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TKR 60 degrees ROM at 2 weeks. No progress at all :-( <

Btw, I'm almost 4wks out and am only at 60, just got my staples out yesterday so maybe that will help. I know it will come in time, but I can't help focusing on the numbers. I am needing to have my other knee done and feel like my numbers need to get better before I do the other one. I go to outpatient pt next week so we'll see how that goes.
 
I hopped on my mountain bike last week to see if I could ride it. Just barely made one revolution on the pedals. Bad idea! My knee is still way too tight. Still at 90 degrees and still waiting. At this rate my goal of riding by March is looking really shakey.
 
I'm willing to bet you will get there.

The seat on my recumbent exercise bike has 6 positions/holes. I call the furthest/longest seat position is #1 and the shortest/closest position #6. Prior to surgery, It hurt to get around on #2 and could not get both feet on the pedals at the same time on #3.

  • After surgery, it took me 6 weeks to get my feet on both pedals on #1 and make a full revolution.
  • It took me until 12 weeks to get my feet on both pedals on #2 and make a revolution without raising my hip to help.
  • At 14 weeks, I could get both feet on the pedals on #3 and almost get all the way around, but not quite, without raising my right hip.
  • Monday will be 16 weeks. This morning, I was able to easily get all the way around on #3, moved the seat to #4 and easily got all the way around, and then moved the seat to #5 and was just a little bit short of getting all the way around.
 
@Mister I'm finding this to be exactly what I am experiencing right now! Read my latest post over on my thread. Laying around too much has not worked for me- the last 3.5 days I've purposely done things different and its like a breakthrough for me. My quads were getting stiffer and stiffer and not firing. I'm waking them up now! I personally think this is key for me to be more active and into sensible, frequent PT. 15 degrees more flex in 3 days and LESS pain. Older people or people with less muscle- will have an easier time- in my opinion- which is not expert by any means. But the last 3 days have told me a lot about my personal program moving forward.
 
Do you have the seat up as far as you can and still able to reach the pedals? If not that may help you. I also had to move the position of my foot back towards my heel. I was able to do the recumbent bike first and found it much easier than my regular bike. You can try one if you have access to it.
 
newlybionic said:
Do you have the seat up as far as you can and still able to reach the pedals?
Click to expand...

I'm 6'4" so my situation is a little different than most because nobody makes a bike frame that actually fits me. Soooo, I have to ride a little lower in the saddle than I should to keep my center of gravity closer to what it should be. Plus, I like to ride a little lower while climbing and descending hills with my mountain bike than I do when riding a road bike. If I rode with my seat where it should be for my knee, I would have to bend WAY over to reach the bar. And yes, you can get risers for the bar but that makes the geometry even worse. My seat position is still very high compared to most people but it's probably 2" lower than it should be if the frame was correctly sized.

What I need is a $20,000 custom made bike frame but that's not in the cards :) My new bike was already too expensive! I'm sure a recumbent bike would work fine but not off-road!

BTW, I can use my little exercise pedlar just fine because I sit way back when using it.
 
@bertschb I'm hoping it will speed up, but if it doesn't I'll just have to resign myself to it.

@Want2hike At 4wks out, do you think it's ok to start on the bike? My ROM may not let me though. I did have my last in house pt today and I got to 70, yea!!

@highlander I think you're totally onto something. I think I need to do more also, not saying to the extreme, but more. I'm actually doing really well except for the ROM. I'm in little pain, cut back on OxyContin to one before pt and other times just Tylenol, sleeping through the night, able to get around without any devices, etc. Did well today, especially after pt, my knee was warmed up and felt I could do anything, in fact my ROM went up from 60 to a 70!
But, after sitting awhile, my knee got so stiff, I actually think it's my quads, that I felt I couldn't do near what I could before. Maybe the key is a lot of warmup. Oh well, we will all get there.
Thanks for all the input!
 
When I first got in the bike I couldn't get a full revolution for a few weeks. But everyday I rocked the pedals back/forth and voila! One day I lifted my right hip slightly and got a full revolution! So if you can't get a full revolution it's ok to just rock the pedals back/forth until it happens.
 
Brian, I understand your frustration at not being able to mtb yet. Since we both enjoy mountain biking, may I share my experience?

My first TKR was slow to gain ROM. Surgery was Oct 2014- my first ride around the block happened early January 2015, but it was painful! Looking back at Strava, I attempted to climb to Griffith Observatory (a local landmark) on my cyclocross bike in April 2015, but my knee was still so swollen and painful that I couldn't make it to the top. It was hurting a lot at work, too. I went back to my OS for a prescription anti-inflammatory, which helped a bit. Gaining back my ROM just took time. Now (2+ years later) that knee bends well and feels great!

My only advice would be to use smooth flat pedals for now (if you're not already) so that you can slide your foot around on the pedal. And raise the saddle- even a little bit helps. You can also swap your crankset for shorter cranks- for example 170mm instead of the 175's that probably came stock on your bike. I made this change on my 29er. It helped but I needed to raise my saddle, which was already high, another compensatory 5mm... and I ran out of seatpost! So I had to order a special extra-long one ($$$). Changes or no changes you will be back on the bike eventually, but it's more fun riding than waiting.

