Total Knee Replacement: Swelling
7 weeks post tkr right knee. 0/120. Intermittent pain at top and bottom front knee when walking. Seems like the swelling never goes away. Icing 4x daily and resting in elevation. Out patient PT 2x week, gym for cycling and few stretching exercises 5x week. Shouldnt the swelling go down?
5 years later and knee is still swollen, therefore ice at night is only choice.
, I’m only about 5 months out from my right knee replacement and I have daily swelling in my ankle from not elevating/icing enough but I have lymphedema which makes it a little worse. At my last checkup I was at 0 to 130+ and the surgeon told me to ice/elevate and rest. He emphasized the rest. I was doing similar you but not at the gym. I have a recumbent bike that I was riding for 30 minutes daily plus doing my stretches and leg exercises. My ankle is still a little swollen since I cut back on the exercise to 3 days a week.
Since your range of motion is pretty good have you tried resting a week to see if that helps?
I’m tagging and to see if they are able to share some of their experience/expertise.
Have you checked with your surgeon to see if he thinks that much swelling is within what’s to be expected at this point? I think that would be a good next step. You could try checking with your PT also but I find that they are reluctant to say anything that might conflict with what the surgeon says.JK
This Question Is Asked By Many Patients And May Be Applied To Many Joints Such As Ankles Hands And Elbows For The Weeks Following The Initial Injury Or Surgical Intervention
This question is asked by many patients and may be applied to many joints such as ankles, hands, and elbows for the weeks following the initial injury or surgical intervention.
Edema is the physiological response to a chemical imbalance within the cells and tissues of the body. This chemical imbalance may be caused by a mechanical stress put on the tissue or a pathological process going on within the body . Swelling is the term we use to describe the abnormal enlargement or protuberance we visualize as the result of edema or excessive fluid within a body cavity or joint region.
The above question references swelling as a result of mechanical stress.; In fact, this patient had a total knee replacement which involves significant mechanical stress to the entire knee complex.; If you dont believe me check out this video on total knee replacement:
When an injury occurs, various tissues are mechanically stressed and thus weakened.; Lets take the total knee replacement noted above.; The initial insult to the tissue starts when the skin and soft tissue is intruded with the incision and separation of tissue and muscle to expose the actual knee joint.; The bone is mechanically stressed with a drill, saw, and hammer as noted in the video and the end result is major tissue disruption with subsequent swelling, which can become problematic if not controlled with ice, elevation, compression, and muscle activation.
If it doesnt challenge you, it wont change you!
Out With The Old And In With The New For Swelling Management
With any surgery there comes a certain amount of pain and swelling associated with it. A total knee replacement is no exception. You are going to experience some swelling and discomfort afterward. Some people may experience more than others.;
Until recently the standard approach to reducing swelling was a method called R.I.C.E. If you are not familiar with that term it stands for:;
The R.I.C.E method has been used for years but as time has passed, newer and more improved methods have been created to reduce swelling and improve the recovery process.;
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When Should I Worry About Swelling After Surgery
Keep an eye on yourself and tell a medical professional if you feel unwell or notice the swelling. This is the case for most swelling that starts after an operation. Keep an eye on yourself for the first 4-6 weeks particularly and mention the symptoms to either your physio or doctor at the earliest opportunity.
How To Manage Swelling After The Total Knee Replacement Surgery
Swelling is a normal part of the healing process after total knee replacement surgery. According to data from the American Academy of Orthopedic Surgeons, it is normal for people to experience moderate to severe swelling in the first couple of days or even weeks following the surgery and continue to experience mild to moderate swelling for at least three to six months after the surgery.
You can decrease the swelling by practicing some post-operative exercises that your medical team will show you. Using compression stocking and keeping your leg elevated for several hours each day can help reduce the swelling significantly. However, keep in mind that you should never do any type of exercise after knee surgery without consulting your doctor.
You can also buy a good quality ice pack. Cold compresses or ice packs will prove to be very useful after a total knee replacement. They help reduce the inflammation and swelling in the knee joint and the surrounding tissue and may also provide relief from the pain.
Your doctor may advise you to use an ice pack three to four times in a day for at approximately 15 to 20 minutes each time. If you do not see any improvement or if you want to use the ice pack for a longer time, you should consult your physical therapist or doctor. After a couple of weeks have passed, applying heat to the area may also help.
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What To Expect Immediately After The Total Knee Replacement Surgery
In recent years, there have been many advancements in pain management following a total knee replacement surgery. In the last 10 to 15 years, advances in using spinal blocks, regional nerve blocks, and other methods of pain control have made life easier for patients undergoing a knee surgery.
During your knee surgery, your doctor or medical team will either administer a general anesthetic, in which case you will be completely asleep, or a local anesthesia, in which case you will be numb from the waist down but still be awake.
