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Revision TKR Against the wind

I’m sure in your case it seems much much longer because you’ve had so many surgeries within a short time. You’ve been in recovery since the first one. That would get anyone down.
 
It's interesting to look back at our journals and see what happened and when during recovery. I thought for sure I stopped using my walker at week 3, but on reading my thread realized it was really week 5. Our minds like to compress time, I think.
 
The PTs have a vested interest in seeing your ROM numbers improve fast. It's something they can put down on paper, to show the insurance companies how effective their treatments have been. It's not for the benefit of your knee, but to make them look good, so the insurance companies keep paying.

In addition, many PTs were trained to believe in the window of opportunity, which just doesn't exist. We know that from the many stories of people here on BoneSmart who have continued to gain ROM over the months.

Have a look at this, from one of our members. (Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time.
"I had a slow recovery. Here's my flex measurements at various points:
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
125 - 1 yr 8 months"
 
Thanks Susieshoes & Jockette! Last 2 years have been a super challenge. I'm going to re-read some Bonesmart materials to regain focus.
 
Day 75 post knee revision surgery. Had a small uptick in rehab progress over the last week. They started working "hands on" my knee over the last week. Seemed to be slight reduction in overall pain levels. Not major but some reduction. As far as improvement in ROM and extension I don't really know. No measurement recently. Which is fine because I think I know the answer, I'd guess its minimal improvement or none. I have "gauges" I use which are 1. degree of difficulty to make a full rotation on the stationary bike. 2. Swinging my leg past the car door when I get in or out. 3. going up the stairs and planting my right knee.
I starting to think like loser when I go to rehab. Complaining about the lack of progress and pain. I really try and be positive and upbeat when I'm there but my true feelings are; "LOSER"! I even think they like to be rid of me.? I wonder if they really think I'm a slacker and don't try hard enough? Thinking about changing to another firm.
 
You are NOT a loser! None of us going through this are losers. We are just all struggling to recover from a very major surgery, and you have had more than your share in a short time. I’m sure it seems never ending!

Others expectations on our improvements are unrealistic which is added stress.

Why don’t you take a break from PT for a while and let your knee and your mind rest for a bit. We get to overthinking our knee. I know I did. I was finally able to relax about mine but it took me 7 months! I still have limitations but they no longer worry me.

I still need the car door open pretty wide to get in it out.
 
Since you're starting to feel as if PT makes you feel like a loser, I suggest you stop going.
Why put yourself through that?

Yes, the PTs probably do feel you should be making faster progress but, as I explained before, they have a vested interest in seeing a rapid progression of ROM numbers.

You're not a loser. It's just that your knee has ideas that are different from those of the PTs. It's on its own schedule for recovery, not theirs. It knows what it's doing. Working harder at PT would not have changed that or made your ROM increase further. In fact, working too hard might even have slowed it down.
Where are you in recovery?? (TKR)

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
 
Thanks Celle & Jockette for the kind words of encouragement. I was having a bad day and went on a self pity rant. I'm frustrated being in surgery/rehab/recovery mode. I am making progress but reality is my body has been thru the ringer the last 2 years. Almost non-stop recovery and rehab with one short 3 month period where I finished rehab and thought I was on my way until my knee would not heal which lead to the revision. So ... expecting to bounce back in 90 days and be back to where I was 2 years ago is not realistic.
The good is I'm 11 weeks post surgery, pain levels are coming down. Pain meds are now intermittent. Some days none, some days 2. Been getting what I call "knee headaches", just aches and throbs. Not high pain level but enough to where it doesn't let you forget it. These are usually at night when I'm trying to sleep.
I'm on my feet more each week and doing more of daily activities. My ROM is **** which limits what I can do in the yard but I think it is improving but very slow and gradual. To be honest I do not know for sure that ROM is improving. Anyway.... thanks again!
 
@skippyhak We all feel the way you feel some days! My knee, like yours has been through "it" these last 2 years and I often get frustrated when my lack of ROM keeps me from doing what I want!

Anyway, I pinned this quote on Pinterest ( my fav!) and thought I would pass it along to you-

"It's ok to have a meltdown, just don't unpack and live there":):wink:

Best wishes!
 
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Saw my surgeon yesterday for 12 week check-up.
Ordered a brace that is designed to help straighten the knee. Referred to it as a "medieval torture device".
If any have had experience with this brace please let me know. I do not have the brand name ordered. I'll post it once I have the name.
Anyway, extension is at 11 degrees, ROM is 103. Also wants me to continue PT for 2 more months twice weekly. I have been making progress the last couple of weeks....so will see.
Surgeon said if still not enough improvement then he would "go in" and remove scar tissue.
 
Your numbers don't sound bad for 12 weeks. Extension, for many of us, is slower coming than bend is. But, it does come without a torture device! I doubt you have adhesions yet. More than likely, the only scar tissue you have are the ones that knit your incisions back together. Lengthening your stride is the best thing to help to stretch out those tight tendons in the back of your leg. That, you can do on your own.
 
Thanks!! Here's the name of the device. JAS EZ Knee Extension. I read all the literature and sounds OK. Directions of use stress " painful or aggressive levels of stretch will be counter productive." If anyone has used this device send me a message on results.
 
