TKR 16+ weeks out and ROM of 90 degrees!

[Tykey]

Later on in the evening, I did a little gentle exercise (heel slides and stationery bike) for a while and then asked my husband to measure my bend, but I could only get to about 105, 110 once at best. Felt really low then, and decided that it had all gone wrong and that this was it and as I have to work and can't keep my leg elevated, my knee would go back to 90 degrees and I would just have to put up with it

Well that's the problem you get if you keep measuring it, it's only very approximate in the first place. Ask ten different people to measure it and you'll get 10 different figures. Even if it really had come down, that will almost certainly be due to doing quite a bit during the day, the next day it will be back up, that's the nature of these journeys.
Measuring ROM has never actually improved it

 

[Josephine]

Their being unwilling to continue what they started because you are time expired speaks volumes.

My sainted aunt!

then asked my husband to measure my bend

Is your husband a physiotherapist or something? And do you have the proper tool for this measuring? I can tell you that not all physios are able to measure ROM accurately. And at best it's not an exact science anyway.

Apart from which, exercises are not a instant result thing. It takes a few days to really see any effect. A bit like growing seedlings (since it's getting to that time of the year!)

 

[icep707]

Hey Sparkle ! Just read your whole thread , as im 2 weeks into recovery, so I have alot of time since sleep is very hard to get. Im so sorry that your recovery has been difficult and disappointing. As I read your thread I couldnt wait till your MUA. I was hoping that it would of been the golden ticket. I dont recall if they took ex rays ? At this point , Do you believe the problem is soft tissue ?? I know you were limited with medication , due to reactions and kidney issues. Also if you dont mind , knowing what you know now , what should I be doing now to increase my bend , im only 2 weeks out ! Or what would you have done differently in hindsight. ?? Sending prayers your way !!

 

[gman33]

Hi Sparkie
I just had my mua done 2weeks ago I was put on a cpm machine bending my knee at120. I was on the machine for24 hrs than at home for 2 weeks. The mua itself is really nothing to worry about. I was in very little pain and when I got off the cpm my rom is now at 100. I do ice all day and returning to work tomorrow for the 1st time in 3 months. This bone smart has helped me through all the tough times and can not wait for the warm weather. Best of luck to you.

 

[sparkie]

Hi All,
Just updating and seeking advice again - my knee has been so much better since I had the manipulation. But, I can still only bend to 118 if I lay on my back with my leg in the air and gently persuade my knee to bend a little at a time. In general everyday use, it just doesn't go over 90 deg'ish without hurting and I am SO fed up with it. I can still only straighten my leg to around 15 degrees.
My leg is still as stiff an old barn door, but is a bit better if I take painkillers.
On the positive side, I can walk much further than I could before the op, but again, this is easier with pain meds.
I suppose I thought that after 13 months, a manipulation and thousands of pounds spent on PT and home equipment, I would be so much better by now?
Is there anything I can do about the stiffness. I really want to stop with the pain killers as it can't be good to take them for this amount of time can it?
I have started seeing another PT and she has suggested heel raisers to put in my shoes. I have not agreed to this as I do not want to end up dependent on having to use these for the rest of my life. I want her to sort out the permanent 15 degree bend, the stiffness and just get me moving naturally and off pain meds.
I am still struggling with getting down a flight of stairs as my knee hurts when it is bent back coming down steps.
I still struggle washing my foot and cutting toe nails etc. I am still a bit unbalanced and appear to stagger a bit when I walk.

Thanks for reading this. I hope I haven't depressed anyone. The are some positives - I am not kept awake at nights anymore. I can walk much further than before the op.

 

[Jozilla]

Hi Sparkie - you have been certainly challenged with this recovery. My opinion is if you are in chronic pain take the medication. Especially if it makes walking easier! I do hope things get better for you. You do sound like you are still improving so be encouraged by the small things!


RTKR - 9th December, 2013

 

[maryo52]

I can still only bend to 118 if I lay on my back with my leg in the air and gently persuade my knee to bend a little at a time

You're there! The docs anticipate 120 with TKR. Yours will likely improve in the next year without trying. What are you doing for physiotherapy? You might have a trial of no physiotherapy (except straightening) to let those tissues have a rest. Sometimes a rest allows them to increase their elasticity. And it might give you pain relief such that painkillers are no longer needed. (How about massage?)

I am SO fed up with it. I can still only straighten my leg to around 15 degrees.

Work on straightening but very gently and slowly. It's a different dynamic. I could feel the ligaments in the back of my knee burn when I tried to straighten. My efforts were stopped soon as I felt that burn.

