TKR Injury vs arthritis

[benne68]

That leg is worrisome. She needs to be seen as soon as possible and -- as Jockette says --by someone who is not associated with the surgeon's practice.

 

[Jamie]

Workman’s Comp cases, as you probably know are not handled the same way as when you work with your private insurance and both cannot be used for the same medical situation. Your attorney is correct that the case needs to get resolved before your wife quits, if that’s in her plans. Not doing that could jeopardize the Workman’s Comp claim.

If you feel she needs to be seen at an ER, it would be wise to contact your attorney first to make sure he is aware and agrees this is something he can support. Workman’s Comp might fight the payment of the bill. And, if you see another medical person, you must make them aware these problems are associated with a Workman’s Comp claim.

I do see a few issues here, though. First, the fact that your wife is not permitted breaks during the work day. Even a healthy person gets a couple of breaks during their time at work. Second, employers must make accommodations for someone who has a documented medical situation, and especially if it is a result of an injury on the job. These are things a good Workman’s Comp attorney should be able to fight for you. I don’t understand why your attorney is not helping. Have you considered finding someone else?

 

[Jockette]

She really needs to see someone in another practice, one not at all associated with the current one. Go to an ER in a hospital some distance away. Her health is at stake and if you continue to not get treatment it may become untreatable.

@Asababy08
I’m sorry that I advised this in post #40. I don’t have any personal experience with workers comp so I didn’t understand exactly how it works. I just feel so bad for your wife and I’m outraged about the lack of care and concern she’s facing, and I’m worried about her healing. I wish you the best as you try to get better help for her.

 

[Asababy08]

I think our concerns got overlooked on here so I wanted to check again to see if we could get some insight . Is it conmon to use different sizes of knee replacement parts ? See pictures . TIA

 

[Asababy08]

So she saw the PA today and he left work restrictions the same and ordered more Pt . Said that she would probably have long term pain and that the swelling was normal since she had tramatic injury in first place and that she would probably have to find another line of work . The PA said that the surgeon had to have back surgery and will be back in august

 

[Asababy08]

So my wife had her first day of PT again . It's been since febuary since she last did PT . It's now April 15,2024 . Pt said range of motion is 110 and her gait is off . Is this common for being 8 months PO ?

 

[Pumpkin]

Is this common for being 8 months PO ?

The range of healing is highly variable with some healing sooner some later.
With you wife having to go back to work so soon and irritating her knee, likely it will take longer for healing.

ROM of 110 is adequate for most activities.
Degrees of flexion that are required for the following activities:
- 65° to walk,
- 70° to lift an object from the floor,
- 85° for stair climbing,
- 95° for comfortable sitting and standing
- 105° for tying shoelaces.

Many members including myself regained ROM well after a year after TKR.

PT will be able to work with her on her gait. Give it time for her to continue healing.

 

[Asababy08]

So she is having difficulty even getting up 3 steps into our house especially if she has been on her feet at work . The restrictions that PA gave her to return to work was 30 hours per week instead of daily . She is a general manager of restaurant that only has her and 4 others day shift and with that type of staffing it's almost impossible to take breaks and ice the way the PA ordered . She is wanting to get PA to revise the work restrictions but unsure of how to approach issue . TIA

 

[benne68]

She is a general manager of restaurant that only has her and 4 others day shift and with that type of staffing it's almost impossible to take breaks and ice the way the PA ordered

Sounds like a very difficult situation for her. Did you explain this in detail to the PA at the last appointment?

 

[Asababy08]

So wife has finished up 2 round of Pt 8 months PO TKR . Still having ROM issues and balance issues . Still cannot kneel . Her knee replacement was due to tibia plateau fracture type 6 . . Her therapist wants more PT BUT IT DOESNT APPEAR THAT DOCTORS OFFICE WILL APPROVE UNTIL SHE SEES SURGEON IN SEPTEMBER AND WORKERS COMP WANTS TO WRAP THIS UP ASAP . Yet she isn't making much progress or is going backwards . Any advice ? TIA

 

[Jockette]

Still cannot kneel

This is very common, many of us don’t ever kneel again after a TKR, unless absolutely necessary, and even then it can be difficult, or uncomfortable at the very least.

I personally don’t know what to tell you about your situation other than what has already been mentioned. Maybe you should read back over this thread to refresh your memory of what has been suggested and see if some of those suggestions might work better for you at this point. I’m so sorry you and your wife are in this situation.

