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Revision TKR Here I go again!<<.

Jordon6,
You are in the angry tissue stage, you do not have to move around a lot to stay loose. Can you reduce the ROM the CPM machine goes through? Might help.
Everything you do at this stage of your recovery should be very gentle for your baby knee.
Be sure to take your pain medication on schedule as prescribed for your pain.
 
Ok fellow smarties!
I'm at 2 and a half weeks and wanted to give updates and ask a few questions. My surgeon that did my revision said that my knee was loose at the femur and tibula. There was also a small mountain of scar tissue that had to be removed.

Positives- The knee is more stable. I have less constant pain that before the revision and even after the original replacement. My extension is super which helps my walking. I sleep well. After the original TKR I didn't sleep for months. If I compared this time to last-I feel like I'm leaps ahead!

Questions-My bend is not that great. Its about 70/75. My doctor keeps reassuring me that there's no guarantee of me gaining more range of motion. He wants me to stay focused on keeping what I have in both bending and straightening. But I'm impatient and sorta scared that I'll end up where I was if I don't gain more ROM.

My therapist are excellent. Very gentle stretches! Lots of dialogue and education about my surgery, joint healing, and muscle strengthening. So different than before!

So friends...I need to reassuring that, at almost 3 weeks, I'm doing ok!
 
You are doing great!

Looking back at my notes on my progress I see you are just about where I was at that point after my revision. I was very nervous that it wasn't where I should be. My doctor assured me everything was great and that once the swelling went down the ROM would come back.

I went to PT for 8 weeks and then decided it seemed it was just aggravating things so I stopped and my ROM was 113. A month later after no formal PT but just ADLs I went for my 12 week checkup and my ROM was 126. I don't know if it would have gotten there even if I had continued my PT but I was a lot happier not going.

Now at 15 weeks I can tell my ROM has improved from there just based on what I can do but haven't had it measured.

However - I still have LOTS of stiffness and the tight band feeling which increases with activity. I do moderate amounts of just everyday walking and ride my stationary bike every day. That feels the best out of anything I do.

I'm still frustrated with the swelling and tightness but happy to see that my ROM did in fact continue to improve. I trust the rest will fall into line as well.
 
Jordon6,
You are doing GREAT, your extension is super :yay:, you are walking is improved, your knee is stable, less pain, you sleep well, and you feel leaps ahead of your primary TKR, you are beyond OK, this is fantastic.

ROM is only a number, at three weeks you are fine, considering what your knee has been through.
Focus instead on the positives, there are many with your revision (see above).

You have plenty of time to increase ROM, mine increased after a year and a half. You are only three weeks from your revision, very very early for your brand new baby knee.
Your biggest challenge will be titrating your activity so it is just right for your knee, not too much (your knee will tell you), and not too little.

:ice:
 
@pumpkin, @flyaway79 Thanks so much for your words of encouragement. I feel like I am doing ok, just need someone else to bounce ideas/thoughts off of--just to check!

This forum has been truly been an great resource for information and support!
 
I agree with pumpkln.
There's no need to worry about your ROM. Your knee needs gentle treatment this time, and slow progress is OK.
Aim for slow and steady progress. Remember, it was the tortoise who won the race, not the hare. So, be a tortoise if you have to.

You have all the time in the world for your bend to increase, so there's no need to rush or worry. I know someone whose ROM was still increasing at 18 months after her TKR and I have read of someone else who found her ROM had increased at 3 years post-op.
 
So the question of the day is-what factors increase and/or prohibit ROM? I am 4 weeks post revision and my ROM is about 80ish. My therapist doesn't measure but after going through this journey for 2 years I can eyeball it. After my original TKR and MUA I heard "don't worry, ROM will come" and it never did. I do gentle stretches and have gentle PT twice a week. I've tried more PT and no PT and still the same results.

I realize every knee is different but what can cause MY knee to not bend past 80 at this point. I've read others recovery threads that have great range at this point and while I try not to compare my progress to theirs, it's difficult feeling like I'm going down the same road and fighting an uphill battle!

Any advice?
 
Jordon6 said:
what factors increase and/or prohibit ROM?
Click to expand...
Primarily it's pain and swelling but after that can be adhesions and a long time after that, could just be a fixed deformity.
Jordon6 said:
what caused MY knee to not bend past 80 at this point
Click to expand...
I see you've had a great number of surgeries on this leg - I take it they are all on the same leg?
Revision TKR June 13, 2017
Lysis and MUA June 16, 2016
MUA December 11, 2015
TKR September 29, 2015

So I don't have to sit and read through your entire thread, was the revision done because you failed to get good outcomes after the MUAs? What was your ROM after each of them?
 
The revision was done because the implant was loose. I don't know how long it was loose. Immediately after the first MUA I got about a 100. The doc said he got full extension while under anesthesia this time. Quickly after I was right back to about an 80 with a push. The second time was during the lysis and the doctor said he got about an 80 but was fearful of a bone break. After that time, I quickly was back to about a 75/80 again.

