MUA 1 Week post op

[Celle]

I'm going to say this loud and clear to anyone who thinks that doing lots of exercise and pushing your knee is the way to get ROM - it's not.

My OS does not allow any PT at all for at least 4 weeks after a TKR or PKR. Even after that, I only did a few heel slides and practiced walking properly.
His patients all do well and he almost never has to do a MUA.

I have had a PKR revised to a TKR in one knee and a TKR in the other knee. I have full function in both knees and a bilateral ROM of 125 to 130 in both knees.

 

[Demo27]

Hi Kameron,

I had my TKR on April 13 of this year. I was fortunate that I had 130 ROM the day I left the hospital. I wouldn't worry about ROM right now...your level of swelling won't allow any range. Please don't try to be a hero about pain meds. Lots of people can't take Oxy. There are many other choices that can provide heavy pain relief. Ask your doc what he recommends. I am glad your ice machine is arriving today. I found that putting water in small containers and freezing it works best in the ice machine (put the entire container in). Much easier than just using ice.

Believe me I know the first few weeks are tough...it gets much better.

 

[KameronSteele]

@Celle, lets say im icing, elevating all week and then I go to the grocery. does that 30 min on crutches reverse all of my icing and elevating. ie-does it set my recovery back any? and I swear my ROM is getting less and less everyday since I haven't been using a belt to pull/tug my foot towards me. still incredibly stiff ..like there's cement in there, even though the visible swelling seems to be going down.

 

[KameronSteele]

@Demo27, I have been better about pain meds and taking them per the tramadol schedule floating around here. im just worried as I read wranglers thread. so scary...

 

[KarriB]

I'm sure Celle will reply, but I'll tell you that at week 4 I couldn't walk for a half hour without pain and swelling. Can someone go to the grocery store for you?

 

[Celle]

Your knee is angry right now and it could take quite a long while to settle down again. Yes, one trip to the grocery store could upset it all over again.
I only went out for doctor appointments for at least 6 weeks.

 

[CATSMUM]

Like Celle, I did very little in the first few weeks. Even now, when I'm almost 11 weeks post op (but more like 8 weeks after my fall), I still just potter around and rest much of the time.

Hope your knee settles soon.

 

[KarriB]

@KameronSteele the truth of it is, the harder you push, the more your knee revolts. It wants to to rest, heal and be babied. The sooner you decide to not push yourself, the easier your recovery. I wasn't on BS for my recovery, but only went out for Drs and pt. It seems you are part of the Over Do It Club.

 

[Josephine]

lets say im icing, elevating all week and then I go to the grocery. does that 30 min on crutches reverse all of my icing and elevating. ie-does it set my recovery back any?

Did you read the articles? Including this one? Activity progression for TKRs
You're 5 weeks out - in the article this is recommended and that assuming you have followed the regimen of weeks 1-3! See, it does not include 30 minutes going to the store, shopping and getting home again! Much less carrying the shopping!

Weeks 4 and 5
Increase walks around, out in the garden or street, to 20mins, longer if you feel up to it.

 

[KameronSteele]

Did you read the articles? Including this one? Activity progression for TKRs
You're 5 weeks out - in the article this is recommended and that assuming you have followed the regimen of weeks 1-3! See, it does not include 30 minutes going to the store, shopping and getting home again! Much less carrying the shopping!

Weeks 4 and 5
Increase walks around, out in the garden or street, to 20mins, longer if you feel up to it.

yes, I did read the articles but missed this one somehow. lol, yes I see ot does not include going 30 minutes to the store. I did ride the electric cart at the grocery store if that matters. and I actually feel really good. my energy is almost back to pre surgery and really the only thing that's different is my knee wont bend.

I emailed my OS this 2 days ago:

hey there Dr J.
ok since no one takes insurance for deep tissue I think I'd like to go to pt if youre ok with that? im estimating my ROM is 20-30. terrible I know. im very unsteady-still on 2 sticks. my knee is like a PVC pipe -full of water... this suckah WILL NOT BEND. not that pt can make it bend as I think forcing it will only create more swelling and stiffness. I just need to know something I can do to help this angry knee settle down. I ice and elevate all day everyday. outside swelling is going down but inside is so tight and stiff.

kinda discouraged.

thanks Dr J. see you the 21st.

