TKR I just want to ride my bike. :(

Jaycey

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@Mustang Shazzy If you continue to read the content following your mention of 8 weeks you will see that the results in terms of ROM of patients who did not have MUA were very good. The passive approach worked in most cases.

Of course the decision on how to proceed is totally up to you. But do note that the procedure will basically put you back to starting your recovery again.
 

Tower6brkrs

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Have you been able to use a pool for aquatic therapy? or even just a hot tub. any water where you can do EZ squats, knee bends even mimic a bike pedal rotation etc? low impact, basically no resistance and all ROM gains
 

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Yeh, no, not the ROM, I'm talking about the MUA. The studies show that they are most effective when done within the first 8 weeks
A combination arthroscopic LOA and MUA can be done at any time. When I had one done, the surgeon wanted to wait until at least the six month point so the inflammation would be less. I had mine at the eight month point because of the Covid surge at that time. After this surgery, swelling and pain did not increase, and within a few days, both had decreased to lower levels, lower than I had had in several months. I was very happy with the immediate results.

This would allow you to wait until you had the second TKR done and at least partly recovered before doing the arthroscopic LOA/MUA, so you didn't have two swollen painful knees simultaneously.

Not every surgeon can do an arthroscopic LOA - it requires a very high level of skill.
 

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Hello Mustang Shazzy,I never considered that I would not be able bike either!They had me in a recumbent type bike in p.t.so I thought I could get on my bike that my husband got both of us one a few months before surgery.We loved riding.I do not want to give it up at all!!!I am also afraid to have anything else done !?Good luck on second knee.And don't forget to make sure p.t. is ordered for it also.I was so just my whole body sick from surgery that I wasn't thinking "hey my first knee was manipulated and it needs a lot of therapy"I just kept going to therapy for new knee and doing my home exercise routine for both.
 
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Mustang Shazzy

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Have you been able to use a pool for aquatic therapy? or even just a hot tub. any water where you can do EZ squats, knee bends even mimic a bike pedal rotation etc? low impact, basically no resistance and all ROM gains
Yes, thanks, just started this on the advice of my exercise physio.
 

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I have been doing water aerobics.
 
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Mustang Shazzy

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Update for anyone who hit the same snag as me with riding a bike.

I started on a recumbent, increased the distance each day. After a while I found I could ride the upright if I did a couple of k's on the recumbent, then eventually I didn't need the recumbent. In October I rode 210 kms for the month in the Great Cycle Challenge, which is the shortest distance I have done in all the years I have been doing the challenge, but to be honest I was stoked because I was scared I would not be riding again...ever. Plus I raised $700 for kids cancer research.

I have a great exercise physio and a program that includes deadlifting and squats which makes me happy. I don't load up the bar, but I can get a good work out with low weight and high reps. My gym has Olympic bumper plates now so I can just whack 5kg plates on and do sets of 10 at 30 kilos. Nothing like the 70, 80 or 90 kilo lifts I used to do, but I can live with that. The stronger my legs, the better. Plus if you're a lifter then you will know the therapeutic benefit of holding iron in your hands and shifting weight... any weight. I don't want to live without that.

I'm on the waiting list for the other knee but I don't think I will go through with it. I am still stuck at 105 degrees and while I have found ways to adapt , the reality is if I come out with two knees stuck at 105 degrees I don't see how I will be able to get out of the bath or up off the floor. So it seems to be a choice between pain or total permanent disability.

My biggest problem now is the muscle and tendon stiffness. Deep tissue massage and cupping from my exercise physio is great and I use a foam roller and lacrosse ball when I go to gym to really get into the tight places. I go to gym 6 days a week and incorporate physio into my gym program. I am still a few degrees off being straight - I put a 5kg plate or a 7kg dumbell on my knee while resting my foot on a stool but the thing that seems to keep it from being straight is tight hammies. The only time I feel good is after a bruising massage sesh with the physio.

I don't know how much of my ROM problem is scar tissue in the knee or stiffness in the muscles and tendons, so I no longer see any value in an MUA.

I've passed 7 months now. At this point I am just hoping that by 12 months the tightness and ROM issues are better but a little piece of me has resigned myself to the possibility that I will have a stiff knee for good and that I should have just put up with the pain.

I walk with a limp, but I think that's because the other knee is really painful. In the morning when I get up the new knee is stiff and it takes a little to walk normally on it. It's weird to watch myself in the mirror when I deadlift because my new knee leg is straight while my crappy knee is bowed because it caves on the medial side. Pretty sure that doesn't help with walking.

