MUA Aussie Icy Pole (popsicle)
- Thread starter dovemck
- Start date
Australia
I think lots of people wind up with some degree of valgus. I think what may make some of us a bit different is how longstanding the deformity is and what that means for rehab. Is that accurate @Josephine? @Orthodoc?
Orthodoc
Former BoneSmart staff member
Each patient is different in the amount of contractions and deformity that they have. Some are severe and other can be mild (even with severe arthritis). In general the knee that is more deformed has worse ligament balance. These knees require more extensive ligament balancing to be performed during surgery (some knees need no ligament balancing during surgery). I am mostly referring to the MCL, LCL, IT band and popliteus when I discuss ligament balancing. (The issues with the ACL and PCL are different.)
With that said, once proper ligament balancing is performed, the knee will now be straight and allow the patient to re-train the muscles and rehab the knee. It is not uncommon that the more "work" that needed to be done on the knee in surgery, the more "recovery" that it may take for the patient to get rehabbed.
Orthodoc
With that said, once proper ligament balancing is performed, the knee will now be straight and allow the patient to re-train the muscles and rehab the knee. It is not uncommon that the more "work" that needed to be done on the knee in surgery, the more "recovery" that it may take for the patient to get rehabbed.
Orthodoc
Josephine
NURSE DIRECTOR EMERITA
Thanks, Orthodoc. Nice summary.
Valgus/varus deformities are very common as it's part of the arthritic process, though valgus is the more common. It's more unusual to find a knee that hasn't developed that kind if deformity.
Here's a gallery of different degrees of vaglus
![[Bonesmart.org] Aussie Icy Pole (popsicle)](https://bonesmart.org/forum/attachments/c1-p1-jpg.24441/ "[Bonesmart.org] Aussie Icy Pole (popsicle)")
![[Bonesmart.org] Aussie Icy Pole (popsicle)](https://bonesmart.org/forum/attachments/osteophyte-jpg.24442/ "[Bonesmart.org] Aussie Icy Pole (popsicle)")
![[Bonesmart.org] Aussie Icy Pole (popsicle)](https://bonesmart.org/forum/attachments/varus-knee-deformity-jpg.24443/ "[Bonesmart.org] Aussie Icy Pole (popsicle)")
Valgus/varus deformities are very common as it's part of the arthritic process, though valgus is the more common. It's more unusual to find a knee that hasn't developed that kind if deformity.
Here's a gallery of different degrees of vaglus
dovemck
member
Thanks to both Josephine and Orthodoc for the information. I know the surgeon had his hand full trying to balance the new knee. Nurses and P/Ts are asking who did the work - you can tell they're impressed (Cameron Norsworthy did my husbands hip arthoplasty - an area he is better known for.
So here I am at day 10 -getting half my staples removed today (can't wait because they itch), doing quite well on balance - learning to walk with my heel following my toes, not the side of the foot leading. I have 2-3 extension ( can force it to zero but it's hard work) and flexion at 60 - I know they want me at 90 but maybe after the staples come out I'll be able to do better. What I still can't do...is life my leg up. Neither from the hip nor with a rolled up towel under the knee. The lower quads are so atrophied I can't hold up a mosquito never-the-less a heavy leg!
I have just started to get a contraction across it - funny as hell to watch, more like uncoordinated twitching across a jiggly bowl of jelly, but hey, it'my lil twitch!
darn right - neither rehab nor TKR are for sissies.
So here I am at day 10 -getting half my staples removed today (can't wait because they itch), doing quite well on balance - learning to walk with my heel following my toes, not the side of the foot leading. I have 2-3 extension ( can force it to zero but it's hard work) and flexion at 60 - I know they want me at 90 but maybe after the staples come out I'll be able to do better. What I still can't do...is life my leg up. Neither from the hip nor with a rolled up towel under the knee. The lower quads are so atrophied I can't hold up a mosquito never-the-less a heavy leg!
I have just started to get a contraction across it - funny as hell to watch, more like uncoordinated twitching across a jiggly bowl of jelly, but hey, it'my lil twitch!
darn right - neither rehab nor TKR are for sissies.
I don't want to hijack the thread, but since aussie and I have similar concerns...
@Orthodoc , my knee was very loose pre-op. The OS could kind of get the lower leg to move side to side--not sure how to describe it. Can I assume that "tightening it up" for lack of a better word, is part of that ligament balancing? My guess is he worked on the LCL (probably among other things) b/c as best as I can determine from looking at knee anatomy pictures, that is one of the areas that has been a bit nagging as far as pain. (It was on my other knee too, but eventually resolved just fine, so I'm not concerned, just curious).
dovemck
member
I'm interested too @kneeper, with the balancing that was done, one side of my knee is quite tight now. I can only imagine this balancing is done by increasing the spacing / thickness of the new pad of the prosthesis. To get my medial lateral just barely tight enough, there has been a stretching of the colateral lateral. Fascinating and clever.
