MUA Low ROM (Knee Bend)

[Josephine]

Most people I read on this forum are much further along at 11 weeks

So what? They didn't have your knee or operation and you didn't have theirs. That's the key to these opinions even though they are well meant.

Everyone prior to TKR kept telling me that I would be in great shape by 2 months post op.

Who is 'everyone'? Friends and neighbours? Ask them when they got their medical qualifications to offer this opinion or better yet, when they had their knee done? (no better not - you don't want to alienate your friends!!)

 

[kimw]

I read your knee recoveries. My experience hasn't even been close. Barely made the 50 ROM mark before the MUA at 6 weeks and not much better after. Had major swelling from Day 1. Still at moderate level. Use the CPM machine (since MUA) to loosen up and seems to make it feel better. Use very low settings so just for movement mainly. So I am now 4 weeks out from MUA. However, all have to do is stand up and it tightens back up with next no bend. I am icing and elevating. The PT I go to doesn't push.

I use acetaminophen and Percocet primarily. I had bariatric surgery (roux en y) 6 years ago and am very limited as to what I can take. Unfortunately, anti antiflammatories are in that category of not taking.

I started acupuncture yesterday. My left knee went out last Thursday because of additional work it is doing, I'm sure. Looking for a lymphedema therapist.

Very frustrated and depressed. Just don't seem to see any improvement. Sorry for the venting. I am grasping...

 

[Josephine]

I read your knee recoveries. My experience hasn't even been close.

I'm sure it hasn't. My recoveries aren't shown to make you feel a failure though. So please don't see them as direct comparisons to your own.

Unfortunately, anti antiflammatories are in that category of not taking.

I am very pleased to hear it. NSAIDs aren't intended for this kind of swelling and they are very poor pain killers as well. I suggest you read this to see how very bad NSAIDs can be for us Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers

I started acupuncture yesterday.

I'm not at all sure that acupuncture will benefit you.

Looking for a lymphedema therapist.

And neither will this because your swelling is not being caused by lymphedema but by swelling reactive to your knee surgery. So that is not going to benefit you either.

 

[patsortho]

I'm literally In the same situation. I had my tkr on 3/21/2017. My rom is in the 50's. Dr wants to do a mua next month. I'm extremely swollen. Weird thing my incision isn't healing

 

[kneeper]

I think some people who have had MUAs sort of start counting their weeks from scratch, so in a sense you're not that many weeks out. Hang in there.

Don't worry about not being able to take anti-inflammatories. There are a bunch of us on the forum (now and in the past) who did not take them during tkr recovery and did fine.

 

[kimw]

I would love to hear from anyone who is still struggling with ROM (less than 80 degrees). I am 6 weeks post MUA and a 70 degree ROM is the best I can do on a good day. If I were improving even slowly, I would be hopeful, but that doesn't seem to be happening. I still have moderate swelling in thigh area and knee is still very warm to touch. I wear a low level thigh support stocking every day. Entire leg was huge after TKR. I elevate and ice. I only have to walk or be on it an hour before it swells up. Do not have a normal gait because of lack of appropriate bend. If I knew it would help, I would have another MUA.

 

[sistersinhim]

Your knee is still traumatized from the tkr, and then then MUA right on top of that. It hasn't had a chance to heal at all. All your knee needs is TLC. Not exercises or PT. It has to heal, then worry about ROM. It will come when it's ready. You can not force it!

 

[newlybionic]

A MUA sets you back to the beginning again. So you're 6 weeks in of the 52 weeks it takes for full healing. Make sure you are elevating your leg the right way.

That way the swelling in your entire leg will go down. Elevate as often as possible and use ice at the same time.
Standing for an hour is too much for you right now. Concentrate on getting the swelling down first and then slowly you can start adding back some activities.

 

[Celle]

@kimw - you will see that I have moved your post from Cork Lass's thread to your own thread.

By putting your post about your knee in her recovery thread, you were derailing her thread and taking it off the topic of her own recovery. I also moved the two responses you received to your post.
Forum etiquette: being polite when posting

So please post any updates, questions or concerns about your recovery here.
We will see them there, as someone checks all the new posts every day.
If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Just in case you couldn't find your own thread, here are the instructions on finding it.
How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[KarriB]

Keep on icing, elevating and resting that knee until the swelling goes down. As Marian said, an hour is too long for you to be on your leg so soon after an MUA. If my knee was down while sitting it still swelled enormously at 6 weeks post op from infection surgery. Some knees need a little more time, rest and elevate as much as possible and try not to be on it for too long right now.

 

[bertschb]

I would love to hear from anyone who is still struggling with ROM (less than 80 degrees).

I struggled with ROM BIG TIME!!!!!
Some background-
I'm 58 and prior to surgery I did two hour mountain bike rides every day. I also snow and water ski, ride snowmobiles and dirt bikes, kayak, scuba dive, etc. I only mention this to let you know I was active and in good shape prior to surgery. Because of this I figured I would bounce back from this surgery faster than "normal". BOY, was I wrong!!!!

Even though I had my knee elevated 95% of the time I was awake and on ice for several hours each day and did NOTHING around the house (I'm retired and my wife is amazing!), my recovery took FOREVER. Still not done after 8 months!

