TKR MUA time limit???
- Thread starter omybones
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Hello ...well it's been 6 months since I had my TKR. Still have limited ROM. Having arthroscopy next week to "trim up scar tissue over knee area." That may ease pain and perhaps improve ROM. Anyone have info on 'time limit' for having an MUA...and what the approximate recovery time would be?? Is it like starting all over again with the physio?? Just would like a little info prior to seeing surgeon. Thanks!
Sorry Jo and other admins, but I couldn't find my origional postings to add this to. Thanks for all your prior help and advice.
Sorry Jo and other admins, but I couldn't find my origional postings to add this to. Thanks for all your prior help and advice.
Suziepi
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Hi omybones,
You must have had your TKR about the same time as me. I also have pain and limited ROM. I have had one MuA already in December. Even though the surgeon got 120 during the procedure a few weeks later it dropped back lot 60. I have now built it back to a little over 90 although a few days later it went back into the 80s.
This week I visited my OS and he is going to investigate my case further. Depending on his findings, the treatment may be another MUA, or arthroscopy or a revision or maybe some other treatment. I won't see him until May so I have to wait.
So I'm not sure about the 'time limit' although I know of one OS who seems to think that 11 months post TKR is leaving it too late.
Suzie
You must have had your TKR about the same time as me. I also have pain and limited ROM. I have had one MuA already in December. Even though the surgeon got 120 during the procedure a few weeks later it dropped back lot 60. I have now built it back to a little over 90 although a few days later it went back into the 80s.
This week I visited my OS and he is going to investigate my case further. Depending on his findings, the treatment may be another MUA, or arthroscopy or a revision or maybe some other treatment. I won't see him until May so I have to wait.
So I'm not sure about the 'time limit' although I know of one OS who seems to think that 11 months post TKR is leaving it too late.
Suzie
I located your previous recovery thread and merged your latest one with it. You'll find instructions on how to locate your previous threads under the OFFICE tab....How To Use This Forum thread.
We've had members who have had successful MUAs done up to a year after surgery. But your procedure to remove scar tissue is different as it actually involves going into the knee. So recovery may be a little longer than with just the manual manipulation. But, in either case it is NOT like going back to square one with your TKR. I doubt you would need therapy afterwards. You may experience some pain that needs to be managed for several weeks and you will obviously need to do bending and stretching each day to keep things loosened up. But you will want to avoid a lot of activity immediately afterwards to keep swelling at a minimum.
A couple of our members have had this scar removal procedure. I'll tag skigirl (Kelly) and she will likely have more specific information for you about what she went through.
We've had members who have had successful MUAs done up to a year after surgery. But your procedure to remove scar tissue is different as it actually involves going into the knee. So recovery may be a little longer than with just the manual manipulation. But, in either case it is NOT like going back to square one with your TKR. I doubt you would need therapy afterwards. You may experience some pain that needs to be managed for several weeks and you will obviously need to do bending and stretching each day to keep things loosened up. But you will want to avoid a lot of activity immediately afterwards to keep swelling at a minimum.
A couple of our members have had this scar removal procedure. I'll tag skigirl (Kelly) and she will likely have more specific information for you about what she went through.
skigirl
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I had what is called an "open lysis of adhesions' where they opened my knee and removed the adhesions (scar tissue) that had grown around my knee cap. I have a thread with that title which you can find if you search.
For me, the pain was not bad at all. I stayed in the hospital for one night. I took percoset for about four days. I used crutches for about a week. My doc really stressed that I was not to exercise on a swollen or inflamed knee as he thought that encouraged the growth of adhesions.
So, no pt at all for three weeks. I mostly rested, kept the knee elevated and iced it. I did heel slides and leg lifts--only things that I did without weight bearing. I was bored!!! But, I made myself read, knit and just let things go.
At three weeks, I went to pt, but my doc had already called my pt and so 8 weeks with only leg lifts, heel slides, sit ups and clam shells. I really took it easy. At eight weeks, I began to slowly ramp things up. It was difficult--my muscles were mush after 8 weeks of inactivity, but I did come back. I was bored and really felt sorry for myself a lot of the time. But, I did work in my studio, so it was not a complete loss!! Find something that you can do now so that you do not die of boredom!!
