TKR Dr says trust the knee? How when it's unstable and gives out?

DEL2022Jun-25

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My Dr's PA recommended bike riding to tighten up the muscles around the knee. I didn't ask if she meant stationary or road bike but I doubt it matters. There have been many postings about how to get the bike set up if you aren't using a bike already.
Probably stationary, unless you're a long time regular rider and you live in an incredibly super safe area with no traffic, hills, or crappy streets.
Stationary because if you fall, then the stakes are high. You should ask what type of bike -recumbent or upright? How long? Interval training or just straight riding? What other exercises and muscle groups are you going to work out? Post surgery, it's best to work with a trainer who understands how best to help those who are in the recovery process.
 
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mtnplayva

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My Dr's PA recommended bike riding to tighten up the muscles around the knee. I didn't ask if she meant stationary or road bike but I doubt it matters. There have been many postings about how to get the bike set up if you aren't using a bike already.

Claire56 - I don't have a bike to use but have thought about joining a gym just to use theirs. Our street is very hilly so I wouldn't be able to use a regular bike outside and don't think I could get my leg over it anyway! We bought an elliptical machine before my surgery - wish we had bought a bike instead!
 
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sistersinhim

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I found a recumbent bike much less stressful for my knees, butt, and back. The upright hurt my knee so I bought a recumbent from Amazon. At first, all I could do was to rock my feet back and forth. Before long I was able to do a backward rotation. Eventually, the forward rotations came about! I started with the seat all the way back and had to raise up my butt on my surgical side. After a few weeks, I was able to do it without having to raise my hip up. Soon the seat could be moved forward some. I loved to see those improvements! You will, too.
 

DEL2022Jun-25

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have thought about joining a gym
Hey there! Commercial and even private gyms are a real mixed bag. They will have the machines you need, but the staff may not be experienced on how to work with someone recovering from this surgery without putting the wrong kind of stress on your joints. If I were looking for a gym, I'd probably ask a lot about the trainer's background, where they trained, what sorts of people they worked with.

Check first with all the medical centers in your area, to see if any of them have wellness classes that have classes for mobility and strength or for people with osteoarthritis. You can also look for classes like "Twinges in the Hinges" which are aqua aerobics classes geared toward those with joint issues. Many times you can use your health insurance to get a discount on the monthly fee (Silver Sneakers for those over 65). Most of the classes are 3 months in duration, and if you haven't worked out in a long time or ever, they are a good place to start before going to a commercial gym.

Your workout will have: Warmup stretches, strength building with freeweights, bands, or machines, cardio training with either machines or gait training, and cool down with stretches. It can only take an hour and be done 2-3 times a week. It's not just the bike it's what comes before and after for a balanced workout. That's why little brain farts like what the PA said are so incomplete and ultimately not very helpful to someone just starting out.
 
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There are also outfits organized like gyms or health clubs, but that are outfitted with equipment appropriate to rehab and people with special needs, with staff that are trained appropriately. They are unfortunately more expensive that regular gyms.

My father belongs to one. He is 91 and is recovering from a broken kneecap. In addition he has nerve issues in his hip and back. It is working very well for him.

If all you need is an exercise bike it is probably cheaper to buy one but these options exist for those that need them.
 

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Has anyone heard of buckling happening this late in the recovery?
When is your next appointment with your surgeon? It might be a good idea to let him/her know this is still happening.
 

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Lots of good advice here. I managed an upright bike with zero resistance but had to just rock the pedals for awhile, then circle my legs backward for a couple weeks before I was able to do a complete rotation forward. I also felt better when I made it to the pool- walking and stretching and gentle exercises for the first couple weeks. Keeping a log of my exercises and how I felt the next day helped me to stay patient.
 
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mtnplayva

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Has anyone heard of buckling happening this late in the recovery?
When is your next appointment with your surgeon? It might be a good idea to let him/her know this is still happening.
It's next week - I've been in a few times and he keeps saying it is just going to take time. I told him PT thought it was neuromuscular and he said that they were just grasping at straws :(
 
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mtnplayva

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Well not good news from the doctor - he's extending my leave for 6 weeks. He feels instability in the knee when it is slightly bent, which is probably causing the knee to buckle when I walk and the sensation that it will buckle on every step. He said they can do another surgery to put a wider piece of plastic in there but they don't like to do that until after a year. He thinks I should be able to compensate for the movement by strengthening the quads more. So more PT, working on my gait and reducing my reliance on the cane. I'm happy to know it's not all in my head but not so happy about the thought of another surgery in the future.
 

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We’ve had members get the spacer exchanged for a different size and did well. I’m sorry he wants to wait so long to do that, if that’s what it needs, but it will give you more time to heal, as multiple procedures in a short time can take quite a toll on the knee. Also, waiting gives your knee time to improve, which might be all it needs, which could avoid another surgery.

Just be careful with the PT. You are still healing, so don’t work too hard with it, and don’t do anything that increases pain and swelling, as that will be counterproductive. Too many PT’s really don’t understand this year long healing process for this recovery.
 
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mtnplayva

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Just be careful with the PT.
I found that out earlier in the week - he said my ROM wasn't good enough (it's been 115 for weeks now) so he tried pushing my knee. I stopped him and told him he wasn't going to do that. I am happy with 115 so I don't care if it increases. He was not happy but I really don't care!
 

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Good for you for stopping him from continuing to bend your knee. :yay:

My surgeon moved my knee too far at every check up. He wasn’t rough about it, but it still hurt. At my 4 month check up he wasn’t happy with the 124 measurment he got, because at the previous appointment he had pushed it to 128. Note I said, he got that number, not me by myself. No way could I bend it anywhere near that number by myself. So at this appointment, he did it a second time. I told him twice it was too far, but he wouldn‘t release my leg and I actually couldn’t move it myself from that much of a bent position, laying down, especially with him holding on to it. I was so angry. It was the last time I let him do that. My next appointment was at 7 months, and I ”declined” to get up on the exam table, but I stayed sitting in the chair in the room, and bent my leg myself. I only saw him one more time, at my one year check, again declining to get in the exam table, which he was not happy about, and I will not go back to him.

Your ROM most likely will continue to improve, as you are still healing, and will for quite a while. My ROM continued to improve well into my second year, as my whole leg continued to heal and relax.
 

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