Bilateral TKR I Can't Believe It...I Did It!!!

[Justrosieinsa]

Happy Anniversay Pamx2! I'm at 14 wks post BTKRs and I read through your posts and I am pretty much where you were at this time. Have my last insurance covered PT session tomorrow and after that I am on my own. I do have an elyptical and a recumbent bike some leg weights at home. I will have to discipline myself to keep up the exercises because I need more ROM and stronger quads to be able to do stairs and standing up from lower seats.

Congratulations on a job well done!

 

[kneeper]

Happy knee anniversary!

 

[skigirl]

Wow, that was amazing. I am so glad that you are feeling well and strong. And that we were able to help you!! thanks for such an inspirational post!

 

[Pamx2]

Hello Everyone! Here I am 18 months out from my BTKR and I've got a blip in my recovery and some questions for you. I just saw my OS a few days ago and he is happy with my left knee...it's at about 120 degrees. But my right knee is stuck at about 95 degrees. He wants me to start wearing a brace that keeps my knee flexed...wearing it for a few hours in the day and a few hours in the evening if possible...just to see if I can stretch my knee and get a bit more ROM. He wants to see me in 3 months, and he said if I haven't gotten anymore ROM in my right knee he'd like to do manipulation under anesthesia (MUA).

HERE ARE MY QUESTIONS....
1) By the time I would have MUA I would almost be 2 years out from BTKR. Is that too late in the game to be having MUA??? And
2) how long would it take my right knee to recover after MUA?

I'm worried because I'm not having pain in my knee right now unless I over-flex it (like if I trip) but otherwise it's fine. The only thing I still cannot do is walk down a flight a stairs like a normal person. I still have to take a step at a time because my right knee cannot flex enough. I worry about having MUA because I'd most likely have it in January and my daughter is getting married in May. I just don't want to be dealing with a sore knee. Thanks for any advice!

 

[Pumpkin]

@Pamx2 ,
Welcome back, sorry to hear you are having trouble with your ROM, and may have to have a MUA. Here are some links to a couple of articles about MUA. Seems like it would be up to you if 95 degrees is enough or if you would like more ROM. Good luck moving forward.
MUA (Manipulation under Anaesthetic) and Adhesions
MUA: the ineffectiveness of early MUA (JBJS)

I will tag @Josephine , to answer your questions about MUA after two years.
Keep us posted on how you are doing, what ever you decide,

 

[Mutley]

Hi Pam,
Not sure if this reply will be any help or not but thought I'd say it anyway! I had an MUA at 9 weeks after TKR. Have to say the pain & recovery was awful. Waking up from the MUA was worse than the original knee replacement. Anyway, I'm now 21 months post op. Although my surgeon managed to get from 80 to 120 my ROM is now about 100. We had discussed the possibility of trying it again but my surgeon said no, there was nothing more to be gained & basically what I have now is what I will have from here on In. Very frustrating :-(
I can manage to walk down most stairs but occasionally I have to do one step at a time. Riding a bike requires the saddle to be up as far as possible and adopting a rather unique cycling style! I know what you mean about pain caused by tripping over things & giving the damn knee an unexpected extra bend :-(
If you were advised to have an MUA I'm sure the knee will have recovered in time for the wedding, it's just whether you want to put yourself through it & what you will gain?
Good luck & make wise choices

 

[Dhare63]

If you decide to go forward with MUA, just be sure to treat the knee gently and control swelling after. For me, the pain after was no where near as bad as the TKR. Everyone is different however. If you have it in January you should be okay by May. It's all in the recovery and how you approach it. Slow and steady, ice and elevate.

If you decide against MUA, and if you haven't tried it before, a warm pool with an exercise bike in the pool may help. I did this and it was great.

Whatever direction you take, keep us posted and let the gang know how we can help!

Be well,

Dawn

 

[Josephine]

By the time I would have MUA I would almost be 2 years out from BTKR. Is that too late in the game to be having MUA???

It would be a tad unusual but no reason it can't be done. I think maybe he wants to do this in order to see what flexion he can get while you're under. Often times, the flexion while the patient is awake is misleading and more is achieved under anaesthetic. I've known cases when we took photos during the procedure to show the patient was was achieved while they were out and they'd be mightily surprised! This does NOT imply that anyone thinks it's "all in your head" or anything. We have no idea why these things happen like that but clearly they sometimes do.

However, should he find that your flexion really does have a block on it and he can't get it past 96 either, then at least he'll know he's got a problem to be resolved. Presumably he will try forcing it then but, being a skilled surgeon, he will know the limit he can go on that. If it still refuses to shift, then he may have to do an arthroscopic lysis instead. Whether he proceeds to that straight away or books it for another day remains to be seen. I would certainly recommend you ask him about this though.

how long would it take my right knee to recover after MUA? I worry about having MUA because I'd most likely have it in January and my daughter is getting married in May. I just don't want to be dealing with a sore knee.

