TKR After a year and 2 months

[Guss]

I am starting my 12th week of therapy. I can bend to 100 ROM and can be forced to 105 (ouch). I can walk upstairs down is difficult.
I can walk a mile , and after I MUST ice. it is sore. I was told by the therapist 105 to 110 ROM may be the best I get. At the end of this week I may have to stop therapy. I am still not sleeping well, usually 2 hours at a time and icing all night. Thigh and ankle tight and sore, hopefully I can do therapy myself, when has anyone else stopped therapy and what was your Range of Motion?

 

[Jockette]

You can stop PT any time you want. I stopped just before my 8 week anniversary.

Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

I was told by the therapist 105 to 110 ROM may be the best I get.

Your ROM has a very good chance of improving more than this amount, mine continued to increase well throughout my second year, and even a bit more in my third year!

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery!

 

[benne68]

I can bend to 100 ROM and can be forced to 105 (ouch).

Please don't let anyone force your knee. It can be cause inflammation, which in turn, will reduce your ability to bend! Once all the inflammation has gone down, your bend will come back.

I think PTs get very hung up on the numbers, when what is more important is your function. I think it's interesting to know what flexion needed to do different things. For example, we need
- 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

You sounds like you are on track for less than three months post-op. Remember, this. is a year long recovery!

 

[Flashlight]

Hi, I found that walking and my stationary bike was all I needed. I continued my daily activity around the house with frequent rest periods. There are some interesting YouTube videos out there as well for exercising and most important stretching post TKR. I had thigh pain and ankle soreness. I would use a heating pad around my thigh while using an ice pack on my knee. It took awhile for my ankle to improve. At first, I was told I would never get passed 120, then I hit 130 and now at 10 months I'm at 140. Every day you just have to try, and it does get better. Hang in there.

 

[WFD]

@Guss , I had/have similar ankle problems after my last few surgeries. I found that the calf muscle on that leg was short, tight, and weak. Stretching the calf gave me some relief and (much later when I could tolerate it) strengthening the calf muscle helped also. Your mileage may vary of course but you might compare your two calf muscles to see if you have the same issue.

 

[EalingGran]

There are some interesting YouTube videos out there as well for exercising and most important stretching post TKR.

Have a look at my pilates teachers free videos on YouTube. Google Katja pilates and they come up.
She has a 20 minute glute strengthening one which is for post injury and doesn't have any squats. I have been doing it most days. There is another slightly harder one with some squats at the beginning- which I now do at 8 months post surgery.

 

[Guss]

Thank You for the information about Katja Pilates. I can possibly do the glute strengthening exercise. I would do it in bed , I am not able or confident I can get off the floor yet.

 

[EalingGran]

Her 12 minute arm strength one with light weights can be done seated and is good to maintain the upper body.
I would suggest folding a mat on top of the mattress to make the bed firmer if you are doing exercises on a bed. This helps to protect your back. It is how my teacher helped me in the first few weeks.
She taught me a way to get up and down to the floor which might work for you.
It involved putting my weight on the seat of a wooden chair ( forearms- elbows to hands) and levering myself down with my operated leg extended out to the side. I was able to kneel on my good leg though which helped.

 

[Layla]

Happy Three Month Anniversary, Gus!
I’m betting there was a big firework display to mark this three month milestone for you.
Hope you had a nice holiday! @Gus

 

[Guss]

Thank You, Layla, hope you had a good holiday. I was told today that I had 115 ROM before total knee replacement. And getting close to that is all I can expect. 105 ROM is where I am today. I'm hoping they are wrong. Anyone else know where they started before TKR, and how far their ROM improved or didn't?

 

[mendogal]

Thank You, Layla, hope you had a good holiday. I was told today that I had 115 ROM before total knee replacement. And getting close to that is all I can expect. 105 ROM is where I am today. I'm hoping they are wrong. Anyone else know where they started before TKR, and how far their ROM improved or didn't?

Hi, Guss. I may be an outlier, and feel free to disregard this... it's been helpful for me to focus on function rather than numbers, and you might find that reframing helpful... So consider the things in daily life you need to do: can you get on and off a standard toilet without relying heavily on grab bars?
can you step up and down any stairs and curbs you need to without skewing your leg? can you comfortably ride a exercise bike?
Your ROM has plenty of time to improve, but obsessing on numbers is like checking your stock market or retirement funds every day: in the long run, just makes a body anxious!

