TKR 8 weeks post TKR

[mendogal]

@Steveg63 please don't stress over range of motion at 18 weeks. For one thing, you're already really functional!
Flexion required for the following activities:
- 65° to walk,
- 70° to lift an object from the floor,
- 85° for stair climbing,
- 95° for comfortable sitting and standing
- 105° for tying shoelaces.

For another, it honestly does improve with time! It takes very little swelling to limit flexion, plus tendons and ligaments are still readjusting to your new improved structure.

Some of our members have shared charts of their progress regaining flexion. As you can see, for each, it returned slowly but surely.

Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months

Bertschb’s ROM history
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

 

[mendogal]

@FleuveStone re: kneeling
There's a BIG difference between briefly resting our newer knees on the ground (soft carpet or mat) with the knee bend at 90 degrees and butt way up in the air versus kneeling with butt tucked in over heels!
Some of us can do the former within two months, though it feels very weird due to the sensory nerve issues. It certainly makes getting up and down easier, not to mention seeing and retrieving cat toys or treats from under furniture.
I can tolerate more of a bend and hence a bit more pressure now, so it's easy to do a bit of floor scrubbing if I need to.
But I really have no need to do a full on kneel. Since I had to stop formal bowing in or sitting and walking in seiza (traditional Japanese kneeling position, common in martial arts) due to knee arthritis over 20 years ago, it's simply not part of my daily life.

 

[FleuveStone]

@FleuveStone re: kneeling
There's a BIG difference between briefly resting our newer knees on the ground (soft carpet or mat) with the knee bend at 90 degrees and butt way up in the air versus kneeling with butt tucked in over heels!

Thank you for this, I think I've been a bit OTT avoiding ANY kneeling position, such as climbing into and across a bed for a moment. Being unable to do simple knee-bent yoga poses like child's or hero started a long time ago and I'm doubtful I can ever do them again, even with props. We don't know though, do we, what the future will bring.

 

[Nancybcello]

I am a huge Pilates fan. I have progressed more with that than anything. I suggest a good instructor who can tailor the movements to meet you where you are. Nothing that hurts or is excessive. Getting the rest of me to move and all the other muscles and joints to work together made a big difference. I am 8 weeks out

 

[EalingGran]

think I've been a bit OTT avoiding ANY kneeling position, such as climbing into and across a bed for a moment. Being unable to do simple knee-bent yoga poses like child's or hero started a long time ago and I'm doubtful I can ever do them again

I was keen to do four point kneeling (hands and knees) to do cat stretch/ back strength work as I have spinal stenosis/ lumbar arthritis and episodes of sciatica.
Until I could kneel my back pain was worse than my knee pain.
I bought thin knee pads ( about one inch thick) and I still use them for pilates classes. I can now kneel briefly without them to, for example get something in a low cupboard/ floor.
I found gradual regular practice of kneeling really worked. It does feel a bit weird, especially early on due to the odd sensations in the numb patch. There was a paper which said that many more people can kneel with practice after TKR/ PKR. I checked with my surgeon at my six week check up that my implant was fine to kneel on. I think this is true for most implants

 

[FleuveStone]

That's encouraging, @EalingGran ! I like the idea of having some knee pads around.

 

[Steveg63]

Not been on here much, so little update, 21 weeks post op tomorrow, walking better and further, managing 2 to 3 rounds of golf a week, all be it in a buggy.
Still can't ride my bike as not enough bend in the knee, frustrating!
Climbing stairs is OK, not pretty and wouldn't chance carrying anything up, coming down stairs is still painful to the rear of the knee, try it a few times a day.
Bend is slightly better, but no where near 120degree, can now nearly rise of a chair with both knees bent.
Hopefully bend will improve more over coming weeks.
Hope you all have a good week.

 

[Layla]

Thanks for the update and Happy Five Month Anniversary!
Even better times ahead as you continue to make progress over the next several months.
@Steveg63

 

[Steveg63]

Hi everyone, not posted for a while, I had my 6 month follow up on Wednesday, consultant not too happy with the bend, said I should have more bend, easily bend 90 degree, with a push 100 but not much more. He hasn't discharged me and wants to see me again in 3 months where manipulation will be on the agenda.
I walk upstairs ok and getting more confident in coming down, but depends on the steepness of the stairs.
Don't seem to have progressed much Iver the past month or so.

 

[mendogal]

What I found helpful were heel slides, seated on a good solid chair. Always do each one slowly with deep breathing.
Start by slowly finding your current comfort level. Do a few, just holding it there at that limit, for five seconds.
Then find a place just a little outside your comfort range, but not into pain. Do a few, holding for five to ten seconds.
Release and straighten you leg to give it a little stretch break.
Carefully see if you can slowly find a place with a little more flexion, still not painful, just uncomfortable. Deep breathe into it, etc....

