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Bilateral TKR My recovery thread.

Newsflash.. I exercised on my stationary bike tonight and about half an hour later I fixed my dinner with only mild itching. I didn't have to stop cooking and scratch or rub. Yes it was a bit uncomfortable but nothing like its been before. So maybe I should exercise before standing in one spot! Maybe circulation has something to do with it? Such a mystery. :shrug:
 
scaredinCA said:
I think the doctor nowadays are too busy to be fascinated with these types of things. They just blow it off as another whackadoo.
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I think you are very right . . . but I also think doctors get ho-hum about the stuff they see a lot of and get, well, a little lazy and don't dig very deep or miss something important.

Patients eventually get smart and realize they have to solve their issues . . . thus, how this forum came to be!
 
I have another question. I know in time that a persons bend will get better and better.. But no one seems to talk much about extension getting better over time. My extension is the same as when my pt ended and the physical therapist said something that really has stayed with me. She said she thought my legs were set at where they were. Could that be true? My extension just hasn't come back in time, but then I haven't really been working on it either. When she made that comment, I guess I sort of gave up on it. So has anyone's extension gotton better over time? I'm seven months from surgery. Does that mean I need a mua or is it too late for that also?
 
I don't think our legs are ever "set" that was a stupid thing to say to you. You can gently increase your extension by straightening your legs out in front of you and gently applying pressure so that the back of your knee touches the table. My pt used to put a 1 lb weight on my knee.

It is better to have a zero extensions since your quads are not fully functioning unless it is zero or near to it. What is your extension? Or even what was it at the end of pt?
 
AT the end of pt my extension was the same as when I first started it. Good leg was about 5 and the bad leg was about 12 and I think its the same now as it was then. I can now sit on the floor with ease and put my legs straight out in front of me, but they are far from being flat on the floor. My daughter pushes on them and the right one is about at 1, almost flat on the floor , but that left one hurts too much to keep pushing it. I also lay face down on the bed and hang them off the bed for 15 mins at a time with no problem. When I sit in the chair to watch tv, I put my legs up on a chair in front of me and put 3 pound weights on my knees.. But the extension stays the same. (I can tell that my quads are much stronger than they used to be at pt).
 
Quite frankly, I think you are doing fine. I have been through multile surgeries in my lifetime, and this has been one of the toughest. After such a traumatic surgery such as this one, you need to give yourself a year plus to recover. Your legs have been: sawed, hammered, glued, stapled(?), sewed(?), etc, etc. Please give yourself time to heal. Dont let a PT flip you out - very rarely have they had a tkr (and you have had two!). Keep doing your home therapy - you will get there. Be patient with your body.
 
Thank you for the vote of confidence. However, they say our bend will keep improving with time, but they also say that your extension should be seriously worked on right away. Does that mean it doesn't improve with time like the bend does?
 
And who be 'they'? This is not something I've ever heard.

And the best way to improve extension in late stages is to focus on the proper gait when walking. Do you know about that? The heel, toe, heel toe?

[Bonesmart.org] My recovery thread.
 
Joesphine, I'm not sure who they is.:rotfl: Thank you for replying, and yes I do know about heal toe and I try to remember to walk properly. I guess when I say "they" I mean from everything that I've read and then what the pt said. I wish she hadn't said my knees are set, because thats when I came home and sort of gave up on trying so hard, I simply lived my life. Now I'm wishing I had kept trying to straighen them more. The fact that I am not an active person probably made things worse and I didn't notice how my legs weren't straightening like they should have. A more active person would have noticed it much sooner.
 
Extension does improve with time . . but extension issues are harder to solve. After my last intervention my ROM was 10/90; four weeks later it was 10/105. Working on my extension tended to hurt more so I had to work on it more slowly and persistently. Now I have -5 extension. Just hang in there and keep up the steady efforts, being careful not to incur pain. Do you warm up the back of your knee ahead of time?
 