Honestly, I think your surgeon is being impatient. And I don't think you have scar tissue.
It's still less than 3 months since you had your revision - plenty of time for ROM to improve.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
 
I haven't posted since early November. I'm now 4 months since my revision. About the time I started my brace therapy to improve my extension. I wear the brace 3 times per day for 35 minutes each time. I was measured Friday and had no improvement in extension. Still 11 degrees bent. I have no ideas on why its not helped to improve the measurement readings? I had the technician come back to my house after a week just to check that I was using the device properly and he confirmed I was using it correctly. So I must say with the time, discomfort its discouraging. The good news is my ROM has improved some. 112 degrees the other day. The brace creates a fair amount of soreness and slight swelling so as far as feeling good or healed its a negative. I see my surgeon in early January so maybe he can shed some light on my progress or lack of it. I'm going to rehab once a week for exercises and let them work and stretch my knee. They just say getting extension back is a slow process. Anyway...my knee is slightly worse than it was before the revision as far as pain, swelling and soreness. If I was not using the brace maybe it would feel better. But in spite of the pain associated with this treatment I'm going to continue until I see the surgeon. A leg that is bent like mine will never allow me to leave the ranks of the disabled.
One thing that I feel has been completely missed by all the Drs., PT's etc is the problems a leg that has become bent. I did not understand that and only one PT mentioned that it would make for a difficult recovery but was unwilling to elaborate at that time. I'm assuming didn't want to interfere with what the Dr. was telling me. Might scare me off as far as getting knee replaced and she'd be blamed for losing a procedure for the Dr. Everyone is scared of doing something wrong or misspeaking and incurring the wrath of the Drs.
The good news is I think I have a chance to return to golf. The golf swing and rotation do not seem to overly irritate the knee. But keeping good balance and swinging smoothly is very important. Walking on uneven ground is a problem, sand bunkers. I'm very limited in how much walking I can do.
I wish I knew back then what I know now about a bent leg and knee replacements and how difficult or impossible to ever get a leg straight. And a bent leg will always be subject to pain and swelling from limited use.
Plus low back and hip pain for all the compensations.
If I could get back to playing golf with my friends that will be huge. The last 24 months have been endless rehab, surgeries, pain and a sedentary life. The amount of work and discipline to go through all this for such poor outcomes is truly devastating for me and my wife. Frankly I'm not sure if I'd never had this knee replaced that I'd be better off. Maybe....
 
skippyhak said:
I wear the brace 3 times per day for 35 minutes each time. I was measured Friday and had no improvement in extension. Still 11 degrees bent. I have no ideas on why its not helped to improve the measurement readings? I had the technician come back to my house after a week just to check that I was using the device properly and he confirmed I was using it correctly. So I must say with the time, discomfort its discouraging. The good news is my ROM has improved some. 112 degrees the other day. The brace creates a fair amount of soreness and slight swelling so as far as feeling good or healed its a negative.
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I think the brace is a waste of time. Not only that - it's doing harm and your knee is telling you so, by hurting and swelling.
That soreness and swelling is why you knee can't extend further. The brace is causing irritation and inflammation. It's working against you. I'd stop using it. Instead, I'd spend that time icing the back of my knee, to try and reduce the inflammation and swelling.

It isn't at all unusual for extension to take longer to achieve than flexion. There are big muscles and tendons at the back of your leg. They have shortened and they need to be stretched again, gently and slowly. That takes time, but you have time, because ROM, both flexion and extension, can continue to improve for a year, or even longer, after a knee replacement.
You're only just over 4 months into this year-long recovery. Apart from your surgeon's impatience, there's no need to rush. You have all the time in the world.
 
They’re right in telling you extention can be a slow process. One of the best things to do for extention is Bridge your leg between a chair your sitting in and a stool or ottoman. Building time with that slowly should help as well as walking and lengthening your stride.
 
5 months since my revision and I continue to improve slowly. ROM continues to improve. I'm now able to use my recumbent stationary bike. I'm also now playing golf 3 days a week using a electric cart and a hdcp flag so I keep walking at a minimum if I choose. I'm also continue to use my brace between 1 and 3 times a day. I've found overall that is helping my knee as long as I do not do it too much. Overall I'm walking more each week; last week was 60,000 steps. I stopped PT about a month ago. Exercises were good but I can do all of them at home if I'm willing. The knee and leg is still sore a great deal of the time. I use prescription pain meds at night to reduce pain at bedtime. But this is about 1 or 2 pills per week. I also use prescription pills to help play golf. Usually 2 5 mg pills per round. I think my recovery is at about 60 to 70 percent. I met with my surgeon last week and he's pleased with my progress. His opinion is everything is "normal" considering how traumatized the knee and leg has endured over the last 24 months. All the pain I'm still experiencing is "normal" in his opinion. He expects the extension to improve over the next 3 to 4 months. So I'm just moving forward. Getting back to normalcy in spite of fairly high pain levels.
 
I’m glad you’re getting somewhat back to normal in spite of the pain you have. I hope you are enjoying the time you play golf.

I am doing the same with bowling. Throwing the bowling ball does not hurt my knee. I’ve had to change my approach to the lane and when I throw, I bend at the waist, not my knees. But it’s nice to be back with my friends doing what I enjoy.

At 10 months I’m not happy with my new knee yet, I still have a long way to go.
 
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