TKR Left TKR with intra operative fracture

[Layla]

Hi there safi,
Great to know that the fracture is healed! The news had to make you happy.
Your surgeon can suggest MUA and even try to persuade you, however, this is your knee and your recovery and you do not need to feel pressured into a procedure you don't want, now or ever. Explain that you're not comfortable undergoing MUA right now because you trust there will be progress, even if it's slower than expected. You'll continue to improve over the next several months, even up to a full year post op. If you feel it will empower you to bring someone with you to the appointment for support, please do so.
All the best! Thanks for the update, safi.
@safi

 

[sistersinhim]

I was actually in 2 knee braces, one for each leg after my kneecap removals in the early 90s. The knees came back just fine without PT or MUAs. I did my normal daily activities, and to aid the bend, I sat in a tub of hot water that warmed my knees. I would slide my butt back and forth to work on the bend, but never to pain! Do not do this unless you have no unhealed places on your knee. You might want to ask your doctor about it, too.

He scheduled an appointment to see my surgeon on 4/13 and I fear I am going to be pressured into this procedure.
Just a bit worried at the moment and hoping for some reassurance that me not wanting to go ahead with this at this time is ok.

You are the boss of everything that happens to your knee! Your medical people work for you and you have the final say so. Don't be bullied into anything. I hate to say it, but and MUA is easy money for the doctor, and in my opinion, is done way too often in the US.

All you need to do is give your poor knee time to heal, and bend on its own timetable. Again, don't be forced in to doing anything you don't want to do!

 

[Jamie]

I strongly suggest that you bring someone with your to the surgeon appointment. It’s easy to become overwhelmed when facing a surgeon who is pressuring you for something you don’t feel comfortable doing right now. The second person alerts the surgeon to the fact that you are in control of this decision and he may not push you as hard with a second person in the room.

Should you really have adhesions (the reason for doing an MUA), there would be time for that later. We have had plenty of BoneSmaties who did need an MUA later in their recovery and did just fine afterwards. This is your choice and frankly it sounds as though you are listening to your body signals that indicate it needs some time to adjust to all the trauma you’ve experienced and continue to heal.

 

[safi]

Thank you @Jockette
That is exactly how I feel and really really do not ever want to have a MUA ( I read one of the risks is possible fracture!! Yikes) but it is worrying me if they try to pressure me and I refuse I don’t want them to say I’m being obstructive and refuse to work with me further.
I am sure given time after the brace is off that it will improve as you mentioned about @sistersinhim and all the other people’s experiences here I have been reading about.
Can you tell I am a terrible worrier

 

[safi]

Thank you @Jamie and @sistersinhim, you kindly responded whilst I was replying above, it is reassuring to hear all that you say.

 

[safi]

Thank you @Layla too!

 

[Jockette]

Can you tell I am a terrible worrier

We were all worried to some extent in our recoveries, this is a new experience for us, if it’s our first joint replacement. Add to that, pressure from the medical team to do something that does not make sense to us at this time.

As Jamie said, we have had members who did get an MUA that did help them. We’ve also had members whose MUA did not help them. Either way, it is my opinion that 6 weeks is way too early to consider it, even if I hadn’t had a fracture or a brace. I would also worry about a new fracture doing an MUA after healing from a fracture.

Try to relax, keep posting here, we are here for you.

 

[Jamie]

You are not being a “worrier.” You are being an active participant in your surgery and healing process, listening to your body, considering your options, and making the right decision for you at this point in time. I doubt that your surgeon would refuse to continue seeing you if you made this decision. And, should he take that route, I’d say you’re better off without him. Medicine is not an exact science. Each person is unique. He should know that and respect your decisions on treatment once he presents your options.

 

[benne68]

I am so sorry you are feeling pressured by your surgical team. I agree with you that it's ridiculous for them to expect you to have good flexion after being in that brace for the entire 6 weeks.

It's easy to feel intimidated by surgeons -- but try not to let his "expertise" force you to do something you don't agree with. It is your knee, your recovery -- not his. And you have a right to say no.

Here's a tip shared by another member who was being pressured to agree to an MUA and was feeling intimidated by her surgeon. She went to her appointment. listened to the doctor, asked a couple of questions and then said, "let me think about and I'll get back to you." That way, she didn't have to say "no" to his face.

I think you are taking a very sensible approach. We have lots of members whose flexion has come back slowly -- but did come back. Here are a couple of examples:

Campervan’s ROM history
92 - 8 weeks post op
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months

Bertschb’s ROM history
2 months - 80 degrees
4 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
12 months - 140 degrees

Just remember that we are all different and our bodies heal in their own time.

 

[Jamie]

Another thing to consider is that this comment came from the surgeon’s PA. These people, while well-meaning, aren’t always the best in patient relations. The PA should not have made this comment. This is a surgeon’s decision and it is likely that the surgeon would not approve of them advancing such a suggestion at this early stage of your recovery. Be sure and let the surgeon know how this offhand comment affected you. That feedback for the PA is an important part of their training.

