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TKR 2 weeks out

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What factors does your ortho doc use in deciding when and whether or not to do MUA? I'm now three weeks post op. My ROM is 5 to 95 (or 105 w/PT pushin' it). Is there a time frame w/in which most MUA is done? (I've read best results if done w/in 8 weeks of TKR surgery)

My PT said this morning that if my numbers don't improve by the end of next week, that we might wanna contact my doc and look into MUA? Does this sound right? Or too soon?

As always, I appreciate your comments and suggestions.

Frustrated & concerned. JMB
 
Well, in the UK we tend not to manipulate until about 10-12 weeks but I know some US surgeons are a tad more pro-active about it. There's certainly no "best before" dates and though it can be done any time, three weeks is certainly far too early.

Actually 95 isn't at all bad for three weeks out so I really wouldn't worry about it now. What's probably stopping your flexion is the swelling which acts much like a plaster cast. The flexion is there, it just can't show itself. So your job right now is to rest, elevate, ice and take your pain meds on schedule so the pain and swelling gets managed properly and goes away. Once that happens, you will find you have all the flexion you could want! But it could take up to 8 weeks for that to happen, maybe even more.
 
Just thought I'd share something w/everyone that I've found very helpful. My older brother from Alaska previously had BTKR several years ago. He's had great success w/his "new knees" and is an avid cyclist. Anyway, he told me that when I first got on a stationary bike at PT I wouldn't be able to peddle all the way around b/c of limited flexion in my new knee. He was right. He also told me, however, that there is a devise that you can purchase that attaches to the pedal crank that has 4 holes to "shorten" the length of the crank, thus making it easier to pedal a complete circle even w/limited flexion. Well, he sent me one of these contraptions and bless his heart, it works like a charm. I took the part to PT w/me and they put it on their stationary bike w/the pedal reset in the lowest position. And off I went! Since last Monday, I've been able to go up two positons, bending my knee a little more each time, as I pedal my stationary bike.

So if anyone is having issues with not being able to bend their knee enough to pedal a stationary (or a regular bike for that matter) let me know and I'll get the name and location where these pedal crank adjuster(s) can be purchased.

Best to everyone. Have a great weekend. JMB
 
JMB, see what did I tell you??? Listen to Jo. She had to pound it in my head a couple of times, but I finally get it. Example, yesterday, I just did easy exercises and slow peddling. This am, hardly any swelling in my knee, in fact, I could sit on the bed and pull both my knees up to my chest with no problem, (yes, I admit, I did squeel with delight). Then today, of course, I had to push the knee and guess what, it has some swelling and I can't even get it half way to my chest. I totally understand if swollen, won't bend!
 
mbitney, I want a picture of that device, it's name and where your brother got it. A link to the store would be nice too!
It's sounds much too good not to have on this forum.
 
Did some seaching online this morning and found them. They're called "crank shorteners." The two websites that sell them (that I found) are at "hostelshoppe.com" and "tandemseast.com." They're sold in sets and range from $80-120 dollars per pair. Sorry, but I don't have a photo of my shortener, but there are excellent photos of these devices on the two websites that I've mentioned. Hope this helps. Have a great day everyone! JMB
 
Hi. I will be four weeks post op on Monday and can totally relate to everything I have read here. Black days and even blacker nights, sleep problems (every night) and continuous pain. Just wish that the 'experts' had told me a bit more. Knew I would have pain but not prepared for all the pain in different parts of the body! Night before last had awful awful pain in the top of my left arm. Thought I was having a heart attack at one point! Used heat cream and painkillers. My physio told me the next day that it was due to using the crutches and using muscles that weren't used to doing so much work! Thanks for that - if I'd known that maybe I wouldn't have written myself off so quickly!! All a huge learning curve and just about realized that this is not a quick process! Never had major surgery before and as someone else said was not prepared for feeling so wiped out! Just a shower and drying my hair called for a quick lie down on the bed! Anyway - thank you again for all your help and I just hope I'm starting to turn the corner!:rolleyespink:
 
Hang in there Jeannette, we're all in this for the long haul! Progress is measured in baby steps, not leaps & bounds. Be patient. That's what I'm trying to do (though it's much easier said than done.) Best of luck. JMB
 
Here is one crank shortener I found at www.tandemseast.com :

[Bonesmart.org] 2 weeks out



Here is another at www.adaptivemall.com that is quite inexpensive compared to the first one:

broken link removed: https://ep.yimg.com/ca/I/am_2168_40410145
 
Oh wow! Who ever would have imagined such a thing! Thanks for that information. In the Library, I think, Jamie? I'll tack it onto the PT thread.

Jeannette, I can well remember being drenched with perspiration after a shower the first 2-3 weeks. So much, it almost made me feel like I needed to shower again. But I would also be trembling with exhaustion at the overall effort. It's perfectly normal. Just plan that immediately after the shower you have a large drink and a loooooong rest! (with your legs elevated, of course! :wink1:)
 
Yep....agree, Jo. I had no idea there was such a thing out there to help folks.....especially the one that does NOT cost $100+!!!
 
