TKR First Goal After Serious TKR Complication

[sistersinhim]

I have had both kneecaps removed, one in '91, and the other in '93. Because of the extra length of the patella tendons with no kneecaps there, they had to be shortened. Each leg was put into a total leg immobilizer for 6-8 weeks each. I was worried that my knees wouldn't bend again, but they did. I never took PT, I just did my normal daily activities the best I could. I wasn't able to do too much at first but as I healed, I was able to do more. Moving more caused my bend to come in naturally. I never forced it, it just came back.

I'm sure your knee will bend just fine. But, let it do it on its own. No forcing it, that will not help at all and possibly cause you a setback. Try not to worry, you will be fine, just be gentle with it. I think you'd be better off not even going to PT for at least a month or so and maybe not at all. The more time your knee can settle down, the better. Remember, you are still in a healing mode from your TKR, too, so that's a double healing your body is concentrating on. Keep it easy!

 

[Layla]

Hi Neecey,
Best of luck in PT this week. Go slow and easy. Don't let them hurt you.
Happy Two Month Anniversary and a great week to you!
@Neecey

 

[Neecey]

I see my surgeon in one week and I’m worried that he’s going to want to do an open MUA. Long story short, I had TKR on 1/26. Two weeks later while in PT I suffered an avulsion fracture of the patella. Knee immobilized for 8 weeks. My ROM today (5/1) was 75 (I was at 41 a month ago), but I only gained 3 degrees this past week.

My surgeon warned me that immobilizing the knee would make it very hard to regain my ROM and I might need an open MUA, as he would not do a closed MUA on me due to what happened to the patella which shows a definite risk for a closed procedure.

I hate the idea of opening up the knee again. It healed beautifully and I so worry about infection. Wondering if anybody has had an open MUA and if so why did the doctor do it open and what were your results?

 

[Jaycey]

@Neecey The choice as to doing any procedure is your's and your's alone. No one can force you to have MUA. I agree with your concerns. Infection and the risk of another fracture are both pretty valid reasons to avoid open MUA.

 

[sistersinhim]

I agree with Jaycey. There is too much of a risk of refracturing your kneecap and of getting an infection to even consider a MUA, opened or closed. I was in an immobilizer on each knee for 6-8 weeks, so I know what you are going through. You have all the time in the world for that bend to come back. To assist my bend at around the 10th week, I got into a deep tub of very warm water. I put my knees under the water and rubbed them. I then brought them up and slid my butt forward to aid in the bend. This helped me quite a bit. I never did any exercises or went to PT, just used my knees naturally and my ROM came back on both of them just fine. Yours will, too, but it just takes time. Don't try and push it, you'll only set yourself back.

 

[Neecey]

I sincerely appreciate your response. May I ask why you were in an immobilizer? Was it related to a TKR? I’m worried that-since my progress slowed precipitously this past week (improved only 3 degrees and that was with PT’s help)- I’ve done all I can do and need an MUA to achieve a functional knee. Di you remember how long it took you to return to a functional ROM?

 

[DogTiredKnees]

@Neecey, I haven’t had an open MUA. Just a usual closed one.

I sustained an MCL avulsion fracture during knee revision surgery, and am still wearing my hinged leg brace 24/7. On Friday it will have been 7 weeks. My flex was 80 degrees last week, but like you I am concerned about causing another fracture, once the brace is off and I’m back working on my knee flexion.

Wishing you a speedy recovery, I’ll be following your updates.

 

[Neecey]

Ouch -I feel your pain! I’m so sorry. Were you at 80 before the revision surgery, or have you been working on your ROM since they put you in the brace? My doctor removed the brace at two months and that helped a lot but I still have a long way to go. I totally understand your worry.

 

[sistersinhim]

May I ask why you were in an immobilizer?

I had both kneecaps removed at about 18 months apart. When they are removed, the patella tendon was way too long and had to be shortened. My first one, on the left knee, was cut off and sewed back together. The right one was wired together. These tendons needed to heal before any bending was allowed. It felt so good to get those hot things off of my legs. They were full-legged! Once off, I'd bend just a little bit and it felt so good!

I’ve done all I can do and need an MUA to achieve a functional knee. Di you remember how long it took you to return to a functional ROM?

I really can't remember the timeframe since they were done in the early 90s. I never stressed about not being able to bend them. I knew it would happen in time. I had already had 4 knee surgeries by then and knew how my knees worked! I was able to do what I needed to do and the bend improved a little each week.

