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TKR I can’t believe I’m still dealing with this darn Knee^

Thank you for your words of encouragement! I do appreciate it. Yeah, I'm right there with you about the stairs....arghh! Hoping your therapy goes well!
 
Hey there, just wondering what your rom is now? Did your self MUA Help at all?
I have been working hard on going up and down stairs as I'm traveling around South America ( think Machu Picchu etc) but my bend is still not great- 100o at best and my extension seems to be getting worse.
I'm at a loss as to where to go next. I still limp and I still seem to get very stiff and sore after walking and standing too long!
My surgeon just says I need to get brutal with it!
I usually take Panadol Osteo ( think it's 1400mg longer acting paracetamol) but I can't find anything similar here and my Spanish is pretty poor!
Hope you are getting on well now.
 
@Kiwint ,
Sounds like you are doing way too much, and should be using a cane if you are still limping.
While you are traveling you still need to rest, ice, elevate, and medicate, when you can. Stiffness and soreness is pain and needs to be treated.
My best guess is you still have swelling in your knee, and until it goes away your ROM will be limited.
Getting brutal with it will just make your tissues angry and inflammed, increase swelling, and reduce your ROM.
Remember: Work Smarter, Not Harder.
When you return home you may want to seek out a second opinion about your knee.
Here are some articles you will find helpful.

MUA (Manipulation under Anaesthetic) and Adhesions
MUA: the ineffectiveness of early MUA (JBJS)
Myth busting: the "window of opportunity" in TKR
Myth busting: the "window of opportunity" JBJS
Myth busting: no pain, no gain

Enjoy the rest of your vacation, and take it easy,
 
I saw Machu Picchu when I saw it 40 years ago!!! They had an old train that just crawled up the mountains. When I was there, it was just mostly ruins with no nice little signs telling you what everything was----but it was magnificent.

However, I do remember how hard it was to walk---I would take 12 steps and then huff and puff for a while---I was five months pregnant when there too!! I agree with Pumpkin that you will need a second opinion at some point---many docs in S. America were trained in the US and they speak English. But, for now, it appears that you had your tkr in Feb, 2014 and then had a MUA in March of this year. That is a lot for your poor knee to take.

Now 6 months later, you are still stiff and sore. How long have you been traveling around SA? Here are some things I would try if I were you: 1. I would get a cane or two hiking poles to help with your gait so that you do not limp. 2. I would elevate the leg--toes above nose as much as I could. Put your leg on a chair while you eat lunch, even. 3. I would wear support hose of some kind, if you can find them, to keep the swelling down as much as possible. 4. I would take every opportunity to rest----shorter hikes, shorter shopping days.

Are you wearing pre surgery hiking boots? If so, they have the wear patterns of your old knee---mine hurt my feet and made my gait less fluid. it was a relief to get all new shoes. For now, you will have to accept that your knee is not 100% and give yourself more rest breaks.
 
@Kiwint - I'm pretty frustrated, myself. I am going to PT twice a week, love where I go. But seems like I gain ROM and then go backwards. 108 is the best I have reached, but after a weekend of lots of stairs and walking I was struggling to get 100. Yesterday I was 106, and my extension is usually 2, although there are days when I'm a 3-4.

The pain is discouraging.

Best of luck to you! Thanks for asking about my progress!
~ Mary ~


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Mary,
Sorry to hear you are having trouble with pain and ROM, welcome to the slow train to recovery.:friends:
You most likely have internal swelling blocking your ROM, what does your surgeon say?
Glad to see your post,:)
 
Surgeon says he feels okay with my progress...takes about a year, he says. PT says my knee is stubborn...ha! It really is a balancing act to keep active but not over-do and create swelling...


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Kiwint said:
I usually take Panadol Osteo ( think it's 1400mg longer acting paracetamol)
Click to expand...

The fact sheet on Panadol Osteo says it's presented as caplets, each containing 665 mg of Paracetamol (Tylenol).
If you take 2 caplets, you are getting 1,330 mg per dose, so you should not have more than 6 caplets per day. This would be a total of 3,990 mg in one day, just within the recommended maximum of 4,000 mg (4G) per day.
 
Hi Mary, we have not chatted before. I had my knee done dec 18th 2013. I was on PT for four months and finally when i could not get over 105 told my doc that i was quitting and would not do an MUA as he wanted me to do. I still did some and i repeat some not a lot of basic stretching exercises. Month by month with no strenuous exercise i have improved where today i am at 126 and nine months out. but i really just laid off all the pushing the rom to the point where it hurts at all. I have no pain good enough rom for me and for me think that basically resting it is the way to go. If i was to do the other knee i am not sure i would even use pt at all. Thats my story in a nutshell and i so so wish you continue to improve and be well. God Bless. Bill
 
Thanks, Bill! I'm glad to hear you're doing well!
Unfortunately, I can't say the same...I am scheduled for an MUA on Oct 10. I actually am relieved, so I shouldn't say it's unfortunate.

