TKR Foot and toe numbness

[Curiousnva]

good morning, I'm 9.5 weeks post op from right knee replacement. Struggling with extension. PT has told me to stop coming and wasting my allowed visits and money. I am at 10 in extension and 100 in flexion. Had two therapists say they feel my implant is to big and that they don't think I'll get any better. Suggested I return to my os which I did last Friday. He told me to get a dynamic splint and try for 2-3weeks to see if that will straighten. If thatdoesn't work said we can try mua. He saysthe implant is the correct size. Don't knowwhat else to do. I hang my legs off the bedtwice a day with 10 pounds of weight onmy ankle. As well as sit a lot with legpropped on a table on and off at night. Idid set up an appt with a different os at adifferent practice for the end of march.Just to get a second opinion. I've beennursing this knee for 10 years. I had apretty bad motorcycle accident in 2006. Bad tibia plateau break. In 10 years I'vehad surgery to fix that. I'm 2007 hadscope surgery due to falling on the kneeand chipping a piece of bone. In 2010 hadanother scope to clean out a lot of stuffthat had built up. In 2013 had surgery toremove the plate and screws that were installed after the wreck. My poor leg hasbeen through so much. Really thoughtthis new knee would do so much better.Any suggestions or feedback is greatlyappreciated. Thanks

 

[Jaycey]

@Curiousnva you might notice I merged the second recovery thread you started into your existing thread. We like members who are in recovery to keep all their updates on one thread so that we have your history in one place and can advise if needed. If you would like the thread title changed just let us know. Thanks!

 

[Curiousnva]

Hi, ok thanks. I didn't know that.

 

[Jaycey]

I'm going to tag a couple of my colleagues that have experience with knees to address your question. But I have a feeling their advice is going to be stop all this sitting with weights on your feet, ice and elevate and get the swelling down that is hindering your ROM. @KarriB @Pumpkln

 

[Curiousnva]

Ok thanks. Everyone says the swelling looks ok. Unless its internal? I'm thinking the dynamic brace the doc wants me to try will be in this week. That thing sounds painful. Guess you set it on 0 and strap to the leg.

 

[Jaycey]

Unless its internal?

That's exactly what it is. I imagine your soft tissues are very angry due to all the weights business. Are you icing and elevating?

 

[Curiousnva]

Elevating yes. Not so good on the icing. The ice machine from the hospital didn't feel to me it got very cold. I am using frozen veggies now. 20 mins on the underside of knee 20 on top of the knee. Just started today. I'll try that 2-3 times a day. Kinda hard to do. I'm single live alone and back to my job full time. It's not an office job. I'm a project manager for a crane and rigging company. Drive a lot and walk a lot.

 

[newlybionic]

You're only a few months out from a major surgery on a very beat up knee. Was your extension at 0 before your TKR? If not it is going to take you longer to get to your full extension. Right now you definitely need to ice and elevate your knee more. Pick up a few ice packs from a local drug store. They will stay colder than frozen veggies so you can ice for longer periods of time. You can bring some in a cooler during the day and use it while driving if you can. Definitely at the end of your work day you need to spend about an hour elevating and icing for an hour or more. The best thing as far as extension is just putting your leg on a table and allow gravity to do the rest. Once you feel pain, stop. Try to take full strides when walking heel to toe. If you are limping you will need to use a cane to practice. It does get better.

 

[Curiousnva]

I was at 0 prior. Flexion wasn't full but at least 120 or so. I'll try it, wanting to move forward.

 

[KarriB]

You're early in a recoverythat can take up to a year. My OS recommended returning to work at 12 weeks and a year before feeling 100%. I'd stop with the weights because that can be what's aggravating your knee and possibly causing internal swelling. My PTs wouldn't use any weights at all until 4 months and that was for strength training. I also found riding a recumbent bike helped loosen up my knee and gain ROM.

Icing for 20 minutes isn't enough. You need to ice for 40 minutes at least and an hour can't hurt. You also might try toes above nose elevating. Sometimes I'd lay flat on the sofa with my legs up on the sofa arms, then throw an ice pack on my knee. Extension often can take longer. Newlybionic gave you the stretch I used which let gravity do the job. My extention is better on m TKR than on my natural knee, my TKR can almost hyperextend. Also be sure you're walking correctly and taking long strides. Here's a link extension photos of how to work on extention.

http://bonesmart.org/forum/threads/extension-how-to-estimate-it-and-ways-to-improve-it.9529/

If none of these ideas help you may want to see a different OS, but one that specializes in revisions. However at 9 weeks you can still gain both flex and extention, but t does take time.

 

[Curiousnva]

I'll do all that and see how it goes. I've been let go by PT. Started going when was 6 weeks post op. They said nothing they can do. They were doing nothing but strength training from day 1. I'm just very frustrated. It seems since so many knees are done these days they would be more knowledgeable and helpful on everything.

 

[KarriB]

Strength training from day one could be what is causing your limited ROM. Your TKR isn't a sports injury that needs rehabbed, it's a traumatized with broken bones, muscles and compromised soft tissue. The absolutely worse thing for it is strength training until it is healed from the surgery. Would you have wanted a broken leg rehabbed like this, or would you've waited until the bone healed? Unfortunately not everyone knows the best treatment for a TKR.

I think you should take a few weeks and do absolutely nothing but the extention stretches with ice and elevation. Then see how the knee feels.

 

[Curiousnva]

I'll do that. I'm headed to my gym today to do some upper body stuff. I gotta move something. Guess it's ok to warm up using a recumbent bike?

 

[Pumpkin]

No resistance, no longer than 5 minutes. You can increase in 5 min increments next time if no increase in pain after 5 min

 

[KarriB]

 

[RMasano]

My extension is coming along as well as it probably should be. My inhome PT suggested the brace, but my OS didn't. Don't know why. She emailed him and his nurse's response was she didn't think he would go for it. Sorry you are struggling. I've learned that this journey takes a ton of patience!!!

 

[Curiousnva]

I usually do fine on the bike. Have been doing 20 mins no pain. I just keep it adjusted as to not push past my rom level.

My PT gave up on me. My os is the one that suggested the brace. It just blows my mind how the PT's give up. It's at a outpatient clinic at a huge rehab hospital here in Va. looks like they would be some of the most helpful.

 

[KarriB]

If you give all the strength work a rest, ice for more than 20 minutes you may be able to adjust the bike to give you more rom.

 

[Celle]

You do need to ice for at least 45 minutes each time. 20 minutes isn't long enough.

 

[Curiousnva]

Went to the gym. First time since surgery. Warmed up on the bike. Went slow and moved the seat forward in 5 min increments for 20 mins. Then just worked biceps and back. Half of what I was doing. Felt good to be back at least. Tomorrow my back and arms will be sore. May take my mind off the knee pain I'm icing now