Went to PT today and again, my ROM is about 75 and the therapist is already telling me that at 4 weeks I'm behind and if I don't improve , the doc will probably insist on another MUA.

I just don't know how much I can go through! The MUAs really don't seem to work and I really wonder about putting my knee through this again.

@Josephine yes the same knee
 
Jordon6 said:
the therapist is already telling me that at 4 weeks I'm behind and if I don't improve , the doc will probably insist on another MUA
Click to expand...
Well, a) there is no timetable for these things so her idea of you being 'behind' is somewhat questionable and
b) there is a limit to how many MUAs would be appropriate or effective.

I take it all these surgeries were done by the same surgeon? If so, I think it's time you tried another one who would be more experienced in these problem cases. There are such surgeons, you know, and it seems to me yours isn't one of them! I know you probably trust and respect him but sometimes we have to face the fact that though they might be really good primary knee surgeons, they are not 'really good' revision surgeons. Do correct me if I'm wrong, of course.
 
@Josephine the doctor that did my revision is a different surgeon than my original surgeon. I took your advice about seeking a doctor that specializes with revisions. I'm just confused about why this keep happening to me!
 
Ah, well if we all knew that, we'd be wise old things, wouldn't we?
(translation: we're all of us only human!)
 
@Jordon6, I'm way late to this party, but I had some trouble with adhesions after my LTKR. I did mine in March of 2013. I was not aware of the BoneSmart Forums until about two years after my knee surgery. I too let the PT force me past my limit. I did PT for about 3 months before I finally quit in disgust.

I tried every therapy I could find. I did active release, a therapy that athletes use that involves metal tools being worked crossways over my adhesions, medical massage, and a bending brace. All were extremely painful and did not yield much movement. I was at about 98 degrees at the end of all that.

I was offered a an MUI and declined because I just couldn't face the pain and rehab any more. Then in 2016 I went to see a chiropractor about other issues and we discussed my knee pain. She began to massage my knee twice a week. It is excruciating, so she only did it for about 5 minutes at a time. Three months of that and my adhesions were gone.

My knee only bends to about 105 degrees to this day, but it is not painful. It works for 80 percent of the things I do, and I'm good with that. I go to the gym 5 or 6 days a week, I swim, I ride a bike, I dance, I can go upstairs no problem, but down is still stiff. But I am NOT IN PAIN. Four years out and I still keep working at it.

You have been through a lot. Perhaps you can try a chiropractor to help you. It may not be perfect, but I think it will get better.


Sent from my iPad using BoneSmart Forum
 
@Mscant thanks!

Bonesmarties I have an issue! This weekend sat in a rocking chair and rocked about an hour (at my therapist recommendation) and later that evening I sat on the back of my husbands truck while he did yard work. While I sat I kicked my leg (the replaced knee) back and forth. Sunday when I got up I was very sore and struggled to put weight on my knee. I was using cane but had to use the walker to get around. I iced and elevated most of the evening and again this morning still sore. I think that the pain isn't in the knee itself but in the soft tissues surrounding the knee. Should I be worried?
 
Just based on what you said you were doing, I would say don't be worried. You were using your muscles and tendons a bit, and most likely they swelled. Did you ice afterward? Elevate? I ask because that might reduce the swelling, and therefore the soreness. A few times early on in my recovery I did more than I should have, often at PT, and my knees would be super sore the next day. Ice and elevation helped, as did doing no exercises for a couple days. I would soon be back to where I had been. This is probably what's happening with you, so ice and elevate, and do lots of resting. :ice:
 
@SusieShoes I iced yesterday off and on. I agree with you about those tendons but when I was sailing along and hit this bump I kinda got nervous! I guess I made them angry:no-fin: I had PT today and canceled. I think I'll ice and rest today. Hopefully the rest will help!:sleeep:
 
Jordon6 said:
This weekend sat in a rocking chair and rocked about an hour ( at my therapist recommendation) and later that evening I sat on the back of my husbands truck while he did yard work. While I sat I kicked my leg ( the replaced knee) back and forth. Sunday when I got up I was very sore and struggled to put weight on my knee. I was using cane but had to use the walker to get around. I iced and elevated most of the evening and again this morning still sore. I think that the pain isn't in the knee itself but in the soft tissues surrounding the knee. Should I be worried?
Click to expand...
I think you just did too much, for too long, and now all your soft tissues are upset, inflamed and swollen.
5 minutes of rocking would have been enough and just bendign and straightening your leg once or twice in the truck would have been plenty. You don't have to keep your knee moving continuously. In addition, in both those situations, your leg wasn't elevated, so that also increased the swelling. Take a couple of days of rest, ice and elevation and then see how the knee feels.

I notice that, a while ago, you said that you had your knee revised because it was loose. That looseness alone would have been sufficient irritation to have caused the adhesions. I don't think you have an inherent tendency to develop adhesions. They just happened because of the faulty first TKR.
 
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