic wrap) so wear extra large slacks.
c] Take your walker to surgery. I took my old crutches. They put me in a wheelchair as my wife got the crutches and I left the building on the crutches.
procedure started at 9AM after surgery waited for the surgeon to do another patient, then left the building a 2PM.
d] Next day I walked around the block on crutches with my wife.
e] 2nd day, walked a 1/2 mile.
f] 3rd day, removed the huge bandage.
g] small Range of Motion my make cycling a problem.
Speedskater,
I'll look into a pre-op physical therapy session. Your time at the hospital is what my doctor quoted me, 5 hours. Yes Range of Motion is my main goal, and of course no more pain and weakness in that leg. The walks you took on the day after surgery and the 2nd day are impressive. On crutches, or with a waker? Had the nerve block not worn off when you did those walks?

Tailwinds,
Charlie
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Old 10-19-23, 10:11 AM
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Folks,
Originally Posted by Chancy
I read a recommendation from the hospital to have a comfortable chair where you plan to spend most of your time during the first weeks. A nurse on the "ortho care team" (with the hospital) said many patients find use of a recliner helpful to elevate the knee. Then on the web I read, from a medical institution, "Recliners and sofas are not recommended after your knee or hip replacement because they are not supportive, difficult to get out of and can limit range of motion."
What chair did you use as your main place to sit/relax and elevate?
I am still debating getting a recliner, any thoughts, personal experience?

Tailwinds,
Charlie
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Old 10-29-23, 01:03 PM
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Just had my 6 month follow-up. the X-rays looked just like the 3 month ones. Next follow-up is 12 months.
More thoughts:
h] after the surgery in recovery, the anesthesiologist and physician assistant told me all kinds of stuff, before my wife entered the room. I didn't remember any of it.
j] Dentists ~ I went to my dental hygienist. He wouldn't do the work, because I needed to take a Antibiotic before the appointment.
From the surgeon and Primary Care Physician ~ wait 4 months after surgery and then anytime up to 24 months.
* * * * * * * *
I used crutches outside * steps and walker in the house. The house is too cluttered for crutches.
I have had 3 different operations in the last decade. Surgery wounds were never a big problem.
Only actually used the crutches for less than a week. But then with the crutches in the park, as self-defense from kids on skateboards and adults on new E-bikes & cell-phones.
Now Range of Motion is 128°, but it took a long time to get there.
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Old 10-29-23, 01:13 PM
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Surgeons know next to nothing about effective rehab and rely 100% on outside physical therapists. I would talk to the recommended PT and a couple of others about knee rehab.

In general I would avoid taking pain meds post op as you will be more likely to do damage without the pain feedback.

There are machines that move the leg and flex the joint after normal knee surgery and these might be good for an artificial knee as well. Worth checking with the PT that are associated with the hospital.

With my wife's hip replacement her surgeon used a different approach to gain access to the area and as a result her recovery was much faster. Surgeons are not known for innovation or being receptive to change and when I have talked to them they have usually provided very out of date information and often false information regarding the best approach, risks involved, and recovery time.
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Old 10-29-23, 01:23 PM
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Originally Posted by Chancy
..."Recliners and sofas are not recommended after your knee or hip replacement because they are not supportive, difficult to get out of and can limit range of motion."...
WOW!!! Can's believe they told you this. My recommendation is to get a Lift Chair. That will help immensely with getting in and out of your recline. I can see where a non-assisted recliner would be a problem but many, MANY of my patients swear by their post surgical recliner. Now the problem is that you can get stuck in your recliner and that's why I recommend a Lift Recliner. I spent some extra money and got one that fully reclines flat if necessary and it has been a real God send. Further more, after your recovery Lift Chairs remain marketable.

During knee surgery the joint is placed in traction. This can add to post surgical pain. I would recommend that you concentrate on stretching exercises to get your supportive ligaments and muscles used to the stretch.

