Post Operative knee replacement, ongoing pain, please help

[4weddings]

My husband who is 70 had a total knee replacement 6 weeks ago and the pain seems to be intensifying rather than diminishing.  He had a childhood injury to this knee, then another operation 13 years ago but is crying with the pain most of the time and has gone from ordinary pain killers to needing morphine.   He has physiotherapy 3 times per week, also hydrotherapy and acupuncture, they all say he is making some progress but very slowly and keep telling him exercising will relieve the pain.
He can walk around the house for short periods without either crutches or a stick so has some function but the pain seems unrelenting and is affecting his life quite seriously (and mine).
He says the pain now is worse than prior to the operation and I am wondering if this is normal.   It is so painful he cannot do the exercises as he should and the knee is very swollen and tight.  

He has seen the general practitioner who is managing the pain but I am wondering if this is how it should be or if something is going off track and we should be seeing the surgeon for a follow-up.  Thank you if anybody can help me.

[Theretoo]

I had knee replacment surgery (both knees) almost four years ago and still have pain almost every day, and my knees are very stiff. Since I can walk and perform most household chores, my operation was presumably a success. I don't have the same level of pain that you do, but when I do, I guess I will seek help from an orthopedic doctor. I guess I just presumed that the pain would go away, or why the operation? Good luck to you.

[4weddings]

Thanks for your reply, I haven't visited this forum for a while.  It is now nearly 8 weeks since the surgery and slowly the knee is becoming functional but is still very tight and painful and the morphine is continuing.  We attend physiotherapy 3 mornings per week (3 different physios) and hubby has been taking the morphine only on those days which masks the pain but he can manage the physio.  He is also going swimming (near us, unlike the physio) most afternoons and doing the exercises in the heated pool.   In addition he gets acupuncture once a week and yesterday had the knee manipulated.   All comment that the tendons are extremely tight and the acupuncturist's needle bent.     Today is the first morning he proposes to attend physio without the morphine as after a few hours he is extremely depressed and tearful and this can't continue.    We have an appointment with the surgeon in 2 weeks and hopefully he can stop the ongoing pain as life is very miserable at present.
I am sorry to hear you still have tightness and pain after 4 years - do you take anti inflammatory tablets?

[molly34]

I am 70 years old had a knee replacement4 weeks ago and am amazed at the pain I am still sufferingI am doing the physiotherapy exercises the hospital gave me ,is this enough?

[JainMD]

Hi,
How are you feeling after Total Knee Replacement?
There are two important things in post-operative management of surgery. First is the management of pain with help of pain killer.
Your analgesics should be 2 to 3 in number, each a different class of drugs. These drugs should be spaced out over 24 hour’s period so that there should be sufficient coverage at any point of time during day.
Physiotherapy is must to acquire strength and ROM around the joint.
Bye.

[Lively59]

I had bilateral knee replacements two years ago and recently my left knee has been paining me quite often.  I have to sit on the aisle seat in theaters so I can stretch it out or if in one position too long it becomes excruciating.  My right knee may get a bit stiff from the lengthy sitting but that is all.  Why is the one so painful?  I stretch my legs daily and walk stairs everyday at home and in school where I teach.
Does this mean my operation is deteriorating so soon?
Also, I hear that these titanium knees are good for only 10 years, is that a fact?                
                                   Lively59

[JainMD]

Hi,
How are you?
You have mentioned that you have undergone bilateral knee replacements two years ago, any problem during surgery or during your recovery period?
How old are you?
Knee pain has many causes, including pathologic processes in the knee and disorders in distant locations with referral to the knee area.
Can you tell me when this pain is more? Do you experience any grinding, locking, catching, or giving way of the knee? When did your pain begin, what were you doing at the time, and what were the initial symptoms?
Grinding is characteristic of osteoarthritis; locking and catching are characteristic of meniscus injuries and osteochondritis dissecans (meniscus injuries are much more common than osteochondritis dissecans); and giving way is more characteristic of ligamentous injuries.
Are there any positions that make your knee more or less comfortable?
Have you tried anything to help the pain and, if yes, has that been successful? Have you ever had surgery on your knee?
The answer to your question lies in doing an imaging study of knee to find out the exact pathology.
Keep me informed.
Bye.

[cowher]

i have a question for you, i am 41 and have had 8 knee surgeries from osto. i had a half knee in the right, 2 years ago, it still hurts and i cant get on my knees, i need both replaced, but how do you know what knee type is right for you, there are so many out there.