Here's my ROM history:
2 weeks - 60 degrees
4 weeks - 70 degrees
6 weeks - 85 degrees
8 weeks - 90 degrees
4 1/2 months - Still 90 degrees!
5 months - 110 degrees
7 months - 120 degrees
8 months - 125-130 degrees?

I could write a book about my recovery and how slow it was but the great news is I am recovering!!!! It took 7 months before I could ride my mountain bike. My surgical knee is still larger than my non-surgical knee and it's always warmer as well. I think it was at least 2-3 months before I could stand up for more than 30 minutes without it getting uncomfortable. My OS and PT guy both started talking about an MUA a couple weeks after surgery but I decided I wasn't going to go that route. I did PT from about 10 days to 3 weeks post op. All that did was cause more swelling so I stopped going.

At 8 months I can now do almost anything I want. My knee is still stiff after sitting for a while. I still have to be careful when stepping over the edge of the tub after taking a shower because my ROM still isn't normal. But, my ROM continues to improve. This forum was a huge help for me. TONS of great articles and the admins are so helpful and patient. I did a lot whining the first few months after my surgery because I was utterly unprepared for how long this recovery would be. But, I am recovering and you will too! You just need to be incredibly patient. You are just starting down the path to recovery. You have many months yet to go. At my current pace, my full recovery will take more than a year. Oh- don't get hung up on how fast everybody else is regaining ROM. I made that mistake and got really bummed out because of it.

BTW, this is what my knee looks like after 8 months. Still pretty big.

 

[kimw]

Thanks so much for replying. You don't know how much I need to hear that there is still hope. IF I know that I can achieve a good range ultimately, I don't mind a long recovery. I just have lots of folks telling me (esp. OS who wants to do a 2nd MUA --NO!!) I am not working hard enough.

 

[liam2015]

hi @kimw ~ i know what you mean about accomplishing the surgeon's "goals" ~ it's very stressful going for appointments with such little progress in r.o.m. mine continues to be very slow, going into 11th week. i barely make 90 degrees r.o.m. on my own, but it was up from 82 degrees at previous physio. my surgeon says he will "release" me when i reach 100 degrees and has me come in once a week. i dread going.

@bertschb ~ very encouraging to hear of your progress, that it can be done gradually and not to worry about the timeline.

 

[Celle]

Here's another post to encourage you. Don't forget that ROM can continue to increase for a long time - a year or even much longer.
This is what one of our members wrote about the slow development of her ROM. (Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time.
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
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"

 

[sistersinhim]

@liam2015, you can always cancel your appointment with your OS. There is no need for you to have to go weekly. It's a waste of money.
@kimw, working hard increases swelling and lowers ROM. Tell your doctor you want more time to 'work' on your range. And then do not work on your range. Work on your range and getting that swelling down. That will increase your ROM.

 

[dvannie]

I'm currently sitting at 65 degrees at 5 weeks and have my OS surgeon threatening me with MUA since two weeks when I was only 10 degrees. I've done the PT route which only put me in reverse for improvement and presently I'm taking a break until my next appt with the OS where I'm sure I'll have to tell him no yet again about the MUA. Don't get me wrong. It's very difficult not to waffle about it, I mean these people are supposed to be the experts right? It wasn't until my last appt with the OS where he didn't even remember my history of my previous scarring or injuries that I realized he didn't really know me and that I had to advocate for myself and do what I instinctively know what's right. I've even started bringing my mother in law with me to these because she's not afraid to call hogwash on him

 

[kimw]

Still haven't got the hang of posting correctly. After rereading instructions, I think this is where I would request a thread title chang. Please change my title to Low ROM (Knee Bend).

 

[Celle]

That's right, Kim. One of the staff has changed your thread title for you.

 

[Mister]

@kimw - let me start off by telling you that this is in no way your fault!
I had an mua at 3mo. I was stopped at 78 and it would not gain anymore rom at all. The manipulation worked for me, but is still slow going. At 6mo tkr and 3 mo mua, I think I'm about 110.

When my os and pt started talking about mua, the first thing they said was that this was definitely not my fault. And that they knew how hard I had worked, it just happens in some people. Apparently, I grow scar tissue excessively, at least in that knee.

Of course my os did start talking mua sooner than 3mo but I told him I wanted to wait and see and he was ok with that.
Honestly, I would question why your dr is pushing you to have another mua so soon after the 1st one. And why he is saying this is your fault, because it's NOT your fault.
I would think though it's a good idea to wait and let it do some healing and get a 2nd opinion.
And you are probably doing way too much. At 3mo post mua, there is no way I could stand for an hr.

Your main goal right now needs to be icing, elevating and resting. You're having too much swelling to gain rom. For example, I just had my other knee done 2wks ago. First thing I did when I came home from hospital were those 3 things. Started pt on Monday and by continually icing and elevating, on Wednesday I had gained a whopping 10 degrees! That's a lot! And the more my swelling has gone down, the more rom I'm gaining.
So what I'm doing is icing, elevating, resting and taking my meds around the clock. You cannot do this too much! Just try it and see how it works.

I'm sorry this was a long post, I will be praying for you.

 

[DebM]

@kimw i am a 'slowie'. I was threatened that I had a small window for improvement and if I didn't aggressively exercise I would never get a good result. I gave up all formal PT at about 2.5 months. I am now almost 6 months out and notice some sort of improvement every week. My OS is very pleased and has always told me improvement will continue for 12 months even up to 2 years.