Jeepers, that would be 4 months on! I think you can trust you'll be safely over that hump by then, with or without your poor flexion!

 

[Pamx2]

Thank you, Josephine, for your advice....and thank you Pumpkin for tagging Josephine for me. I've been searching the Internet to read about MUA two years or more after TKR but really haven't been able to find much. So I was worried that doing MUA that far out isn't advisable. I trust my surgeon...about 99% of the time...because he has been great so far and has years of experience and is well respected by all. But I can't help but be cautious with my knees...you all know what I mean. Thanks Dawn and Mutley for your advice too. Mutley, I have to do the same thing when I try to ride a stationary bike. It's very difficult for my right knee to make a complete rotation. I've not dared to try a regular bike because I'm sure it wouldn't end well. I will keep you posted...thanks again!!

 

[scaredinCA]

Your headline caught my eye.. You can't believe you did it... Well its been a yr and two months since my BTRK and I STILL can't believe I did it.. I was so scared and found every excuse to prolong not having surgery. I waited much too long because of fear and now my legs have never gotton completely straight because they were so bent before surgery.. If ONLY.... I think I walk around in shock over having done it finally. But thank God I did.....

 

[Pamx2]

LOL...I was the same way...SO SCARED!! My legs were so bowed before my surgery I looked like I had been riding horses all my life...which I hadn't. My knees were finally so painful that I had to use a cane, and use a wheelchair for long distances. I was so backed up against the wall that I had no choice but to get my knees done. That's why I'm hesitant now to have MUA done. I think my knees are fine. Sure they are not like they were when I was a kid. I can't ride a bike...and I have to take steep stairs one at a time. But my knees don't hurt when I'm standing...and I can walk and walk and usually my feet are the first to start hurting before my knees are sore. So I'm not pushed up against the wall this time and I don't want to rock the boat fixing something that doesn't seem to be too broken. I'll be getting my brace hopefully this week that I can wear for a few hours in the day or night and see if that helps stretch my knee a bit.

 

[scaredinCA]

So are you unable to completely straighten out your knee and whats the brace supposed to do? I know how you feel though because my knees aren't perfect by a long shot. I'm at about 95 in both and I doubt they'll get much better than that and I can't straighten them completely. I think they are about 5 in that department. I haven't asked for a MUA because, like you, I don't want to mess around with what I do have.. And like you, my feet hurt much more than my knees now!!

 

[Pamx2]

Hello Everyone....Just an update to give you a Friday afternoon chuckle. The flexion brace my OS wanted me to wear arrived a week and a half after I saw my OS. I went to his office and the representative from the brace company fitted it on my right leg. She explained how the brace worked...I'm supposed to wear it working up to 8 hours in a 24 hour period, hopefully while sleeping, while it gently flexes my leg. But as I have this brace on it something doesn't seem right..but I'm not sure exactly what. So I thank the rep, head home, and get the brace back out of the box and go on to youtube to look up instructions regarding this brace (it's so amazing what you can find on youtube!) Anyways, I realize that they've given me the wrong brace. It's for extension. That's right...it's supposed to help straighten my knee. I look on the paperwork...it says the brace is for extension. On the brace box...ditto. So I call the rep and she insists it's for flexion. I tell her it says printed on the brace..."Right Knee Extension". The way this brace is designed, there is no way its going to be flexing my knee. It wants to keep my leg straight. So I take back the brace to my OS's office, the rep apologizes for the mistake, and she orders a brace to be sent directly to my house. I just got the brace in the mail. I pick up the box, and notice right away it says LEFT knee flexion on the box. I open the box and the brace also says it's for the left knee, and I can tell by the design of the brace that it is labelled correctly...it's for the left knee. I've decided this is a sign that I don't really need a brace to do the work that I can just do on my own. I've been avoiding sitting in my recliner at night and have either been sitting on the floor doing nice knee stretches and bends...or at least sitting on the couch where my knee sits flexed and stretching past 90. And guess what...I'm getting more ROM out of both my knees! Lesson learned...it's good to keep stretching those muscles long after TKR so they don't decide to tighten themselves back up a bit.

 

[scaredinCA]

NO NO NO please make them do their work.. Theres not much excuse for this error right after the other error and its not your fault.. They get paid to do a job so please make them do it and get it right. Sure you can probably improve on your own, but why should you? Your doctor wants you to do this, so make the rep work for her pay.. Just my unasked for advice.

 

[kneeper]

I'm glad you're getting more ROM but I agree with scaredinCA--make them get you the right one.