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Bilateral TKR Halfway there...transitioning issues<<

So what happens if you don't do any exercise at all and just your daily activities with icing/elevating the leg?
 
I am not really doing many daily activities these days. Sold my business shortly after my surgery (coincidence) and so I end up just getting up and going to the bathroom, eating, etc. Lot of sitting and watching TV. And my knees got tighter and had more pain after a 5 or 6 week break from exercises.

But I also feel a lot of pain when I over do it. So I'm going to focus on walking and a few exercises until my next follow up with my Surgeon Nov 2.


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That's a while to wait. What has your doc said about this?
 
Told me to get my butt moving. Don't need to get aggressive, just to keep it moving.


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I wanted to update my recovery. I am about 7½ months post op on TKR on both knees. My biggest issue remains extreme tightness, aka The Claw, Vice Grip rubber band feeling on both knees.

I have hired a personal Physical Therapist. He specializes in people having issues after their initial PT.

He's baffled. He doesn't think my issues are related to scar tissue or adhesions. And the reason is this:

Both my knees get completely locked up tight from any vibration or movement. In other words, I don't need to bend my knees or exercise them for this to worsen.

For example, brushing my teeth, taking a 5 minute shower (in my stand up shower)... even hitting a pothole driving down the road can trigger this. So I have it all day, every day. The only thing that helps is icing and elevating. And compression.

I'm using Tubigrip sleeves now when I need to go out and about. The slight compression they give takes the edge off "The Claw".

My therapist says this doesn't sound like the way scar tissue acts or adhesions. He says it's possible that my nerves haven't recovered and this is causing this tightness. I'm curious if @Josephine has any insight on this?

I have read the article on the rubber band feeling. I'm just beginning to question if that's what I'm dealing with or if I have something else going on?

Whatever it is, it's in both knees. That makes me think this is still part of the recovery process.

But I am curious for those of you that have experience this feeling, was your experience similar?

Bilateral TKR 2.8.17


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Do you remember that on May 25, 2017, I said this to you
Josephine said:
it's because of all this exercising you are doing. 270 reps per day- that's just insane! And completely responsible for the pain you are complaining of.
I also don't understand why you are still doing these at 15 weeks out.
Click to expand...

mpj200 said:
He doesn't think my issues are related to scar tissue or adhesions. My therapist says this doesn't sound like the way scar tissue acts or adhesions.
Click to expand...
I agree with him 100%!
mpj200 said:
He says it's possible that my nerves haven't recovered and this is causing this tightness. I'm curious if @Josephine has any insight on this?
Click to expand...
Yes, I already gave you my thoughts on that here on Jul 15, 2017
Josephine said:
mpj200 said:
I think part of my frustration is that I have this pain everyday, day after day.... after day. For over 5 months now. It's starting to wear me down.
Click to expand...
This give me pause to think you have something more serious than just post-op pain going on.
Everything you've said thus far, plus this
mpj200 said:
I do also have some burning pain on the outside of my knees. But that's more of a shooting pain and comes and goes.
Click to expand...
makes me think you probably have Complex Regional Pain Syndrome (CRPS or RSD). I really think you need to ask your surgeon or your GP to refer you to a neurologist for further investigations.
Click to expand...

You said you would be seeing your neurologist but so far as I can see (and I've just read through this thread from beginning to end three times) you never reported back what he said or even if you ever saw him?
 
Thought I posted my results. Nothing showed up with the nerve test. Had a follow up with my surgeon today and he finally conceded I may have some nerve issues going on. He put me on Lyrica for now to try and when I get back to the US I will have more test.


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Getting ready for a trip to Europe and have a question about medication. I’m traveling to the Netherlands and wondering if I will have any problem taking my pain medication with me? I don’t know that I will need it, but would prefer to take it just in case. It’s Dilaudid (hydromorphone). Any suggestions or info I need to know?


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I had no issue with medication flying within the US as long as it was in a checked bag. But I'm not sure about international travel. People have to be able to take their meds.
 
Yeah I’m just worried about customs. This is morphine.


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Just wanted to wish everyone a Merry Christmas! I went to Europe in October for 3 weeks and made it through, thanks to Tubigrip. Did get really sore towards the end and took a little pain medication for the flight home.

January 7 will be 11 months for me on BTKR. Still feel the same as I did 8 months ago.


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To update my situation, I did have a nerve test and ruled out nerve issues.

I have been at the same place for 8 months. Very tight and lots of discomfort. No pain if I’m sitting or in bed. But walking I have a hard time bending my knees. My gait is terrible.

It’s low pain, but high discomfort. Overall, it’s worse than before I had BTKR on Feb 7, 2017.

My flexion has improved to about 110 or so. When I stretch my knees and bend them, I can feel whatever is clamped on both knees, start to stretch. I ride a stationary bike 3 or 4 days a week for 10 minutes. And stretch the knees for about 10 minutes 3 to 4 days a week. No pain. Just stretching. But as soon as I finish stretching, my knees get tighter. Not looser. They almost lock up.

