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TKR Can lost ROM be regained

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I'm sorry you are having problems with muscle pain. I had my first TKR in July 2015 also. I had a revision 8 months later and two weeks ago I had my other knee done. My life like yours has been 'knees' for almost two years. I wound up researching what could help with shin splints and kept trying different things until my left knee finally calmed down. It was more a trial and error. I did try icing that area as often as possible. I did some stretches to try to get my other muscles to loosen up, massage the area where there was pain and then followed it with ice. In the US most health insurances don't pay for chiropractors for anything else but back manipulation so it was trial and error. I hope you keep looking for an answer. The last thing you should do is to give up.
 
Is there anyone can help me? I had good ROM in both knees but last August the muscles and tendons in both knees tightened up, and became very painful and I lost 10 degrees ROM in both knees. Can it ever be regained after this length of time? I am having weekly massage on both legs and doing weekly Pilates. Last week I started a course of Acupuncture. I have been given stretching exercises to do, but so far not much change, except perhaps a little less stiffness. I am taking 1,000mg paracetamol 3 x day and sometimes at night as well, although I don't get pain in bed. I am also using Voltarol 12 hour gel morning and night. Nothing seems to be helping the pain though. Has anyone any other suggestions please.
 
I've changed your thread title, @Majic .

Have you asked your surgeon about the loss of ROM? It does sound as if it's a muscle problem.

Have you tried massage at PT?

Another course might be to seek a second opinion from another surgeon, although as it's both legs the problem is probably not with the replacements themselves.

I'll ask @Josephine if she has any suggestions, but she is away at the moment, recovering from shoulder surgery It will be a week or so before she's back.
 
@Celle Thanks for your reply. I don't go to PT anymore, as they said they don't know what is causing the problem, and it is a waste of time and money for me to carry on going.
I have found a Masseuse locally who is massaging my legs weekly, and I do notice some improvement afterwards, although it can painful at the time. She says that some of my muscles are rigid. I haven't been back to the OS, as he X-rayed them both in July and said they were perfect, and I get no trouble from the knees themselves, but pain at what I am told is the IT Band entry point. The last time I tagged Josephine I think she thought it was muscular and not really a bonesmart problem, but I don't know where else to go for advice. I spoke to an Osteopath who said in his opinion it was still everything settling down, and the Acupuncturist said she sees a few muscle and ligament problems after TKRs. I have spent hundreds if not thousands of pounds trying to sort this very painful problem. I am hoping to find someone else who has had this problem and has recovered.
 
I'm sorry your problem has been so persistent. You certainty have tried a lot of people who might have been able to help. I'm at a bit of a loss as well, but I can give you our article about IT band problems, just hoping that something in it might be of help:
ITB (ilio-tibial band) issues and treatments
 
Majic said:
I had good ROM in both knees but last August the muscles and tendons in both knees tightened up, and became very painful and I lost 10 degrees ROM in both knees. Can it ever be regained after this length of time?
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It depends upon the reason it became retarded. That's the key.
Majic said:
I have found a Masseuse locally who is massaging my legs weekly, and I do notice some improvement afterwards, although it can painful at the time. She says that some of my muscles are rigid.
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Well there is your answer. I see you've tried a number of therapists except the very one that might be truly helpful which is a chiropractor. But do choose one who uses chiropractic therapeutic massage and not just manipulation. You certainly don't need tha1t.
Majic said:
I am also using Voltarol 12 hour gel morning and night.
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Have you ever noticed a series on BBC2 called "Trust Me I'm A Doctor"? There was one where the presenter, who is a doctor, allowed himself to be a guinea-pig for a range of laboratory procedures investigating the effectiveness of these topical medications. This involved him having some electrodes inserted into his skin and even samples of muscle take with a special biopsy needle. Brave man! However, he had recordings and samples take before using the gels and then at intervals afterwards. So far as I can recall, they used three NSAID gels, Voltoran, Ibuleve and another. In all three, these tests showed quite conclusively that all these products only penetrated the skin by about 5mm and even then varied greatly in effectiveness. In no case did they come anywhere near penetrating past the subcutaneous fat! So it's all advertising hyperbole and a great bit waste of money!
Majic said:
The last time I tagged Josephine I think she thought it was ..... not really a bonesmart problem
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Jackie, can you show me where I said this? Because I am truly shocked. In fact, I'm far more likely to say that there is nothing outside of the scope of this forum in much the same way as I would say there is no such thing as a silly question!
 
@Josephine Many thanks for your reply, I am sorry I have been so slow to get back to you.

