Bilateral TKR Bilateral TKR manipulation scheduled

MARLEYKAI6

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I had bilateral TKR on March 15, 2019. My recovery has been slow, mostly I believe from the swelling and in the beginning a bad reaction to all pain meds. I attend PT twice a week and usually take a day or two for recovery from the PT.

I saw the surgeon for my 12 week check up last week and he has scheduled me for a manipulation this coming Friday. I am very unsure if I want the manipulation but Dr says this is the time to do it and it should be done. I have about 125 degrees in left leg and 110 in right, although he measured right at 90 because it was so swollen when I was there. He said it is scar tissue that is causing stiffness and needs to be broken now.

I am so unsure about this procedure and feel like I am just blindly following orders. I also have to say that I really like my surgeon and knees is all he does for the past 25 years. I feel like he has tons of experience and has done a great job with me so far so I hate to question his advice.

I need to figure this out quick, any advice out there? Thanks.
 
Hi and Welcome to Bonesmart!

Your 125 and 110 numbers are great. I’m shocked he wants to do an MUA with those numbers.

I understand wanting to trust his decision, but I think you have to trust your intuition and common sense also. Just because they recommend doesn’t mean we have to consent. And he can’t do it without your consent. If it was my knee (s) I would not consent with those numbers.

You are very correct about the swelling hindering the bend. Did you do any extra activity a day or so before your appointment? Swelling is still very common at 12 weeks, even if we don’t overdo, but especially if we do overdo.

I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
@MARLEYKAI6
Welcome to BoneSmart, glad you joined us.

I have about 125 degrees in left leg and 110 in right, although he measured right at 90 because it was so swollen when I was there.
Your ROM is fantastic on the left and great on the right. Usually once you reach 90 degrees very few surgeons will perform a MUA.


although he measured right at 90 because it was so swollen when I was there.
It is swelling blocking your ROM, suggest you take some time to get the swelling down and avoid any activity, therapy that causes your knees to swell, and increase pain and discomfort.
This includes telling the PT to work on getting the swelling down, they can use retrograde massage, and electrical stimulation to help. Do not let them do anything that increases pain and swelling.
Saying no to therapy - am I allowed to?

ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM!
ROM (range of motion) information

I agree with Jockette, I would not have a MUA with those numbers.
 
My ROM is still improving at 2 years post op as my whole leg continues to relax.
 
I can only dream of the numbers you have. And even with my not-so-great flexion this far out from my surgery, my OS has never uttered those "M" words. To me, when you have low ROM due to a lot of swelling, having a surgeon go in there and forcibly bend that poor swollen knee to get a higher number would just cause more pain and swelling, thus causing your ROM to go even lower. In your case, with your ROM at such great numbers, and not quite 3 months out, I'd say skip the procedure and keep doing whatever you've been doing-it's obviously working. Yes, you'll have days when you've overdone a bit and your knee responds with more swelling; those days you just need to ice and elevate more, and give your knee a break. It's YOUR knee and YOUR recovery; and only you have the final say in how you want to recover. You can listen to any advice you choose, but in the end it's YOUR decision on which path to take. And we here will support your decision, whichever way you choose.
 
Do read the article Pumpkln left you on refusing to do therapy. I think it's criminal that he is 'requiring' you to have MUAs because there is no way you have scar tissue/adhesions in either of those knees. If you had you wouldn't be able to bend your knees past 80 or 90 degrees! YOU are right and he is - well - mistaken! It's your choice and no matter how much you do admire, trust and like your surgeon, you have to advocate for yourself and refuse to have this done. It's your right, you know. That's the law.
 
With numbers like that I would never even consider a MUA. They are great and there is no reason to go through the pain and setback a MUA will cause. I think your OS is wrong. You've already had 110 before it swelled. That's proof that the swelling is causing the 90, not adhesions. Please think very carefully before doing this unnecessary procedure.
 
What? Your flexion in both knees is good.
 

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