Bilateral TKR Flexion Splint

bturner425

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Has anyone used a flexion splint to increase flexion and extension? My doctor recommended one and I have to go through my physical therapist to get one.
 
Hi, welcome to BoneSmart.

I never heard of one, and there are a zillion stretching exercises one can do for both flexion and extension. Doesn't mean it won't work, though, might be worth a try if it's not too expensive; it's what works for YOU that counts and every knee recovery is different.

You don't say when you had surgery, so here's our general info just in case it was fairly recent.

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
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.
 
Will you tell us when and which knee you had your surgery on? We will add it to your signature. Knowing those things will help us to better advise you.
 
Bilateral total knee replacement. Revision on Right knee. Removed Makoplasty on medial side tha t was installed in 2016. Had all this done June 18.
 
Hi and Welcome to Bonesmart.

I have a partial, also, mine is a Patellofemoral.

Why was yours revised?
 
It should have been a total to begin with. In two years the rest of knee deteriorated from arthritis and the prosthetic started to misalign. It really hurt.
 
Wow, I’m sorry you had to go through the partial. Mine is not great either. I should have waited until I had enough arthritis for a total, but I didn’t know any better. I thought I read enough about partials before my surgery but apparently not.

I don’t know anything about your flexion splint. What is your ROM right now? You are only 2 months post op.
 
@bturner425, I’m curious why your OS recommend the initial PKR. Was your initial problem due to OA or an injury?

I had a lateral PKR on my left knee back in April. I blew out my lateral meniscus over 40 yrs ago and have had progressively worse issues with that side of my knee the past 20 yrs. When I went for consultation back in January, I asked my OS why no TKR. When we reviewed my X-rays, he showed me there was absolutely no signs of arthritis or deterioration under my knee cap or medial side. All my issues were due to catastrophic injury induced arthritis not due to OA from aging. He did admit that time could change that, but he made a good point of why replace parts that aren’t broken yet. We can deal with them, if and when that happens.

So far, I’ve been pleased with the direction taken, but it’s only been 4 months.
 
Problem all along has been OA. The last MRI I had on the right knee with the PKR stated the cartilage was deteriorated and "getting worse."

ROM is 95 and 10 left knee and 105 and 5 right knee. I seem to have hit a wall. still a lot of pain and now I have the nerve thing going in my knees. They just painfully buzz all the time.
The flexion splint t is a device you attach to you knee and dial it up to stretch it. You wear it for 30 minutes cranking it tighter every five minutes. It uses static progressive stretching to supposedly increase ROM. A brand name is JAS Systems.
 
Last edited by a moderator:
That doesn't sound so good to me. The stretching Bible is Bob Anderson, Stretching, ISBN 0-7207-1351-X. Right at the beginning he states that stretches should be held for 10-30sec only. He emphasises that holding a stretch for many minutes is not the way to do it. I would be very wary!
 
You are very early in this year long recovery and you have lots of time for your ROM to improve. Actually your numbers are pretty decent. I am 17 months post op and my ROM continues get better!

Surgeons and PTs are often in a hurry and forget that this is a long recovery.

What gets our ROM back is Time:

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

Our range of motion is right there all
along just waiting for that to happen so it can show itself.
 
Walking, though not to excess, is a great, gentle way to increase both flex and extension.

If your leg has not been straight for a long time it can take a while for it to relax and stretch and become straight. Not much in this recovery happens quickly, and trying to “encourage” it too much only upsets the knee, and if the knee is upset, it will be harder to bend and straighten it.
 
I am working on getting more extension and was wondering if applying heat to my hamstrings and behind the knee prior to stretching might help to loosen that area up for more extension. I just need another 5 degrees.
 
@bturner425 you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. If you would like a new thread title just give a shout.
 
I am working on getting more extension and was wondering if applying heat to my hamstrings and behind the knee prior to stretching might help to loosen that area up for more extension. I just need another 5 degrees.

At two months post-surgery, I’d say you probably shouldn’t apply heat behind the knee joint itself. Heat might increase swelling, which would lessen flexion and possibly increase pain. That said... you could try it just to see what happens, keeping in mind that it could have an adverse effect. Also, you could apply heat elsewhere on the leg: thigh muscles, calf, etc..

Your extension will get to where you want it to be. Those hammies are tough tendons and take a while to gently stretch (the only way to stretch) back to full length. They shortened during your bad knee years. So it will take time, but not too very much. Have you read Roy’s exercises for extension?

https://bonesmart.org/forum/threads/rom-and-extension-stretches.13159/

Here is an article on Extension and Ways to Improve It.
 
@bturner425
It's only just over 2 months since you had this major surgery - much too early to be worrying about either flexion or extension, since they can both continue to improve for at least a year. Trying too hard to increase them fast is likely to keep your knees inflamed and prevent them from increasing ROM.

In spite of what you've probably been told, 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
 
Doctor is getting me ready for a Stat-a-Dyne flexion device. It's been three months since my surgery and I still only have 90 degrees flexion in my left knee. I am pretty depressed today. Still a lot of pain. Knees are numb. Calves are on fire. I can't sleep without waking up 10 times a night, even with my CPAP. My wife has to do everything, including all the farm chores. Positive notes: I know it is healing and it will get better. I don't feel the arthritic pain anymore. I do have some good days. I'll look back at this and say I did it.
 
I am going to tag @Josephine
our forum director and nurse to address your concerns.
 

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