Again, I can find plenty of resources describing the challenges for the surgeon, less for thr P/T or O/T.
Again, I can find plenty of resources describing the challenges for the surgeon, less for thr P/T or O/T.
Orthodoc
Former BoneSmart staff member
It can be possible to "tighten" up a ligament. However, it is more typical to release and lengthen the shortened/contracted ligament to equal up to the tension of the other side.
Orthodoc
dovemck
member
Theory is I'll be ready for discharge on Friday - 3 days from now.
Had a busy day - started with how to cook yourself breakfast class (best brekkie in 2 weeks I reckon), had a good morning P/T session and then had a home visit! Occupational Therapist drove me out to the house and I got to show her I can get up 15 steps to my front door on crutches - and then walked through the house measuring and getting tips/hints. Got to say hello to my fuzzy kitty kids before heading back to the rehab hospital - where it all went pear-shaped.
Wasn't supposed to have an afternoon P/T session because of the home visit, but nurse ran up to me as I came in the door, handed me two endone and a glass of water and told me the Doctor had been in and decided I didn't have enough ROM and needed to see the P/T for another session.
P/T had been 'worded' up and decided we needed to start with lunges, then the roller skate board, use a strap to pull the foot into a more flexed position...She also told me I need to work harder and not to be afraid of a little pain. Now that just ticked me off, I'm working my butt off, I'm trying hard, stretching and taking care of myself. When she asked me what I thought was limiting my ROM I pointed out two spots on my knee where the tightness was holding me back. I said I'm sure the swelling is a large part of it (you can't tell where my knee cap is yet and I'm still producing enough heat to warm a small village in winter) She told me that 14 days after surgery there's no swelling holding me back, just muscle stiffness because I haven't challenged and worked through it yet. I did what I could, pushing as hard as I could without hurting myself and went back to my room where I've gone through a couple of ice packs, pain meds and I find that at the moment, I can't even lock that knee because it's sore and swollen.
I think they want me to 'hurt myself' so they can get one good ROM measurement before discharging me.
It's not going to happen. The ROM will come without me pulling a muscle. No one has looked at the leg, the swelling to see if it's holding me back, just making assumptions and I'm rather appalled. If they want better ROM before discharge that's fine, I can stay past Friday, but I'm not buying into the ROM now or never ****.
Very angry and very disappointed tonight.
Had a busy day - started with how to cook yourself breakfast class (best brekkie in 2 weeks I reckon), had a good morning P/T session and then had a home visit! Occupational Therapist drove me out to the house and I got to show her I can get up 15 steps to my front door on crutches - and then walked through the house measuring and getting tips/hints. Got to say hello to my fuzzy kitty kids before heading back to the rehab hospital - where it all went pear-shaped.
Wasn't supposed to have an afternoon P/T session because of the home visit, but nurse ran up to me as I came in the door, handed me two endone and a glass of water and told me the Doctor had been in and decided I didn't have enough ROM and needed to see the P/T for another session.
P/T had been 'worded' up and decided we needed to start with lunges, then the roller skate board, use a strap to pull the foot into a more flexed position...She also told me I need to work harder and not to be afraid of a little pain. Now that just ticked me off, I'm working my butt off, I'm trying hard, stretching and taking care of myself. When she asked me what I thought was limiting my ROM I pointed out two spots on my knee where the tightness was holding me back. I said I'm sure the swelling is a large part of it (you can't tell where my knee cap is yet and I'm still producing enough heat to warm a small village in winter) She told me that 14 days after surgery there's no swelling holding me back, just muscle stiffness because I haven't challenged and worked through it yet. I did what I could, pushing as hard as I could without hurting myself and went back to my room where I've gone through a couple of ice packs, pain meds and I find that at the moment, I can't even lock that knee because it's sore and swollen.
I think they want me to 'hurt myself' so they can get one good ROM measurement before discharging me.
It's not going to happen. The ROM will come without me pulling a muscle. No one has looked at the leg, the swelling to see if it's holding me back, just making assumptions and I'm rather appalled. If they want better ROM before discharge that's fine, I can stay past Friday, but I'm not buying into the ROM now or never ****.
Very angry and very disappointed tonight.
Reebok
member
Good on you for sticking to your guns.
You dont need to hurt yourself just so they can tick a box
You dont need to hurt yourself just so they can tick a box
dovemck
member
Status 14 days post-op:
- 38 clips/staples removed. I don't have a straight scar, mine follows the side of the kneecap which is why I have so many clips
- Extension 0
- Flexion 55
- Still icing because joint is still throwing out some serious heat!
