TKR 4 weeks post right TKR dificulty bending

[Campervan]

I was probably the most vigilant person with my exercising and the ROM only moved when the knee was ready. I thought if I keep up the exercises then it will just slowly improve - NOPE! It would just go nowhere for weeks and then one day I'd realise I could do something I couldn't do the day before. And I'd go to physio, she'd measure and sure enough I'd gone up. You can get an app for iPhone or Android that measures ROM. Here's the Android one I use
broken link removed: https://play.google.com/store/apps/details?id=ROM.goniometry

Yes it makes one feel depressed when we read others are reporting 130 at 4 weeks. Well, that's their knee not yours and unfortunately it looks like you, as I was, is a slow recoverer. I still get annoyed when I see others with 145 and I'm sitting generally just over 120 but I can do everything I want to do for now. You have to learn to accept what will be and get on with your life. Find something else to focus on.

I CHALLENGE YOU to try doing nothing, and I mean absolutely nothing except gentle stretches and short walks, for around two weeks or even a month and just see what happens.

Maybe go and read my whole thread. It was called Slow, Slow Quick Quick Slow but I've now changed it and here's the link. It'll take you a while but it might give you some comfort that others have gone through the same type of recovery as you're experiencing.
https://bonesmart.org/forum/threads...and-still-recovering-from-nerve-damage.12959/

 

[DogLoverx3]

Oh good, @Campervan , I'm not the only one that secretly gets annoyed (and hugely jealous) of the people that are lucky enough to have 'perfect' recoveries and hugely impressive ROM numbers!

I know I sounded harsh above, but I fell into the same mindset of needing to push myself and do more in order to improve and I truly believe I've set myself back by doing so, so hate hearing of someone else who's doing the same thing. There's so much great advice on this forum, if only we'd just listen to it.

 

[SFBaySailor]

I'm going to stick my neck out here, and say that I think that some folks here on BS are being a bit harsh on @marco4432 .
After all, the poor fellow has lost his job and cannot get UI income. He was prodded into having experimental procedures done on his knee pre-TKR, which caused him to waste 7 weeks of FMLA leave. Now he has no more FMLA available. That is one big predicament! He mentioned several times that he was torn between the BS philosophy of "less is more", and the advice of his OS and PT. I don't think he has deliberately ignored the BS advice. He has spent a good deal of time icing, elevating and taking things easy. Josephine in fact said that she thought the CPM would do no harm. He was just doing what his OS recommends, by renting the CPM and having the MUA. Many people put faith in their doctors' opinions, and it is difficult for some folks to deviate from that. I think he should be offered encouragement, and not be chided for making these decisions. Try putting yourself in his position.

His main concern is that he needs to get back to work, but at 4 months post-TKR, and almost 1 month post-MUA, his knee extension is only -30. That is not very good progress at this stage in the game, and he can't walk properly because of it. My suggestion, and others have also suggested this, is that he get a second opinion from another OS.

Roger

 

[marco4432]

Thanks for everyone who replied, howeer I would just ike to clarify that after MUA it was -30 now -15 The CPM machine is a passive way to slowly bend knee, it can not force you to bend, it will just lift you up and as to flexation it does nothing to help as ones leg is not held in the machine, so if you set it to -10 it will do nothing to help or force straightening ( CPM = Pasive motion ), PT and OS suggest sitting on a chair extending leg on another chair and use weights or let gravity hep to straighten leg.
As of last week I no longer can afford PT so I do exercises and CPM at home I do not force in any way to the point of unbearable pain. On my l

 

[kneeper]

I'm sorry you're having such difficulties. It does sound like if you can't get the dynasplint the extension exercise the PT & OS recommend is the next best thing.

 

[SFBaySailor]

PT and OS suggest sitting on a chair extending leg on another chair and use weights or let gravity hep to straighten leg.

Marco,
I had extension problems at first, but not quite as bad. Maybe -7 degrees. I did the exercise you mention every time I was sitting around at home watching TV, etc. I used a 2.5 lb weight placed directly on top of the knee, and eventually a 5 lb weight. It was a bit uncomfortable at first, and I could only do it for 5 minutes at a time. But eventually it got easier, and it did get me to 0 degrees after a few weeks. Keep giving it a try.

 

[marco4432]

Sorry I got disconnected. So in brief I do not think that I overdo any exercises, there are days I do nothing, when I do nothing I lose ROM and the knee tends to be more stiff. My walking has improved since gaining -15 but at 5 months, I feel that there is no way I can return to work.