A year later, my knee cap moves freely and my rom has increased --it is now 148. The surgery and rehab were a pain, but well worth it. I will tag Dhare63 since she also had an open procedure and maryo52 who had an athroscopic procedure. Good luck and don't worry! Kelly
For me, the pain was not bad at all. I stayed in the hospital for one night. I took percoset for about four days. I used crutches for about a week. My doc really stressed that I was not to exercise on a swollen or inflamed knee as he thought that encouraged the growth of adhesions.
So, no pt at all for three weeks. I mostly rested, kept the knee elevated and iced it. I did heel slides and leg lifts--only things that I did without weight bearing. I was bored!!! But, I made myself read, knit and just let things go.
At three weeks, I went to pt, but my doc had already called my pt and so 8 weeks with only leg lifts, heel slides, sit ups and clam shells. I really took it easy. At eight weeks, I began to slowly ramp things up. It was difficult--my muscles were mush after 8 weeks of inactivity, but I did come back. I was bored and really felt sorry for myself a lot of the time. But, I did work in my studio, so it was not a complete loss!! Find something that you can do now so that you do not die of boredom!!
A year later, my knee cap moves freely and my rom has increased --it is now 148. The surgery and rehab were a pain, but well worth it. I will tag Dhare63 since she also had an open procedure and maryo52 who had an athroscopic procedure. Good luck and don't worry! Kelly
I had the arthroscopic lysis of lesions. Skigirl and I have the adhesion removal topic pretty well covered together. It was the best thing. Here is a video on my procedure.
It totally worked but that was not evident for about a month after I had it done. It really was not that traumatic. It's just that it took a while for things to start stretching again. I had to stick with gentle stretches (no strengthening) for a month, which I did myself because at that point I had lost confidence in PTs.
My MUA had brief results. Within a week my ROM started going backward. Another MUA would not have helped. Too much gristlely white scar tissue in there adhering to everything. Some of us just grow a lot of scar tissue and it fouls up the works and is best taken out.
It totally worked but that was not evident for about a month after I had it done. It really was not that traumatic. It's just that it took a while for things to start stretching again. I had to stick with gentle stretches (no strengthening) for a month, which I did myself because at that point I had lost confidence in PTs.
My MUA had brief results. Within a week my ROM started going backward. Another MUA would not have helped. Too much gristlely white scar tissue in there adhering to everything. Some of us just grow a lot of scar tissue and it fouls up the works and is best taken out.
Dhare63
post-grad
Hi omy, sorry I missed your posts the first time around.
I had major problems with missing extension, and after an MUA and tons of, massage, rest, I ended up with a revision of sorts. My OS went in through the TKR scar, removed the spacer, then surgically removed all the scar tissues around and behind the knee. He said it had calcified and was creeping into the spacer behind my knee, hence not being able to get extension. He also did a posterior capsular release.
this was a long and challenging surgery for all of us. The first four days were very painful, then suddenly I felt a lot better. I didn't need crutches and the joint was much more free to move. Yes I had swelling, yes I took meds for pain control, but I took it very easy with stretching and pt. I focused on controlling swelling and really took it slow. I changed to a different pt and she was very gentle, but helped me to keep the flexion and extension I gained through surgery. The last time I saw my OS in January, I had 2 and 120, which is great for my needs.
If this is done with a scope, it should be pretty easy to bounce back from.if it is open, you will have a bit longer recovery. In any case, take it slow, control swelling, find someone who does lymphatic massage to move the swelling into the lymph system and away from the joint. I was able to ice all the way around the joint then used compression hose after icing to keep the swelling down. This all helped a great deal.
I wish you all the best. Please let us know what questions you have. I found so much help here and I know it aided me in my recovery.
Be well,
Dawn
I had major problems with missing extension, and after an MUA and tons of, massage, rest, I ended up with a revision of sorts. My OS went in through the TKR scar, removed the spacer, then surgically removed all the scar tissues around and behind the knee. He said it had calcified and was creeping into the spacer behind my knee, hence not being able to get extension. He also did a posterior capsular release.
this was a long and challenging surgery for all of us. The first four days were very painful, then suddenly I felt a lot better. I didn't need crutches and the joint was much more free to move. Yes I had swelling, yes I took meds for pain control, but I took it very easy with stretching and pt. I focused on controlling swelling and really took it slow. I changed to a different pt and she was very gentle, but helped me to keep the flexion and extension I gained through surgery. The last time I saw my OS in January, I had 2 and 120, which is great for my needs.
If this is done with a scope, it should be pretty easy to bounce back from.if it is open, you will have a bit longer recovery. In any case, take it slow, control swelling, find someone who does lymphatic massage to move the swelling into the lymph system and away from the joint. I was able to ice all the way around the joint then used compression hose after icing to keep the swelling down. This all helped a great deal.
