Left tkr, 4.5 weeks about 110 range of motion and still can not straighten leg. Seem to have hit a roadblock. Figuring I will need a manipulation at some point for scar tissue break up. Swelling still significant.
TKR Left TKR March 6, 2024
- Thread starter Kancoltex
- Start date
@Kancoltex Hi and Welcome to Bonesmart.
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. Enjoy interacting with others who are on the same journey, here in this thread.
A ROM of 110 at 4.5 weeks is fabulous. Why do you expect to need a manipulation? You still have significant swelling because you just had a major surgery that caused a lot of internal trauma to the area, and you are still early in the healing process, which takes an average of a year.
I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.
Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
3. Do what you want to do BUT
5. At week 4 and after you should follow this
6. Access to these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
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. Enjoy interacting with others who are on the same journey, here in this thread.
A ROM of 110 at 4.5 weeks is fabulous. Why do you expect to need a manipulation? You still have significant swelling because you just had a major surgery that caused a lot of internal trauma to the area, and you are still early in the healing process, which takes an average of a year.
I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.
Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
You have not hit a roadblock, you are having a normal, and even better than some, recovery. Straightening the leg takes time and often takes longer than regaining the bend. Try to be patient, it will come in time, as you heal
And, manipulations are done for extremely poor bend, not to make your leg straight.
Not all scar tissue is bad. Normal scar tissue is needed because without it, our surgical wound would not heal. “Bad” scar tissue is more appropriately called “adhesions” which could require an MUA (manipulation) but adhesions are rare, especially early in recovery.
And, manipulations are done for extremely poor bend, not to make your leg straight.
Not all scar tissue is bad. Normal scar tissue is needed because without it, our surgical wound would not heal. “Bad” scar tissue is more appropriately called “adhesions” which could require an MUA (manipulation) but adhesions are rare, especially early in recovery.
My extension was slower coming in than my bend. My OS said to not worry about it, that it would come in, in time, as the knee heals. It took me about 4 months to get straight. It didn't bother me, because I had read that for many, extension came in slower because those muscles and tendons in the back of the knee are much larger than the other areas of the knee. These take longer to stretch out.
It sounds like you are doing quite well. Don't fret, that extension will come!
It sounds like you are doing quite well. Don't fret, that extension will come!
NeedaThneed
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Oh I agree 110 is fabulous! You’ll get more over time. And it’s normal to not fully extend at 4.5 weeks. Just don’t make the mistake I made and force it painfully and give yourself hamstring tendinitis! (Set me back many weeks).
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The swelling is what interferes with flexing and straightening.
The best things to reduce swelling are elevate "toes over nose" and ice 45-60 minutes at a time, and to not let PT bend or stretch you into pain.
Pain is the healing knee's only way to say stop and it has to be respected. Gentle non painful stretching is fine. But any increase in flexion obtained by forceable means is reversed as soon as the swelling it induced roars back.
The best things to reduce swelling are elevate "toes over nose" and ice 45-60 minutes at a time, and to not let PT bend or stretch you into pain.
Pain is the healing knee's only way to say stop and it has to be respected. Gentle non painful stretching is fine. But any increase in flexion obtained by forceable means is reversed as soon as the swelling it induced roars back.
