High Tibial Osteotomy It’s Done! From Revision to Tibial Tubercle Osteotomy

[Pumpkin]

Glad you found us, just wish the 60+ lady you mentioned would find us, and stop letting them over work her knee.

 

[Josephine]

1. 2 but I took an oxycodone about 2 hrs ago

Okay

2. Oxycodone 5 mg. I usually take 1 at night. If I have therapy like today I will take 1 an hour before I go and 1 when I return home. If no therapy 1 in the afternoon.

And this manages your pain adequately?

3. I am not icing per instruction of pt

Ice. Your surgeon told you it was important and it is. It will not affect the PT's treatment but more about that later ...
You must ice while you elevate.

4. I do elevate several times a day half hour to an hour.

Jolly good!

5. Flexion on my own 90 straightening 8

Under the circumstances, that's not at all bad.

6. Moderate

I would expect that.

7. I don't do much of either... I tried shopping my knee was killing me. I do light cleaning but it takes a while. I tire easily and have to take breaks

Of course you tire easily! You shouldn't be shopping yet! Activity progression for TKRs


My comments in bold
heel slide in bed and while sitting 4x 3reps of 10 - heels slides are terribly easy to do badly and doing 4 intense sessions per day is badly! Read this Heel slides and how to do them
Walking with right leg bent when going up 3x 4 reps - does 'up' mean upstairs? Are you then forcing your knee to do stairs normally? If so STOP! Do them one at a time until you find you can do them normally and easily
Quad tightening in bed 3 x 3 reps of 10 - these are okay but only one lot of 5 reps and once a day and none at all at the weekends
Leg dangling end off bed 1x 5mins in the morning before getting up - this is a punishing thing to do. Read this and follow the instructions within Extension: how to estimate it and ways to improve it.

PT
Knee straightening when he pulls my leg 3x 40 sec
Knee bending when he bends my knee 3x 40 sec
Quads 3x reps of 10
Bend knee with strap 3x reps of 10. Hold in bent position 5 sec
Heel slide 3x reps of 10
Lunges 3x reps of 10
Walking back and forth 5x
Astym 2x week. I stopped today! Told pt I know longer wanted it!

I suggest you quit the PT altogether. With that routine, she is doing you far more harm than good.

there was a lady there in her late 60's she was literally begging her pt to stop... Was painful to hear! Pt kept telling her just a few more seconds

If I do one thing to justify my life, it's to get the message out that all this brutality is not only unnecessary but actually harmful.

 

[skigirl]

And, once you tell a health professional to stop a porcedure--they MUST do so. It is assault if they continue. If I had heard that begging, I would have been tempted to call the police.

 

[kneeper]

I would give your knee a break. I let them try astym on my first knee and I think it just further aggravated sensitive tissues. Never again.

 

[bibi]

Hello All.. I know it's been awhile but here's my updates:
I did go back to therapy last Wednesday. I was scheduled for an Astym. I told my pt I no longer wanted it! I did not believe it should be my best course of recovery. He looked at me as if he was insulted! Kept asking me why? Wasn't it helping? He kept leaving the room and went into the office I am guessing to speak to the head pt. I explained that it was very painful and my knee was too traumatized. He literally invaded my space when questioning me and trying to persuade me to continue with the astym. No Sir! I also shared my concerns about him instructing me not to ice??? I told him I am not a doctor or a pt but I do know swelling- icing!
He did do some DEEP MASSAGES, had me do some exercises that wasn't too strenuous. But I could see he was visibly upset. He even suggested dry needling!
Monday past was my reevaluation and I was also assigned another therapist. She was present when I had the conversation with the other pt.
My rom was 92 and my extension -10. Without assistance. She did some deep tissue massages and noted my hamstrings are tight. They are. Had me relax. Did a few non strenuous exercises. Asked me to walk so she could observe my gait. Gave me some suggestions. Told me to go home and make sure I walk heel-toe do a couple reps of heel slides a day and to ice and elevate.
I think I found a winner!!

 

[Celle]

Congratulations on sticking up for yourself and for insisting on what you want.
You are the boss, so continue to say what you will and will not allow or do.

