MUA 10 weeks after TKRS and not yet happy

[L.I.T]

@BARBRI, here's to hoping you can get the pain under control. Glad it's looking like snow shoveling won't be a necessary evil in the near future.

PS - maybe you need one of these ha!

 

[BARBRI]

Too funny!

 

[kneeper]

Watch the forecast and if it's a snowy week, make shoveling the only activity you do. you might also do it in installments. In the short run it's worth it to hire someone. I was able to get friends & hire people to cut my grass for most of my recovery and it was so worth it. And that isn't nearly as hard as shoveling on the knee.

 

[BARBRI]

L.I.T. You live in a beautiful part of the world. I have been to St George for the World Senior Games [softball] twice before and we are going again this October.

 

[Josephine]

Hello, BARBRI - I've just come back from leave and have spent some time reading your thread here. I have some comments/observations to offer.

My ROM is currently between 100-110 and I am about 10 degrees short of a full leg extension after over 12 weeks and knee is very stiff.

It is the knee bend that the PT and I are most concerned about rather than the extension.

Any PT that shows that much doubt over such an excellent over such an excellent outcome after only 10 weeks needs to go on a refresher course! And that your surgeon would agree to doing the MUA is also very puzzling.

Had the MUA on Thursday. Went pretty well and additional pain and swelling from the procedure is not onerous.

Since you had no post-op pain or other repercussions, I can assure you that you definitely had NO adhesions. If you had any and then had an MUA, you would know all about it! No pain means NO adhesions. So the procedure was unnecessary and in all probability done as a placebo.

I also feel that I need to continue to do some harder activities to maintain ROM and to break down scar tissue.

Let me tell you a few facts about this so called 'scar tissue' or adhesions. In a primary knee replacement it's actually a pretty rare occurrence. However, what IS common are these issues
1. doing an excessive amount of activity and/or exercise causes the tissues to become warm or even hot. Over heated tissues also tend to be dry and hot dry tissues are far more likely to produce adhesions. This is the real danger
2. what is a far more common cause of stiffness is swelling. Now swelling is not inevitably externally apparent. What is very common after knee surgery is internal swelling and this can often be more responsible for stiffness than anything else.
3. (and most importantly) adhesions are actually pretty rare. As Celle said, this is not to be confused with scarring that occurs to seal a wound. THIS 'scar tissue' is a different thing altogether. So read this and be better informed MUA (Manipulation under Anaesthetic) and Adhesions

 

[BARBRI]

@Josephine,thank you for taking the time to review my thread and for providing the feedback.
When I stated that it is the knee bend that I and the PT were most concerned about I did not mean to imply that we were excessively concerned at that point. Just that was the area that we wanted to concentrate on.

As far as the MUA is concerned it was felt by me,the PT and the OS that I was not likely going to progress beyond 100 degrees flexion without it. My research indicated the benefits of an MUA as indicated by the article provided by Spex10. My extension and flexion improved as a result of it.

And finally, since day one I have had and continue to have knee and lower leg pain. I have recently backed off of my exercise regime as I may have been over doing it causing additional strain and pain.

Thanks again.

 

[kneeper]

That's the way--listen to your body. It's a lot of trial and error knowing how much is too much and sometimes you don't know while your doing it.

 

[BARBRI]

Other than normal day to day activities I have not done anything for the past 3 days. Feel a bit better. pain and stiffness subsided somewhat. Hard for me not to go to physio or the gym daily. No snow to shovel thank goodness and none in the forecast. Existing snow melting. Plan to do a little pedaling and stretching today prior to going back to physio and the pool tomorrow.

 

[Celle]

Instead of going back to both physio and the pool on the same day why not start with just one of those?
If you have no increased pain or swelling, after that, gradually add in the other.

 

[BARBRI]

My physio will be limited to 15 minutes on the bike and some knee presses.

 

[Celle]

I'd be inclined to just use the bike at first and skip the knee presses. Add them back later, if you don't get any increase in pain or swelling.

 

[BARBRI]

Good advice Celle. Thank you

 

[BARBRI]

Good news today at Physio. Achieved 0 extension and 120 flexion. Now if only I could get a good night's sleep.

 

[KarriB]

Wow! Those are great numbers! Keep doing what you have been! Have you tried icing your knee through the night or when you wake up?

 

[BARBRI]

Thank you KarriB. Yes I ice during the night in addition to taking a Tylenol extra strength and 2 hydromorphone. I am okay for about 2-3 hours then the pain begins.

 

[Jamie]

You're doing the right thing at night. It's just going to take some time to resolve. Do you take more meds after about 4 hours to get through the rest of the night? You know they only last about 4 hours.

 

[L.I.T]

@BARBRI, as I would have said as a kid, we're twinkie dinks! The Night time Pain duo! You can wear the cape and I'll carry the invisible lasso.

Congrats on the flexion! Whatever you are doing, it's working! Can't wait to see that knee in action, come October!

 

[Cratchit]

Wow, BARBRI, your extension is great! Mine only measured at 110 yesterday. However, l am able to do just about everything l want and need to do so l'm not too hung up on that number. Hope you've managed to get a better night's sleep

 

[Red's Mom]

@BARBRI how are you doing these days?

 

[BARBRI]

How am I doing these days? Thank you for asking. Let's see. For the most part pretty good. Having more good days than bad. ROM is 0 extension and between 115-120 flexion. Very little swelling. But still have some lingering stiffness and pain which manifests itself mostly at night,like right now.Over did it at the gym the other day and have been paying for it for the past few days.Still cannot say that I am glad to have had the surgery,but am more confident now that I will be some day fairly soon.
I have been following the progress of many of you even though I have not been active on the forum lately.