MUA Coming up for 12 months and still not so great. Anybody else?

MarkR

new member
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Hi everyone from sunny Western Australia,
I am 62 and ten weeks in from my TKR left knee surgery.
Early recovery was hell but at this point I am much more comfortable and active; walking the dog every morning with a crutch and swimming 500m twice a week (no kicking yet). Going for physio every second week.
My ROM was 100 deg four weeks ago at which point it has completely stalled and stubbornly refuses to improve despite lots of daily stretching.
I still have pain and swelling (4cm bigger in circumference than my good knee) which I wasn’t really expecting at 10 weeks.
When I bend my good knee the patella and surrounding skin all move around loose and easily but in comparison my operated knee is tight like a cricket ball. The skin covering it is so tight that it feels like it will burst when I try to bend it past 100 deg. Not sure what I can do to remedy this. Have been rubbing moisturiser into it in an attempt to make it more elastic?
Feeling pretty despondent about my progress. Looks like I will be a good candidate for an MUA.
Would very much welcome any feedback and encouragement as my family are thoroughly sick of me endlessly discussing my knee problems.

Best Regards,
Mark
 
@MarkR :welome: to BoneSmart

Although you are already 10 weeks post surgery I have attached our BoneSmart guidelines.

Knees all take a long time to heal, each knee and every surgery is different, in 2019 I had my first replacement left knee, it took a good year before I could finally say it was successful and I still have days that it reminds me that it is an ongoing healing process, my right knee was replaced just over 4 months ago, very different experience than my left, but I'm not worried as its a long way yo go still.

Swelling is what stops the knee from bending, the more we force and the knee is not ready it will swell - catch 22 I'm afraid, the only remedy is :ice: and lots of it, make sure you are icing all sides for a minimum of 45 minutes several times a day, rest & elevating is important too, don't overthink things, it will get better and the bend will improve once the swelling subsides.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose

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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


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.
 
Hi MarkR. Your recovery seems to be on track to me. I'm 5 months in recovery from a TLKR and it has been a roller coaster ride of both physical and mental issues. I never thought it would take this long to recovery but every day things have improved. Take care of yourself and recovery will come slow but sure. Jcx
 
@MarkR , I am in a roughly similar spot with similar symptoms.

From your description it seems that your lack of progress is caused by the presence of the swelling. An MUA will not fix swelling, but is only useful if you develop adhesions or other scar tissue formation.

I think you may be getting too much exercise. You may find that if you rest and ice more the swelling will go down and the RoM will improve.

Recently I got sick and pretty much stayed in bed for 5 days. My knee shrunk one cm and my RoM improved by 5 degrees.

Maybe try giving you knee a break for one week and see what happens?
 
I agree with the others that your knee is likely swollen because of too much activity. My first knee recently became very stiff and uncomfortable after a year. I had been doing lots of work outside and my knees were telling me they weren’t very happy with me. I cut back on the amount of time I was working and when I finished, elevated and iced. The issue eased up and I now pace myself better, still elevating and icing when I’m done.
 
I am 62 and ten weeks in from my TKR left knee surgery.
Hi and Welcome!

Please tell us your surgery date and we’ll make a signature for you. :flwrysmile:

Most doctors won’t do an MUA once you’re past 90, so stop thinking about that. WFD is right, an MUA doesn’t fix swelling.

Cut back on your activity, including exercises for ROM, and try to relax. This is a year long process. Where you are now is not where you will end up.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
Thanks very much for all your valued comments.
I had perceived that more activity and exercise were signs of my recovery improving.
I‘m inclined do much more now as my health improves.
I think I will have to re-evaluate that line of thought and try resting up with more ice and elevation.
A week with little to no exercise and lots of ice would be well worth trying.
My surgery date was 15th Feb 2022.
 
Good plan. I had the same situation. Same place for a couple of weeks and it I worked my knee it would swell and stiffen more.

I’m at 16 weeks and a few weeks back the swelling went down and that made a big difference. Stay patient- I struggled with that. Aqua phys therapy helped me but time was probably a factor too.
 
If anyones interested and may be in my current position:
I had a week with lots of rest and ice. No stretching or exercise.
swelling and pain were very significantly reduced.
Feeling good but stiff and ROM back to 90 deg.
Had a check up with my surgeon this morning. He has booked me in for an MUA on Fri morning. He says now is the optimum time to carry it out.
If my ROM is still poor in a couple of months it will be that much harder for an MUA.
Wish me luck. Hoping this isn’t going to set me back too far.
Will report back.
 
Best wishes with the MUA. It will cause a bit of a setback, as quite a bit of force is used to do an MUA, so there will be new soft tissue trauma. However, there is no incision or the other traumatic things done during the original surgery, so recovery will be better.

Is the correct date for the MUA May 20? If so, we’ll add it to your signature.
 
Hi everyone and thanks for your kind thoughts.

Went into hospital Fri for my MUA followed by 18 hours in a CPM machine.
Not the best experience. Sore from the MUA and the machine ran through the night pushing my ROM to 125 deg. Needless to say I didn’t get any sleep and arrived home feeling like I had been run over by a train.
Three days later I am seeing a new physio and my ROM is about 120 deg.
I am doing everything I can to hang on to this ROM. If I can do this all the pain and effort will have been worthwhile. Feel like I have been set back a few weeks in terms of swelling and pain but remaining optimistic as always .
 
Went into hospital Fri for my MUA followed by 18 hours in a CPM machine
:flabber::flabber: I'm not surprised you are feeling like a train ran over you. I hope it will be worth it in the end for you, but to me it sound extremely excessive and forceful.
Praying that your knee will recover and your bend improves, make :ice: your very best friend and allow your body /knee to heal, I would suggest rest and elevation but I think your surgeon & physio team may just push you to get the numbers they want.
 
Not the best experience. Sore from the MUA and the machine ran through the night pushing my ROM to 125 deg.
I declined having an MUA at 8 weeks because my knee is still swollen mostly from PT. I couldn’t imagine that brute force would make my knee any better. My thoughts are with you for speedy healing and good end results.
 
Went into hospital Fri for my MUA followed by 18 hours in a CPM machine.
Not the best experience. Sore from the MUA and the machine ran through the night pushing my ROM to 125 deg. Needless to say I didn’t get any sleep and arrived home feeling like I had been run over by a train.
I agree with @Sara61 this sounds excessive. Make sure you also take time to rest, ice and elevate.
 
I wish you well as you work to retain your range of motion! I too am having an MUA on June 9, but I have heard nothing about this machine that you’re talking about. I have been told that I will be sent home and go to PT right after the procedure. PT will continue every day for two weeks as I fight to keep the range of motion acquired through the MUA.
 

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