His reply:No PT…lots of NSAIDs and ice, and time. If you don't have 90 of motion by 8wks post op will have to bend your knee for you...

im awaiting his reply if tramadol (currently taking) is safe to take with Mobic. anyone know? and knee is still stiff as allll get out!

 

[bdink21]

Oh boy So it looks like your OS just wants you to to rest, ice, and elevate hoping the swelling will come down and you will be able to bend your knee. I know that 3 weeks of resting may seem like a long time but that really seems to be your only option at this point. Hang in there.

 

[Josephine]

His reply:No PT…lots of NSAIDs and ice, and time. If you don't have 90 of motion by 8wks post op will have to bend your knee for you...

Wow! LOVE your OS! He's definitely a BoneSmartie, for sure!

if tramadol (currently taking) is safe to take with Mobic

Since Mobic is an NSAID, the answer is yes. However, you'd be much better using Tylenol as per the chart I left you. But if you really want to, you can actually use all three! Just make sure you only take it every 8 hours, not like Tylenol, every 6 hours.

BTW, don't fret about the MUA. It may just be what you need from the looks of it.
MUA (Manipulation under Anaesthetic) and Adhesions

 

[KameronSteele]

BTW, don't fret about the MUA. It may just be what you need from the looks of it.
MUA (Manipulation under Anaesthetic) and Adhesions

@Josephine,
1) do you think 8 weeks is time enough to determine if its adhesions/scar tissue?
2) will an MRI or xray show either?
3) if I am the same now as 8 weeks, should I give it more time or do MUA?
4) trying Kineseo tape today
5) second visit to OS is this Monday
6) this is my knee today. This is all the bend I can get, even here it feels tight. Any more and it will certainly explode.

 

[Josephine]

do you think 8 weeks is time enough to determine if its adhesions?

Not as a rule but there are always exceptions to very rule!

will an MRI or xray show either?

Nope

if I am the same now as 8 weeks, should I give it more time or do MUA?

As I said before, I think if your surgeon suggests an MUA you should go for it. Even if it's not adhesions, at least you'll know.

trying Kineseo tape today

Hope it works for you

this is my knee today. This is all the bend I can get, even here it feels tight.

I think that's about 40 degrees but I could have used a better photo, one that shows both hip and ankle

 

[KameronSteele]

@Josephine, is this better?

 

[KameronSteele]

can any one comment on the above pics and what you think ROM is? lying flat its tight as a drum and wont budge any more than that. how long after I stop doing anything and just sit, elevate and ice should I see some improvement? its been about 1.5 weeks since ive been doing just that. tomorrow is my 6 week OS follow up. any advice, encouragement or suggestions are greatly appreciated. thanks again.

 

[KarriB]

I'm terrible at guessing ROM. Are you able to ride an exercise bike at all?

 

[KameronSteele]

@KarriB, not even a little.

 

[KarriB]

After my infection surgery (may have mentioned this on your thread but I don't remember) my revision OS said no bending for 2 weeks, which stretched into a month and just be sure he put me in an imbolizer with steel or aluminum bars. I was so worried my knee wouldn't bend when the infection finally cleared and I was allowed to bend. I'd ask the OS "will my knee bend again?". He always said (I saw him twice a week for a month) "it'll bend when we tell it to bend." When he finally said "non-aggressive bending" he demonstrated by sliding my right foot about 3 inches with his foot. So I took it very easy as the concern was the sensitivity of my soft tissue and the infection. But a month after I began non-aggressive bending I was riding an exercise bike for just 5 minutes (for a few weeks I could only rock the pedals back and forth) and I was back to teaching first grade part time. My point is, that even if you have to have an MUA, the window of opportunity has not closed.

An MUA may help, it helped @tigz . She has gone back to work and has seen improvement.

 

[KameronSteele]

@KarriB, you were in an immobilizer for a month?! and a month after that you were gentle bending for a month and this allowed you to rock the pedals on a bike? I tried this a couple weeks ago..rocking back and forth but i got a couple inches at best. should I keep doing this? Even though it's still very stiff, I'll be 6 weeks post op Tuesday-I supposed I shouldn't be thinking MUA yet? im gonna go look for @tigz mua thread. thanks for the reply!