 

[safi]

Thank you all again, it is very reassuring to hear all your wise words and yes, my hubby will go with me to the appointment.
@benne68 thank you for the tip about what to say to the surgeon about thinking about it and not having to say no to his face, I will definitely remember that.
You are all helping me to relax a bit more and not stress about it as much, it is much appreciated

I have the first therapy session since seeing the PA tomorrow, so I will also be interested to see how he interprets the report and I will explain my concerns to him too.

 

[Jockette]

Be very careful at PT. Remember,
Saying no to therapy - am I allowed to? also applies to PT. You are very early in recovery and you’ve had the complication of a fracture. Make sure the PT knows this. Don’t force anything. Gentle movements for mobility are all you need, this soon after having a brace. Take your husband into the room with you.

 

[FleuveStone]

@safi , thank you for sharing your journey so openly and honestly. I think we tend to underestimate how much effect grief (over all we're missing out on) can affect us. You're tackling it head on. I admire your courage and wish you all the best.

 

[safi]

Thank you for the kind words @FleuveStone
I had not thought of it as a type of grief at all but you are absolutely right, thank you!
Best wishes with your own recovery too.

 

[eaglemom]

I think your handling all of this beautifully. Frankly we all worry about things on some level - some of us just admit it!

I just want to share how I handled my last "insurance ordered" home PT. She came to our home & was quite lovely, as long as she thought she was in control. During the initial visit I told her she would not be touching my knee / leg. She informed me she would be touching it. I informed her she could leave! (That was very difficult for me, but I said it.) She was shocked. She wanted to know why she couldn't touch my knee. I said that it was my knee, my healing and I was in charge. I didn't want anyone pushing my knee down, bending it up, moving my kneecap & I didn't want the risk of infection. She rolled her eyes and said I was ridiculous. I said we could do this two ways: my way where I'm in charge and you get paid to walk beside me or you can leave. Again she was stunned. She had a very curt response that I didn't know what I was doing. I just looked at her and said that's on me not her. I said since she was uncomfortable with my approach I'd call her company and request someone else - oh no. She agreed to anything I said! Did we get along perfectly, no. Did we reach a healthy agreement between us, yes. I did do some of her exercises, but mostly we walked. All of that ramble being a reinforcement to tell you, you’re in charge. At the surgeons office, at the PA's office, and certainly with PT. You just have to find your voice. I don't usually speak up like that, but I did.

You've got this.

 

[Layla]

Hi safi,
How did your first session go today...if you feel like sharing?
I hope it went well for you.
@safi

 

[safi]

Hi @eaglemom and @Layla

That was very impressive and brave eaglemom and glad it worked out well for you, you are right we are the ones in charge it’s just easier said than done sometimes!

Therapy went pretty well, he completely agreed with me that it was much too early to be considering MUA so that was a relief. He had me doing a few different gentle exercises and practicing walking and even a low step up with bad leg and down on good which did not hurt at all with my brace off, which felt weird but very good to actually be doing that. I told him that just having the brace unlocked for the 2 previous days had seemed to help with my flexion already as I was able to bend as I walked etc. and that helped it feel more comfortable.
Obviously I was sore and a bit more stiff later on but I alternated icing/ elevating and walking around the house and this morning it feels pretty good.

He has advised that I can take the brace off for short walks around the home but to keep it on and unlocked if I have to go out for any longer amounts of time ( my outings have only been for appointments so far)
Sleeping has been better without the brace on and I was actually able to turn on my side with a pillow between my legs for a short while which felt like heaven for my back after being stuck on my back for 6 weeks!

I also just started the short course of prednisone so will see if it has any effect at my next therapy on Tuesday.

Thank you for checking in on me it means so much to me.
I hope you all have a wonderful weekend.

 

[benne68]

he completely agreed with me that it was much too early to be considering MUA

I'm sure that has you feeling much more confident, as well as relieved. Sounds like your PT is a keeper!

just having the brace unlocked for the 2 previous days had seemed to help with my flexion already as I was able to bend as I walked etc. and that helped it feel more comfortable.

That's wonderful news. Take things slowly; you've got this.

 

[safi]

Thank you @benne68, yes relieved and hopeful moving forward, it is going to take a while as unfortunately my leg has atrophied a lot due to the 0 degree brace and I’m not as young as I was but hopefully I can get it built back up, it seems I have even lost some on my right leg too I guess to not moving around as much as I used to.

 

[sistersinhim]

Sleeping has been better without the brace on and I was actually able to turn on my side with a pillow between my legs for a short while which felt like heaven for my back after being stuck on my back for 6 weeks!

Freedom from that brace feels wonderful! Add to that, sleeping on your side, and it's almost heaven! I know you are so glad that thing is finally off.