[rjmorley]

And to all of you.  I did a lot of research prior to my uni-knee replacement and most offer excellent wear data.  I am 46 and these things only last 15 to 20 years.  Ask for the one that takes the least amount of bone away.  Look up Stryker.com, Biomet.com, or search "knee replacement" and look for manufacturers.  I have a Biomet part.  One factor for me was that Stryker has two posts that go into the bone, Biomet has only one, I took the biomet because I have an ACL repair last year that required the new ACL to be attached with plugs above and below.  It was so close to where the Uni-Knee was going, that the two posts would have created a problem, even though it may have been more stable.  As for pain....God bless you all....I nearly start crying when I read your posts.  I have been on Lortab 7.5mg for over a year (with little to no relief).  The doctors wont give me anything more because of "addiction" concerns and the loser dopers out there.  Now with my recent knee surgery, again I am in pain, and again the doctor wants to give me the minimum.  (which does nothing)  So I suffer, praying that the pain will go away soon.  I had surgery two weeks ago.  What I say to you is go into that doctors office and fight...fight for your pain relief.  If you are suffering and the doctor is not managing your pain and will not work with you about your pain, contact the state board.  If you took you car in for new brakes and after, the brakes still did not work, what would you do?  Be honest about your pain, don't try to be tough.  Good luck and God bless you.

[CaptMatsko]

I have a total knee replacement almost 3 weeks ago.  I'm only 34 years old but couldn't stand the severe pain in my right knee.  I had 7 scopes and one major operation on the knee before this point.  After leaving the hospital I had to go back in with severe calf pain.  I was back in the hospital for another 4 days.  Now I am at home and still having semi-severe knee pain.  I can't find a location to rest my knee that gives it any relief.  Anyone have any suggestions to lesson some pain?  Does a swimming pool do anything?  Should I prop the TKR up in the air to sleep?  Any info is greatly appreciated!

[Alisahurts]

I am five weeks post op TKR left knee. I am right there with you. Physical therapy kills me and my range of motion is only 82 degrees. I can't make a round on a bike yet after five weeks. To say I am frustrated would be an understatement. After surgery, they sent me home with 20 percocet and then told me to go to tylenol after I used those. I could not take advil until I was off blood thinners then I could use that. I am only 45 and have found that they medicate older patients without a question but because we are younger and at risk for addiction, we suffer. My 85 year olf father in law had his done and said it was a piece of cake. I later found out they had him on some strong medication. No wonder it was a piece of cake.
As for finding a position that is comfortable...I found being on my side with the operative leg side up with a pillow between my knees is most comfortable. Make sure to support your ankle so that it doesn't bend inward or it will cause pain. Also propping it up on a wedge that I got from walmart helps to. It is a big triangle wedge support that is used to prop you up in bed so you can read etc...but I use it under my leg to get it above my heart to help swelling. Be sure to pull your foot out from under the cover because pulling the toes down will cause pain. Do not put a pillow bend your knee to prop it up making  the knee bent. This will diminish your extension and will make walking and therapy difficult.
Aquatics in heated pool and time spent in whirlpool will help but you can't do any of that until your incision is totally healed. Meaning absolutely no scabbing left. For now icing is best to help eleviate swelling which causes much of the pain in 20 minute intervals. As hard as therapy is and as bad as I hate to admit it, it will help and at five weeks you should be a little more optimistic. I am not saying I am ready to say I had it done but I am walking without assistance most of the time at home now. I don't dare go to therapy without my cane because most of the time, I can't put much weight on it after therapy until the next day. I am not sure I should feel this way but I understand it isn't painless.
I hope my rambling helps you some. I too am still desperate for any info to help me as well but these things I have learned and am only to happy to share them with you.
If anyone has any advise on getting our docs to help us with pain relief I for one would like to here it. To tell someone who has had this type of surgery to take advil five weeks post op has to be to basic.

[suzy12345]

it has been 6 weeks since my tkr, i suppose im doing ok, but my skin around the scar is so sensative, i cant stand a duvet on it at night, and a skirt swishing around on it is awful, it feels burned, but its not red, i cant see anything wrong, but its driving me mad, has anyone else had this problem.  sue

[zephyrarose99]

This is the second time I've read a posted question in which the person with the knee pain was told by her Dr. that she has the knees of an 80 y/o woman...my Dr. said the same exact thing to me.. is this some kind of canned phrase ortho-docs get off on using?  And what's the deal with Dr.s being so stingy on the pain meds?  Don't they believe the pain we are having?  Have they ever had a knee problem?

