TKR 7 month angst

[Jockette]

I feel that walking must be a good strengthening exercise.

I agree that walking is a good strengthening exercise and I think it’s often overlooked.

My nearly 1 year old R knee is still worse now than before the left op in October.

After a tough first year I had a lot of improvement in my second year, as my whole leg continued to relax and heal. Hopefully you will see the same. Since you still have pain, take things slow and easy. If in time things don’t improve, you can always look into a second opinion, with a doctor who has no association with the one who did it.

 

[Darvi]

Thank you Jockette. That's what I love about this site: Sympathy and good advice! I shall try to think longer-term and relax more - I'm able to use the year old knee, it probably just needs to fully settle down.

 

[Layla]

You're welcome, Darvi!

I hesitate to post sometimes as I always seem to be complaining, although I think we all find it reassuring when others at a similar stage share similar problems.

Please don't hesitate, this is how we all learn! We thank you for your honesty in sharing your journey with us.

Physio has examined the R and says nothing wrong - may be a post-operative pain I have to live with.

With two major surgeries within less than ten months, the first knee (right) likely did a lot of favoring, while still healing, as the other was deteriorating. I marvel at those that return for a second surgery within months. Brave souls, people in pain.

I hope the blues fade quickly, as they usually do. Long sleepless nights tossing and turning don't help, I am sorry!
Hopefully the holidays will be a pleasant distraction as you grow stronger and reagin stamina. Slowly but surely you'll get there and I'll bet things will begin looking up in the New Year!

 

[Darvi]

Thanks again for the encouraging messages.
I now have a problem regarding my 10 week old L TKR. My surgeon signed me off at 7 weeks saying my ROM was 90 on bend and 5 on straight, he didn't measure, just glanced. ( I'm not sure which is flexion etc) He said to continue exercises as progress was ok. He also said the knee was bent pre op at 5.

My PT actually measured me last week and said I am around 90 and 15!
He seems quite concerned about the straightening and mentioned MUA which I really don't want and the surgeon didn't suggest.

I'd like to hear from anyone who's gone through a similar experience.

Pre op, I was walking quite happily with a bent leg, so should I still be ok post op if it doesn't go down to a much smaller number?

Is it common for a previously bent knee to remain bent after the op?

My leg is still swollen and stiff anyway so maybe, like so many other people's legs, it will improve.


PT said my walking is good with very little limp.

 

[mendogal]

@Darvi
Your numbers are 90 degrees flexion - a right angle bend - and 15 degrees extension (off of flat = 0 degrees). Please be aware that in our cumulative experience no two professionals measure the same patient knee quite the same.

For most of us, including those with good range of motion pre-op, extension (straightening) takes longer to come back than flexion (bending).

At 10 weeks you're not the only BoneSmarty at 90 degrees/15 degrees. Working harder or letting PT aggressively manipulate your knee won't help and will cause rebound swelling so the numbers will actually worsen.

For increasing the bend, very slow and gentle heel slides while seated on a chair will help. I would take a short walk in the house first to lightly warm up and loosen the joint first. Each heel slide should be in time to slow deep breathing and just stay within your current comfort range. After doing a few, try slowly going into that gray zone where it's a little uncomfortable but not painful. Hold it for a slow count of five. Only do a couple more.

If your knee is ok with this, try doing it two or three times a day, but don't increase how many repetitions you do in each session for a few days. You want to give a knee a chance to relax into this exercise, not demand that it work at it.

For increasing the extension, which even more so requires relaxation of muscles and tendons, many of our members have had success with lying tummy down on the bed with the thigh supported on the bed and the rest of the leg allowed to relax downward. @EalingGran can discuss this better than I can as she used this technique!

 

[Jockette]

He seems quite concerned about the straightening and mentioned MUA which I really don't want and the surgeon didn't suggest.

MUAs are designed to break up adhesions, which will allow a better bend. They do not help with straighteneing. I’m surprised your PT did not know that.

Many of us increased our extension (straight) by just walking and letting time heal our leg. I know that @sistersinhim walked at times with a longer stride, thereby stretching the back of the leg, with each step. 10 weeks is still considered early days, you will improve as time goes on.

 

[sistersinhim]

My straightening came in slower than my bend did. I knew a MUA wasn't beneficial for straightening, but occasionally needed to help with bending. I didn't worry much about the extension, knowing it would come in eventually. But, to gently help it along, I would walk with a longer than normal stride, with a heel to toe gait. This helped. Those large muscles and tendons behind the knee take a while to stretch out, and this was a good way to help with that. Since this could throw my balance off, I always had something close by that I could grab on to. You might want to give it a try.

