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TKR Can't straighten leg or walk eleven weeks post op<

JamesAB

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Hello everyone, Seven weeks ago I had a RTKR. In addition, in order to partially correct a walking disability, the surgeon rotated the lower leg, by a few degrees relative to the upper leg. I have never been able to completely straighten (flatten) the leg by two or three degrees but since the operation this angle is more like 10 - 15°. I cannot put my foot flat on the floor or take my weight on the leg and consequently, even with an aid, I can't walk at all.
Noting that I have lost most of the muscle strength in the leg I have bought a pedal type exerciser and as well as weekly PT sessions, I have restarted Pilates which had been on hold since the op. I think this is helping.
Obviously my big worry is that I won't walk again, or not for a long while.
I would be interested to hear if any one else has had a similar experience and if so, what the outcome was.

Thanks and regards, Jim
 

Roy Gardiner

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Hi, welcome to BoneSmart

Don't overdo strength exercises or training as yet, your knee is not healed. Healing must be well along the way before you do anything strenuous, or you'll just compound the damage done during surgery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Celle

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Hello @JamesAB - and :welome:

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:
 
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JamesAB

JamesAB

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Hello Celle.
I had a TKR of my right knee on 21st November 2018.
Regards,
Jim.
 

Celle

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Thank you, James.
I've made a signature for you now.
 

maryo52

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When I had extension issues (10 degrees), I had my husband push down on my knee, covered by a pillow, and work on extension very gently. Those ligaments in back complained and he knew to go slowly and stop soon as I said stop. I got full extension but it came slowly. I assume your surgeon is on top of this and there's a plan.
 

Bismitmom1

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Hi Jim! My extension was crummy for a while after a month or two since we were concentrating more on flexion. I had a crooked leg from no cartilage in the inside of my knee, but I could walk even though it was straightened. Have you talked to your surgeon about it? How difficult it must be to not be able to walk even with an aid!

Sent from my Pixel 2 XL using Tapatalk
 
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JamesAB

JamesAB

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Thank you for your replies. There seems to be a difference of opinion as to whether or not to push on the knee to straighten the leg. I can't increase my stride because I can't walk. The exerciser and Pilates are helping me. In fact today I note that my leg feels more like a leg and less like a lump of lead. My surgeon seems content that he has fulfilled his part but he will see me again in five weeks and if there is no improvement he will refer me to someone who can deal with the problem. It is indeed crummy not to walk and sitting down for weeks on end is soul, never mind body, destroying. Pilates is regaining my overall strength and I am optimistic about the future. Fortunately I have a treasure of a wife who really looks after and motivates me.
 

Roy Gardiner

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When I had extension issues (10 degrees), I had my husband push down on my knee, covered by a pillow, and work on extension very gently. Those ligaments in back complained and he knew to go slowly and stop soon as I said stop. I got full extension but it came slowly. I assume your surgeon is on top of this and there's a plan.
We recommend no pushing or pulling on the knee.
There seems to be a difference of opinion as to whether or not to push on the knee to straighten the leg.
There is indeed a difference. I favour the idea of assisted stretches as described above and pictured here http://bonesmart.org/forum/threads/rom-and-extension-stretches.13159

As always, 'no pain, more gain' is key.
 

Izabel

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Hello @JamesAB and sorry to hear of your difficulties.

I had problems achieving full straightness on my leg and,, like you, cannot do long strides as I cannot walk either as I currently have a spacer rather than a hip due to infection with no weight bearing on that leg. I now have full straightness because I did it slowly by pushing my knee into the bed, using what little strength I had in my leg, and holding it for a count of five, then release and perform again for a repeat of ten counts. I still do this every morning when I wake and at various times throughout the day. It took me at least 10 weeks before I reached zero on straightness.

I too have a peddler and started with rocking back and forth then progressed to full rotation backwards for 10 repetitions and this past week I have really progressed to full rotation forwards. So now I do 5 minutes, 10 backwards, 10 forwards, 10 backwards and so on. I have really gained muscle in my calves and thighs as I had atrophied dreadfully.

This is a long and frustrating journey but with persistence and patience we will get to a good place ... but I must admit the patience is the hardest part!

Hang in there.
 
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JamesAB

JamesAB

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Thanks for a most encouraging reply.
Jim
 
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JamesAB

JamesAB

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Thank you, Jacey. I hope I can build on it.
 

donnag1108

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Awesome!! I am finding for myself these little victories are what keep me going!
 

Celle

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Although you're concerned about it, @JamesAB , it's actually not unusual for extension to take longer to achieve than flexion. That's because of the large muscles and tendons at the back of your leg that have to be stretched gradually and gently.

It sounds as if your extension is making some progress and that's good.

There's no need to rush to get ROM, either flexion or extension, 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

This article may help with extension:
Extension: how to estimate it and ways to improve it
 
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JamesAB

JamesAB

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Tried to walk with a Zimmer today but knee hurt too much when I put weight on it. Will try again tomorrow.
Thought I'd help out by doing the ironing (one of the few things that can be done sitting down.) It took me several hours at the end of which time my leg and foot had swollen like a balloon. It doesn't seem to happen when I sit with the leg stretched out?
 

Celle

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Thought I'd help out by doing the ironing (one of the few things that can be done sitting down.) It took me several hours at the end of which time my leg and foot had swollen like a balloon. It doesn't seem to happen when I sit with the leg stretched out?
Sitting with your leg down will make it swell. That's why we advise that you elevate as much as possible.
 

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