[sudot]

i had a total knee replacement 16 months ago ,and i am still having a lot of pain and tightness ,i have ad no end of physio and it as done no good whatsoever.i am on 2 lots of painrelief and it does no good .i was told last year that i now have nerve damage,i am 58 years old and suffered with pain since i was at school,i have attended pain clinic,no good more physio ,no good so what can i try now.i still need a stick to walk outside as my leg is so painfull ,i now wish i hadnt had it done but it was a case of i had to,i dont sleep very well as my leg throbs all night long and feels as tho a tight band is round it, the surgeon said he would try pain injections now,

[RGoodwin13]

Knee pain either before or after surgery is one of the most common orthopedic conditions and is always a challenge.  Icing is recommended as is compression.The combination is known as cold compression therapy.

Coldone Knee Wraps and others make ice compression wraps which will stop knee pain and knee swelling if used several time a day while the pain is active.  Thereafter use the wrap after any strenuous knee activity or whenever pain is present.

As will all pain, keeping ahead of it is far better than trying to deal with it after it reaches a point of intolerability.

Good Luck,

[warren2627]

your right the pillow does work at night between your legs.
I am shocked that they only gave you 20 pills.I left re-hab
with a prescription of 80 percosets.
I am 4 weeks out of surgery(tkr)I had my left one done exactly
1 yr.ago.I was back to work In 7 weeks.I do not have an
office job.They say every surgery Is different,my right knee
Is giving me trouble,my leg Is swollen,causing me some pain.
It Is holding up my recovery and It Is pissing me off.
Dont worry about not being able to go around on the bike,after
5 weeks I could not do It either(last year)


warren B.

[warren2627]

I hear about people who had double knee replacements at the the
same time.I have to say god bless you all.I myself who had 2 knees done
exactly one year apart was able to support my self on my good knee
at all times.I wonder what the therapy Is like when somebody
has them done together.I may be wrong but I seem to be hearing negative
things for those peolple who had them done this way.

warren B.

[pita2009]

hi keith here. I had a total right knee replacement 9 nov 2008 and have had to ungergo 2 more opperations since on the same knee. Before the knee replacement yes I was in pain but coped. Now its been an absolute mess. I cannot walk very far. no pain killers help. The swelling is still there. below the knee around the actual knee and the quads its 2 inches thicker than my left knee. Now my view is what a terrible mistake I made when I agreed to the procedure. The consultant appears to have washing his hands. I saw another consultant who says nothing can be done. Has anyone else experienced this lack of concern. Just go away it might get better in a year or so.

[1944rubina]

I am 3 weeks on from my right knee replacement. The left one was done last year the same time. I made notes for 3months after my 1st surgery and on looking back I only had panadein, and took panadein forte on some days. this time I have endone and panadol. I now take 1 endone most days and panadol 6 hourly. pain management is 100% better this time. I have to say when getting the staples removed I asked for a follow up script for endone and my G.P.  was reluctant to give it. habit forming!! who gives a bugger when in pain you are helpless to think and do anything. Lets face it 1 endone a day for a few weeks isn't a drug addict in the making. as far as sleep goes 4hrs  is good but make up some with naps daily.I am very happy with my 1st surgery and this one seems to be on track. Take the medication and don't try to be tough is my advise good luck to you all  

[Dr Vinod]

In a total knee replacement surgery:
I can sum up like this, it is 40% surgery and 60% physiotherapy, so lot of motivation for physiotherapy and counselling should be done before the surgery and if you are not ready then you have to think for the surgery.
Always remember the operative pain will be present for 1 weeks to 3 weeks and later there should be no pain and Physiotherapy will help this.
Time of surgery is very important and  if you are too old and with low motivation and lot of associated symptoms it is difficult to heal completely.
Take care!

[1944rubina]

You are spot on with your comments. I am now walking without crutches and no pain just a stifness which will go as days go by. Physio everyday is most important. You can do this at home with a check from physiotherapist now and then. I expect to be golfing in about 4 weeks. just a few holes and build up to 18. all the best

[Dr Vinod]

Wow, Rubina you are the motivation to all the people going for knee replacement surgery or having lot of fears about knee replacement.
Please give a detailed experience for other patients who would be benefitted, whenever you have time by a neat post. Take care and best of luck for the Golf thing!

