MUA Manipulation and stiff knee after TKR

[maryo52]

Suzie, I don't know if you're familiar with my ROM saga. Let's just say I know the territory. I pined for bend the way one pines for a high school crush. My discouragement was profound. I'd always been someone who achieved what I set my mind on, and that didn't happen with my knee recovery.

My ROM went backwards shortly after MUA. That's a rarity. But then after the scar tissue was taken out, my bend was still limited. But the limitations had been removed. That's the point to keep in mind: your limitations have been removed. It took my knee weeks to exceed 90, but that was a great day. I wasn't seeing a physio during that time so I wasn't getting measured. For those weeks it seemed I was getting nowhere. I finally drew different angles on a piece of paper -- a 95, 100, 105, and 110 degree angles -- bent my leg and asked my husband which angle it looked most like. But that was only after my knee was clearly past 90.

The moral of this story is, hold onto your hope, my dear. So sorry to hear about your father-in-law and sister. They really should pick a better time!! lol I had a mom who needed me constantly so I know that one too.

 

[Suziepi]

Hi Maryo52
I am so glad you have told me your knee saga. What has happened to you is very similar to me. I would work and do anything as well to improve my bend. Like you after my MUA the ROM dropped to 60. I would work with the physio and exercise and I finally got it back to over 85. Then the next week it would be back under 80.
I moved on to a well known physio who manipulated my back as it was crooked. The physio thinks that the back and the knee nerve situation was causing the knee to be in pain. Two weeks later the physio got 97. This week I suspect it has fallen back again. I will just have keep on working on it.
Now my dad who is 96 has just had a fall. So we have another relative to visit
Thanks again

 

[maryo52]

You are moving in the right direction, two steps forward, one step back. Isn't that the norm for Life?

Anyhow, as long as there's progress, there's hope, and I think you will be pleasantly surprised over the next month or two. Just go easy on that leg. I had to focus on stretching only. I'd do 10 at a time 3x day, hold the stretch, no pain. It's a less is more situation because too much effort stimulates the scar tissue.

 

[Suziepi]

Hi maryo52,
That sounds like very good advice. Especially in respect what is required to discouraging the increase in scar tissue. One thing I am guilty of is trying too hard to get more ROM by pushing things too far.
I have decided to retire so my last day of work was last Friday. I am thinking I need other interest, although I am not sure what I will do. I know once I get this knee to function ok, I can look at other things
Thank you again.
Suzie
P.S. it looks like you are a fellow Pisces and water Dragon as you were born 10 days before me. You must be a awesome person

 

[maryo52]

So that's it, I'm a water dragon. 61 and still learning about myself!!

 

[leejaa]

I am sure you will find more than one thing to do now that you are retired. I realized when I was home recuperating and especially before I returned to work that it was going to be OK when I retire. Having the time to think and not be tired from knee pain and work gives your brain the opportunity to come more alive on a personal level. I cannot retire yet -6-7 yrs away but now I know it will be OK and I will find things to do that feed the soul. Good luck with your knee progress, yes sometimes less can be more if we let the knee rest a bit and not tell it what to do and enjoy finding things to do though with all your family issues you will be already occupied.

 

[Suziepi]

Hi Maryo and Lee,
Water dragons are awesome. Last year was the year of the water dragon which occurs every 60 years. I worked with a Chinese lady who knew about the Chinese horoscopes. She warned me that significant events happen for dragons in their year (good or bad). So I had to take care. And it sure was a bad year, my mum died and we had to get my dad into a nursing home. My knee played up on me again hence the TKR. Oh well bad stuff can happen to us all!

You are right Lee one good thing about being off work recovering from the operation. Is that it has given me time to realise I want more out of life and I don't want to sit in an office doing the same thing I have done for years . At the moment I am just enjoying what the day brings. Even if there is a lot of drama going on. After my dad had a fall yesterday , my son rang to say his wife had a car accident. The car was a write off, but luckily the wife and kids were ok.
Suzie

 

[Suziepi]

Hi all
Well I had my first visit to my OS the other day 5 months after he had performed a MUA on me. At last he is acknowledging that there was a problem with my knee and sent me off to do blood tests, CT scans and X-rays. He said to see him 4 weeks time but to still keep going with the rehab program.
Well I had the tests and I was able to read the diagnosis of the X-rays and scan. There didn't seem to be any arthrofibrosis or infection, but both test said there was effusion of the joint. Now I am at loss, as after some searching on the internet i learn that is just water on they knee and would explain why it is swollen. The knee has been swollen since before the TKR, but at least before TKR I had more ROM.

Can anyone further explain what effusion on the joint means after a TKR And how it can be treated?
Suzie

 

[maryo52]

That's a big question. I did a lot of research on it at the time and don't remember all the answers but googling Post-TKR effusion I came up with this link FYI: https://www.ncbi.nlm.nih.gov/pubmed/17265437

I had lots of workup and the bottom line was "non-specific synovitis," which is medicalese for "I don't know."