 

[benne68]

I'd like to hear from anyone who's gone through a similar experience. Pre op, I was walking quite happily with a bent leg, so should I still be ok post op if it doesn't go down to a much smaller number?

Is it common for a previously bent knee to remain bent after the op?

My leg is still swollen and stiff anyway so maybe, like so many other people's legs, it will improve.

I also walked on a bent knee for many months prior to my right TKR. It took many months, but I did eventually get to full extension. That knee is nice and straight now, despite my prior history.

Like you, I had a lot of swelling in the knee (it was swollen pre-op as well) and I agree that contributed to my difficulty straightening the leg.

Please don't let this therapist's comment worry you. Sometimes their lack of knowledge shows in strange ways. Trust your surgeon -- he clearly doesn't see any benefit to an MUA, or he would have mentioned it.

At just over two months, you are still early days in this recovery. Give it time.

 

[EalingGran]

many of our members have had success with lying tummy down on the bed with the thigh supported on the bed and the rest of the leg allowed to relax downward. @EalingGran can discuss this better than I can as she used this technique!

I did do this to gradually extend my leg.
It is actually quite a strong exercise- so don't do it for more than a few minutes at a time and definitely don't be tempted to use any weights.

 

[Darvi]

I logged on as soon as I could this morning and was overwhelmed by the reassuring responses from so many people who had taken the time to reply immediately.
Thanks to everyone who posted, it really feels there are friends thousands of miles away who care and can offer advice.
Thanks again, I will keep you posted.

 

[Layla]

Hi Darvi,
It's been a few weeks since you've posted. I hope you enjoyed the holidays and you're doing well.
Let us know when you have a minute. We'd love to hear from you.
Happy Three Month Anniversary, Lefty and Happy 2025 to you!
@Darvi

 

[Darvi]

Thank you, Layla, for the New Year wishes and the same to all at Bone Smart.

I have been doing the lying on the bed, letting the knee and foot dangle exercise a few times but am very wary of ending up with the same pain at the back of the knee as I still have on the R leg.

I still stretch and push down on the thigh daily, but it’s reassuring to read of Jockette who just used walking and daily life to improve things. I shall also try the long strides idea suggested by Sistersinhim.

I still get pain and stiffness in both knees most days (it’s better when I sit around more!)

On the plus side I can walk carefully but properly downstairs now.

I read Jockette’s journey with interest but it finished at around 7 months. I don’t know if it continues somewhere?

Thanks again for everyone's interest and tips.

 

[Jockette]

I read Jockette’s journey with interest but it finished at around 7 months. I don’t know if it continues somewhere?

Thanks for taking the time to read my very long story. I did continue to post past 7 months, and my one year check is post #700.

PKR - My Drama Queen Patellofemoral Knee

@jboles Thank you so much. :console2: My stomach is tense already, as it usually before my check ups. I honestly don’t expect any answers as I seem to have rare issues. But I am interested in what he will say. I probably won’t agree with him, he does not think the Bonesmart way. I don’t...

bonesmart.org

My PKR will be 8 years old this coming March. In my case, it’s been a very tough road. While my ROM did improve, ROM is not the whole story of success. I still can’t go downstairs foot over foot. My knee often feels out of joint. I’ve had 3 second opinions and once they see that my X-ray looks fine, they stop looking for a problem. Don’t they know X-rays don’t show everything? My second, second opinion did order blood tests, but those were fine, too. My third second opinion refused to look further and do the MRI of my knee that I requested. However, like your surgeon, he did order a lumbar MRI and told me to see a spine surgeon (before he saw the results of the MRI) (I think, if they don’t know what to do, they “pass the buck.”)

I suspect something went wrong with my surgery, possibly with the lateral release, which was done during the PKR surgery, as that is the area where I have the most discomfort. My knee has never healed well. Honestly, it has changed my life, and not for the better, like it was supposed to. This happens sometimes and I truly believe that not everything can be fixed. I am managing well enough, but it’s not fun having a knee like mine.

I blame myself for trusting the first surgeon I saw, because I didn’t know any better. I have since learned that PKRs can be iffy, and I personally also suspect the Patellofemoral PKR that I had is the trickiest and least successful. Lesson learned, the hard way. I truly thought I’d done enough research and knew what I was getting into, but that proved false.

You still have lots of time to improve, at only one year post op on your first knee, and 3 months post op on your second knee. Even with a less than desirable outcome, I did have a lot of improvement, in all ways, in my second year, and even a bit more in my third. Best Wishes as you keep moving forward with your healing.