It's possible your quads are tight and don't want to release enough. Warm moist heat and/or massage to the meat of the thigh muscle before trying heel slides might help.

 

[Steveg63]

Thanks for the reply. To be honest have been ignoring these, will get back on them.

 

[Steveg63]

Not posted for a while, 7.5 months post op, update on results so far, can walk upstairs, downstairs is still a challenge, just come back from 4 days golfing, no pain or swelling. Walking without any limp or pain, can walk 5miles no issues, however still can't peddle my bike, my rom seems to be stuck at a little over 100.
Use my tens machine and regular exercise but just can't get this bend past the 110, any advice on this would be appreciated.

 

[EalingGran]

Have a look at my pilates teacher's free sessions on YouTube ( Google Katja pilates). There are lots of different stretching/ strengthening sessions. Gentle stretching of the glutes/quads could help to release the muscles and improve your bend. Just go gently and don't force anything. If you find something that seems to help just gradually build up- but do it slowly.
It sounds as though if you can walk 5 miles and play golf without pain, that you are quite fit and there are no serious issues with the knee. Hopefully- your muscles/ soft tissues are just very tight.
Good luck!

 

[mendogal]

I agree with @EalingGran that tincture of time and possibly very gentle relaxing and stretching are all that's indicated - members have noted marked increases in range of motion for well over a year. Here's just a couple:

Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months

Bertschb’s ROM history
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

 

[Rockgirl4]

@Steveg63 You like me in 2020. I had 98-100 degrees by the 7-8th month, but never officially measured higher or seemed to gain more on a day-to-day basis. At times, I could warm the knee up doing other things and get some more range, but it wasn't something reliable, nor enough to ever trust myself to get on an actual bike again. I can only barely ride a stationary bike 5 yrs later, and only for 5-6 minutes. It aggravates that ankle horribly. You can tell my lower leg is compensating for the knee, & 3 PTs couldn't help me fix it that, so we gave up. If that means I just have to give up biking, I can live with it. I can do other things just fine with no pain.

As for other ideas, I tried Dry Needling in the Quadriceps muscle on that leg at the 2 year mark, as I was hoping for more range of motion. I hurt my hib badly in a car crash at age 21, and those ligaments don't work on that side. I manage it with certain lumbar/sacral exercises and stretches, and those are easier the more bend I have in the knees. My surgeon knew my quad was a big part of my arthrofibrosis problem before and after the TKR on that leg, so we felt it was worth trying. It helped significantly for 5-6 months, but then I lost the benefit. There's no way to "lock in" the suppleness of that muscle so to speak.

@Jockette and I have both posted here a lot that we each gained more range of motion into the 2nd/3rd year though. I could even tell something felt different last summer, and that was past my 5-year anniversary. I think some of us just need longer than others, I'm still amazed when I've done a lot of floor work on my back/hip/pelvis in the early evening, and the rest of the day I notice I have so much more bend going down the stairs---like A LOT OF BEND!! It's very bizarre!!

 

[Steveg63]

Hi all, not posted for a good few weeks.
I am now 10 months into my new knee.
As my last post I have no issues with pain in my knee, just back from a 4 day break in Barcelona, as you can imagine loads of walking, biggest day was a little shy of 20,000 steps, the 3 other days over 12,000 each day.
I am still having difficulty in the bend, just about 100 degrees, don't measure but can judge it at this.
Walk down stairs ok, upstairs is still challenging, still can't pedal my bike, which is a little sole destroying.

The main issue is the tightness in calf and hamstring muscles, do my stretches every day, have a 'sports' massage every week, which includes a little dry needling, when the muscles are really tight, all of this helps but still really tight!

Sat here typing this trying the heel slides and the tightness under the knee and on top to the inner portion makes these slides not very slidy...lol.

Don't know what else I can do to improve this bend, any thoughts would be appreciated.

 

[Jockette]

After a tough first year with my ROM I had a lot of improvement, in all ways, in my second year, as my whole leg continued to relax and heal. I hope you will see the same.

 

[Layla]

Barcelona! That sounds like fun. Twenty thousand steps is a lot.

Sat here typing this trying the heel slides and the tightness under the knee and on top to the inner portion makes these slides not very slidy...lol.

Slidy, that's a good one.
How about trying a bag underneath your foot as a way to reduce friction, making it easier to slide your foot back and forth. Sit comfortably in the chair, or on the edge of your bed with the bag underfoot. Then slowly slide your foot back, bending your knee as much as is comfortable for you. Don't get into to pan though, mild discomfort is ok, but any more intense...stop. Start slow, just a few reps once or twice a day and gradually increase at your comfort level allows. See if that helps. Good Luck, Steve. Happy Sunday!