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Revision TKR Here I go again!<<.

Hi Jordan.... I received a private message from you and would love to reply, but when I go to the message, it says it's locked. I'd be happy to share info on my TKR with Multiple Sclerosis on board, but I'm being dumb about how to reply. I have read the info and issues you have provided here. These TKR's are tough. Mine was a nightmare, as you know. Ended up with a manipulation and then a scope. Extensive scar tissue. The Scope was the one smart thing I had done. My ROM is 115. Send me another private message, if you would like, and hopefully I'll be able to reply. I will say that with MS the muscle spasms were a huge issue in recovering. I was smashed on Baclofen for months.

Here's a good one for you----I am having my other knee replaced on July 1. This is the true definition of insanity.

Old Fashioned menisectomy 1973 (Slice open the knee, remove ALL of the cartilage)
TKR R knee 11/2013 w/Oxinium knee (nickel allergy)
MANIP 1/2014
SCOPE 3/2015 (The smartest move I made)
 
@HereIam
You can't post in the PMs until you have made at least 10 posts in the general threads. That's why you can't reply to Jordon6's PM.
I see that you haven't updated your own thread for a while and that it has been locked. If you'd like your thread to be re-opened so you can post on it, please let us know. Your thread is here:
https://bonesmart.org/forum/threads/my-nightmare.22617/page-2

It might help other people if you both post information and experiences in your recovery threads about having a TKR when you have MS, rather than keeping this information in a PM conversation. Of course, if you want to discuss private or personal matters it's OK to do that in PMs.
 
HereIam
Thanks for your reply. I felt as though the MS had a bit to do with my slow recovery. Unfortunately, my right knee was replaced and that is my weaker side. Most MS flare ups happen on this side-weakness, spaciticity, and numbness. I tried asking the PT and doctor if this would be why I was still weak and they both said probably not-but I felt like it was.

Your story is similar to mine, I, too, have scar tissue. Had a MUA at 12 weeks an now at 9 months have more scar tissue which limits my ROM. I have gotten 2 different opinions about why I'm not further along, and each doctor acts like its a guessing game. I'm very frustrated.

I enjoyed hearing from you.
 
My knee feels 10 times better since I've been out for the summer. ( I teach first grade). I took off 12 weeks but I battled pain and swelling. I had the MUA at 10 weeks and then went to work 2 weeks later.

I quit PT because of the pain and swelling and they kept pushing which turned into more swelling and pain.

Jo, now that my pain is better ( about. 2, 3 in evening) I'm wondering if I need to proceed with the arthroscopic surgery for scar tissue? I have no infection and the radiologist could not be certain of looseness since it's not been a year, but my knee is still stiff (ROM about 95). During my appt with the OS who did the TKR( he recommended the scope) gently pushed my knee and didn't measure but determined it was about 90/95- I noticed that it wasn't as painful as when I went to therapy, probably cause it's not as swollen but it's still tight and stiff.
 
I go in this morning to have arthroscopic removal of scar tissue. My OS explained it a little but could someone tell me the recovery time? Avid what to expect in at home PT?
 
I think the larger problem that you have is overly aggressive PT has caused some chronic swelling in your knee. You, yourself, can see that resting the knee is having a positive effect. Probably a summer of resting and icing the knee would have made a big difference.

However, you have had the surgery to remove adhesions--which I really doubt were a big problem. So, now, rest, ice and relax. I had an open lysis of adhesions---(removal) and even so, the pain lasted a day or two at most. I did spend quite a bit of time on the couch afterwards.

I had had quite a bit of bleeding after my TKR and that did result in a lot of adhesions in my knee. Since my doctor stressed at great length that if you exercised a swollen, hot knee you caused more adhesions to form, he was quite strict about exercise. No pt for four weeks, and then, only gentle stretching and leg lifts, clam shells--things done non weight bearing for the next four weeks. At eight weeks, I began real PT---but not aggressive PT. If my knee swelled, even a little, my PT would immediately back off. It was a delicate balance of doing something five time to see if the knee swelled. If no, then try 8 times. if yes, back off to 2 times.