- I'm now on my 2nd full day of crutches
- I have mild hypertension - have only been given my Tritace twice in 2 weeks. Today BP is 120/ 70. Yesterday afternoon it was only 94/ 60.
tiredwife
alpha
@dovemck Hubby has stitches, but not the normal ones, they are kind of under the skin and are just 3 long zigzaggy ones. Your extension is great! Flexion will get there (baby steps). You will need to ice for a long time yet. You seem to be doing pretty good. You are only a couple of weeks out, so you are still very early in the process. Don't rush it and then overdo it, it will cause a setback.
NetballKnees
senior
Hello @dovemck ... You sound very knowledgeable and capable. It must help in your recovery and I think it will go really well. I have just written a big post, but realised it was mostly about me, so have deleted it and will put it in my thread. I was told on Bonesmart here that lunges and squats were for strengthening the knee and unnecessary at the start when you are really only trying to recover it and reduce your swelling. I am glad your extension is 0. I have read on here that some Bonesmarties find extension the hardest to get, but I was like you and went to 0 very quickly, but then again, all the fat is in the back and sides of my legs, so perhaps that's why not much flexion.
Take Care dovemck ... Keep sticking up for yourself and let your recovery proceed at YOUR pace and I am sure it will happen. Like the saying we had for hair products over here (I am sure you would remember it) - it won't happen overnight - but it will happen. Hugs .. Ellen
Take Care dovemck ... Keep sticking up for yourself and let your recovery proceed at YOUR pace and I am sure it will happen. Like the saying we had for hair products over here (I am sure you would remember it) - it won't happen overnight - but it will happen. Hugs .. Ellen
dovemck
member
The rehab doctor stopped in tonight and honestly I'm so disappointed in the way this is going.
My main P/T is very supportive and although she would like to see more flexion, she knows to motivate me she needs to point out my advances. We do interesting things to challenge what I can do rather than spending endless hours pushing and pulling over those that I can't.
The doctor went on about my 'problems', how I'm not getting results because of pain (but of course he's in charge of the pain relief here) and how I need to get off opiates, how he won't be sending me home with more than 28 days worth of drugs. Apparently he's a rheumatologist and let me know that he can't give me steroids or keep me on Celebrex too long. Although I maintain I can't get the flexion because of swelling, he still hasn't even looked at the knee - what? He then proceeded to blame it all on the surgeon - the surgeon told him to be hard on me, he wanted me to have 120 degrees flexion by now, but when I suggested that no one has told the surgeon about the limitations that have come up, he quickly changed the subject, instead telling me (and I believe threatening me with an MUA) I told him I know about MUA, it's used to break up adhesions however it what I have is swelling and at any rate that sort of decision is a month or more away.
To be told during the say during rehab that I'm doing a great job and 'getting there' then getting the doctor doom treatment at night is really messing with my head. When I first got here I was told they prefer but couldn't compel me to do my outpatient here, now they're keen to tell me about a rehab place closer to home. No mention at all about coming back here. I think I'm too hard for them. I don't think I fit into their mold. I don't get mad, I don't make scenes but I do challenge BS when I hear it.
There's a one week waiting list for the out patient facility, so I'm going to work harder on getting the swelling down during the downtime rather than killing myself trying to get more ROM, just gentle exercises. I know 55 degrees isn't enough!
My main P/T is very supportive and although she would like to see more flexion, she knows to motivate me she needs to point out my advances. We do interesting things to challenge what I can do rather than spending endless hours pushing and pulling over those that I can't.
The doctor went on about my 'problems', how I'm not getting results because of pain (but of course he's in charge of the pain relief here) and how I need to get off opiates, how he won't be sending me home with more than 28 days worth of drugs. Apparently he's a rheumatologist and let me know that he can't give me steroids or keep me on Celebrex too long. Although I maintain I can't get the flexion because of swelling, he still hasn't even looked at the knee - what? He then proceeded to blame it all on the surgeon - the surgeon told him to be hard on me, he wanted me to have 120 degrees flexion by now, but when I suggested that no one has told the surgeon about the limitations that have come up, he quickly changed the subject, instead telling me (and I believe threatening me with an MUA) I told him I know about MUA, it's used to break up adhesions however it what I have is swelling and at any rate that sort of decision is a month or more away.
To be told during the say during rehab that I'm doing a great job and 'getting there' then getting the doctor doom treatment at night is really messing with my head. When I first got here I was told they prefer but couldn't compel me to do my outpatient here, now they're keen to tell me about a rehab place closer to home. No mention at all about coming back here. I think I'm too hard for them. I don't think I fit into their mold. I don't get mad, I don't make scenes but I do challenge BS when I hear it.