No I have never warmed up the back of the knee first. What do you use, a heating pad? My daughter massages the whole knee gently and then pushes on it. It goes down just a tiny bit but the pain prevents us from doing it more than three times. Mary how long has it been since your surgery?
 
I'm three years post TKR, resolved my extension issues at about six months post TKR. Nice help from your daughter! I had the same problem, it hurt a lot, and I was good about not pushing to the point of pain. I placed a pillow under my knee and had my husband very slowly push down. The pillow made me feel less vulnerable. Although he did a few of these each session, they were held for a minute or two during which I tried to relax the leg. You can use anything that's handy to warm the area up. I have a commercial hot pad that's warmed in the microwave. You can make your own using rice. Or use a heating pad. I you warm the area for 20-30 minutes so it really sinks in. That will bring blood supply to the area and perhaps over time help things along. Don't expect immediate results.
 
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One more question. Do you remember where it hurt? My pain is partly in the back of my knee (on outside area) and then partly on the side (inside) of knee. I can feel that something needs to be stretched out on the inside because it hurts from the knee clear down to my calf. But the pain in the back of the knee is the worst and even when I bend my leg it feels like something is dislocated (but I'm sure its only a feeling).
I feel like I'm starting all over again because I've let this go for a few months when I should have been working on it the whole time.
 
Well I don't think any harm was done. My ortho was kinda of breathing down my neck because extension is so important to gait. Not pushing but keeping the pressure on.

Did you have a bowed leg prior to this? I'm wondering if shortened medial ligaments may be playing a role. Give yourself time and don't freak out or push things such as try to make up for lost time. Slow and steady is always best. Really, it was weeks before my extension budged much. Don't despair.
 
My legs weren't bowed, but they were bent, I could not begin to straighten either leg out. I think before surgery they were 30!!! I am so grateful to be able to walk again without horrible arthritis pain and I can bend my knees better than before surgery. And its better to have extension at 12 rather than 30.
 
Has your surgeon discussed this with you at all? I don't know what they do about "ligament balancing" for someone with extension issues. If I were you, I would be curious to know if he expected you to achieve full extension. But I bet if you were 30 before (no wonder you're having trouble with extension!) and you're 12 without much work on it, I bet you'll get more extension. Again, patience Grasshopper!
 
I'm starting to wonder if the Jas System or a Knee extension Board would help me get these legs straight? The extension board costs $120.00 which isn't cheap but maybe its worth the chance? I don't know what the cost of Jas System is but it look much more complicated so would probably be much more expensive. I'm having other health problems right now that worry me, so I keep putting the knees off.
 
Those are good ideas. Have long have you worked on extension? I would give your modified efforts (gentle steady efforts on a warmed knee) a few weeks first. If your OS writes a Rx for the JAS your insurance will cover. Not a bad idea to collaborate with your OS if your efforts at home yield no efforts. PS I think you are as impatient as me!
 
Hmm I don't know about being impatient, but I am guilty as anyone could be that I have not followed through with my exercises and am now paying the price. For several months I have done very little in the way of exercises, so I have no one to blame but myself. I suppose I just got too discouraged when I kept trying and wasn't really getting anyplace with straightening. It seemed as though my knees were surrounded by rubber bands and when pushing on my knees they would go down a bit, but the minute I let go, they went right back to where they had been. I'm thinking now that I probably wasn't holding them down long enough or often enough for someone who's legs were as bent as mine were before surgery.
 
scaredinCA said:
It seemed as though my knees were surrounded by rubber bands and when pushing on my knees they would go down a bit, but the minute I let go, they went right back to where they had been.
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This is the nature of the beast. But over time with repeated, gentle efforts, you will get there. You have to take the long view (not look for immediate results). Thus my comment about impatience! And not exercising did not hurt you. Not sure how your extension lag slipped through the cracks. I would've thought your ortho would've monitored that. Mine did.
 
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