TKR Frustrated and defeated

[Ghosthunt]

I had left TKA in Dec 2023. At 12 weeks still only at 90 degrees flexion. Had MUA on Monday 03/04; MD said he was able to flex my knee to 120; went straight to PT where they only got my knee to 107. That Friday I was down to 95 degrees. I’ll now be going to PT 3 times a week instead of twice. I’m feeling frustrated and like a failure. I’m doing the exercises, participating in PT and still in a lot of pain. I’m ready to quit as it doesn’t seem to be helping anyway. I’m looking for suggestions. Should I stop worrying about the degree of flex? I’ve been able to straighten to 0 degrees since day one after TKR. I’m still very stiff. Swelling is better but I’m walking with a cane again since MUA

 

[Roy Gardiner]

Welcome to BoneSmart

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Roy Gardiner]

Should I stop worrying about the degree of flex?

I think so.

Had MUA on Monday 03/04

March 4th is just a few days ago. MUA is like resetting your recovery to zero, you shouldn't expect immediate improvement.

The BoneSmart view is that you need to do gentle stretching (see guidelines above) and let time take its course. Healing will happen slowly and surely.

I’m feeling frustrated and like a failure

No. Recovery is not something you control. It happens in nature's good time. But you can hinder it by overdoing exercise; it can compound damage and worsen recovery.

Relax, take it easy. It will happen.

 

[sistersinhim]

@Ghosthunt, what is the exact date of your TKR in December, and which knee was it?

The MUA re-injured your healing soft tissues, and you can expect less ROM because of that injury. You can actually help those healing tissues by doing fewer exercises and PT, not more. This will allow the swelling to go down, allowing a better bend. Even if you don't see much swelling outside your knee, you can be sure there is a lot of swelling inside that capsule area. Just a little bit of fluid will make your knee stiff and restrict its bend. Ice and elevate as much as possible, and you should see improvement.

 

[mendogal]

I add to all the above good info: icing and elevating, "toes above nose", should be a good 45-60 minutes at a time to be effective.

 

[MSuki]

You might consider rescheduling a couple of appointments (ie skip them) and see if that makes you feel any better. You shouldn’t be doing things that cause extra pain at PT either way, but sometimes it’s hard to push back when you’re already struggling with recovery. As mentioned above, your recovery has been reset and now you’re back at week 1.

 

[Jockette]

I’m doing the exercises, participating in PT and still in a lot of pain. I’m ready to quit as it doesn’t seem to be helping anyway. I’m looking for suggestions.

In our efforts to do what the professionals say, so we can improve, sometimes we overdo the exercises/PT, which causes more swelling, which in turn, reduces ROM.

Try taking some time off all this “work” and spend more time icing and elevating, to give your knee/leg a chance to settle down. Truly, it’s ok to relax your efforts, your knee will thank you. This recovery does take an average of a full year, so you have lots of time to improve. Where you are now is not where you will end up.