MUA Good Strong Knee - No Bend<
- Thread starter Gel-girl
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Gel-girl
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In first thing this am -7 November 2019. Keyhole for adhesions MUA and possible “soft tissue’ removal at the back of the knee-meniscus which according to surgeon’s partner cannot grow back. Went under about 9:15. Came round about 11 in pain at about 7. Half an hour later she gave me morphine by mouth! Got down to about 5 when transferred to ward. PT came soon after to put me on CPM machine which really hurt at top end so she got me 30mg of codeine which was brill when it kicked in. Drinking lots and been up to the loo twice, using zimmer but able to put weight on leg! I’m in with 2 thr and one tkr (whose 88-she’s going through it poor love). I had to explain I’d only had keyhole and was a whole lifetime younger than her. She thought I was Wonder Woman! In overnight on CPM machine and also leaking a bit of blood. Machine has got easier and surgeon says I’m 100 at least. CPM saying 90 but he said that’s a computer they lie - haha. Bend is uncomfortable but not painful had 2 paracetamol and 30mg about 80 mins ago. The machine is straighten but I’m not really going with it so my leg is not really straight and surgeon says they didn’t manage it under anaesthetic so the plantar fasciitis and Achilles tendinitis isn’t going to be much better (this is on other rightleg where I put the weight when walking and standing as my original tkr leg is shorter due to being bent for so long. Feeling positive just want to keep up the bending when I get home tomorrow. Surgeon did mention hiring a CPM machine - not sure about that, not because of the cost but I want to see if my strength can do it myself.
Easy does it on the exercise so your knee can heal. I think you'll do fine without the CPM machine. If you can do it on your own, you're using your own muscles.
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Gel-girl
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It’s stopped now so must have been on a timer. Good advice @sistersinhim thank you.
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Gel-girl
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A week out. I was working on moving knee using skateboard and rocking on static bike. Bruising has come out all the way up and down at back of knee. Wound checked and dressings changed today. One wound is still bleeding slightly but I think that was as dressing removed so was scab!
PT has me doing lunges, squats and leg raises plus bike and pushing leg back with other leg. I told him the knee was very swollen and hot was it a good idea to do this amount of exercise. He told me that ‘we’ have to get in there to be one step ahead of the adhesions. I must admit I can do the exercises with a good amount of uncomfortable a small amount of pain at the top end! As I’ve only had keyhole and my muscles are ok - am I alright doing this? I am worried about not being able to bend and stiffen up again!
My flexion isn’t quite 90 but is there abouts on the bike in the morning. My extension is non existent and I’m not listening to Pt who told me to hang knee from edge of seat to stool and then move on to laying oven gloves over it with tins of beans in each pocket to weigh it down. Can only manage about a minute before the pain/ache sets in!
Pain-killers ran out yesterday so only paracetamol last night which was not enough! I got phone appointment with Nurse Practitioner at GPS who was very reluctant to re-issue but I managed to persuade her. So on high dose codeine again. Hope I sleep better tonight.
On a positive note I’m 50% better than 1 week after tkr
PT has me doing lunges, squats and leg raises plus bike and pushing leg back with other leg. I told him the knee was very swollen and hot was it a good idea to do this amount of exercise. He told me that ‘we’ have to get in there to be one step ahead of the adhesions. I must admit I can do the exercises with a good amount of uncomfortable a small amount of pain at the top end! As I’ve only had keyhole and my muscles are ok - am I alright doing this? I am worried about not being able to bend and stiffen up again!
My flexion isn’t quite 90 but is there abouts on the bike in the morning. My extension is non existent and I’m not listening to Pt who told me to hang knee from edge of seat to stool and then move on to laying oven gloves over it with tins of beans in each pocket to weigh it down. Can only manage about a minute before the pain/ache sets in!
Pain-killers ran out yesterday so only paracetamol last night which was not enough! I got phone appointment with Nurse Practitioner at GPS who was very reluctant to re-issue but I managed to persuade her. So on high dose codeine again. Hope I sleep better tonight.
On a positive note I’m 50% better than 1 week after tkr
Here is Bonesmart’s view of these exercises:
BoneSmart philosophy for sensible post op therapy
You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...
bonesmart.org
As Celle often says, adhesions are not just sitting there waiting to pounce if we don’t exercise enough.
MUA (Manipulation under Anaesthetic) and adhesions
First let me first put your mind at rest - this is quite probably nothing to do with not having done enough PT or been 'good enough' in following orders. Here is my standard mini-lecture on the subject so read and absorb ... All the structures in the body, muscles, tendons, ligaments, even gut...
bonesmart.org
I don’t understand how some medical professionals can recommend this. I’m glad you’re not doing it!