Try not to worry about it so much and don't force that bend! It will come naturally.

 

[DogTiredKnees]

Thanks, @Neecey

Were you at 80 before the revision surgery, or have you been working on your ROM since they put you in the brace?

I was between 60-80 on a really good day before the revision surgery. But extension was about 15. I’ve been doing a few mild stretches since the surgery, but nothing major as the brace is quite restrictive and I am only partially weight bearing. Also have fractured femur and tibia

 

[Layla]

Hi Neecey,
Happy Four Month Anniversary!
I hope you have a nice holiday weekend!
@Neecey

 

[Roy Gardiner]

my surgeon gave me the OK to resume PT next week

he said just do what my body allows me to do -no machines and no PT pushing to bend my knee

No PT even touching it, IMO. Get them to show you the exercises, then do them to the point of discomfort, not pain

my progress slowed precipitously this past week (improved only 3 degrees and that was with PT’s help

Hope they weren't pushing you! Progress will I'm afraid be slow, your body will have adapted to reduced ROM. BUT you will get there.

 

[Neecey]

(NOTE: I apologize that I have yet to figure out how to attach this to my original thread in the recovery forum. Pls move it as necessary.)

Just wanted to share that everything I’ve read on BoneSmart regarding taking it easy on PT and letting time and healing do the job has been absolutely true with my recovery from a “potentially devastating injury” (my surgeon’s words) two weeks after my TKR. My knee was immobilized for two months starting two weeks after my TKR due to an avulsion fracture of the patella while using a “bender” machine in PT. The brace was removed 4/12 and my knee was very stiff. Today-7 weeks later-I reached my first goal of a 90 degree bend! Granted, this was after an hour of PT but still it bent 90 degrees!!!! My PT told me I exceeded his expectations and he thinks I can easily reach 100 degrees by the time I see my surgeon again in 3 weeks. (Note that I could only bend 90 degrees before surgery).

I’ve worked hard in PT but I refused to use straps to force my bend and of course refused to get on that “bender”
machine again. My PT has been super gentle with the knee as well. I think a major help has been the pool, which I now do 3X/week- mostly water walking but also squats, knee bends, etc. SO helpful and pain free!!

I’m not 100%!yet but I finally shed my walker and now only use a cane outside of my home. I pray each and every day for protection from another complication and I do my exercises religiously. I’m driving again and am starting to see the light at the end of the tunnel.

So thankful I found BoneSmart to give me encouragement through a very dark time in my recovery.

 

[Layla]

Hi there Neecey,
Thank you for your inspiring update and your kind words in regard to the forum!
It is wonderful to read of the progress you've made. You've been on quite the journey, but things are looking up.
I wish you a wonderful Summer 2023!

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.

How can I find my threads and posts? I hope this helps!
@Neecey

 

[DogTiredKnees]

So glad to read that you achieved 90 degrees, @Neecey. That gives me hope!

I wore my leg brace for 11 very long weeks following my MCL avulsion fracture. Like you, I was concerned about how my knee would cope once normal activities resumed. It’s been 12 weeks since the revision surgery and I’m still on 2 crutches with a very stiff knee.

Reading your positive update has definitely cheered me up

 

[Neecey]

Hang in there!! It’s SO hard, esp when you see others who had the same surgery up and about in a few weeks. Just yesterday a friend who had her right knee done ten days ago drove herself to church and was barely limping!

I’ve found just trying to use the knee in everyday situations helps the most. I also dangle the leg over a high bed or a double cushioned chair (or on the table at PT) helps the most. That and water walking in the pool. I think the last few degrees will be the hardest, as last week I was still at 90 and seemingly made no progress. Gotta keep pushing it though!

Keep us posted on your progress. It will come but it will be s-l-o-w.

 

[sistersinhim]

Gotta keep pushing it though!

Actually, sometimes that can have the opposite effect, causing more inflammation and swelling. That will reduce your bend. Time and gentle everyday movements is the best PT!

 

[Jockette]

My knee was immobilized for two months starting two weeks after my TKR due to an avulsion fracture of the patella while using a “bender” machine in PT. The brace was removed 4/12 and my knee was very stiff. Today-7 weeks later-I reached my first goal of a 90 degree bend!

I’m so glad you’re coming along well.

@FionaW here’s another member with a broken patella.

 

[DogTiredKnees]

Thanks, @Neecey

 

[FionaW]

Thanks @Jockette