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MUA 10 weeks out and low ROM<

Great, thank you.

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rtkneeandy said:
The entire knee is tight and hard. Like its swelled in deep. Worried about arthrofibrosis.
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Well stop worrying about it. It's an extremely rare condition. Where did you find out about it anyway - a Google search?
KarriB said:
@Josephine will have questions for you that may help shed some light on your bending problem.
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I actually already asked you my questions back in December 2nd, post #7. I doubt much has changed since then
 
You would be correct, not much jas changed. I feel like things are going ok. Just so locked up that's all. Need to get my mind off of ROM. Stuck at 65 flex. I have my first PT Tuesday next week. I will take charge and keep them at bay. Icing and elevating most of the day and also at night,

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And yes it was Google...

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rtkneeandy said:
Stuck at 65 flex
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65 flexion at about 4 weeks post-op isn't too bad. Your knee won't bend much more until that hard internal swelling starts to go away. To help that to happen, continue to rest, ice and elevate as much as you can, and only do a minimum amount of exercise. Just walking around your house is sufficient.

Don't get trapped into thinking that working harder at exercises will improve matters,, because it won't.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
TKR: work “smarter” and not “harder”
TKRs and our fast food society
Lose the Work Ethic While You Are Recovering!

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

This is what one of our members, bertschb, wrote about his knee and the way that his ROM developed:
I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.​
 
Just thinking out loud here, has anyone read or heard of someone that didn't get their range of motion back? I'm looking down the barrel of a possible manipulation under anesthetic and just thinking about what the possibilities are if I refuse it, not to mention the outcome

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@rtkneeandy - It's only just over a month since you had this major surgery - far too soon to be "looking down the barrel" of possible MUA.
Stop worrying about it. Your knee will bend more as its swelling decreases. It knows what it's doing, so try and trust it.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

In any case, even if your surgeon suggests an MUA, you have the right to say "Not yet. I'd like to wait a bit longer."
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

Having an MUA when it isn't necessary will only damage some of the soft tissues that are trying to heal. It will increase swelling and set your recovery clock beck to Day 1. There is no benefit to having an MUA so early in your recovery. MUA: the ineffectiveness of early MUA (JBJS)
 
I was only around 70 at 4 weeks. It took me until 6 weeks to get to 90--and that happened once the swelling went down. And then it moved along quickly. Remember that the knee can be swollen even if it doesn't look too bad.
I know it's easy to obsess, but don't think about it as a day by day thing.
 
I'm only repeating what my surgeon told me I have read what is above.... and believe you me I want to believe it. Hopefully you understand how difficult it is when your surgeon says this is what's needs to happen and then I read... No worries ROM will improve for a year.

Back to original question. Has anyone else been told that they need a manipulation and rejected it, and their ROM did improve? My surgeon was very adamant about me having 90° by 7 weeks or he was going the other route. Again I realize all this is my choice, I'm just looking for more information to make that choice, and by the way thanks for taking the time to reply.

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Thanks kneeper, that helps, to hear of other positive and simular outcomes.

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It sounds like I should go in for my 7 week visit and tell him I'm going to wait for my ROM and hope for a positive outcome

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Kneeper... My knee goes to 60 and then bam.. it's like a concrete wall almost solid. And like someone said it's not overly swelled just moderate. I realize there can be internal swelling as well. When you're just got better was it just from daily activity or were you doing therapy as well?

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rtkneeandy said:
Back to original question. Has anyone else been told that they need a manipulation and rejected it, and their ROM did improve? My surgeon was very adamant about me having 90° by 7 weeks or he was going the other route.
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Heaps of people have postponed an MUA and had their ROM increase without it.

At a guess, an almost equal number have had the MUA and discovered no benefit from it.

There are a few, a very few, who genuinely needed an MUA and benefitted from it.

Most early MUAs are done because of surgeon impatience, not because of a genuine need for them.
 
Thank you celle. Good to hear, I hope you understand it's hard when the surgeon is telling me to do something but then again I'm sure you've heard a lot of this. Thanks to everyone for their patience and listening to me wine about my seemingly insignificant troubles and thank everyone for their time you guys really do make a difference.

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Maybe this will help...a month after my TKR i experienced an infection which led to a 2nd surgery. My OS put me in an immbolizer and said NO bending. This lasted for a month. I did obsess over whether my new knee would bend again. I saw my OS twice a week for that month and often asked if my knee would bend again. He always answered, “the knee will bend when we tell it to bend”. When the month was over (seeping from the infection stopped) my OS prescribed non-aggressive therapy, easy heel slides and walking around the house without the immbolizer. Although my knee was stiff, it did bend and a month later I was riding a recumbent bike at PT. I was released from PT with a flex of 109, but my bend did increase for months after that.
 
Each time I had my kneecaps removed, I was put into immobilizers for 6 weeks. Once out of them, my knees starting bending just fine. After a month, I was walking without assistance devices! I never had PT, either, I just used my knees normally!
 
Wow karri, sister, that helps alot. Thank you both. I wish these OS would get on this page. You have to assume the only reason can be speed of recovery, otherwise I can't see why they would want to push people like this other than maybe collect Physical Therapy money for that side of the machine.

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There are times when MUA is called for, but it doesn't seem to be as often as "threatened." Wait and see how you are at 7 weeks.

As for your question about my PT:
For my 2nd knee my PT appointments for the first 5-6 weeks consisted of mostly intensive icing with the "GameReady" ice/compression machine (15 minutes or so), followed by a few exercises.

At home, I mostly iced and elevated, though I did do a few exercises (and stretches morning and evening due to tight muscles--a regular occurrence for me).
Perhaps 5 heel slides 2-3x/day; walking about 10 minutes and a little daily activity such as fixing very simple meals (microwave or sandwiches). I had help with grocery shopping, errands etc. so I was able to keep my time on my feet very minimal.
 
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