 

[EalingGran]

it's been helpful for me to focus on function rather than numbers,

Agree with @mendogal on this.
My surgeon has never bothered with measurements or worried me about it. I have great mobility of the joint ( 145/0) but what I can do is much more important.
I couldn't do stairs normally until about 6/7 months out- but there were plenty of people on this forum who could despite much more limited ROM. Focus on what you need to do to live your life well and find a sensible physio/ PT who will help you with gentle stretching and later strengthening work to achieve your goals.

 

[sistersinhim]

My doctor never measured me, either. He just asked to see what I could do. I am one that let only my daily activities rehab me and I've done great!

 

[InkedMarie]

Thank You, Layla, hope you had a good holiday. I was told today that I had 115 ROM before total knee replacement. And getting close to that is all I can expect. 105 ROM is where I am today. I'm hoping they are wrong. Anyone else know where they started before TKR, and how far their ROM improved or didn't?

Hi, Guss. I may be an outlier, and feel free to disregard this... it's been helpful for me to focus on function rather than numbers, and you might find that reframing helpful... So consider the things in daily life you need to do: can you get on and off a standard toilet without relying heavily on grab bars?
can you step up and down any stairs and curbs you need to without skewing your leg? can you comfortably ride a exercise bike?
Your ROM has plenty of time to improve, but obsessing on numbers is like checking your stock market or retirement funds every day: in the long run, just makes a body anxious!

I’m in agreement with you. With both knees, measuring only happened a handful of times with each.

Marie

 

[Guss]

I saw my doctor on Monday 7/17, he has said since my third week it was scar tissue causing my problem of not being able to bend my knee. He checked my ROM I was at 95, if my ROM doesn't improve, he said I will need autoscopic surgery to remove the scar tissue. Probably in October. Has anyone had good luck with this type of procedure? I'm concerned about doing this.

 

[sistersinhim]

Even if you don't see swelling outside, you more than likely have inside swelling. That will hold back your bend.

There is always the possibility of getting an infection every time you open the knee up or even give it shots. I think you can give it a couple of more months to see if you improve, there is no time limit! If you don't, then something probably needs to be done to it. If it does improve, then you know that it just needed more time.

 

[LD of Michigan]

Ld, so after five months has the tourniquet feeling gone away? I'm eleven weeks out and still have the tourniquet feeling around my thigh and ankle, hoping it goes away soon.

Sorry for the delayed response. Yes, that feeling went away completely at about four months.

 

[benne68]

@Guss Before you agree to any intervention, please read @JusticeRider 's recovery story. Like you, she was "threatened" with an MUA because her surgeon thought her ROM wasn't getting good enough fast enough to suit him.

She resisted. It was a tough road for her, but here's what she reported recently, at the 11-month post-op mark:

This has been a very, very long process. I struggled hard the first several months and had very limited ROM, lots of discomfort, and felt very ‘behind’ the average knee replacement patient. My surgeon and PA and PT told me if I didn’t get a MUA, I would basically be a 45 year old cripple.

Progress began slowly around 5 months and gradually gained speed as time went by. I found stores of patience I never knew I had. I was more depressed than I’ve ever been, and found I could survive it. My husband has been my rock and my cheerleader. BoneSmart was absolutely essential.

Over the 4th of July weekend, my husband and I went on a 4 day horse camping trip in the mountains. We packed up all the food and gear for us and our two horses, drove four hours to the campsite, and set up camp. That alone was a lot of work, and I barely thought about my knee. We rode three days in a row, including some very challenging trail and some very fast riding. We also did a bit of hiking with our dog each day. Through all that, my knee held up beautifully. Hauling water for the horses and scrambling around in the underbrush looking for firewood was not a problem. All these things would have been unthinkable a short 3 months ago. I believe I will reach my goal of a backpacking trip before the end of summer.

 

[Flashlight]

@Guss I agree give it some more time. At 4-months I was doing better standing for longer periods of time, but it wasn't until the 5th month going into the 6th month that I really began to do so much better. My doctor wasn't that concerned about ROM. If you are doing something that increases your swelling, try stopping that activity for a few days. Those deeper tissues take a little bit longer to heal.

 

[skiforever]

I have had the experience of a tight band around my ankle since right after surgery. It does vary a bit. Sometimes I have pain. Certain exercises cause pain all the way down the front of my leg. Sometimes I am not aware of the ankle, so maybe it is improving (6 weeks post-op).