Another thing to prepare for is making sure you have all low grade infections under control. Take care of that lingering fungal infection on your feet and nagging sinus infection too.
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Old 10-29-23, 02:11 PM
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I think that many of the recommendations are aimed at patients that are much less fit, than bike riders.
If you have one good leg & two good arms, getting out of a recliner shouldn't be a problem.
I felt out of place at the physical therapy center. I was one of the few healthy & fit patients there.
* * * * * * * * * * * *
k] when going downs steps for the first few days, it might be easier to go down backwards. With only one leg, you might go over-center when going forward.
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Old 10-29-23, 07:25 PM
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Originally Posted by Speedskater
Just had my 6 month follow-up. the X-rays looked just like the 3 month ones. Next follow-up is 12 months.
More thoughts:
h] after the surgery in recovery, the anesthesiologist and physician assistant told me all kinds of stuff, before my wife entered the room. I didn't remember any of it.
j] Dentists ~ I went to my dental hygienist. He wouldn't do the work, because I needed to take a Antibiotic before the appointment.
From the surgeon and Primary Care Physician ~ wait 4 months after surgery and then anytime up to 24 months.
* * * * * * * *
I used crutches outside * steps and walker in the house. The house is too cluttered for crutches.
I have had 3 different operations in the last decade. Surgery wounds were never a big problem.
Only actually used the crutches for less than a week. But then with the crutches in the park, as self-defense from kids on skateboards and adults on new E-bikes & cell-phones.
Now Range of Motion is 128°, but it took a long time to get there.
Speedskater,
Good to here that your recoveery is going well. Are you don't go and get your teeth cleaned until at least 4 months after surgery? If so, that good to know for I have a Cleaning scheduled (5 months ago) for 1 month after surgery. I'll need to postpone that.
Zandoval,
I can easily get out of my new recliner with just my good left leg and my arms. I did check this out in the showroom before purchase. Thanks for the heads up about the knee being in traction during surgery. I will ramp up my streches for calfs and hamstrings.
Tailwinds,
Charlie
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Old 10-29-23, 07:40 PM
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Originally Posted by Calsun
Surgeons know next to nothing about effective rehab and rely 100% on outside physical therapists. I would talk to the recommended PT and a couple of others about knee rehab.

In general I would avoid taking pain meds post op as you will be more likely to do damage without the pain feedback.

There are machines that move the leg and flex the joint after normal knee surgery and these might be good for an artificial knee as well. Worth checking with the PT that are associated with the hospital.

With my wife's hip replacement her surgeon used a different approach to gain access to the area and as a result her recovery was much faster. Surgeons are not known for innovation or being receptive to change and when I have talked to them they have usually provided very out of date information and often false information regarding the best approach, risks involved, and recovery time.
Calsun,
I beg to differ for my doctor has a lot experience and is well versed in the rehab requirements. In fact all my doctors I see are knowledgeable about their craft and good at what they do or I find a new doctor. I get my referals from my primary care physician who has been practicing in this area for over 40 years, is sharp and knows all the doctors around here, good and the others.
As to not taking pain meds post-op of knee replacement, you go first buddy! From what I've read and folks I've spoken with TKR post-op pain is tough can be pretty rough. Te meds they give take the edge off it to make it managealbe. Some of the PT's and nurses here even suggest taking you pain med 1 hour before physical therapy for you'll need it kicking it after your session.
Tailwinds,
Charlie
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Old 11-04-23, 12:27 PM
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A little late to the game but I can add my experiences from my first TKR done in April.

Recliner is what I used for recovery but yeah it can be a bit tough to get in and out of at first. Mine is actually a wingback chair that reclines, the foot/leg support starts at the top of my calf but does not fully extend my leg. You want that full extension as you rest to help with rehab and so you don't wind up walking with a limp. I just kept a pillow under it. Same principle while sleeping, pillow under lower leg/foot to keep the knee extended.

Pain meds....yeah take them. I tried to stop the small dosage of oxycodone after the third day. Big mistake, stay on them. Most docs are diligent about not getting you hooked now days. I can't speak for what the docs are using on you on terms of the hardware and possibly doing damage. Mine was done by the VA and the parts are bonded to the bone now. They told me I couldn't damage the replacement parts doing anything. I was actually walking on the knee within hours of the surgery. So no, I don't think taking the pain meds are going to lead to you damaging anything.

On a side note, my PT tech wanted me to schedule my meds for an hour before her visits the first two weeks.

Get a good no slip mat for the shower and rails if you can. I didn't get rails but used the walker to get in and out of the shower. The VA glued the wound and put on a bandage that stayed for two weeks. It was supposed to be waterproof but I still covered with with saran wrap and tape when showering. Didn't want to risk an infection. I am surprise how unnoticeable the scar is. You'll want to work the scar with your fingers as soon as the wound is healed to break up the scar tissue and to help with your flexibility.

12 oz water or soda bottles are the trick for the ice machine as mentioned already. 4 of them will fit in easily and you can just keep rotating bottles. I used the ice machine a lot to include sleeping with it.

Sleep is one thing they did not warn me about. I had a really hard time sleeping for a couple of months. Doc's said that's pretty normal even they are not sure why. My pain med guy had me start taking 3mg of Melatonin and that helped a lot.