[suz8947]

I found this forum while searching for complications after knee surgery.  I am amazed that so many people have the same problems I've had.  I had bilateral knee replacement 6 yrs ago & nearly died of kidney failure shortly after the surgery.  Have had continual swelling & pain with the left one - after series of cortisone shots (which didn't help), 3 rounds of physical therapy & now just had arthroscopic surgery to see what was inside...some scar tissue but nothing outstanding.  Surgeon cleaned it out, felt good the 1st 2 days, but now 4 wks out from arhtroscopy, it is very swollen & painful & stiff...just like before.  Icing it & elevating it helps but if I had it to do over, I don't think I would have put myself through this last surgery.  I would NEVER advise anyone to do bilateral knee replacement, 1st of all, after what I went through.  The physical therapy is very difficult--remember, you are literally cut off at the knees & put back together, so you have to learn how to balance your body all over again.  Do them ONE AT A TIME.  I am starting to think that some people tolerate these prosthesis better than others.  I apparently am one who doesn't tolerate them well.  I was 55 when I had my knees replaced...and I hope that they last till I die because I've learned that knee surgery is one the worst in the pain dept.  Aspirin works well for the pain but you must be careful due to stomach issues.  Best wishes to all.

[deviek]

I left my ortho docs office two weeks with the same response.  He said it's just a flare-up.  Continue the Mobic like I've been doing for 4 years and go home.  No injection because he said it could cause infection.  I fell on my right leg 2 months ago and hyperflexed my knee way beyond the point of where it would go to.  I have a chip of bone off in the area of the most pain, but I was still dismissed.  I'm looking for another MD.  This is the 2nd replacement in the same knee.  The one in 2003 was defective and so it was replaced in Oct. 2004.  I am becoming a cripple.

[klk76]

I had the right knee replaced 6/30/09 without problems and back to work in 4 weeks, 6 weeks ago the left was replaced. Pain doesn't stop on the vicodin, range of motion is less and now they are saying a manipulation is in my near future. Same surgeon, same type of knee--they are saying scar tissue is the culprit. Just wierd.  But thought I would pass on that I have used Stopain and ActiveOn both topical rub on products that has lessened the knee pain way better than the pills have done to this point.

[quadrider]

I had TKR 6 weeks ago.  When I left hospital I was able to bend at 90 degrees. Yesterday the physio measured it at 122 degrees and commented it is one of the best he has ever come across.  I am 52 years young.  What I am now finding though is that for the first 4 weeks panadol was about all I used (once I was out of hospital) but now that I am on it more the pain has increased to where I need much stronger pain relief and it is also swelling a lot more than it did earlier on.  I feel like I am going backwards!  I am now being told that I am doing too much but I thought that if I could do it then why not.

[lynngirlnow]

I agree with everyone that too many doctors are too stingy when it comes to prescribing "adequate" pain medications.  I just don't understand why that is????

I am a 48 year old female who is 5 weeks post op from bilateral total knee replacements.  Yes, that's right...both at once.
Some thought I was crazy doing both,, but believe me folks, the benefits have farrrr outweighed any risks.
I would highly recommend to anyone who is having severe pain in both knees due to osteoarthritis to consider having both knees replaced simultaneously.  Although I still have some pain and real discomfort in the area surrounding my knees and my lower legs, (especially at night) I am sooo glad the surgery is over and I don't have to go thru the whole ordeal ever again.  I am well aware the implants won't last forever, but life is just too precious for me to go on suffering with bum knees whilst still in the prime of my life.

I do believe that for most of us, the final outcome of our surgeries is largely in our own hands.  I knew beforehand that none of the procedure was going to be easy and I fully expected and was informed there was going to be pain for months after the surgery.  It's just a different kind of pain.  My progress will be a direct result of my effort with P/T.
I just going to my local Y and will be using the pool as often as 4 days a week.  There are recumbant bicylces there and other machines to help facilitate my recovery.  I intend to rid myself of my post operative pain with exercise however excruciating it will be.
Best of luck to all of you
Jeanne

[myprimarypurpose]

I had tkr in March, good for six weeks and then buckling and pain. After many tests ruling out breakage and movement, they felt the plastic piece had jumped the post. They operated on me again and replaced the plastic. Good for four weeks. now terrible pain stepping down and MORe when i step off. They can't find anything wrong and I am dying here. Can anyone help me? I have to walk with crutches. I am sixty four.