Josephine mentioned that the swelling acts like a plaster cast to limit ROM. Interesting that she used that description because that is EXACTLY how my leg feels when it is swollen, like I have a plaster cast on it. When I am swollen my ROM is limited. I can significantly improve the ROM by simply icing and elevating for 20 minutes. Less swelling = more ROM. It is a simple formula.
 
I am now just past 4 weeks from having my left knee replacement. I had 3 weeks of at home therapy, which was very mild, I thought. At the end of the 3 weeks, I was using my cane and not the walker anymore. I've finished my first week of out patient PT and now I rarely even use my cane. My own issue is that I still think I should be feeling better than I am, even though all the professionals tell me I'm wrong. My knee aches every morning and my evenings are tough...I'm usually feeling kind of low by then. I attribute that to overdoing the daytime activities, which I have also been warned about. I am elevating and icing whenever I think about it, still taking my pain med (hydrocodone) at night and doing ibuprofen and Tylenol during the day. the best news for me was when my dr told me I was done with the T.E.D. hose!! So what I am learning, albeit slowly, is that I have to be patient...but it's SO hard! Again, this website is very helpful and it's keeping me grounded. I just have to keep getting back on when I feel sorry for myself!

I know there was a thread about hot knee or warm knee...my knee is a little warm to the touch...normal? It's still and achy, but not to the point of really hurting most of the time. thanks again for all the support...I know I'm doing fine...but this is harder than I thought!!
 
It IS hard, hon.....and it's perfectly normal to have a warm knee. It's busy healing in there. Keep working on your patience....it's so important not to push yourself too hard in these early stages of recovery. At 4 weeks, you are still in the early stages.....and remember if you are still aching, it means you still need those pain meds on a regular schedule. Take them!!
 
Re: 2 weeks out-LKR 7/20/11

Thanks Jamie! You don't know how much those words help me. I still keep forgetting I'm in the early stages of recovery. It feels like forever. Funny thing...I remember asking my doctor's nurse if I'd be able to go to Las Vegas at the end of August. I thought that seemed like plenty of time for recovery. She told me, gently, that it would not be a good idea at all. Thank goodness I took her advice! So I will continue my PT, 3 times a week for at least the next 3 weeks. My PT is very businesslike, not making it easy, but not pushing me to anywhere near the point of pain. I rest, ice and elevate when I get home. I just want to be able to bend my leg without the ache. That will be a happy day for me!

Thanks again for this website...I'm so glad I found it and decided to write!
 
:thumb: Now you've got the right idea!!!
 
Re: 2 weeks out-LKR 7/20/11

I'm into my 5th week, post LKTR. Went back to work part-time this week. Mistake! Knee gets stiff, hot, and sore sitting at my desk at the office. I try to move around and ice & elevate it as much as possible. Saw a TKR client at PT last week, he told me that he's taking 3 mos. off from work. Wish I'd have talked to him and found this forum earlier and I'd have at least tried to take 2 mos off post surgery. Oh well, trying to make the best of it. Any suggestions on how best to manage would be appreciated. I don't want to lose the precious progress I've made since my surgery. My ROM is from 5-110 degrees. My PT has set up an appt. to see my ortho doc later this week to discuss MUA. I think its too soon for that. What does everyone else think? Still doing my stretching and strenghening exercises at home and riding my stationary bike up to 30 min a day. Icing my knee and elevating it also every evening. Sleeping better at night. I think I'm making progress slowly, but steadily. Resigned myself to being patient and knowing that the healing process is different for each person & likely may take quite awhile for me. I'm learning to be more patient and being content with progress measured in baby steps instead of leaps and bounds. Hope all is well for my friends at bonesmart. Stay positive and motivated. JMB
 
JMB,

With those numbers at 5 weeks and still making progress, I don't think the MUA is necessary. I did the MUA because I just wasn't making progress with the ROM and extension (although the walking was improving).

Also, there is a secretary at my school who is back to work at 8 weeks. She has had a lot of swelling. She sits most of the day and is only able to elevate her leg about 18 inches off the ground. I politely suggested that if she's going to be at work, she might want to elevate it higher, but I don't think she feels that is possible.

Best of luck to you. I hope things go well! Keep icing and elevating!
 
JMB,
I too am five weeks out. I have been working really hard on my extension this week which has seen me go backwards in my flexion. I guess because the knee is tired and a bit angry from the extension work. My ROM is about 5 to 120 but it seems I take One-step forward and two backwards. My knee ached all night too so instead of my usual bad sleep I had an awful sleep!! I know we will get there but yes it is a lesson in patience. I changed physios and my new one is much more aggressive especially with extension. Keep up the hard work....I see my surgeon next week and am hoping for a great report!
 
Tar Heel:

How many wks post-op was yr MUA? What did the MUA do for your ROM numbers? What was MUA like? Lots of swelling, pain, etc. afterwards? If so, for how long? Have you been able to maintain the gains you rec'd from your MUA? Please advise. Thanx JMB
 
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