TKR mikb314159's recovery thread<

[mikb314159]

Yes, its pretty frustrating.
I’m doing everything to try and get ROM to 90. Made some progress this weekend. I do not want the MUA.

How are you doing?

 

[Poctdb]

My thread is up to date so you can read it there.

Briefly, I am doing really well. Everyone is telling me I am way ahead of where most people are at this time....but I still want it to move faster.

If you do not want the MUA.... I do not want it for you either. My most powerful “bend knee bend” thoughts are being sent to your knee.

 

[tabbykit]

After my original TKR 4 years ago the OS threatened MUA if I did not reach 90 in 6 weeks. With some aggressive PT I just about managed to avoid it. Then my bend got worse, was told due to adhesions, and had 4 years of a problem knee (was finally 60/30). Had revision 17 June, having joined these forums, and was determined to avoid aggressive PT and threat of MUA. 5 weeks today, and my bend is 60 at PT, up from 55 10 days ago, which was up from 50 on the first session. Saw my OS last week (different from the first OS) and he said it is going well, slow but sure improvement. No mention of MUA. I have learned a lot on these forums and while some have a successful MUA early on, it is beneficial to allow some more time for improvement.

 

[Josephine]

Made some progress this weekend. I do not want the MUA.

Then refuse to have it. As I said before, you have the right. He can only recommend, he cannot command.

 

[Celle]

I’m doing everything to try and get ROM to 90. Made some progress this weekend. I do not want the MUA.

You don't have to have the MUA if you don't want it. Just say you'd like to wait a bit longer.
Saying no to therapy - am I allowed to?

Don't make the mistake of thinking that the harder you work at your exercises, the better your ROM will be. Doing too much can actually work against you, by keeping your knee swollen and inflamed.
Knee recovery - Lose the Work Ethic!!
TKR: work “smarter” and not “harder”

 

[mikb314159]

I am still having a lot of swelling in my knee and calf. I use the ice machine all night and ice with ice packs every 1 to 2 hours. (Depending if I’m home) I also elevate my leg just about most of the day. Any suggestions on what more I can do?

ROM Note: Yesterday I got to 70 degrees knee bend. With the Doctor wanting to do manipulation on Tuesday if I’m not at 90 degrees. I’ve decided if I can get to 80 degrees by Tuesday, I’m going to cancel my appointment.

 

[Jockette]

I am still having a lot of swelling in my knee and calf.

This is why you have a low ROM number. Note that I did not say a poor ROM number.

You’re not quite 6 weeks out of a surgery that is extremely disruptive to your entire leg. An MUA at this point will only further disrupt your poor leg.

Try to relax, don’t work hard on your bend, and let your knee heal. Doctors are way too impatient for us to regain our ROM. It will happen all on its own if you allow your knee the privilege of sorting itself out. (My favorite quote from Josephine!)

 

[mikb314159]

Thank you for the quick reply.
Is there anything more I can do for the swelling?

 

[Jockette]

Is there anything more I can do for the swelling?

Rest, ice, elevate. (you don’t always have to be in bed, but overnight is great!)

Don’t overdo.

Be patient.

I know these things are hard, been there, done that, but seriously, this will all get better in due time.

 

[mikb314159]

Thank you so much you are very helpful.

 

[sistersinhim]

I am going back to see him on August 6th, and if I’m not at 90 degrees, he is going to sedate me and force / manipulate my knee.

It is much too early to even think about having a MUA! You have all those soft tissues that are trying to mend back together after being cut open. A MUA will force those healing tissues apart some and cause much inflammation. This causes more pain and swelling and lowers your bend number. Your ability to bend your knee depends on the amount of swelling you have. It's not a lazy, out of shape knee. It is a traumatized, injured knee. Watch a live tkr surgery on youtube. You'll see why you are swelling and why it takes a year or more to totally heal from.

I iced and elevated the whole time I was sitting or lying down for my first 6-8 weeks. My elevation was toes above my nose. This routine reduced my swelling and pain. But, at only 6 weeks, if I was up doing more and normal, my knee would blow up with swelling. That made my ROM go down. I would immediately go back to my recovery routine to get that swelling back down. Once you get that swelling down your numbers will improve. A MUA will not help right now, just harm your knee and your numbers. You can have a MUA at any time.
https://bonesmart.org/forum/threads/myth-busting-window-of-opportunity-in-tkr.6895/

 

[Celle]

Yesterday I got to 70 degrees knee bend. With the Doctor wanting to do Manipulation on Tuesday if I’m not at 90 degrees. I’ve decided if I can get to 80 degrees by Tuesday, I’m going to cancel my appointment.

How much exercise are you doing? I suspect that you're doing too many exercises, in your desire to increase flexion. That'a a mistake, because it's keeping your knee angry and inflamed, which increases swelling and decreases flexion.

I suggest you stop all your T exercise and just do no more than 5 heel slides per day.
Heel slides and how to do them properly
Those, plus short walks around the house, are all the exercise your knee needs at this early stage of recovery.

Your surgeon thinks otherwise, but there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Tell your surgeon you want to wait before considering an MUA. It's your knee and you do have the right to say what happens to it.
Heel slides and how to do them properly
CONSENT: what it means and how it can be used

 

[Josephine]

It is much too early to even think about having a MUA!

I agree with this 100%.

 

[Poctdb]

@mikb314159

Many things can happen as to why patients can’t keep appointments.
You can cancel without a reason.......

 

[winemama]

@mikb314159 I didn’t hit 100 till 12 weeks, the swelling behind my knee was the problem. You have to be your own advocate,you know your body. My opinion is give your knee a rest. Good luck

 

[Poctdb]

@mikb314159
How are you doing?

 

[mikb314159]

Thanks everyone for the help.
Been taking it easy since Thursday night. Elevation, ice short walks.
New pain problem. When I lay down, elevated or not, for more than 30 minutes I get 9 to 10 level pain in my knee. If I move my leg to a different position, the pain subsides and then comes back within about 20 to 30 minutes. This has been also causing problems when trying to sleep.
This is new.

 

[winemama]

Are you taking enough meds at night?? You have to space them so you are getting max coverage at night.

 

[mikb314159]

I take 1 an hour before bed, and 1 4 to 5 hours later. I always get up just about every 4 hours for a bit.

 

[sistersinhim]

I also had to frequently change positions after my tkr for months. Have you tried to cut back some on your daily activities? Nighttime pain is an indication that you are doing too much during the day. Cutting back should help.