My teenage son is 6'6" and raced mtb through high school on an XL Specialized Stumpjumper cf hardtail. A pro fitting helped dial it in. He also has the fs version of the same bike. If he grows another inch he will surely need an XXL, but he will have to buy that bike himself. :yikes:
 
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Thanks for the feedback Diana. I don't want to be clipped in when I eventually get back on my bike so I'll swap out my pedals - at least until I see how things go. I have a dropper seat post and I could probably raise it higher but I wouldn't be comfortable riding off-road (and especially downhill) with it that high. My problem is I'm stubborn and I just don't want to ride on paved roads/trails. I much prefer mountain bike trails.

It sounds like I might be on the same recovery path as you if you had trouble riding six months after your first TKR.

BTW, my new bike is a 2017 XL Specialized Stumpjumper Pro Carbon 29 :-)
 
bertschb said:
My problem is I'm stubborn and I just don't want to ride on paved roads/trails. I much prefer mountain bike trails.

BTW, my new bike is a 2017 XL Specialized Stumpjumper Pro Carbon 29 :)
Click to expand...

Good bike I have not made the switch to 29's yet. I can barely ride my road bike as it is.

Maybe you could put road tires on your MTB and ride on smooth surfaces at first to start out.
 
4 month update-
No change from my 3 month update. Still at 90 degrees ROM. Still swollen although not as bad as at 8 weeks. Still waiting for any sign of improvement in ROM :-(

---------- 8 weeks ----------------------12 weeks -----------------------16 weeks ---------
[Bonesmart.org] 60 degrees ROM at 2 weeks. No progress at all :-( <
[Bonesmart.org] 60 degrees ROM at 2 weeks. No progress at all :-( <
[Bonesmart.org] 60 degrees ROM at 2 weeks. No progress at all :-( <
 
It is looking less swollen. Its odd that ROM hasn't increased much. Still lots of time though...
 
Yeah, I can see that swelling has come down some. But, my knee hits a brick wall at around 90 degrees.
 
Pretty bummed today. I've been stuck at 90 degrees ROM for so long (3 months now) I feel it will never improve. I had hoped to be able to ride my bike before we left our wintering grounds on April 1st but that's NOT going to happen. I stare out the window every day at the hills I so wish I could be riding on. I know ROM is supposed to improve with time but after 3 months of zero progress I just don't see how my knee will magically start bending. I also have no clue why my knee is still swollen so long after surgery. There is no pain so why the heck is it still swollen??? Stupid lame body!

Sorry for whining. I wouldn't mind a slow recovery but what I have is NO recovery. NO progress. I'm scheduled to go to a driving school in 3 months and at this rate it's doubtful I could even get in the car (Corvette Z06) let alone drive the manual transmission. I know there are a lot of people who are much worse off than me and I am thankful I can walk but I'm still bummed anyway.

I hope the rest of you are seeing gradual improvement in your recovery!
 
Are you icing and elevating to try and get that swelling down? Are you working hard to try and increase your ROM? If so, you are sabotaging your ROM. If you are still swollen, then your tissues are inflamed. Something is causing that inflammation. Have you seen your OS? Maybe he could prescribe some anti-inflammatories to help get that swelling down. As long as you are that swollen your ROM won't increase. So, IMO your main job is to get down that swelling. I wish you luck with your recovery.
 
sistersinhim said:
Are you icing and elevating to try and get that swelling down? Are you working hard to try and increase your ROM? ...Have you seen your OS?
Click to expand...

I'm elevated all day and on the ice machine for probably 5 hours a day. Other than walking, the only "exercise" I'm doing is using my little pedaler thing for just 5 minutes or so a few times a week. Icing and elevating has done nothing to reduce swelling but I do it every day because it's supposed to help. I don't see my OS again until April when I get back to town.
 
I would say maybe its time to step up your PT or find an OS that will help you determine whats holding your ROM back after 4 months. Is it your tendons, quads (like mine), adhesions etc? Everyones journey here is different. My knee was traumatized early in my life and after several major surgeries and deformity- I know by talking with my OS and my PT- that I need a different approach to rehab. I only had 94 degrees before surgery. So all that combined means I have to work hard and push for my ROM- not to the point of major swelling- but at 5 weeks- I spend at least half my day- doing frequent exercises- PT sessions, icing repeating. And its working- but each degree or two of new ROM- is EARNED. Laying around and letting "time" magically make it happen is not going to work for me or my goals- long distance backpacking, cycling again etc. You seem to be an active guy too- my opinion will be very unpopular on here- but ask yourself at this juncture- how is the minimal PT, minimal training, lots of rest thing working out for you at 4 months?

There are lots of folks on here who have had great success with the BS mantras- but there is also a good percentage that need to add a more aggressive regimen. Let the admonishments fly :)
 
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