Again no real pain. But it does feel stretchy and sticky. Does that sound like scar tissue? Arthrofibrosis? @skigirl does this sound familiar to you?


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Last edited:
When traveling abroad, I recommend you bring enough with you and bring in original RX bottle. I’m 12 weeks post op bilateral TKA and am stiff in the morning, with knees clicking. I start the morning with a stationary bike ride and Tylenol which really helps. Then I go to the gym for aqua aerobics or senior aerobics.
 
I am curious if anyone else has had major scar tissue issues that required going back in to scope it out? I understand @skigirl has?

I have been at the same place for 8 months. Very tight and lots of discomfort. No pain if I’m sitting or in bed. But walking I have a hard time bending my knees. My gait is terrible.

Overall, both my knees feel worse than before I had BTKR on Feb 7, 2017.

My flexion is about 110 or so. When I stretch my knees and bend them, I can feel whatever is clamped on both knees, start to stretch. I ride a stationary bike 3 or 4 days a week for 10 minutes. And stretch the knees for about 10 minutes 3 to 4 days a week.

No pain. Just stretching. But as soon as I finish stretching, my knees get tighter. Not looser. They almost lock up. Even brushing my teeth and showering causes them to lock up.

When stretching, it feels stretchy and sticky. Does that sound like scar tissue? Arthrofibrosis? @skigirl does this sound familiar to you, or to anyone else?


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Wow what a connundrum. I had adhesions in my left knee---the spacer was a little too small and there was some motion in that knee. How did it feel? I felt like I heard velcro ripping when ever I stood up. Also, I had a lot of pain while bike riding. I went on a 10 mile ride the day before the surgery and I was in agony when I got back to the parking lot. It was almost a raw feeling pain.

I had good flex througthout--- 135, so that was not it either. My doctor did an open lysis of adhesions---a fancy name for adhesion removal and put in a the next size up of spacers. This was a two to three month recovery (oh boy am I sick of recovering!!) and it solved the problem.

For your problem, I am not so sure. I know that Jo cautioned you about doing too much in the early weeks and we have had folks who end up with tendonitis when there is too much early activity. But the problem of "locking up" is not one that I have heard often.

Here is what I would do. One, I would get a second opinion from someone who specializes in revisions. They are the docs who are used to seeing the problems and the solutions. If you check out the Orthopods in your area, they always list what they are most interested in doing. You might have to click through a lot of docs, but I think it would be worth it.

Second, what did you PT think at the end of your work with him/her? Did he offer any suggestions? My PT always had a lot of ideas, but he was not always right!! However, a bad gait is not a good sign and really leads to pain and discomfort. Yes, of course, some of this could be nerve pain, but it seems that there is a soft tissue element here too.

One thing that I tried was lymphatic massage. I found a lymphatic massage therapist in the yellow pages and then checked with my PT---he said she was amazing---and she was.
she did a lot of massage around the knee---I went at about 6 months out---and gave me a "wrap" to wear at night. It really looked hookey---sort of a verticle ridged foam pad.
I really only put it on to "be nice". The next morning, I was in shock---the swelling had gone down quite a bit. I saw the therapist and wore the "wrap" for about a month or two. It did make a difference in my knee swelling. Perhaps you might try something like that? Be sure to check the credentials of the therapist with your PT or the PA at your doc's office. Keep us informed about your knee---it is frustrating to be dealing with swelling and stiffness at a year but certainly not unheard of here on the forum.
 
I was released at 3 1/2 months. I was fine then. A little sore, but not the same issues I am having these days. If my PT was aggressive, that pain was in the first few months.

The pain I have now started after I stopped all PT and stopped exercising at home. I took it easy and it started to get worse.

To be clear, my current issues happened after I was discharged from my first PT at 3 1/2 months.

About 3 months ago I hired a private PT who specializes in problem recoveries. He tried cupping, dry needling, scraping (?). And he was stumped. He had no clue.

The thing that’s odd to me is that I can crank down on my knees (both of them are about the same) and bend them, push them really hard, and it doesn’t really hurt. It just tightens up when I finish and becomes even more uncomfortable. And it stays like this all day unless I’m off my feet.

I wear Tubigrip anytime I go out. Which is 3 or 4 days a week. I’m retired right now... or more like between businesses.


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*UPDATE *Just had my 1 year follow up. It was awful. The Surgeon diagnosed me with Arthrofibrosis and isn’t overly confident that surgery will fix the problem. Both knees TKR a year ago and both feel worse now than before the surgery.

I am getting a second opinion next week but very frustrated. Up until yesterday, my Dr’a told me they would scope scar tissue at a year if I couldn’t break through it.

Anyone else had this awful clamping around the knee? It starts the minute I get out of bed and hit my feet and last all day. Everyday. It’s the exact same feeling each day for the past 8 months. And it’s the same all day. The only relief is to prop my knees up. I’m still icing both with my Iceman coolers 2 to 3 hours a day.


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I think a second opinion is a very good idea. How does your OS know you have arthrofibrosis in both knees? Is there test for that? Did you have a MRI? It just seems like it'd be difficult to 'see' scar tissue.
 
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