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TKR MUA at 3 weeks post op?

My stiffness/tightness was the last thing to hang on. The pain was much improved, but that stiffness was still there. I would measure both knees and my tkr was still larger than the old knee. That explained the tightness. Even if they was no outward swelling, the swelling inside was still there. That a small place to have extra fluid and would make it stiff. Icing and elevating should help that stiffness you have.
 
Hi. This is my first post but as I had my ltkr just 2 days before you I thought I’d put my experience down here. I had a very aggressive physio in hospital and really worried how it would be once home but I was pleasantly surprised. Did the exercises given to me but very gently and on my 3 week assessment my ROM was 95, was walking without limping and without putting weight on crutches. Then I went down with shingles and for the next two weeks did virtually nothing other than walk round the house. When I saw the physio on Monday which was two weeks after my initial visit my ROM had increased to 106! Really pleased with how things are progressing bearing in mind my setback. Good luck!
 
@Reynards, how about starting your own recovery thread. That will help you to have a 'diary' of your recovery and you can receive posts from others on it.
 
But there is good evidence for early manipulation. Here are 2 articles (which this board does not let me post the full link, I posted all but the first letter).

ww.ncbi.nlm.nih.gov/pmc/articles/PMC4669325/ (add a w to address, I can't post the full link)

They conclude that early manipulation within 12 weeks of performing the TKA had a higher mean flexion gain (36.5°), higher final range of motion (ROM) (119°) and higher knee society score (89 points) compared to those performed after 12 weeks which were 17°, 95° and 84 points respectively. Other studies have also reinforced the idea that early manipulation within 12 weeks has a better outcome than those performed after 12 weeks.​

And this:

ttps://journals.lww.com/jbjsjournal/subjects/Knee/Abstract/2014/08200/The_Effect_of_Timing_of_Manipulation_Under.5.aspx (add h to address, I can't post the full link)

Conclusions: Orthopaedic surgeons should have a low threshold for performing early manipulations with the patient under anesthesia within twelve weeks after an arthroplasty, to achieve higher knee range of motion and improved clinical outcomes.​

There are lot's more studies with similar conclusions, some showing best benefits from even earlier manipulation.

I don't want to upset anyone but when I was reading these posts I felt I had to weigh in.
 
Hello @Ferdinand1 .
Welcome to BoneSmart! Have you had or are you preparing to have joint replacement surgery? Please start a thread of your own in the appropriate area of the forum and tell us more about yourself. We're here to support you on your journey!
 
@Ferdinand1 ... you're correct that there are studies out there that talk about the value of early manipulation for knee replacements. There are also just about an equal number out there that say that it's fine to wait a while. It's not a black and white issue and people are different in their recoveries. Generally we advise people to wait until their knee has a chance to heal from the surgical trauma and we also tell folks that we've seen a number of MUA's done months after surgery that work just fine. But it eventually comes down to a person's own individual situation and consultations with their surgeon.

I'm not sure where you got the idea that members cannot post links on BoneSmart. We don't allow people to post links that take members offsite but the exception to that would be something from a government or other legitimate medical or educational site that was pertinent to a thread discussion. Your two links would have been just fine.
 
I don't think it is fair to suggest that the doctor is suggesting the MUA as a means to bill more---that is a very cynical idea. All of us have our opinions about recovery from surgery. This doctor's advice is not the same as the advice that I got from my own OS, but I assume he believes what he is saying. Some of this is related to where he got his training.

My own OS cautioned me several times to never allow anyone to force bend in my knee. He felt that anything that contributed to more swelling was counter-intuitive to recovery. Think of this with your own common sense---you have swelling in your knee right now--caused by a physical therapist. I think that you should be resting with your knee elevated for most of the day. My own doc told me at four weeks that I should be down and resting for two hours for every one hour that I was up. Your knee has had increased trauma. So---take three days and rest for the majority of the day with your knee elevated. at the end of three days is the swelling less? that is an answer that is obvious to you. If the swelling is less, then more rest and elevation will bring the rest of the swelling down.

Many people can also take anti inflammatories---has your doc suggested Celebrex or some other anti-inflammatory to you? If not, you can call the PA and ask him/her about getting a script. I think that a week or two of rest will change the recovery of your knee. Once the swelling is down, you will be able to see the bend. You can do quad sets, leg lifts and clam shells while you are resting--- just do things in moderation. I never exercised at home, my PT thought it was funny!! I went to PT twice a week and in between I did almost nothing for the first month. I eventually did bike riding and swimming for PT---but not until my swelling was down.
 
@skigirl Your input is very much appreciated!! Although it may indeed be cynical to suggest an early MUA was for financial reasons, I truly have to wonder. The first time I heard this was from the only GOOD PT that came to my home. Also my OS had a very different and opposite idea on recovery, he told me this is a very painful process, basically saying let the PT's force my knee to bend til I was in tears, or I wouldn't get my ROM back. Well I'm happy to say that I found this site and have had the PT's I see at the office on an extremely short leash, making it very clear what I will and will not allow.

It's been a few weeks since my last post as I decided to "unplug", stop worrying, and just relax. This did me extremely well.
Now at almost 8 week PO and the external swelling is what I consider minimal, my extention is now less than 10°(down from 20° 2-3 weeks ago) and my flextion is at 90° (up from 70° 2-3 week's ago), all without painful PT. I feel much better now thanks to the Bone Smart way, I only wish that I found this site sooner as it would have saved me 2-3 weeks of agony at the beginning of my recovery.
 
@Rsmach1 So glad you are now on the right track with this recovery - well done!
 
Rsmach1 said:
I only wish that I found this site sooner as it would have saved me 2-3 weeks of agony at the beginning of my recovery.
Click to expand...
At least you found us! Just think if you hadn't and were still doing those awfully painful exercises!
 
No, no, no. My first TKR was really slow to get to 90 degrees flexion. The pressure was on for me to have that by 6 weeks. I stuck with the advice I found here, and it eventually came around just fine, it's great now. I just told them I would never do MUA, to stop mentioning it. Stick to your guns and the good advice you get here.
 
It sounds like you are on your way and really, will continue to improve during the next year. so, relax, enjoy that new knee and the new freedom from knee pain that it will bring you.
 
I've definitely learned that relaxing and patience is the key. Yes I am already enjoying the new knee although I have a ways to go. I never realized how bad my knee actually was, until now as I'm seeing the things that caused me pain no longer do so. I was finally comfortable with driving as of last Friday, and that in itself was a huge plus.

PS. Merry Christmas and Happy Holidays to all, and thank you for this site!
 
Merry Christmas and Best Wishes for the New Year, to you, too!

We are all blessed who have found this site!
 
Being able to drive is a huge blessing!

Merry Christmas!
 
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