I have read your comments that I do to much, but I assure you that is not the case. What I would like to know is am I disabled as I cant walk 200 yards without being in pain, I can not walk down stairs, especially if I use the right knee first the pain is terrible as soon as I put the weight on my knee. Some TKR's fail - am I in that category or since its only 3 weeks post MUA is there any possibility, that in three months I will be able to work?

Please don't respond if your only input is that I am trying to hard as I assure you I am not. Nor comments that I should not listen to OS who has trained for years or PT's who have a good reputation. Please I am just looking to see if someone who has had a slow recovery such as mine and can give me an honest answer, (things will get better or I am in the one percent that surgery has failed and there is nothing I can do about it ).

Thanks again if anyone can give me some honest advice and not blame me for doing to much at five months which I have not, or blame me for doing what my trained OS who has a good reputation has instructed me to do.

I will see my OS on 01/31/14 and will ask him the same questions (I won't leave before he gives me his explanation)

 

[marco4432]

But as I am not a surgeon I guess I will have no idea if what he tells me is true or false ??

Thanks for taking the time to read my post

Regards

M

 

[DogLoverx3]

I have to work on my extension as well Marco. Another home exercise is to sit in a chair with your leg straight out in front of you with your heel on the floor and press on your leg, above your knee, for a count of 30. I've read on here another exercise where people lay on their stomachs in bed, with their leg from the thigh down hanging over the side of the bed and let gravity do it's thing. That's great how much your extension has improved. Keep up the good work & remember that slow and steady wins the race.

I didn't see your 2nd post, but that's pretty impossible for anyone to predict as no one has a crystal ball.

 

[SFBaySailor]

But as I am not a surgeon I guess I will have no idea if what he tells me is true or false ??

Marco,
That is what 2nd opinions are for, and you should get one from another OS if you feel you are not getting the answers you need. At your OS visit on 1/31, you should insist on an X-Ray, and insist that he review it with you.

 

[marco4432]

Thanks DogLoverx3, I have a Basset Hound Streaky, if he could speak he would tell you that I hae tried all these forms of exercises, If I may ask I see I had my TKR 2 1/2 months before you could you tell me what your numbers are at present, if I recall when I was at 5 to 6 weeks post op I was using a walker alot of pain and ext 70 and flex was at -18.

Thankyou

M

 

[marco4432]

Thanks SFbay sailor, I have had four sets of x-rays done, but he did not reiew any of them with me this time he will and I will get copies, then 2nd opinion as I would have no idea what the x-ray will show me I just hope if I get a second opinion the Doctor will be honest but somehow I doubt it.

M

 

[DogLoverx3]

Hi Marco, we're always told to not compare our recoveries or numbers to others but I am currently at 115-120 after 'warming up' and -5. I was 75/-10 out of surgery, went up to 110 and then fell back to 80-85 for about 3 weeks from overdoing it. It's finally just started moving again. I had perfect ROM before surgery and I know that's a factor as well. I still have a lot of pain and sometimes use my walker at home. I use a cane outside of the house and will always use an electric cart when available. ;-)

btw, my 1st ever dog was named 'Streak'

 

[SFBaySailor]

5 to 6 weeks post op I was using a walker alot of pain and ext 70 and flex was at -18.

Marco,
I think you are mixing up the flex and extension numbers.
Anyway, at 6 weeks, I had about -5 extension, and about 115 flex. I transitioned to a cane at about 4 weeks, and used it for another 3 weeks. Back to work at 8 weeks in a desk job. At 8 1/2 months post-op now, I am 0/130. Before TKR, I had about the same flex, due to the arthritis.
Keep doing the extension exercises. And on the days that you do "nothing", be sure to at least walk around a little bit and keep the knee moving. Good luck at the OS.

 

[Campervan]

Hi, I can't say whether your TKR is a failure but I can give you some of my experiences. If you can get hold of your XRays then you can upload them and @Josephine I am sure will review them. If you get a second opinion, advice is to make sure its one that isn't associated with your current OS and even one in a different town and is an experienced revision specialist.

I have gone through two years of slow recovery but I guess the difference is that I could walk a couple of kilometres by 5 months post op. I would have "start up" pain which is where it hurts to weightbear after getting up from the couch or out of bed or anything where I'd be sitting for a while. My flex is now just over 120 and extension not quite zero. One thing I did have about a year or so ago was pain just below my knee on the outside of the leg, to the point I could hardly weightbear. I had aggravated the fibular head, which my physio mobilised and since my extension has improved it has gone away. Because of my lack of full extension I was putting too much weight through the fibula head.