Once the surgery is finished and the anesthesia wears off, your doctor will provide you with certain pain medication either through an intravenous tube or orally, depending on your condition after the surgery.
These medications usually include a strong opiate or opioid-like fentanyl, morphine, or oxycodone. They are only meant to be used for a short period of time as in larger doses over time, these medications can cause addiction and physical dependence. It is important to follow your doctors prescription and advise to prevent any adverse reactions and reduce the occurrence of side effects.
Overview Of Total Knee Replacement Surgery
A knee replacement surgery is a surgical procedure that is used to replace a damaged knee, usually because of severe arthritis. Also known as knee arthroplasty, the surgery makes use of plastic and metal parts to cap the ends of the bones of the knee joint and the kneecap. This surgery is typically recommended for people who have suffered a severe knee injury or severe arthritis. It is more common in middle-aged or older adults since the condition of osteoarthritis is quite common in this age.
Osteoarthritis is a degenerative joint condition that causes a breakdown of the cartilage in the knee joint and also the adjacent bone in the knees. Rheumatoid arthritis and traumatic arthritis can also cause damage to the cartilage of the knees, causing a need for undergoing a total knee replacement surgery. The ultimate goal of a knee replacement surgery is to replace the parts of the knee joint and kneecap that have been damaged and to relieve the knee pain that is no longer controlled by medications and other treatments.
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When To See A Doctor
People should speak with a doctor as soon as possible if they think that they have developed a blood clot or infection.
Signs of blood clots include new or worsening pain or swelling in the calf, ankle, or foot and redness, swelling, or tenderness above or below the knee.
Part of a blood clot can break loose and travel to the lungs, where it can get stuck and cause a blockage. This condition is called pulmonary embolism, and it is a very serious and sometimes life threatening emergency.
Signs of pulmonary embolism include:
- shortness of breath
- sudden chest pain
- coughing with chest pain
Blood, or systemic, infections require immediate treatment to prevent further serious complications. Signs of infection may include:
- high fever, typically higher than 100.4ºF orally
- worsening pain, swelling, flushing, or tenderness of the knee or the area around the surgical incision
- leakage from the surgical incision
- worsening pain during rest and activity
How Long Should I Ice My Hip After Replacement
In saying this, a good rule of thumb is to ice a minimum of 3-4 times a day for 15-20 minutes at a time. Its especially important that you ice after therapy and activities or exercises that challenge your range of motion, endurance and so forth. This could even be a longer walk, after an hour of errands and so forth.
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Severe Swelling Of Foot After Knee Replacement 7 Days Ago
7 days post-op total knee replacement. ;Foot is twice normal size and cant do PT or even ambulate with this 10 extra pounds of weight. ;It feels like I’m walking on a waterballoon. ;I am doing cold therapy and elevating the leg as I was told to do. ;Anyone experience this after knee replacement??
0 likes, 18 replies
Posted 6 years ago
This is just a possibility……during surgery the sometimes have to use a tourniquet for blood loss control and this can cause temporary damage and swelling which can create swelling. I would call the surgeon and see if there are any concerns and if you can get something for relief. Otherwise, they may tell you to back off the excercise a little, elevate and ice and just wait for normal blood flow to return and pull the fluids off in a natural course of time. Either way, I don’t think you are looking at a quick fix. Swelling is so painful and you feel completely helpless.
Posted 6 years ago
You make a very good point in that yes, there is a tourniquet involved. ;That explains the bruising on my thigh as well. I have no chopice but to back off the exercises. ;I cant walk on this bag of fluid that is my foot. ; Thank you for your input – very helpful
Posted 6 years ago
Im 2 weeks post op and i still have good swelling,its just part of the package i think,and if you do exercise/physio then it swells even more..elevation and ice is the key thing,but it is a long road to recovery and we all mend at different rates,good luck;
What Should I Expect During Weeks 6 Through 12
This period after joint replacement is a time of continued improvement. You will probably notice an increase in energy, a desire to do more activities, and a noticeable improvement in your new joint. Please keep in mind that every patient is different and will improve at different pace. If you are not happy with the pace of your recovery, please contact your surgeons office to discuss your concerns.
After your six-week follow-up visit, you will likely start using a cane to walk and move about. Use the cane until you return for your 12-week follow-up visit. Walk with the cane as much as you want as long as you are comfortable.
Back to work
Many patients return to work after the six-week follow-up visit. Tips to remember for returning to work include:
- Avoid heavy lifting after you return to work.
- Avoid standing or sitting for long periods of time.
- Avoid activities such as frequently climbing stairs or climbing ladders.
- Avoid kneeling, stooping, bending forward or any position that puts the new joint under extreme strain.
