TKR Clonking knee cap 9wks post op

[BundyGirl]

Hello all.... well i thought i was going well as im 18 weeks on Monday and the knee is no longer clonking..... BUT.... I can't get the knee straight the knee is approx 8 degrees sometimes 15 degrees qway from being straight and won't go. The knee is still swollen and the muscles are very sore. The surgeon is talking going under again and making it straight. Can anyone tell me what this is like? Whats covery like? Just what can i expect?
Thanks

 

[Izabel]

Hello all.... BUT.... I can't get the knee straight the knee is approx 8 degrees sometimes 15 degrees qway from being straight and won't go.

Hi @BundyGirl ... I just LOVE The Minions .

I am just 3 days away from you. Had 90 bend at 3 days but for the life of me cannot straighten either, like you at varying degrees. It is very frustrating indeed. I have tried everything recommended but will let you know if and when I find the cure.

 

[chicklet]

Are you icing and elevating your knee? The swelling could be contributing to it not being totally straight. Are you doing a lot of exercising?

Plus - time. I know it feels like an eternity to you (and to me!) but you’re only 4 months into a year long (or more) recovery. Maybe your knee just needs more time.

 

[BundyGirl]

Ive backed off on some of the exercises... i want to see if that will help and reduce the swelling. But then im also worried if that will be bad as well.... thoughts?

I currently ride exercise bike, walk and general life plus physio exercises

I don't go back to surgeon for 8 weeks so hopefully i'll improve more by then

 

[SusieShoes]

Extension (getting straight) involves stretching the big tendons and muscles at the back of the leg. These shortened during the time when your knee was bad. Maybe you didn’t walk a lot. Maybe you had a limp? The hamstrings are thick and tough and it takes time to get them to stretch back to full length.

It sounds like you are doing the right kinds of ordinary exercise. Walking is a good one for extension. If you want to work specifically on extension, keep the exercises gentle but work regularly on stretching these tendons and muscles. The key word is “gentle.” Aggressive exercise, and especially the use of force, risk injuring the tendons and muscle. TKR is difficult enough without that!

Here is an article on Extension and Ways to Improve It.

 

[BundyGirl]

Extension (getting straight) involves stretching the big tendons and muscles at the back of the leg. These shortened during the time when your knee was bad. Maybe you didn’t walk a lot. Maybe you had a limp? The hamstrings are thick and tough and it takes time to get them to stretch back to full length.

Before i had the op i was walking 5ks most days but yes had a bit of a limp.
The calf muscle is where im getting all the pain now. I go have massage every other week and she works on it and agrees it's very tight. Is her working on it a good thing or is it bad?

My usual physio is away at the mo and her fill in guy was ****. He said all the muscle tightness was in my head and then he proceeded to try and force the knee down. My surgeon was angry with this and said im not allowed to see him any more.

So ive missed the last 2 weeks appointments eeeek. Im scared to go back till my one gets back.

Your article was good im just feeling confused, unsure on how to handle it now and yeah scared

 

[SusieShoes]

I hear you. It’s difficult to know what to do when you get conflicting information.

Your surgeon is right: no forcing the knee! That’s how knees and their surrounding tissues get hurt. But you can gently coax them.

Massage shouldn’t cause your calf to get worse. You could try resting it for a few weeks, maybe use heat to relax the calf muscle. If the massage is helping, though, why stop?

I say wait until your trusted regular PT is back. You won’t lose any ground. Rest might actually help. Above all, you should only work with someone you trust!

 

[BundyGirl]

Thanks Susie!!!
Im going to hold off on rushing back to physio.... I've just done a heap of reading on here. Going to work on how i actually walk and make sure it's heel to toe.

I actually don't think i ice my knee enough. I was on the belief i didn't need to do it any more since i'm 18 weeks tomorrow since op... but i take it because it's still swollen and warm i should be still doing it? Elevation means raising leg up as in higher than waistline right?

Sorry 20 questions... i also only take ibuprofen now and then... should i be on more of an anti inflammatory med?

 

[SusieShoes]

There really isn’t any rush. My knees were warm for about five to six months (the left longer than the right) and I iced daily after any exercise for several months. The day came when my knees found icing quite unpleasant, which told me they no longer needed it. The way I look at it, this recovery takes as long as it takes and I would go along with whatever was working well for me... and in the end my knees would be forever. That’s how it played out. My knees are great now and I don’t have to do any icing or monitoring my activity or any of that.

But I did have to do those things for as long as I needed them!

NSAIDs like ibuprofen and naproxen (Aleve) are not good meds for TKR. They’re rough on the gut, for one thing, and they’re actually contraindicated by many doctors for early TKR recovery (there’s evidence they inhibit bone growth). If you can rely on icing to ease inflammation (it’s pretty good for that) and Tylenol for pain, that’s the approach with the fewest potential problems.

 

[Celle]

Hello all.... well i thought i was going well as im 18 weeks on Monday and the knee is no longer clonking..... BUT.... I can't get the knee straight the knee is approx 8 degrees sometimes 15 degrees qway from being straight and won't go. The knee is still swollen and the muscles are very sore. The surgeon is talking going under again and making it straight.

First off, I would say a definite NO to rushing back into surgery (what's his rush?). It's quite normal for extension (straightening) to take longer to achieve than flexion (bending).
As SusieShoes said, that's because the big muscles and tendons at the back of your leg have to be stretched gently and gradually.

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

Ive backed off on some of the exercises... i want to see if that will help and reduce the swelling. But then im also worried if that will be bad as well.... thoughts?
I currently ride exercise bike, walk and general life plus physio exercises
I don't go back to surgeon for 8 weeks so hopefully i'll improve more by then

I also think it's a good idea to cut back your exercises. Just let your daily activities be your exercise, and concentrate more in reducing the swelling with lots of rest ice and elevation.

You can help to stretch the structures at the back of your leg if you extend your stride a bit when walking.

My usual physio is away at the mo and her fill in guy was mess. He said all the muscle tightness was in my head and then he proceeded to try and force the knee down. My surgeon was angry with this and said im not allowed to see him any more.
So I've missed the last 2 weeks appointments eeeek. I'm scared to go back till my one gets back.

I agree with your surgeon. That fill-in guy was a bully and he's probably caused some of your problem.
Sty away from PT for a while.

Have you read this article?
Extension: how to estimate it and ways to improve it

 

[Celle]

PS: This is your knee. You're the on.y one with the right to say what happens to it. Others, such as your PT and your surgeon can advise, but you have the right to choose whether or not to accept that advice. Do what feels best for your knee.
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

 

[BundyGirl]

Celle and Susie Thank you!! I couldn't sleep last night because of all this... i was feeling ill and freaked out. This is a work related injury so that's another reason why i feel pushed and have to do all these appointments and gym sessions.

Ive just woken now and decided to just pop my sneakers on and go walk around the shops... do my bits and pieces for the day then rest it. Ill elevate and hit the knee with ice. Ive woken and the knee is swollen and stiff

So im on my 2 days off from work at the mo so will concentrate on these things for now. Still feel a bit blue and worried about it. But definitely glad i turned to the forum for support.... wish I'd done it a few weeks ago.