I know exactly what you mean that if you stop exercising your knee feels stiffer. I found riding my exercycle on a low tension setting with the seat high would ease the stiffness. As my ROM improved I slowly lowered the seat. Turns out that was a bad thing for me to do as my patella is being pulled to the outside as my inner quads are not working as I have now been diagnosed with femoral nerve damage from the nerve block, which is why I can't raise my leg straight (it droops down from the knee). The nerve is slowly regenerating and he lag getting less.

 

[marco4432]

Hi Campervan, I think your right the pain from walking is because I can not straighten my leg hence all the pressure of walking with a bent knee, at my MUA MY Doctor said he got full extension and bent it to 130 easily, after MUA I increased my bending to 110 but lost extension to -30, two weeks later i'm at -15 whereas before MUA I was at -10, my knee does not feel swollen, so whats wrong hopefully my OS will tell me why, PT wants me to get a dynasplint but insurance wont pay for it and I cant afford it.

I just wish my OS will tell me the truth but I doubt it,

Thanks for your input

M

 

[Josephine]

Some TKR's fail - am I in that category or since its only 3 weeks post MUA is there any possibility, that in three months I will be able to work? or I am in the one percent that surgery has failed and there is nothing I can do about it

Marco, I said in a previous post that there is no way for us to know this.

if anyone can give me some honest advice

I thought I already had done so.

I will see my OS on 01/31/14 and will ask him the same questions. But as I am not a surgeon I guess I will have no idea if what he tells me is true or false ??

As I said previously, that's because he doesn't possess the gift of seeing into the future. He's not holding back on you, actually he's being perfectly honest.

at my MUA MY Doctor said he got full extension and bent it to 130 easily (but) my knee does not feel swollen, so what's wrong

Well that's a good sign and should give you hope. It certainly tells me that there is nothing much wrong with your knee and that it's quite likely most of your problems are due to internal swelling which you cannot see but will make your knee feel tight and stiff. That's why, with great apologies, I am still of the opinion that your exercise regime (not you) is probably to blame.

If you can post your xrays when you get them, I will take a look and see what I can see.
Here are A few tips on posting xrays

 

[kar1963]

Hi marco.. I am sorry you are having so many negative things happening. I too had an MUA.
Was it a miracle cure for, pardon the pun, "the bends"? Nope not at all.
Did it help? Yes, it did.
Did it take time to get where I am at today 0 and about 11? Yes.
Do I still have work to do? Yes..

Take a deep breath - your thoughts on a second opinion is a good one. I did that about two weeks ago and the only thing it gave me is peace of mind that my knee is ok and my OS is telling me the truth. I am glad I did it and told my OS I did and he was fine with it.

I do not want to seem intrusive and I am sure funds are tight, but did you look into filing for social security due to disability? And I would file for UI any way and let them turn you down with reason in writing (you might have found out that already). Did you or can you speak to lawyer about the termination?

I wish there was one good answer anyone of us could give you but we can't. We are not living your recovery and are not your Dr. I can only tell you to keep trying and try to stay on the positive side. I know that is hard to do but try. Try not to ask yourself or even put the nibblet of the thought of permanent disability in the way. Like I said I am 5 months replacement, 2 months post MUA and am I walking miles? Nope not yet but I can almost walk down a flight of steps without too much difficulty and I have not been able to do that in over 10 years. Do I still feel pain ..yes ..but I am a front seat passenger on the 'this will get better' train...

I wish the pain and problems go away for you and for your strength to get past them. And the chair with the weight on your knee did the best for my extension i also did .. ok no laughing trying to visualize this.. I would lay in bed sideways, bed needs to be next to a wall ... I would wiggle my bottom as close as I could and then raise my leg straight up against the wall.. I would lower my heel down the wall a little bit then straighten my leg and press the underside of the knee toward the wall. As the extension got better I slowly moved further from the wall. It sounds funny but it helped me ... My husband and cat would look at me like I lost my mind but hey, they both have good knees!

 

[Pjmc]

@marco4432 Wondering where you are with the knee now. My surgery was before yours.
No way could I work full time. I really hope things have improved for you.

 

[woodstock3]

Hi' thanks for the encouragement and the support.