On panadol and metacam in the morning and panadeine forte at night, but that's mostly for the other knee. I don't have much pain from the new knee now.

So at this point in my recovery do I recommend total knee replacements? No, I do not.

Merry Christmas everyone.
 

Roy Gardiner

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I am not a physiotherapist or formally qualified in any way to give an opinion; I've just got experience of BTKR and done a lot of reading. And anyway ignorance has never stopped me offering views.

Bearing that in mind - it's possible you may have adhesions (everyone has scar tissue, that's not a problem). Adhesions are caused when tissues gets dry, inflamed and then stick together. MUA could indeed be useful to fix this problem.

Muscle and tendon stiffness may well be caused by exercise without enough corresponding flexibility stretches. Strength training does not promote ROM. If you haven't got adhesions then stretching WILL allow greater ROM. I suggest concentrating purely on ROM and stretching for a while.

You could also try using a static bike purely for ROM.

  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
 
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Mustang Shazzy

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17th of March is the date set down for my second TKR - Got my right done in May last year.
If I wasn't in so much pain I wouldn't have it done and if my place came around a few months ago I likely would have said no. I am still struggling with ROM. Can't get it straight even with a 10kg weight sitting on it and 115 degrees is the best I can do for the bend. That's no better than I was at 6 weeks. It took me ages to ride a bike and get back into a gym routine. Seeing my exercise physio regularly and doing my program 6 days a week.
Telling myself that my recovery has been hampered by the fact that I couldn't actually straighten it before the op and the massive bleed in my calf combined with how long it took my quads to heal after being cut. If I come away with the same ROM I reckon I can still do most things, probably not get out of the bath tho. Not opting for a MUA on the right when they do the left, will just give it time and have faith, I can see I have come a long way. It took me awhile to get to this mental space - I had a expectation that by 2 months I would be pain free and as functional as I was before the op.
 
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Mustang Shazzy

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March 24th now. Second one. First was left knee May 2 2022, now right. Both robotic assisted TKRs…
We are TKR mirror twinnies. I got the right done May 20 2022 robotic assisted and now my left is happening on March 17.

How's your ROM on the first? Did you find your quads took a long time to heal after the screw holes?
 

Jockette

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@Mustang Shazzy
I‘ve moved your post above out of the Monthly team thread as we reserve that thread for surgery date information, and so members can see who else has surgery the same month. We prefer all other comments and discussion to take place in a pre op or recovery thread, such as this one.. :flwrysmile:
 

Roy Gardiner

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telling myself that my recovery has been hampered by the fact that I couldn't actually straighten it before the op
That is a key issue. The body adapts to restricted movement capability and the tissues shorten. TKR frees up the capability, but does NOT adjust the tissues. This takes time and stretching exercises.
Can't get it straight even with a 10kg weight sitting on it
That's not the way to do it, sorry. Adding weight makes the body resist; GENTLE stretching is needed.

My own ROM, Extension and Quad exercises

I had a expectation that by 2 months I would be pain free and as functional as I was before the op
You were compromised before surgery, so it'll take time. Lots of stretching, every day. No pain.

Have you tried the static bike regime I suggested?
 

sistersinhim

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@Mustang Shazzy, my extension was slower to come in, too. I achieved better strightening by walking will a longer than normal stride, with a heel-to-toe gait. This helps to stretch out those large tendons and muscles in the back of the knee. It didn't happen overnight, of course, but did work. I'm now a little hyper-extensive on that leg so it worked well.
 

LD of Michigan

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It'll get better :console2:. My first full revolutions (five wks) on a mounted standing bike in PT were painful, but it faded after a few days of more peddles (about twenty revs total).

Then I resumed to work on a recumbent bike to rest the knee. I my case I DO believe I had to push thru to get the 'bend' in as it were. But had pain increased I would have backed off and waiting until later. I really want to do light bike trial riding as I was able with my RTKR in 2019. But rested in between the efforts to get the knee loosed for the revolutions.
 

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The first time after my tkr that I rode my outside bike was only for about one mile, but boy, did that feel good! I knew then that my normal life would be coming back.
 

LD of Michigan

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Yes, I so look forward to that for all of us enjoying that exercise...:bicycle1:. I just ride about college campus field to avoid obligation to keep up with others. There are rental bikes nearby. Just insert card and off you go with the bike. No need for lifting/ storage.

I'm thinking of knee pads though this late summer when I attempt biking. I've fallen down steps on wood. I don't want to fall on concrete. Does anyone here use knee pads?
 

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