The type of PT you are getting does seem to be standard procedure after MUA but Bonesmart disagrees. You are allowed to disagree also:
Saying no to therapy - am I allowed to?
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Gel-girl
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Thank you both - all good advice and I will take it into consideration as the Bonesmart way I know and love.
I will carry on doing the exercises as I am 2 years out from a TKR with a good strong knee that allowed me to exercise leading up to the keyhole and MUA.
What I won’t do is tell them (PT) how many or much I do and will only do the exercises to just short of uncomfortable! Im mainly rocking on the bike and pushing leg under chair. The other exercises do not seem to affect the knee as such - I don’t do them as much or push as much as PT tell me as the other knee can’t cope these days.
My bruising has come out in the last couple days having gone from nothing to yellow and ‘black as your hat’. It’s also sensitive and sore which is making it difficult to sleep as it’s all round the back and inside the knee. On the outside of the knee is a hard lump that hurts when I lie on it so I’m moving about a lot in bed without getting comfortable!
I mentioned the lump to the dressing nurse who told me it’s probably water!
I will carry on doing the exercises as I am 2 years out from a TKR with a good strong knee that allowed me to exercise leading up to the keyhole and MUA.
What I won’t do is tell them (PT) how many or much I do and will only do the exercises to just short of uncomfortable! Im mainly rocking on the bike and pushing leg under chair. The other exercises do not seem to affect the knee as such - I don’t do them as much or push as much as PT tell me as the other knee can’t cope these days.
My bruising has come out in the last couple days having gone from nothing to yellow and ‘black as your hat’. It’s also sensitive and sore which is making it difficult to sleep as it’s all round the back and inside the knee. On the outside of the knee is a hard lump that hurts when I lie on it so I’m moving about a lot in bed without getting comfortable!
I mentioned the lump to the dressing nurse who told me it’s probably water!
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Gel-girl
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Also I’m using the Cryo cuff about 3 times a day for about an hour. I love it as the knee is kept cool for the whole time. I wish I’d bought it for the tkr. Anyway the PT said this was too long and too often! What are your thoughts? It doesn’t affect my skin and I put a therma flex gel covered in a cloth on the back which also stays cool for the whole time. I think these gel pads are the best and wish I’d had them for my tkr.
I don’t think PTs totally understand icing after a surgery like this. Their shorter recommendations are more tied to a “simple” injury.
As long as you have a cloth between you and the ice source, like you do, we feel you can ice as long as you want. And you love it, so do what you feel is best for you. (Just an FYI, we’ve had 2 members that I remember, who’s surgeons told them not to ice at all, in the first 6 weeks!
This is just another example of the differences of opinion!)
As long as you have a cloth between you and the ice source, like you do, we feel you can ice as long as you want. And you love it, so do what you feel is best for you. (Just an FYI, we’ve had 2 members that I remember, who’s surgeons told them not to ice at all, in the first 6 weeks!
This is just another example of the differences of opinion!)
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Gel-girl
member
I know I’m in a different situation than typical tkr or MUA being over two years out and only just had an MUA but I’m fed up of the aching and the pain and GPs trying to get the swelling down with anti-inflammatories and not addressing the management of pain.
I have another appointment tomorrow with another GP - I’m hoping I get some kind of pain relief cause paracetamol and 2 x 10mg slow release zomorph is not cutting it.
I always thought I had a high pain threshold before this whole journey!
Vent over
I have another appointment tomorrow with another GP - I’m hoping I get some kind of pain relief cause paracetamol and 2 x 10mg slow release zomorph is not cutting it.
I always thought I had a high pain threshold before this whole journey!
Vent over
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I'm so sorry you're having these issues, especially so long after your TKR. I'm sending good wishes for a speedy recovery, no pain and a good result after this latest procedure.
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Gel-girl
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Saw the surgeon's registrar on 27 December 2020. Good meeting - he was very positive and managed to get my knee to 100 he reckoned - I reckoned about 92-94!! I had 4 questions/comments for him.
1. Copy of report about the operation - he said no problem. I have this morning got in touch with the GP to see if they received anything - they had I now have a copy via email.
2. I would appreciate not being discharged (I feel, in retrospect, that 5 weeks discharge with my tkr was a little too soon! He said no problem and is seeing me mid April (I'm away for most of March and then its Easter).
