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13 weeks post-TKR...manipulation ?'s

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Laurierocs

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Hi,

My OS wants to do a manipulation on me. I am 51 and my ROM has gone backwards from 115 after 6 weeks of PT to 108, which is what it is now at 13weeks and still going to PT 2x a week. He said because of my age, I will want more ROM. I wanted to wait until June when school is out(I work in a school) but he wants to do it immediately and said the longer I wait, the less success the manipulation will have.

My ?'s are these:

1) What kind of recovery are we looking at? It took me 8 weeks to get back to work after the TKR. I work in the school lunchroom, hard physical labor for about 5 hours a day.

2) What's to say my ROM could end up worse than what it is now at 108?

3) He said if I got onto a "Leg press" machine, I could manipulate it myself. What are the chances of that happening realistically? I mean, if the PT couldn't help me with more ROM, how could I do it on this machine?

4) If I have this manipulation...do you think I should change PT's? Maybe mine wasn't aggressive enough?

THanks! I would really enjoy any feedback.

Laurie
 

gatiger

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Someone else will have to handle questions 1 & 2, my thoughts on #3 & 4: Depending on your tolerance for pain, a leg press with enough weigh would certainly give you a good stretch, but I wouldn't want to try that by myself. How to get out from under if it lowered too much; Once the wight comes down, how to get it back up. Just a couple of concerns there. IF you are asking, "Maybe mine wasn't aggressive enough?" then I would guess that he wasn't. I used to ask if, "Maybe mine is INSANE?" just sayin
 

Doug

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Laurierocs,
I have lifted weights since I was 13 and am now 55. I'm at 8 weeks post TKR. There is no way on this green earth that I would recommend getting on a leg press to bend the leg. When you lower the weight you may not be able to stop it and yes it will bend your leg but you are going to scream..Some machines have a lock so this won't happen but I'd be darned if I would get on it. Trust me on this. I did it on a bike Saturday and I am still icing my knee. Personally, I think the bike and hot tubs are the best for ROM training. I was at 130 last week.
Can't help with the other issues.
 

Josephine

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1) What kind of recovery are we looking at? It took me 8 weeks to get back to work after the TKR. I work in the school lunchroom, hard physical labor for about 5 hours a day.
Recovery should be short and swift, maybe a few days of pain and stiffness not more than a week.

2) What's to say my ROM could end up worse than what it is now at 108?
Be most unlikely. Worst case scenario would be no change at all.

3) He said if I got onto a "Leg press" machine, I could manipulate it myself. What are the chances of that happening realistically? I mean, if the PT couldn't help me with more ROM, how could I do it on this machine?
Can't help here, sorry.

4) If I have this manipulation...do you think I should change PT's? Maybe mine wasn't aggressive enough?
Part of the reason for an MUA being necessary is that some people have a tendency to not produce enough of the egg-white like fluid that lubricates the ligaments, tendons and muscles or that the fluid they do produce is more viscous that usual. If this be the case, then the ligaments and other structures become 'stuck' to surrounding tissues which results in the poor ROM. It is this that the surgeon will free up in the manipulation. Mostly it's a chance thing and may or maybe not due to the efficacy of the physiotherapy.
 
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Laurierocs

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Thanks everyone that replied. I think I will go ahead and schedule the manipulation. Sounds dreadful....but worthwhile.

Laurie
 

gatiger

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Laurie, Newwoman had the manipulation done and somewhere back in the posts she explained how her's went. She seems to have benefited from it. I thought about and graciously declined, but I am a little further ROM-wise than you are.
 
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Laurierocs

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Thanks Gatiger, I just did a search and found Newwoman's post about her manipulation. By the time I can have mine done, I hope it won't be too late. We're leaving on a cruise next week, so it will be another 2 weeks before I can get it done.

I've heard of people having the manipulation and then going to their PT right away afterwards. And then I've heard of people spending the night with the CPM machine going all night. And then there's the epideral (sp?) or the block. I wonder which method is best?

Laurie
 

gatiger

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I ALWAYS prefer to be completely out, but some docs don't ask. Some people like the block, I guess its just whatever. I think going right into PT afterwards is a key point.
 

Josephine

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If it was me, considering that a spinal take about an hour to do and a GA about 3-5 mins - all for a procedure that takes about 3 minutes to do - IMO no contest!
 

gatiger

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The first knee surgery I had the Ortho asked which I wanted and went on to say that with a spinal I would be able to tell what was going on. I told him that if I needed to be checking on what he was doing, then I probably needed someone else.
 

Doug

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I couldn't have said it better. Knock me out, wake me up, and give me some dope so that when my head clears I don't have a monkey on my leg!!
 
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Laurierocs

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Ok, it's my MUA is scheduled for April 10th. I don't really know what the plan is yet, other than I know I'm getting gas. (You know what I mean, ha!) I hope they give me the block with it. They said I will be spending the night with intensive PT every 2 hours. I can't say I'm looking forward to starting PT all over. I feel the 3 months I did were a waste.

I absolutely love this board! I thought I was the only one that was having trouble sleeping at night. I used to look forward to going to bed, now I dread it and can't lay there in the morning anymore, I just have to get up and stretch my knee. Just so many things I have in common with other TKR.

Thanks everyone for the support!

Laurie
 

gatiger

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I would not say you will be starting over or that what you've done was wasted. This will just free things up for you to go further not start over.
 

Nursepair

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Hey Lauri, glad to see you got your manipulation sorted out. I am beginning to hope to have one too, my knee just doesn't want to budge any further. I am sick of not being able to even walk up the stairs properly, and it still hurts like mad when I try to bend it and straighten it. Hurts to get up and make myself a cup of rosy , my hubby is still in Europe and I miss him. The pain is keeping me up all darned night and I can't stop crying today. I know there are people worse off than myself, I know several personally, but I still can't help feeling sorry for myself at the moment. Sorry for venting, I can hardly see the keyboard now I'm so damn tired. Sue
 

Josephine

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NP, you have a hug as well!! You sound like you need one!


ai21.photobucket.com_albums_b286_flagady15_smilies_36.jpg
 

Nursepair

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Thanks Josephine, I do. I feel better now, I will finish looking at the earlier threads, then I'll try to get some sleep!! Sue Hope you knee is feeling better now. Hope you don't get too much snow, my mum told me they may get some. Kevin should get back late Friday night, so should just miss it. Sue xoxo
 

Pattipoo

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Hey NP.....If you're going to have a pity party, make it a GREAT one! Put some loud music on and CRY to it!!!....you may just start to sing and dance (one legged dancing!)....sorry you've felt bad today. We all have them.
Instead of crying, I cleaned out my walk-in closet.....just got finished. It'll look nice for about a day and a half!!!

Touch your screen.......POOF.........I just sent you a big ol' "country" feel good vibe!!!
 

Nursepair

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Thanks Patti, it worked, I turned my Cliff Richard CD on my computer, cried excessively, then I touched the screen now I want to listen to country music.....oh no, that just aint right!!
 

Newwoman

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Hi Laurie,
If you need any questions answered about my manipulation I would be happy to share with you just fire away.
I've been there and I survived it and my knee is still bending further.
Cathy
 
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