Mr Andrew Carrothers 2023-11-08 Person 5 5 0

What I discovered (and wish I’d known) 5 weeks and 4 days after my total knee replacement op. 1. My part in my TKR is a part time job, but it affects my mobility and the rest of my quality of life. Worth a lot of effort. I’m streets ahead of many people who had their TKR before me. I’ve been massively motivated by wanting to get my life back, wanting to look after my grandchildren and garden, walk miles across the fields. It’s good to think about your TKR in terms of you needing to prioritise your part in its success with lots of effort and physiotherapy. You can help yourself a lot. 2. PHYSIOTHERAPY AND LARGE EXERCISE BALLS - the TKR is the first part of regaining movement. The second part (physiotherapy) is equally vital and only you can do it. Exercises to straighten and bend your knee, exercises to rebuild the neural pathways so you can walk properly and others to help you balance. All this 3 times a day, plus walking twice a day, increasing your distance, stride and confidence. Use ice packs and pain relief to ease pain and reduce swelling. When you can’t initially do an exercise bearing weight, do it without full weight. Sitting on a big exercise ball and rolling it back and forth is less painful and very effective at achieving an improvement in bending your knee and less painful than bending and holding in pain. If you don’t do the (sometimes painful) work to increase flexion beyond a right angle, you won’t be able to kneel. Start with many gentle quick repetitions and build to slower ones. 3. CRUTCHES: crutches are helpful, until they’re not. Using crutches helps to get going, but you’ll not proceed past a certain point until you give up the crutches. First give them up in the house then outside. You legs and knees are working differently when you’re on crutches - 100% different in my case. I felt unsteady and thought I needed crutches BUT it was only when I gave them up my walking asymmetry started to return to normal and my balance improved. 4. HEALTH APPS My smartphone gives me Apple Health free. Look on your phone if you can or install a health app. Apple Health has a section ‘Show all health data’ this gives really useful daily information on several relevant functions such as walking symmetry, double support time and step length. You can track your progress daily. 5. MUSCLES MAKING A FUSS - ‘WHERE ARE OUR BONES?’ Rebuilding neural pathways. I had a few hours immediately after my replacement when my knee muscles went into strong, involuntary and painful spasm. Nearest analogy - like the end of the first stage of labour in childbirth. It hurts a lot and it passes. Most people don’t get it. I understood later it was my muscles and neural pathways panicking. Effectively they’re in spasm as they look to re-establish the link between brain and bone. The old neural pathways have been severed and must re-connect so the knee works again. It’s hard work. Part of the essential Physiotherapy.