If 8 months of PT hasn’t helped her yet, then she needs another option. PT cannot help her heal if she isn’t able to take care of her healing needs at work. All the PT in the world cannot undo that fact that she is on her feet for many hours a day, which is hindering her recovery.

 

[Jamie]

Did you look into finding an attorney who would actually help you with your wife’s case as I suggested back in April? Workman’s Comp is tough to deal with. They have control of the situation and will try and push you to do things that may not be in your wife’s best interest. You NEED a good attorney who can be tough with them. Workman’s Comp cannot close the case without your agreement. If your wife is going to be left with permanent disability of any type, a good attorney will ensure that she receives disability payments.

Your wife’s healing is probably “normal” given the situation she’s been in. Mose people need at least a full year to recover from a TKR. Working as she is and pushing is adding to that timeline. But pushing like that can lead to chronic pain, which should qualify her for some type of compensation. These are things you really need an attorney to explain for you, as each state has different rules for these types of injuries.

 

[Asababy08]

So aggravated . Now on 3rd round of pt , still cannot squat or kneel . Doctors and Pt therapist have all told me I need to find another job due to my injury that resulted in total knee replacement . On light duty at work for 7 months and job is hounding me about labor cost whereas I am the GM am limited to a 30 hour work restriction and yet upper management is fussing about labor costs . I have PT 2 days a week that requires me to leave early then I also have 2 days off . Still have to schedule employees to cover me when I am not there . Can't quit till workers comp settles this case . Just stressed cause I can't get answers . mmi comes in September . So over this

 

[Asababy08]

So I think this is a legitimate question . Does anyone who has had a knee replacement go to PT for maintenance or anything past a year . My wife was wondering this since she is still going to Pt 10 months Post OP due to this Being as result of an injury . She is thinking that she will have to go to maintain the progress she had made even after the 1 year mark . Thanks in advance if anyone has info

 

[mendogal]

Most of us aren't workers comp cases, so different answers! Workers comp will need to address that.

I'm on Medicare. Medicare at one time never did pay for "maintenance" PT but was facing big lawsuits a few years ago from post-stroke and motor disease patients who were cut off PT due to documentation showing they had "plateaued" - not at best function but no measureable progress. Feds had to agree that 1) sometimes a plateau is normal but temporary and 2) that sometimes ongoing PT is needed to prevent decline that results on medical complications.

For most of us post op, this scenario doesn't really apply; if there's ongoing problems, it's not a matter of maintenance but of the ortho or other physician assessing, diagnosing, and treating the problem.

 

[Asababy08]

Totally understand .
I was wondering if work restrictions at 101/2 months is common for those who get knee replacements or just because it's a workers comp case ? Could work restrictions be permanent ?

 

[Asababy08]

Wife finally has permanent work restrictions from doctor and doctor said that they will see her as needed. Doesn't sound like standard protocol. So her job has decided to cut staffing by 1 person at her job so now she comes home still having to ice and all that because her job keeps her on feet all day up to 7 hours. She can't quit until workers comp settlement is done. She is very frustrated cause it seems like doctors haven't listened to her and I don't know how to help her

 

[Jockette]

I’m so sorry you’re in this situation.

 

[Asababy08]

So my wife finally got a different doctors group paid for by workers comp for her hip /back pain. She said the doctor pulled on her good leg and she got pain in her quads. They did about 15 X-rays of hip and back, and she goes tomorrow for an MRI of hip back and her left leg where the knee replacement is. This insane. They sent her home with a tens unit and a back brace and lotion for pain. The doctor gave her Almost the exact same work restrictions, but her bosses won't even accommodate those restrictions. She can't just go sit down whenever she wants even tho she is the General manager.

 

[Asababy08]

So back in December 2023 , was sent back to work with restrictions of working 20 hours , then progressing to 30 hours a week , no lifting over 50 pounds and ice every two hours . Even after complaining that job wasn't abiding by work restrictions , the PA never modified the work restrictions . Fast forward to 9-5-2024 PA SAID I was at Max medical improvement with 40 % impairment rating leaving the same restrictions in place as mentioned above . The permanent restriction that are noted in the attachment we feel should have been exactly like this regardless whether they were permanent or not since my wife is employed as a restaurant manager and was performing the same duties as all other employees which invoked a hell of a lot of standing and walking due to serving food (subs -national chain Of restaurants ) . Just want to see if what others think or suggestions that one may have on how to proceed with this matter . TIA