I really don't understand why some PTs feel so much need to interfere and mess around with the natural healing process. Nature knows what it's doing and makes a very good job of healing, as long as you don't do anything to upset it. PT therapy should help, not hinder, your body's natural healing processes.

 

[Josephine]

PT therapy should help, not hinder, your body's natural healing processes.

Personally I think PT helps most when it's TOTALLY ABSENT from the healing process!

 

[Celle]

I truly don't think that PT is necessary for most people in the early stages of their recovery from a TKR.
Where PT can be helpful, though, is later in recovery, to help with balance and gait.
Ironically, with the emphasis most PTs put on achieving ROM, many patients have been discharged from PT before they reach that stage.

 

[kneeper]

I'm with you @Celle I've come to the conclusion that PT can help with some things but this need to keep trying more and more aggressive intervention isn't it.
For me, having walked for many years compensating for the knees put some muscles out of whack. Having them show me some stretches and so forth was helpful. I still use them.

 

[bibi]

Hi!
The pt I am assigned to now concentrates on massaging my whole leg. While massaging the back of my leg she remarked my hamstrings are tight. She massaged it, applied heat and massaged again.
Have you ever heard of taping the knee to assist with the pain and swelling? The pt placed a piece of tape on both sides of my knee. She told me if it starts to feel uncomfortable to take it off. I am asking because I haven't read any posts of anyone who had it done.

 

[bibi]

It's called kinesiology tape. When I left pt of course I googled it!

 

[Clipless]

In my opinion any perceived benefit from kinesiology tape can be chalked up to the placebo effect. I've had my left knee elaborately taped up on several occasions. Didn't do a thing- in fact it wouldn't even stay on after PT worked so hard to apply it. Apparently I am made of teflon.

 

[skigirl]

If your patella is moving out of alignment and is thus bothering you or causing pain, there is some slight evidence to suggest that if you tape the knee so that the Patella is held in the "correct position", it will help. I have also had my patella and my hamstrings taped and I also feel that it was of very limited or no value---but I have a friend who swears by having her patella taped into position.

 

[Celle]

Have you ever heard of taping the knee to assist with the pain and swelling? The pt placed a piece of tape on both sides of my knee. She told me if it starts to feel uncomfortable to take it off. I am asking because I haven't read any posts of anyone who had it done.

@Pumpkln has experience with kinesiology tape. I'll ask her to advise you.

 

[Pumpkin]

bibi,
The instructions are correct, if it bothers you take it off. The tape helps some and not others, I have some on right now, and feel it helps.
If it helps then leave it on, if it bothers you take it off, slowly to protect your skin.
You can leave it on for up to 5 days, showering is fine, it dries fairly quickly.

 

[bibi]

Thank you! My patella isn't moving I don't think... PT said it was for the swelling. How does taping assist with that? I still have it on don't feel one way or the other. Although I am feeling slight pain on the inner outside of my knee. Don't know if I should attribute it to the taping or regular pain. Currently lying down with my leg elevated reading my Reader's Digest.
Hoping everyone is healing well and enjoying their Saturday!

 

[bibi]

I am also experiencing a problem of inner sutures coming through my incision in 4 spots. Staples taken out two weeks ago. One of the spots a little bit of yellow pus. I have an additional two small spots near the end of the incision a little bloodied discharge is on the band aids when I change them. Shouldn't my incision be healed by now? And will the string/suture break off or something?
My next OT appt is this Wednesday.

 

[Pumpkin]

I had inner sutures poke out, they usually just fell off. Suggest you let your OS know about the little bit of pus and the bloodied discharge, it is probably superficial, let him know to be on the safe side. It can take a bit for those final spots to finally close.

 

[bibi]

Not too concerned doesn't look deep. I believe it is superficial.
Thanks!

 

[Josephine]

And will the string/suture break off or something?

You can read about that here Closing surgical wounds: how is it done?.

kinesiology tape

Also known as McConnell taping.
Patello-femoral pain syndrome (PFPS), fat pad impingement (Hoffa's Syndrome)