One Month Total Knee Replacement Follow Up!

So, it is officially a month (well, more like 5 weeks) since my total knee replacement operation.
How am I doing?

According to many of the medical professionals I have spoken with, my recovery is nothing less than a miracle. Typically 6-8 months out, many people are complaining of lack of mobility, pain, decreased range of motion, stiffness, along with a multitude of other issues that would arise after you get a new joint put into your leg. It is expected to take an entire YEAR for an implant to actually feel like your knee again. Somehow at three weeks, I was strutting along without crutches! At two weeks, I was walking with one crutch. I think that when they got me up in the hospital the next day after surgery with the walker, my confidence grew exponentially and helped push this along. I continued on with the "nothing can stop me" attitude. Now although I still have some mild pain/achiness in my bones from the trauma of this surgery, I'm casually walking around (limiting the distance so I don't flare up like crazy), but many people have said that they would not have even noticed that I had surgery just a month ago. INSANE!

What's therapy like? 

My range of motion is past the 90 degree landmark, more like at 105 degrees, so I am starting to begin various activities and will be able to begin my strengthening soon (I have a baby quad from all the atrophying right after my surgery, so I may be a tiny bit self-conscious). Range of motion is huge when recovering from knee replacement surgery, or even any knee surgery for that matter, so that you can get back to carrying out daily life tasks and activities as you wish without scar tissue formation. Before surgery, I was only bending my knee at 112 degrees from the arthritis and deformity, so only a month out I am almost better off than I was before with many more months of healing to go! In therapy, I began hamstring curls, the stationary bike, squat tosses against the wall, one legged ball tosses on a nerf for balance, weighted straight leg raises and kick backs, resistance band exercises as well as heat, ice and ROM therapy. I also gained the balance on my feet to begin upper body workouts/lifts again in the gym, so I don't feel entirely like a lazy blob anymore. I actually learned something very interesting this week in therapy. Typically for an injury, a therapist places ice as well as stim which are small electrical pulses via pads on the skin to activate muscle and blood flow. For my knee replacement, I was wondering why I didn't have stim used like the rest of my surgeries. Apparently, there's a small risk that the electrical pulses can reach the implant, and my implant will actually CONDUCT electricity in my leg! Ya learn something new/crazy every day.

What's the word? 

Today, I had my follow up at the Hospital for Special Surgery with my surgeon as well as a routine rheumatologist appointment at NYU Langone to keep my lupus in check. My surgeon legitimately called me a miracle patient. After all I've been through, and after only a month recovery, he said I look as if I am a patient 6 months out of a total knee replacement surgery. I beat the odds with my mindset and I am honestly so proud of myself. I can begin strengthening as I can tolerate which will help me feel like a normal person again! He said that I had a special implant specifically designed for my knee, which also requires no cruciate (ACL and PCL) ligaments so I will never have to worry about injuring my knee. As you can see in the pictures above, I have a real joint space finally. I was bone on bone medially and laterally, and my knee cap was deteriorating. Now, my knee is aligned at the correct angles, and I have a full and mobile joint space. His success rate 20 years out of TKR is 92%. It is a dream come true following this journey. Dr. Sculco has truly changed my life forever.

On another note, my lupus is currently under control and I will continue with Plaquenil and Meloxicam (given my blood tests don't show anything). Both amazing and uplifting appointments, this never happens! Who am I?!

Noticeable Differences in My Daily Life and in Therapy:

1. No Actual Joint Pain or Crepitus (Crunchiness): Up until my TKR, I would always freak people out by having them feel my leg bending and straightening, and actually having it crunch right under their hand. Usually, it was even audible. As you can see in my x-rays, I was entirely bone-on-bone and had no joint space, which caused the bones to rub together while moving and caused that crunching feeling and sound. If I'm up and about walking around, this is NOT good and this signals that every time I moved my leg, I was essentially causing more damage that I could feel with each step. Now, the only leg pain I have is that of the surgery, where I get achiness in my femur (thigh bone) or tibia (shin bone), from them hammering the implant in just a month ago. My joint however has no crepitus and doesn't crunch/make noise, and my joint doesn't actually hurt to put pressure on! I finally have the joint space and support I never had.

2. Smooth Transitions and Fluid Motions: Similar to the point above, because I have this joint space and finished-off joint surfaces, my leg doesn't click and clunk all the time. My PT mentioned that in the past as I was recovering, from behind he was able to see the transition points of my leg straightening and bending as I walked across the room. The point he was trying to make is that there were catching and locking points that you can visually see from the damage and uneven surfaces in my joint. Now, it is one big fluid motion as I walk, with no visual difference between each flexion point (i.e. I walk like a normal person finally).

3. Proper Alignment of My Entire Leg: MY LEG IS STRAIGHT!!! For the last few years, I struggled so much with walking that I learned how to adapt to my new joint alignment. From the extensive arthritis and damage, I had a slight leg discrepancy and my leg bowed inward. I compensated for this by walking on the outside of my foot to avoid the pain with walking heel-to-toe, in addition to attempting to correct something that could not be corrected. Now I am in gait training, where I am learning to walk straight (heel-to-toe) again. It feels so wrong (from walking incorrectly for so long), but it feels so right (pain-free!!!!) This will in the end, help avoid injury to the rest of my body from overcompensation.