I understand your frustration. My knee never actually met the definition of successful TKR. I've had to learn to live with what I've got (eternal stiffness and laxity) with the help of a brace, and then realize that I can do everything I want to. I think your only real worry is the extension lag and perhaps you could state what you've been doing about that. Also, remind us when your manipulation was (as in put it in your signature). All the best, Mary

 

[SAS]

Sparkie, this has not been an easy op for you, I now realise how lucky I have been in my recuperation. I find if I do not exercise I get very stiff so try each day time permitting to use my exercise bike and that does loosen my knees up. As far as taking meds I am lucky I do not need meds now, but a word of caution when I was coming off my meds, I had a very hollow feeling under my rib cage which was becoming a bit uncomfortable so I visited the doctor. The doctor told me to stop my meds as they were causing grazing to my stomach which if I carried on would cause an ulcer. I stopped immediately took some tablets for the grazing for a month and was fine. So do be careful. Stairs were the last thing I conquered I never thought I would go up and down correctly again, but it did come. All I can think of is it is taking much longer for you to get over this operation and plod on, but make sure you exercise that is what got me better. Good luck I hope things het better for you.

Sheila

 

[Wednesday]

Got to agree. When I wake up each morning, my legs feel very stiff. Now I ice them and get them moving before I even get out of bed. It's been a great help.

 

[patient 99]

I suppose I thought that after 13 months, a manipulation and thousands of pounds spent on PT and home equipment, I would be so much better by now?

Hi Sparkie, pleased you came back with an update. I am now at the 15 month stage and like you had hoped for a better outcome. Its a hard call to know when you should keep pushing for something better, or lower expectations, and accept what you have got.

Much of how you describe your TKR applies to me. I've an appointment on 16 May to see my surgeon and depending on what happens then, will seek a second opinion. But there is a little voice at the back of my head which says `this is as good as it gets, so learn to live with it'. The only thing that has helped me is my compression sleeve. Its not very tight and sits just below my knee. It helps with the swelling and makes walking more comfortable.

Most of us have something that we think helps - brace, compression sleeves, exercise, massage, hydrotherapy pool, chiropractor, physio therapy, rest to name but a few. All you can do is experiment and see what works for you.

Have you been back to see your surgeon? Carol

 

[rainbird]

Thank you Sparkie for continuing to post your progress. I have not been so good at it. I am at about 8 months out and not sure where I'm supposed to be at in my own recovery. I had good rom at my last PT appointments at 6 months post op- o and 115-120. I have been going about life like I didn't have the surgery in my need to move on. That said, my knee is still very stiff every day and increases in pain and stiffness as the day goes on. I am wondering if I've been in denial about how much exercise or easing up on activity I should be doing. I've been traveling a lot, so the riding in cars and planes are terrible. My knee doesn't like driving or sitting in the car and I can't get in and out without pain and discomfort.
My friend had cancer and a major operation and I managed his life for quite a few weeks. I'm taking a break from it now, but am still doing some helping out. I think since I've had fibromyalgia for so many years and other health issues, I just want to live a normal life. Feeling sad about aging and having so many issues when others my age are bopping about. Right now I am taking a rest to try not to get more of a cold. Sparkie's post popped up on my email and I'm grateful for the reminder to take care of myself. I do ice daily and have a morning exercise routine that I do, but not enough focused on stretching and bending the knee. Thank you all for listening and feedback is welcome.

 

[sparkie]

Hi,

Thanks so much for the positive advice.
I had the manipulation October 31st 2013.
I peddle my bike and a little floor peddler to loosen up and it does help. But if I stop for 10 minutes and try to get up again, I have stiffened up! I have had months of an osteopath trying to stretch and loosen the tendons and ligaments and he said he has never seen anything like it. As it is lovely a loose and moving freely when I leave his office and when I go back a week later (even though I stretch and exercise in between time) it is just as stiff again!
I started seeing a new PT a few weeks ago as I still can't do a leg raise while sitting on the floor. It does not matter how hard I try. The Osteopath and PT agree that I have plenty of strength in my quads and hamstrings muscles so can't really figure why I can't lift my leg. I think it is because I can't straighten it. The PT favours the "its all in your mind approach"! She has me trying to lift my leg off a ball with a strap to help. And she wants me to wear moulded angled heal lifts in my shoes. I have not even tried them, as I do not want to become dependent on them and have to use them for the rest of my life as she indicted!
I want to walk for more than 10 minutes without my hip and back hurting. I want to be able to get up and down stairs normally. I don't see how I will ever get to go down stairs normally while I have a permanent 15 degree bend as my knee just wants to give way each time?