 

[Layla]

Hi Darvi,
You're pretty brave having both of your knees done within less than a year.
Your Right TKR is almost thirteen months post op and it's been three months for your Left knee. There is still time and room for improvement with both, so please don't lose hope. Wondering about weak muscles and whether you've targeted strengthening exercises with your PT for either knee? I am guessing you have, but if not maybe targeting quads, hamstrings, calves will help. Many notice improvement into their second and even third years post op.

In regard to your most recent surgery, pain and stiffness are considered normal especially after activity or sitting for too long. PT or overactivity can also cause swelling which affects ROM, but it should improve with time. You're at different stages of recovery for each knee. Great news that your gait is looking good. Wishing you complete healing in the new year. Please keep us posted and have a good week!
@Darvi

 

[Darvi]

Thank you so much for your replies, Layla & Jockette. As I'm not familiar with the names of everything, I shall have to ask my PT about targeting those particular areas. I kept a diary of the R Knee but didn't mention things like swelling, although I'm pretty sure that it remained swollen for best part of a year and, in fact, it still is slightly (plus the tight band).
I appreciate your encouragement.

Jockette, I feel so sorry for you. To have spent all that time and effort on recovery in anticipation of greater mobility only to still be suffering.

I blame myself for trusting the first surgeon I saw, because I didn’t know any better.

I don't feel that you can blame yourself. You did what most of us presumably did and researched online, asking around etc and you must have believed your surgeon to be good. Certainly in the UK it would be an expensive business to interview more than one surgeon.
I have received a great deal of help and reassurance from yourself and others and I would like to wish you well with, hopefully, more recovery.

 

[Darvi]

Hi Everyone, thought I would post an update. I'm now at 15 months RTKR and 5 months LTKR.
I'm still experiencing the tight band on both legs with intermittent pain, mainly on the oldest knee.
I haven't done anything extreme 2nd time around, having studied the Bonesmart healing rules and am sure the new leg is better for that. I'd love to be able to say: 'It's wonderful, I'm so glad I had them done, but I'm not at that stage yet. However, it's good to hear from you guys who still suffer a bit as I know I'm not alone.
I definitely am pain free at night, and I realise my stamina is much greater than it was, although I increased my walking distance by 50% recently and suffered accordingly!
I hoped to be able to encourage others but I haven't reached that stage yet.

 

[Layla]

Give it more time, you're making progress, it may feel slow, but with more time and patience you'll get there.
Thanks for sharing an update! I hope you have a good week, Darvi!
@Darvi

 

[Darvi]

Hello all. I'm now at 6 months post LTKR, 15 months RTKR and things are improving.
Left is still swollen although generally feels pretty normal but the first leg still feels worse than the L. I went to the pool this week which felt really liberating and both legs felt less stiff after.
I hope all the people who have supported me continue to improve. It would be good to see how we all are at 18 months.
I have received immense help from staff and patients for which I am really grateful. However, I'm finding it more difficult to get into the site lately and I don't want to subscribe. I would make a one-off donation to show my appreciation.
I don't have much to say on a regular basis and am still not optimistic enough to offer others advice. In light of these points I will stop participating on Bonesmart, but I really do wish everybody the best recoveries possible.
Many thanks to everyone for everything!

 

[Jamie]

Hi, @Darvi! It’s wonderful to hear from you and know you are continuing to make improvements. Don’t be concerned about the length of time full recovery is taking. It can literally be years before you get to the point that you feel things are really good.

I’m glad BoneSmart has helped you along the way. I understand that it may not make sense for you at this point to subscribe to the Insiders Club. But any donation you would like to make for appreciation of what we do would be very helpful to keep us online for others. You can make a donation by clicking on the DONATE link in the blue tool bar at the top of the screen.

As a Basic Member, you’re always part of the BoneSmart family and are welcome to return periodically to post updates on your recovery thread. We are always thrilled to hear from our BoneSmarties!!!

 

[Darvi]

Having said, somewhere in my thread, that i wouldn't participate anymore, I do think of all the people I have encountered on Bonesmart and would like to know how they all are. Apart from all the wonderful staff who have helped me deal with setbacks, I can remember Ann Yo who was very much like me all through. I know there were others too but it's difficult to find them!
Anyway, a quick update on my progress: at 18 months my RTKR is still not perfect, neither is my LTKR at 9 months. However, they are strong, don't give me pain and I can climb steps ok.
Both knees are stiff and have the tight band feeling strongly in the morning but it never fully goes, even on the bike. The pain I used to get on the R which eased then returned after the LTKR has now gone so really just hoping the tightness will go soon.
Hoping others are well! thanks again