Josephine said:
It depends upon the reason it became retarded. That's the key.
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It seems to be something of a mystery as to why I lost ROM, I became somewhat stiff when I had shingles last May/June, but Hydrotherapy and Massage loosened me up and by August I was fairly loose again.

I started them at the end of August and in mid September my Epilepsy became worse. By mid October I started to have sudden blackouts, and my minor attacks became much more frequent, and I became so stiff that it was hard to walk. I went back to the Hospital Physiotherapist who said all my muscles were rock hard, and she could hardly massage them. She measured my ROM, and I had lost approx 10 degrees in each leg. After several weeks of massage, I regained a lot of the ROM in my right knee, and a little in my left. One of the PTs said that she thought that the stigffness and tightness could be caused by leg spasms during my seizures. My Neurologist has agreed that this could be possible. However I can no longer swim or have hydrotherapy or ride my bicycle because of the blackouts.

I have had my Epilepy medication changed several times now, and things do seem to be settling down. I am having weekly sessions with a sports Maseusse, and learning Pilates in order to stretch my very tight muscles.
Do you think that my ROM can be increased in any other way eg should I go back to heel-slides etc.

I will post again about any other things I think of as I have to go out soon.
 
Majic said:
I went back to the Hospital Physiotherapist who said all my muscles were rock hard, and she could hardly massage them. She measured my ROM, and I had lost approx 10 degrees in each leg. Do you think that my ROM can be increased in any other way eg should I go back to heel-slides etc.
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Absolutely not! Have you ever tried chiropractic treatment? Or are your physios fairly rigorous in their massage? I don't think your problem is the lost ROM as such, but you do appear to have tight muscles which need a lot of attention. Have you tried doing any of this yourself? There are lots of stretches you could try and maybe even Acupressure massage which can be beneficial.
Majic said:
I am having weekly sessions with a sports Maseusse, and learning Pilates in order to stretch my very tight muscles.
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This would be excellent and the way to go.
 
It does sound as if the main problem is in your muscles and not in the knee replacements themselves, so your surgeon won't be able to help.
I think massage and gentle exercise is the way to go.
 
@Josephine We have just come back from a short break, and I think I may have done too much walking. However this afternoon I had a massage, and then I have even to see what the GP makes of the problem. I didn't see my usual Doctor, I saw one who was the houseman to my OS until he left surgery and took up general practice instead. He gave me a very thorough examination, and doesn't think it is either TKR as the pain is similar in both. He has arranged for blood tests tomorrow and said he would email my Surgeon to see if he would like to see me again or if some kind of scan might throw up a solution. He said that if nothing came of it he would try to alleviate the symptoms. He thought swimming would be beneficial although he realises that at the moment that is not an option. I just pray that something might come from this. He promised to phone if he had any further thoughts.
 
@Josephine I have heard nothing from my GP so far so I assume nothing has come of his enquiries. I am in so much pain at the moment. With each step I feel as though I have been stabbed with a hot dagger in the outside of each knee joint.
My Husband thinks we ought to seek a second opinion after I have suffered for all this time. How do I go about it in England? My surgeon is reckoned to be the best knee surgeon in our area so I don't know where to look for a specialist in problem knees. I thought I would ask your opinion first, as my GP used to work for my Surgeon. I am in a position to go privately if necessary, although I realise this would be a very costly option. I don't think our insurance would cover it, and I don't know if this option is available on the NHS.
I live 10 miles north of Cheltenham. I would rather PM you my surgeon's name if you want it as it may not be anything that he has done wrong
 
I'll do my best. How far are you prepared to travel?
Majic said:
I am in a position to go privately if necessary, although I realise this would be a very costly option
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You could get a private consultation to start with. That should be no more than £150-200. It's not impossible that he could then transfer you to NHS treatment
Majic said:
I don't know if this option is available on the NHS.
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What option would that be?
 
@Josephine I could travel to Oxford, London, Birmingham or Bristol reasonably easily. But further if it was necessary.

I was wondering whether the option of a second opinion is available on the NHS, as I had my operations privately.
 
Oh of course it is! Though it's not spelt out in so many words.
I'll look for someone for you.
 
Jackie, I am so sorry you are having these problems. You were always a comfort to me when I was having my tkr and recovery. I pray that you will find the cause and a solution really quickly.
 
These are my suggestions (numbers are primary TKR/revision TKR)

Queens Medical Centre Nottingham: Peter James 274/67
Warwick Hospital: Timothy Robertson 194/24
Robert Jones and Agnes Hunt: Orth Hosp Anthony Smith 252/29
 
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