TKR Finally discharged!

Cleo

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I only have a 70 degree bend at 8 weeks post surgery.
I have been given extra physio sessions and the consultant has recalled me early.
Has anyone else managed to improve a bend like this without MUA?
Advice please.
 

sistersinhim

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Welcome to Bonesmart, Cleo. You are at the best place to learn all about the recovery from a knee replacement. When exactly was your replacement? Which knee and was it a total or partial?

I only have a 70 degree bend at 8 weeks post surgery.
I have been given extra physio sessions
You are doing fine for only 8 weeks out. The normal recovery from this surgery takes a year. Your ROM will continue to heal as your knee heals and the swelling goes down. Extra exercises does not help to increase your ROM, it can hinder it and even cause it to go down. As you are healing all you need to do are gentle movements and lots of icing, elevating, and resting. Your knee isn't in bad shape, it is healing from a very traumatic surgery. Time is your best healer, not exercising.
 

sistersinhim

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Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax and let it. Don't try and hurry it, don’t worry about any symptoms now; they are almost certainly only temporary.
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when the pain starts!)​
3. Do what you want to do BUT...
a. If it hurts, don't do it, and don't allow anyone to hurt you.
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again for a few weeks.
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.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep
 
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Cleo

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Hi
It was a total left knee replacement carried out on 17th March.
 

sistersinhim

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Thank you. I will add that to your signature for you. Knowing these things will help us to better advise you.
 

LadyN

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My knee was at 60 degree bend at 6 weeks and 9 weeks, I’m having an MUA next week at 13 weeks post surgery. I’ve been doing exercises and physio the whole time….my surgeon told me to keep trying but said in his opinion nothing would change….and sadly he was right. That said I’ve read if lots of people who’s ROM seemed to stall and then suddenly it started to improve again. Good luck. My MUA was supposed to be done sooner than this but the surgeon was unexpectedly gone for 3 weeks.
 
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Cleo

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Thanks for this, I hope that your MUA goes well. Keep me updated.
 
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Cleo

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I am 12 weeks post surgery with only a 70 degree bend. The physio today advised me to read up on MUA prior to my visit to the consultant next week.
My first question is - has anyone here managed to improve on a 70 degree bend this time after surgery without MUA?
My second question is what are people's experiences of MUA?
 

Layla

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Please notice that we have merged your newest thread with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting. Please post any updates, questions or concerns about your recovery here.

The physio today advised me to read up on MUA prior to my visit to the consultant next week.
I do know that time brings an increase in your range of motion. As the swelling dissipates and tissues begin to heal, you will notice your range of motion increase.

Here is some info from the BoneSmart Library on MUA - I’m sorry I can’t answer your question on MUA as I’ve not experienced it myself, but I’m sure others will stop by to share opinions.
http://bonesmart.org/forum/threads/mua-manipulation-under-anaesthetic-and-adhesions.3656/

http://bonesmart.org/forum/threads/manipulation-for-stiffness-following-tkr.30349/

http://bonesmart.org/forum/threads/mua-the-ineffectiveness-of-early-mua-jbjs.13786/

https://bonesmart.org/forum/threads/who-is-more-likely-to-need-an-mua.69153/
 

Jockette

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Can you tell us more of your knee’s history?

Is this it’s first surgery?
How much pain and swelling have you had in this recovery?
What was your bend the years leading up to this surgery?
What exercises are you doing, both home and at physio?
What are your activities throughout the day?

All of the above can affect how soon we regain our bend.
 
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Cleo

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First surgery, lots of pain and swelling, could bend 120 prior to surgery.
Heel glides, stretches, leg raises, static peddler as far as I can, step ups - all at home.
Similar with physio with the addition of cross trainer.
Normal daily activities, including one or two 15 min walks outside.
 

Jockette

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None of that seems excessive, so that’s good. Sometimes overworking the rehab can keep our knee upset, inflamed and swollen, all of which can affect bending progress.

Are you still doing all those exercises? If you are, I suggest stopping all of them. Let your knee relax and continue to heal. Often, for a lot of us, less is more with this recovery. Your knee will get enough movement just going through your day. This type of movement is what I call “natural PT.”

Spend more time resting, icing and elevating, which will help your knee heal.

Keep in mind that 12 weeks is 25% of full recovery, in this 52 week (one year) recovery. Where you are now is not where you will end up.

Some of us do have soft tissue that does develop adhesions. An MUA will address adhesions, which will make it successful.

However, if you don‘t have adhesions, and the issue is ”just” swelling and the need for more healing, then the MUA might give you some immediate increase in ROM, but if that doesn’t last, then the issue is indeed swelling and the need for more healing.

Layla gave you good links of information, so read through those.

Here is a list of other members who have had an MUA, so you can see those who had success and those who didn’t.
 

2hips1knee

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I had an MUA after 10 weeks rtkr because of a flexion of 70 or 80 degrees. I had improved flexion the next couple days, to 108. Two weeks later, and my knee is tight again. It could be that I had, past tense, aggressive PT, and decided to do my exercises at home. I had the MUA done in hopes it would solve my problem with the bend, but it seems short lived, for me. Like everyone has said on here, everybody is different and there is no exact time frame to get back to somewhat normal again.
 

Jockette

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@2hips1knee Welcome to Bonesmart!

You are a good example of the temporary increase in ROM after MUA, but then the original issue happened again, which is swelling, and time to heal.

Why don't you start your own thread and tell us a bit about your situation. Our members are here to support you. Here's a link to Starting a new thread and posting .
 

sistersinhim

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My first question is - has anyone here managed to improve on a 70 degree bend this time after surgery without MUA?
There is no set time limit on ROM improvement. If it's pain and swelling that's keeping your knee from bending well, then a MUA will not help it and will actually cause a setback because your knee will be traumatized again from the forced bend that it's not ready to do. That will increase the swelling inhibiting the bend.

I suggest you cut out all exercises and just do the things you have to do around the house and yard. As Jockette said, this is PT, too. That is all I did after 12 knee surgeries and my knees are bending just fine.
 
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Cleo

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My physio measured the bend of my knee at 80 degrees yesterday and thought the consultant would recommend a MUA. However I saw my consultant today and he said that as I was making progress I can just carry on with the prescribed exercises as there is still time to make ROM gain so there is no immediate need for MUA. Phew!
 

Layla

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Hi there, Cleo :wave:
Great news! Thanks for updating us. I hope you continue to enjoy steady progress.

Please notice that we have merged your newest thread with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting. If you’d like us to change your thread title, let us know and we’ll be happy to oblige.

Please post any updates, questions or concerns about your recovery here.
All the best as you continue the journey!
@Cleo
 

Jockette

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That’s great that you have a doctor who is willing to let you recover at your own pace.

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!) :egypdance:
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" :yes:

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 
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Cleo

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My surgery was on 17th March and after a slow recovery bend wise I was finally discharged by my consultant on 15th September with no need to return as I can now fully straighten my leg and bend is just short of 120 degrees. I thought I'd never get there and to be honest the consultant said that he thought he would be having me in for MUA.
I was flattered that he asked what I had done to help turn the corner. It was one to one Pilates lessons especially tailored to my needs, then progressing onto group lessons that helped me but I do realise that this might not suit everyone.
Anyway I just thought I would post so that anyone who is struggling knows that it is still possible to make progress a while past surgery. At 12 weeks my bend was 88.
 

Jockette

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That’s great that you bend has improved! It might even continue to improve over the next year or more. Mine did!

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery! :flwrysmile:
 
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