There's a one week waiting list for the out patient facility, so I'm going to work harder on getting the swelling down during the downtime rather than killing myself trying to get more ROM, just gentle exercises. I know 55 degrees isn't enough!
bottomshollow
Former BoneSmart staff member
As long as your knee is swollen and the soft tissues very angry, bend and straightening are impossible. Your knee needs a lot of TLC---rest, elevation, icing, icing, and more icing----and you need your pain meds on a schedule and you'll need more that 28 days worth.
This is your knee and your recovery----please, please do not continue to let these people make your life miserable---you have the power to just say NO!
Please take care of yourself and your knee and keep us posted. We care.
tiredwife
alpha
@dovemck Just let it go in one ear and out the other. Some people have no tact and don't know how to motivate people. Don't stress over the 55. With his first knee ROM was slow coming until we got the swelling under control. He lost some in the hospital and when he got home. With this knee he started at 91 and is probably at 50 or less because of the swelling we are trying to control. It will come, slowly because that is the nature of this recovery, but it will come.
Yes, it sounds like you'd do better at home where you can ice and elevate and do outpatient PT.
Pooh on the doctor of doom.
BTW you've got great extension--so half the battle is already won.
Pooh on the doctor of doom.
BTW you've got great extension--so half the battle is already won.
Reebok
member
I will post a pic of a tattoo I have on my left forearm.
A flaming eight ball with some not-too-nice words in big letters basically telling the world to mind its own business! It is to remind me that the rest of the world can go their own way sometimes and leave me alone.
My wife and I were told we were too young to be married, too young to have kids, too young to buy a house, too young etc etc. then I was told I was too young to have a TKR, repeatedly. Should never have gone racing, never started my own business.
You know what, my wife and I have been together for almost 40 yrs, everything else has worked out as well.
Sometimes you gotta do what is right for you. And go down in flames trying maybe.
When I have doubts, I look at the tattoo.
I would report the night time doc. His bedside manner sucks. Certainly not helping!
You are in the hospital for your health. Maybe he should work at that rather than demotivating you.
You aint done nothing wrong!
I apologise if my language is rather strong, but you need support not criticism.
Admin Note: Post has been edited to remove language not appropriate for the forum. Please do NOT post a photo as it would also be unacceptable. ----Jamie
A flaming eight ball with some not-too-nice words in big letters basically telling the world to mind its own business! It is to remind me that the rest of the world can go their own way sometimes and leave me alone.
My wife and I were told we were too young to be married, too young to have kids, too young to buy a house, too young etc etc. then I was told I was too young to have a TKR, repeatedly. Should never have gone racing, never started my own business.
You know what, my wife and I have been together for almost 40 yrs, everything else has worked out as well.
Sometimes you gotta do what is right for you. And go down in flames trying maybe.
When I have doubts, I look at the tattoo.
I would report the night time doc. His bedside manner sucks. Certainly not helping!
You are in the hospital for your health. Maybe he should work at that rather than demotivating you.
You aint done nothing wrong!
I apologise if my language is rather strong, but you need support not criticism.
Admin Note: Post has been edited to remove language not appropriate for the forum. Please do NOT post a photo as it would also be unacceptable. ----Jamie
Last edited by a moderator:
dovemck
member
@Reebok, @kneeper, @tiredwife, @bottomshollow I know you're right, I'm sticking to my guns and the only alternative the system has left me with is gloom & doom - which is not how I live my life! Waking up on this last full day at rehab, I look forward to the awesome support and lessons I'm about to learn from my P/T and feel exhausted by the ROM nay-sayers.
I have to thank each of you whose messages of support I read this morning and let you know that each of you is helping me to control my own destiny and health care decisions. You bolster me so I don't fold before the unreasonable requests that are going to be made of me. I mentioned they're wearing me down and your support is exactly what I need today, now, to get through this. Thanks for being here for me, each of you has made me cry with relief. I don't feel like the lone wolf bucking the system but a unique human being who just doesn't happen to fit their pre-conceived notion.
I'm packing up my toys -including my shiny new knee -and going home!!!
I have to thank each of you whose messages of support I read this morning and let you know that each of you is helping me to control my own destiny and health care decisions. You bolster me so I don't fold before the unreasonable requests that are going to be made of me. I mentioned they're wearing me down and your support is exactly what I need today, now, to get through this. Thanks for being here for me, each of you has made me cry with relief. I don't feel like the lone wolf bucking the system but a unique human being who just doesn't happen to fit their pre-conceived notion.
I'm packing up my toys -including my shiny new knee -and going home!!!