If you can get on a stationary bike do it as soon as you can. Don't worry about full rotations, just get the movement you can going forwards and backwards. Once the flexibility improved I found that if I started full rotations backwards first for a few minutes I could then switch and get going forwards. I think I was out on my dutch bike in about 3 weeks with the saddle higher than normal and then back on a regular road bike by 6 weeks. Had a full summer of riding and almost got back to my normal pace.

I still have loss of feeling in the outside of the knee, the outer quad and upper calf feel off too. I think they are still adjusting to the leg being straighter again. All the docs say it really takes at least a full year to get to feeling pretty normal.

Pt is crucial, do it and do it hard but listen to thier advice.

Another thing I noted as temps cooled down the fall is that the fixed knee doesn't like riding in temps under 50 degrees without at least leg warmers, sort of burns inside. I guess that makes sense with the metal in there.

Anyway, I'm having the other done next week and am looking forward to a full and regular bike riding year in 2024.

Good Luck!
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Old 11-04-23, 03:09 PM
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Let us know how it went. Best of luck with the recovery.
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Old 11-06-23, 07:01 PM
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Just posted my experience 1 week post op in the main 55+ forum... Pain is still pretty bad, going back to the opioids in the evenings at least...
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Old 11-06-23, 07:32 PM
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Two weeks out from surgery 10/23/23. Had my first outpatient PT session today. It was really just an evaluation to give them a starting point for me. Real sessions begin next week. But, in addition to the other at-home exercises I am to continue doing, the PT did tell me that I can get on the stationary bike as much as I want. Advised me to do a couple short sessions this afternoon and this evening, and gauge how much I do going forward based on how I feel tomorrow. So I rode the trainer for 20 minutes this afternoon, and then another 20 in the evening. Little/no resistance on the lower gear, low RPM. Probably rode equivalent of 2½ to 3 miles each time. It was really just to work on the flexibility. And honestly, bending the muscles and tendons around the knee isn’t that painful. But I am experiencing sharp pain at the skin level. It feels so tight from the excessive swelling…which medical personnel keep telling me is completely normal. So I’ll see how I feel tomorrow and hopefully get back on for some more slow spinning. I’ve also stopped taking the Oxycodone, and am just using Tylenol and Tramadol for a few days now.

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Old 11-07-23, 07:11 AM
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My wife has a toenail that looks like that. She went to a Dermatologist, because it might be cancer. (Subungual melanoma)
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Old 11-07-23, 10:03 AM
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Originally Posted by Speedskater
My wife has a toenail that looks like that. She went to a Dermatologist, because it might be cancer. (Subungual melanoma)
Thanks for pointing that out! As someone who has frequent minor injuries, I’d been assuming this was just the result of something dropped on my toe. But, I can’t be sure when/why/how. And yeah…it looks like photos I found online. So, I’ve got a call into my PCP for advice.

Dan
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Old 11-07-23, 10:48 AM
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More on toenail cancer:

The Bob Marley melanoma story
https://www.healthcert.com/blog/bob-...melanoma-story
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Old 11-07-23, 09:53 PM
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Hi Folks,

Well the right knee is done! Four days out and pain is manageble. I am taking the pain meds like clock work per the doctor. I had a little more discomfort than I expected on day 2, and I realized I had fallen behind on the Oxycodone as the never block was wearing off. My wife put me back on schedule and thigs are better. No, I do not need a drill sargeant to order me around but a second set of interested eyes monitoring the Frequency of the meds can be a good thing (for me). I've been suprised how many litle things I let slip in the past 4 days. you guys who aren't married I feel for you, I glad I'm lucky (enough) to have a partner's helping hand.
Two things I purchased before surgery was a La-z-Boy recliner and a Breg Ice Machine and I'm sure glad I bought them. Our insurance wouldn't cover them and I would buy them again in a heart beat! The Ice Machine and Oxycodone is the tickct early on!
I did not get the power boost recliner for I can get out the chair okay without it.

Tailwinds,
Charlie
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Old 11-08-23, 09:23 AM
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Can’t emphasize the importance of ice enough. My big gains at PT are shadowed by a horrible night lacking in good sleep. I’ll figure this out eventually…. lol
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Old 11-08-23, 09:31 PM
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Any Tips Sleeping Post TKR

Originally Posted by laxpatrick
My big gains at PT are shadowed by a horrible night lacking in good sleep. I’ll figure this out eventually…. lol
Funny your mention lack of sleeping. I was sleeping good the first 4 nights and now less so the last 2. I am re-reading old posts regarding sleeping early on to see if there is anything I can include in my nightly routine, that I am not already doing.

Tailwinds,
Charlie
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