I wish you all the best. Please let us know what questions you have. I found so much help here and I know it aided me in my recovery.
Be well,
Dawn
tks suzie....seems we are in simular situations here ....i"ll see how i go with the arthroscopy , with the option of mua down the track i think...seems the bebefits of mua"s are not allways long lasting though,,buts its an option if all else fails in getting rom..... ...funny as my surgeon puts my lack of rom down to lack of exercise....no so ...if anything i overdid the exercises,,actually started noticing problems after using exercise bike...ie: clicking ,,ripping feeling,,an pain at rear right inner side of knee...3 tests showed no problem re: my inner side knee pain,,so im asking surgeon today to have a 'look around ' in that area while doing arthroscopy....maybe he will see a tiny little alien living in there attacking me with a little pick.....hope you get a good result.....
tks dawn.....seems my forthcoming procedure will be less complacated than yours.. its minium intrusion,,just two tiny holes....."trimming up scar tissue"......yes,using a scope...40min operation & disscharged same day,,although os mentioned he might prolong hospital stay for few days to work on my rom....i agree totally with seeing a gentle physio....i"ll look into lymphatic massage as i still have a lot of welling in knee....thanks an hope ur doing well....
hi josephine....been meaning to reply for a while now...yes,,learning correct way to walk on stairs is most important,,,an i have been remembering , and using your " good leg goes to heaven ,,bad leg goes to hell" when doing stairs....and i understand when walking down stairs to let the good leg do all the work an keep the bad leg straight...bending both knees walking up stairs is no problem and is helping build strength for me...now my ex pt kept insisting that when walking down stairs ,,that the good leg goes down first ,,meaning that the bad leg needs to bend an support it..no wonder my brain an common sence kept saying" no way"..just thought i"d clear that up....thanks 2 much for ur advice ...and its working.....the suns out,,and im doing the many steps (paths) by the beach hereBones, the whole point of being taught by a PT to do stairs is that you learn how to do it properly despite the lack of ROM. That's no barrier at this stage. By letting her teach you, you will learn the art of going up and down whilst keep the operated leg straight! Okay? You should say to yourself, "Good leg goes up to heaven, bad leg goes down to hell"! meaning the good leg does all the steps requiring bend, so it goes first on the way up but the poorly leg goes first on the way down. That way the poorly leg never has to bend. Get it? So let her teach you, she knows what she is doing.
Nothing is loose except right now your muscles and ligaments. That plus the fact that your nice soft, shock absorbing cartilage has been replaced with metal and hard plastic. All you hear is the implants kissing as you move your knee. Short answer, stop testing it to see how much knocking you can produce! It will diminish over time as the soft tissues tighten up. It happens to almost everybody and you will get used to it eventually. After 4 years I can still make my knee clunk on demand!It means nothing.
...gets esier each day....the knee clicking seems to have quietened down also...
Hi, when is your procedure? If your ortho sees that little alien with a pick, make sure he takes a photo so you can post it on here. That'll explain a lot to others here with their unexplained aches and pains!
Many orthos seem to thing that adhesions are caused by inactivity and that more activity will prevent them. You're proof that is not the case. I'm proof that not "working on ROM" gets good results. All I did after that procedure was use a CPM at home and gentle stretching.
Many orthos seem to thing that adhesions are caused by inactivity and that more activity will prevent them. You're proof that is not the case. I'm proof that not "working on ROM" gets good results. All I did after that procedure was use a CPM at home and gentle stretching.
tks mary.my procedure is scudeled for 16th may..i"ll be most interested to see what the ottho sees an what he attends to while looking around in my new knee...i"ve got this feeling that he patella cover may even have come loose....f im correct then it may explain a few things ..I mentioned to a retired ortho aabout getting an mua at the same time ,and was advised against it as it coud make things worse as I seem to have problems in 3 different areas in and around the knee... the knee around the knee..hopefully the arthroscopy will be beneficial ...i"ll ask him to keep a look out for angry pick
sorry mary , I cant seem to edit this post ..
thanks mary..yes , seems one has got to persist & prevail to really get anywhere...no else is going to do it..a patient knows better than anyone if something is not right.....my doctor did"nt have to tell me i was depressed...hey, i knew that allready....getting over it though....looking forward to the outcome of arthroscopy next thursday 16 may...and to see if ortho spies any little alens running amok in my knee....
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