- Expect a period of adjustment. Most people return to work with few problems. However, you may find the first several days very tiring. Give yourself time to adjust to work again and gradually this should improve.
Continue exercise program
Comply with all Restrictions
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What Should I Be Doing In The Early Stages Of My Recovery
- Continue your exercise program and increase activity gradually; your goal is to regain strength and function.
- Follow all therapy instructions.
- Resume activity as you gain strength and confidence.
- For total knee replacement, swelling of the knee or leg is common with an abrupt increase in activity. If this occurs, elevate the leg above the level of your heart , and apply ice directly to the knee. You may continue with elevation and icing as needed to help decrease swelling and discomfort.
- Continued exercise at this early stage is important to achieve the best outcome with your new joint replacement. Based on your needs, your therapy may be continued at home or in an outpatient setting of your choice. You will be given an exercise program to continue exercising at home.
Don’t sit for longer than 30 to 45 minutes at a time. Use chairs with arms. You may nap if you are tired, but do not stay in bed all day. Frequent, short walks either indoors or outdoors are the key to a successful recovery.
You may experience discomfort in your operated hip or knee, and you may have difficulty sleeping at night. This is part of the recovery process. Getting up and moving around relieves some of the discomfort.
You should climb stairs with support. Climb one step at a time good leg up bad leg down. Hold on to a railing, if available.
When you’re a passenger in a car, sit on a firm cushion or folded blanket to avoid sitting too low.
How I Massaged My Knee During Physical Therapy
After warming up on the stationary bike, my offsite therapist massaged my knee with Free-Up massage cream for 10 minutes before I did any of the more demanding exercises.
The massage not only felt good but it seemed to loosen up the muscles as well. My therapist encouraged me to massage my knee at home too, especially before I did my exercise routine .
He recommended the product Free-Up I liked it because it worked well, was not greasy and could be wiped off easily.
Massage at Home:
My first massages were all by hand, either by myself or by my caregiver. Preparation for the massage was relatively simple.
I used a towel and a jar of Free-Up. I sat up on my bed, and put a towel under my knee. I had the Free-Up nearby.
Small amounts of Free-up are all that is needed. A little goes a long way and helps your hands glide along the massage area .
As I mentioned above I started out with minimal pressure but as time went by I increased the pressure. My therapist encouraged me to push away from the wound .
At first, I really worked the area behind my knee and my upper thigh the longest. The towel keeps any Free-Up off your bedding and then it is right there to wipe off any excess cream after you complete your massage .
I would massage my knee for about 10 minutes prior to a workout. Before going to sleep, my caregiver or I would massage my leg for about 20 minutes .
Massaging in bed also allowed me to turn over on my stomach if the caregiver was giving the massage .
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How Do I Manage Pain And Discomfort After Joint Replacement Surgery
Try to take your pain medication as soon as you begin to feel pain. Don’t wait until the pain becomes severe. Follow the instructions on the prescription label. Remember to take your pain medication before activity and bedtime.
If you need to have stitches or staples removed and you’re still taking pain medications, be sure to have a friend or family member drive you to your appointment.
Pain medication may cause nausea. If this happens, decrease the amount you are taking or stop and contact your surgeons office.
If you need additional pain medication, please contact your surgeons office. Give at least a few days advance notice before you run out of the medication. Please plan ahead, especially for holiday weekends.
- You aren’t permitted to drive a car while taking narcotic pain medication.
- It may take several days to have a bowel movement. Anesthesia and pain medication often cause constipation. Drink plenty of fluids and eat whole grains, fruits, and vegetables. A stool softener or laxative can help bowel function return to normal.
- Don’t hesitate to call your surgeons office with any questions or concerns.
Walker, crutches, cane
Use your assistive devices for balance as instructed by your surgeon or therapist. By your first post-op visit with your surgeon, you may have already improved and changed from using a walker or crutches to a cane .
How Do I Manage Swelling After Knee Surgery
It is important to manage swelling after knee surgery, because it can lead to pain and can make it more difficult to resume everyday activity. The best ways to manage swelling are rest, elevation of the leg, and the regular application of ice. Of course, any advice or instructions from a medical professional regarding the healing process and pain management should always be followed to prevent causing damage to the knee after surgery. Medication will generally also be prescribed to help reduce pain and swelling.
While it is important to get up on your feet and start moving around as soon as possible after knee surgery, this should only be done in very short periods of activity. For instance, getting up and walking slowly around the house for five or ten minutes per hour, then resting for the rest of the time, is usually recommended. This allows the knee to begin moving and getting stronger as the muscles build back up, which will help to speed up the healing process and make eventual physical therapy easier, but it will not cause too much swelling. Staying on the feet for too long can make swelling much worse.
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