Rainbird - I have felt like you on many occasion, especially when, as you say, others my age (52) seem so much fitter. I used to be so much slimmer and fitter that I struggle with being unfit now. The whole point of having my knee replaced was so I could get back to doing some keep fit, but I am a long way off what I used to do.
Cheer up though. You are not alone and we all care about you.

Take care

 

[Jozilla]

Have you considered seeing a neurologist? It might help to have a different perspective and nerve conduction test. Hope you have a better day!


RTKR - 9th December, 2013

 

[kneeper]

I wouldn't do heal lifts without consulting your OS and seeing an orthotist.

 

[sparkie]

Hi All,

Just writing in with an update/whinge!


Still no bend beyond 118 nor straighter than 15! Still can't walk upstairs without holding on/pulling on my arms a bit (not enough strength in my leg to push me up). Can't walk downstairs without holding on - still mostly 1 step at a time. I can do it almost normally if the steps are really shallow. I still have difficulty getting in and out of the car and putting trousers and shoes on etc., due to limited bend.
I cannot even do a straight leg lift to half an inch but can still do a tremendous leg tremble whilst trying! It just seems as though my leg is not attached to me when I try!
I have seen the osteopath again lately as my lower back/hip (on the same side as my new knee) is giving me tremendous pain. He is now of the opinion that my new knee leg is now longer than it was and I am leaning over the left and then compensating by holding my body to the right. So, looking at my spine there is a distinct "S" shape at the lower part. He has suggested I wear a heel raiser in my left shoe.
I am still taking paracetamol and tramadol for the back pain and I am absolutely sick and tired of this! The whole purpose of getting my knee done was to enable me to be able to exercise and get fitter. But all that is happened is that I am virtually disabled, in pain all of the time and down right bloody miserable.
OS says "knee is fine". Well I wish he could have it for a while to see how fine it really is!
My leg is still so bloody stiff that it takes me a minute to stand up, using my good leg as I can't get this one under me enough to use for standing, and then to be able to walk off. Once I get going I am ok apart from the back ache. I am still wobbly on bumpy or sloping ground. Oh yes, my leg has wasted more than before the op' and you can see the bones down the front of my leg now and it appears to have a real curve, but I think that is just where there is no muscle.

This has been 15 months now and I had really expected to be so much better than before the op.
I certainly would not recommend a TKR or have another one. I do now know how anyone could have 2 done at once.

I am just trying to get on with my life and forget about it, but I so want to come off the medication and not be in pain.

Thanks for letting me whinge on. I hope I haven't depressed anyone too much.

 

[maryo52]

Have you sought second opinions?

How can you have an extension of 15 and an ortho who says things are fine? Your flexion is OK but 15 extension is not fine.

 

[patient 99]

Hi Sparkie, I think some of us (like me) are disappointed in our TKR outcomes, but do the best we can and try living with it, but your outcome sounds too bad to trying just living with it.

It hacks me off when OSs take an Xray and on the basis of that say everything looks fine. The prosthesis may be correctly positioned, but there are many other things that might be wrong. An extension of 15 needs to be looked at.

I went to my GP and asked for a second opinion. But if you go down this path you will need to do your homework. Most GPs wont send you out of their catchment area unless there is nobody local. So you need to check with Josephine as to who she recommends in your area. Then you can ask your GP to refer you to that person. Again, that's not all there is to it, because you might end up by being seen by one of the team - not the main man. Again Josephine has

 

[patient 99]

Hi Sparkie, I think some of us (like me) are disappointed in our TKR outcomes, but do the best we can and try living with it, but your outcome sounds too bad to trying just living with it.

It hacks me off when OSs take an Xray and on the basis of that say everything looks fine. The prosthesis may be correctly positioned, but there are many other things that might be wrong. An extension of 15 needs to be looked at.

I went to my GP and asked for a second opinion. But if you go down this path you will need to do your homework. Most GPs wont send you out of their catchment area unless there is nobody local. So you need to check with Josephine as to who she recommends in your area. Then you can ask your GP to refer you to that person. Again, that's not all there is to it, because you might end up by being seen by one of the team - not the main man. Again Josephine might have some helpful suggestions. Carol

sorry for sending message twice BS has some bugs.

 

[patient 99]

Sparkie, BS is playing up. I just wanted to finish by saying Josephine may have some ideas to help you round the system. Carol

 

[Roy Gardiner]

Sparkie, when the OS says 'the knee is fine', my guess is that he means the implant is straight and true and firmly fixed. If so this is good news, because it then means that your troubles lie with the soft tissues, which should be fixable without further surgery.

My leg lengths changed after surgery as bow-legs were corrected, so it may well be the same for you.

You don't say what you've been doing by way of therapy, care to tell us?