I would urge you not to go to the same PT and get more aggressive PT on that knee. Instead, rest and let it heal first. Then, begin to exercise very gently.
 
Since you have had an additional surgery, I will give you the recovery list again. There is info there that will be helpful to you.

First are the BoneSmart Recovery Philosophy. . .

- rest, elevate, ice and take your pain meds according to your prescription, don't wait for pain to occur, don't overwork.
- If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
- If you won't die if it's not done, don't do it; if you must do it, short and sweet, not hours on your feet.
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
 
Thanks.

The surgeon removed scar tissue in each side of my knee as well as underneath my knee cap. I'm pretty sore but nothing like before!

I started PT when I got home but she was definitely more gentle than the one I had before. Just some gentle stretches.

I'm optimistic!
 
Keep it gentle, and Rest, Ice, Elevate, and Medicate on schedule as prescribed.
 
Hope that goes well! It should really help. I had to have adhesions/scar tissue removed that were from my first surgery (to try to repair damage to my knee and broken tibial plateau from an accident) when my TKR was done. I have adhesions again but they seem to be letting go, although slowly, this time. I find the best thing is keeping the area (patella, and surrounding) mobile.


Sent from my iPad using BoneSmart Forum
 
Charmed-life
I'm praying for this! I'm trying to be more mobile this time. With my original- I wasn't mobile besides my PT. I think because of the pain and swelling. It's not nearly as bad so I aim to move more!
 
Once you have had adhesions, you are prone to get them again---I know about this because I also had a lysis of adhesions (removal). My doctor stressed that if you exercises a hot, inflamed knee you would cause more adhesions to form. so, for me--no pt at all for three weeks---lots of time on the couch with my knee elevated and iced. I did gentle heel slides, quad sets, leg lits.

At three weeks, I did gentle PT---mostly stretching and icing. Do not be in a hurry here, be gentle and allow that knee to heal. Moving means walking, for instance, it does not mean aggressive pt or exercise.
 
My OS ordered therapy! Mt therapist is much gentler though.she got my flex to 97.

My question is- because my OS got me to 100% under anesthesia, when can I expect that on my own? Without the push? Or is it possible since its been 9 months?
 
You will get to have the same ROM that your OS obtained but it will take you a bit of time. You just had another surgery so you are starting from the beginning in letting your knee heal.
 
At 9 months you're pretty much where your ROM is going to be. As I understand it, orthopedists consider 95 successful. I have very long legs and, no, 95 was not enough. I was stuck at 85 for a long time, with a week's improvement after an MUA. I ultimately had my knee scoped (and at that point my ROM was dropping). The scar tissue was massive. Even after that I only had 95 on the table. I credit my ultimate success (about 125) on NOT doing PT but instead doing very gentle stretches and, actually, a CPM machine for the first month after the scope. I was lucky to have an orthopedist who recognized that if he didn't scope me I'd have an unbending leg for the duration. BTW things got a lot better when I took a break from all efforts to improve ROM, but, again, that was long before the 9 month mark.
 
maryo52 said:
At 9 months you're pretty much where your ROM is going to be.
Click to expand...
Not necessarily so!
We have had people here on BoneSmart whose ROM has continued to improve for well over a year. I believe that @Jamie realised she had some improvement at about 3 years after her surgery.
 
Whoa! I didn't say ROM does not improve. But I don't recall that anyone had significant gains after that point. I would think, Jordon, that you'd get to 100. Sometimes it seems to happen better without trying. When someone says their PT got them to a certainly point, it's like fingernails on a chalkboard to me. What happened to me when a PT did that is, yeah, maybe he or she got a number that made us all feel more reassured at that point, but there was a lash bach in that it made my knee angry which in turn would feed the scar tissue. What I'm trying to say is that our reluctant-to-bend knees can be like a watched pot that won't boil.
 
I pray that it improves over time. I can't settle for 100 just yet!
 
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