3. Did they find any meniscus - yes and it was removed.
4. Did they find any adhesion - yes, loads! They were 'released'. Nothing was mentioned about them being removed.
The report states no signs of medial jointline tenderness, no sign of meniscal symptoms. - Why, then, am I still getting pain, soreness and aching round the medial meniscus area that radiates round the knee and can wake me and keep me awake at night
Findings during surgery - synovial scarring in the notch - excised. Excision of neo medial meniscus. Improve flexion after MUA - passive range 5 deg to 110 deg.
He just nodded when I told him I was still sore, in pain and aching with interrupted sleep every night. He just nodded but just seemed to accept that to be normal - this was at the beginning of the quick 5 min appointment so I did not pursue it.
I have an appointment on Thursday 16 Jan with GP regarding the pain. I am still seeing physio who can't understand why I'm in so much pain at physio as the stretching he is giving me should be stopping those adhesion forming. He mentioned that some of it could be nerve pain - which set me to researching the subject 'neuropathic pain'. |Mmmmm interesting may not mention it at the appointment with the GP but I am going to write down exactly what the different pains are like and when they tend to appear. I was on 4 Tramadol/24hrs and paracetamol 6-8/24hrs. They ran out beginning of last week so I'm taking Zomorph (left over from tkr still in date) I will be honest the Tramadol were helping me sleep a little but paracetalmol worked better for the pain. This is true of the Zomorph which are 10mg but I'm taking 4 at night just to help me sleep - again I don't think they are helping the pain.
On a good point I am walking so much better although I am concentrating on stretches and slow muscle strengthening to get the knee bending enough for a bike ride in the Spring.
1. Copy of report about the operation - he said no problem. I have this morning got in touch with the GP to see if they received anything - they had I now have a copy via email.
2. I would appreciate not being discharged (I feel, in retrospect, that 5 weeks discharge with my tkr was a little too soon! He said no problem and is seeing me mid April (I'm away for most of March and then its Easter).
3. Did they find any meniscus - yes and it was removed.
4. Did they find any adhesion - yes, loads! They were 'released'. Nothing was mentioned about them being removed.
The report states no signs of medial jointline tenderness, no sign of meniscal symptoms. - Why, then, am I still getting pain, soreness and aching round the medial meniscus area that radiates round the knee and can wake me and keep me awake at night
Findings during surgery - synovial scarring in the notch - excised. Excision of neo medial meniscus. Improve flexion after MUA - passive range 5 deg to 110 deg.
He just nodded when I told him I was still sore, in pain and aching with interrupted sleep every night. He just nodded but just seemed to accept that to be normal - this was at the beginning of the quick 5 min appointment so I did not pursue it.
I have an appointment on Thursday 16 Jan with GP regarding the pain. I am still seeing physio who can't understand why I'm in so much pain at physio as the stretching he is giving me should be stopping those adhesion forming. He mentioned that some of it could be nerve pain - which set me to researching the subject 'neuropathic pain'. |Mmmmm interesting may not mention it at the appointment with the GP but I am going to write down exactly what the different pains are like and when they tend to appear. I was on 4 Tramadol/24hrs and paracetamol 6-8/24hrs. They ran out beginning of last week so I'm taking Zomorph (left over from tkr still in date) I will be honest the Tramadol were helping me sleep a little but paracetalmol worked better for the pain. This is true of the Zomorph which are 10mg but I'm taking 4 at night just to help me sleep - again I don't think they are helping the pain.
On a good point I am walking so much better although I am concentrating on stretches and slow muscle strengthening to get the knee bending enough for a bike ride in the Spring.
It's not unusual to be in some pain two months after your procedure. All in all it sounds like you're coming right along.
@Gel-girl.....I am a bit confused by your comment that you were told that "meniscus was found and removed" in your latest procedure November 7, 2019. When a total knee replacement is done (like you had in 2017), the top of your tibia bone that contains damaged meniscus tissue is removed in preparation of placing the metal tray that holds the plastic spacer. There is no meniscus remaining in your knee after a TKR. So, I cannot imagine what the surgeon's registrar was referring to. Take a look at this illustration and you'll see what I'm talking about. The meniscus is removed during the TKR and both cruciate ligaments may or may not be removed, depending on their condition.
Can you clarify this for me, please? I do understand that they may have removed or released some scar tissue during the procedure, but the meniscus comments have me baffled.
Can you clarify this for me, please? I do understand that they may have removed or released some scar tissue during the procedure, but the meniscus comments have me baffled.
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GottaDoIt
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I just checked it and it opened for me. Do you have something set so your computer won't open attachments?
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