 

[Suziepi]

Hi Maryo

Thank you for the response.

I sure hope my current OS can determine some diagnosis and appropriate treatment from these additional tests as its costing me more money. I am getting a little concerned about staying with this surgeon. I am really considering getting a second opinion and to move on from him.

As at present all i have is painfully stiff knee with poor ROM from the TKR and MUA that he performed. Unfortunately I have felt his attitude towards me in the past a little pious , indicating that it may have been my lack of effort in stretching and exercising that had caused a poor result.
Although this time he agreed that there was a problem. And that he would investigate it . I feel I have to wait too long before he does anything to help me. For instance, I contacted him at the end of January and told him I had a ROM of 75 and what should I do. His recommendation was to see him in 2 months time and just keep the Physio and exercises going. Now I have seen him I have to wait another month before seeing him and to get some action.

Sorry about venting all this but I finding it frustrating. But then I guess it could be worse .
Have a great day all!
Suzie

 

[leejaa]

I would try to see someone else for an opinion. He seems to put you off too much. He could at least see you in between and check instead of telling you to come back in months. It sounds like it will also give you peace of mind to get another opinion which is just as important. You deserve some answers and better advice for your progress.

 

[maryo52]

A second opinion is never a bad idea. Sometimes we need to do it for our own peace of mind. There can be so much confusion with TKR recovery. I sought a second opinion at two different junctures, and after all was said in done, my confidence in my OS remained intact. Go figure.

These guys are not great at bedside manner. My OS at least had me come in when I called with concerns. I needed that assurance.

My OS said 2 or 3 times during my ROM saga, "This was not caused by anything you did or didn't do." That meant the world to me.

 

[Suziepi]

Hi Leejaa and Maryo,
Thanks again for your reassurance. I have now booked myself in for a second referral. I also rang my surgeon rooms to see if I could get in earlier. I learnt that the practice is splitting and my surgeon is moving to a smaller group and another location. The appointment I got was the earliest his secretary could give me.

Maryo it is great that you still have confidence in your OS. I guess getting second opinions help to improve that. You are right I think that my OS is a little green in respect to his bedside manner. I just hope that improves for his sake as the Physio's I meet seem to think that he is a smart surgeon.
Have a great day

Suzie

 

[Suziepi]

Hi all
Well this week I got to 100 ROM. That is great for me as forward I go. I was able to ride an exercise bike even though it was raised quite a bit.

 

[maryo52]

What great news!

 

[Suziepi]

Hi Maryo
Thanks for your encouragement. Your prediction on my knee is correct I am getting pleasantly surprised. It just confirms to me that no pain means more gains. With patience and gentle stretching exercise the knee is happier and will heal more and is loosen up.
Suzie

 

[juniper]

Suziepi, great news. I hope I am headed in your direction. I'm discouraged right now. Lots of reasons, not just my knee. I think other things that are hard in our lives affect out healing. I'm trying to focus on, and savor, all the things in my life that are really, really good. There are so many. I met with BJ in Penn. as she took her daughter college visiting, and that was a wonderful thing. What a great site this is. Encouraging and inspiring. I love Bonesmart.

 

[Suziepi]

Hi juniper,
Thanks for the encouragement. I hope things get better for you too. It's a great idea to look at things in our lives that are good or really good. It would be a shame to miss them for the sake of the bad stuff. A good wake up call for me as too much of my energy is consumed on this knee. Time for me to refocus although I will still work away at getting a better knee.
Thanks again and good luck
Suzie

 

[juniper]

Suzie, I don't see my surgeon (or rather his PA) for my one year visit until May 21, at which point it will be almost 1 1/2 years. It's okay. At least I have the appointment. I was avoiding like crazy for a long time, because I was somehow convinced that it was my fault that I'm not getting better. I've done what I can do. Stationary bike, walking, some weight lifing. Began to get massage with a focus on the knee. Work stresses the knee, but I do try to pay attention, balance standing and sitting. I just wish I knew why it still feels so stiff...anytime I'm standing, walking, getting out of a chair, on stairs. It's as though there were a piece of wood stuck under the new knee. Maybe I'll get answers. Today I am going for a walk in this amazing arboretum nearby. Bringing a highschool friend who is still one of my closest friends. It was her birthday this past week. Also taking her to brunch at this amazing greenhouse that's been turned into a restaurant. The cherry blossoms are all blooming and now the tulips. It should be heaven. Hope you are doing good things for yourself.

 

[Suziepi]

Hi Juniper,
That arboretum sounds wonderful. Canberra has just opened one up so the trees are still little. Still it's nice to visit as it has some great views of the rest of the city. Your one must be great to walk in I would love see it. As I love walks but not so much when it rains like today.
You do have to wait a while to get some answer about your knee. I hope that you get some improvement from any action your OS recommends. Obviously something is not right for you.