I'm still at 105-108 bend, and I could probably live with that...but there is still a great deal of pain, which is getting worse. The surgeon says it's caused by scar tissue. My pain is in an area shaped like an upside down horseshoe...down both sides of the knee and around the bottom of the kneecap.

I'm looking forward to some productive PT following the MUA.

I have made myself stop reading about MUA's, as there is an almost 50/50 split on or .

Thanks again, Bill! Super glad to hear another success story!


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Hi Mary! Nice to hear from you again but sorry you are still in pain. I was one of the lucky that didn't need an MUA (although I'm still in pain for a myriad of reasons), but I think, this far out from your procedure (almost 8 months), then it's the way to go for you! I will be keeping good thoughts for you! I can't remember exactly who, maybe @skigirl , who had an MUA or scar removal and said that one of the most important things was to pretty much do no PT for almost 3 weeks after and to only do light stretches and bends. I'm excited there is a light at the end of the tunnel for you! xoxox
 
@skigirl - hello! Someone suggested asking you about MUA's....they thought you had maybe had that procedure....I am scheduled for one on Oct 10
 
Skigirl had adhesions and scar tissue removed, and a spacer exchange.

I am more concerned about your health than I am about your ROM.
Please give serious thought to if you are ready for another medical procedure.

Pooshay just reported increased ROM after two years.
Same with campervan.
You have time to wait and see.


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LTKR Sept 13 2011
Revision April 15 2014
 
Thanks, @Pumpkln, except for the pain in my knee, I'm feeling good. It's been nearly 9 months since the TKR and I know it's possible/likely to gain ROM if I wait. However, like I mentioned...the pain has gotten worse in the past month. When I cut back the PT, it just gets stiffer and the pain doesn't ease up. The PT is easy, they never push to the point of pain....we went to the fair last weekend and I walked for about 4 hours, slowly, no stairs, with lots of stopping, and sitting once in awhile. For days afterwards my knee hurt so badly when I bent or straightened it. It's gotten slightly better, but now it's a lot tighter, less ROM.

The OS says it's all due to adhesions/scar tissue...more than can be broken loose with PT/massage. So I'm feeling pretty confident with the decision for the MUA. No surgery...just a quick "sleep" and bending/straighten of the knee.
 
Some people have been very happy with their MUAs. Just remember that you'll be sore at first. I'm sure some mua folks will offer you some insights.
 
I am sorry that you are having these issues, I am there with you 3 weeks out. The problem that I am having is with bending I push myself but I can not seem to bend, I am only at 70 ROM. I am not sure if it is due to having torn meniscus surgery a year and a half prior to the TKR. I am taking all the advice that I can from this forum and trust me it has helped.

I am presently receiving pt at home, I will be starting out patient PT and I fear the worst, I have been told that they will push you much harder than your in home therapy. I am concerned about the pain. Should I double up on my pain meds before therapy or take meds before and after.
 
@CityGirl, at only 3 weeks out from your TKR, I'm thinking your difficulty in bending is probably from swelling/inflammation.

Have you read all the recovery articles here on BoneSmart? Super helpful and reassuring... @kneeper can better advise...

Hang in there! It DOES get better...but it can take a lot longer than you expect. I have never been lead wrong here!
 
Hi at @CityGirl Yes, it is likely you still have a lot of swelling which could be preventing you from getting more bend right now. Take your pain meds on schedule. It is helpful to not be at the end of your dose when you go to PT but don't take pain meds so that you can work harder in PT. You want to let pain be your guide.
 
Of course, I did not have a MUA---I can understand why you want to try it. If it does not help, you might end up with an arthroscopic removal of adhesions like @maryo52 . She had good results from it. I had an open Lysis of Adhesions (removal of adhesions) because the doc felt that the spacer was too small and causing movement which increased the adhesions.
 
So....here I am, Monday afternoon, had the MUA on Friday. Josephine was right, it's nothing to be afraid of. The anesthesiologist even injected a nerve block into my thigh, so the procedure really was pain free. The general anesthetic went well and was real quick.

OS was pleased, he was able to get 130 degree bend. I have some inflammation now, and am pretty sore, but am elevating and icing and have effective pain med. I have been gently working it, but I know the swelling is keeping me from any real flexing.

Next week they will decide if I will go back to PT or if they think I can do it myself at home. I'm hoping for PT...I feel like it's really helpful, especially looking forward to trying it after the MUA.

BEST NEWS?? The pain is gone, the pain I have had with every movement. Yay! It had hurt up and down the outside and inside of knee, plus around the bottom of kneecap. Yay! It's GONE!!
 
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