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TKR Nanners adventure to the other side

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Well, I think a revision is overkill too! Why would a surgeon talk about a revision if all that was needed was maybe a scope to remove some scar tissue from behind the knee. Maybe you could talk to another ortho surgeon.

You certainly deserve to be able to straighten your leg.

Let me tag Orthodoc and Josephine for their input.

You have been working hard to try and get that leg straight and need some good answers, not just hearing you need a revision!!

Maybe an MUA and some scar tissue or adhesion removal is all you need. It must be sooo frustrating being literally stuck with the same extension numbers no matter how you try. And I know from your posts you have done all the right things to get some more extension.
 
Nanners,
IMHO you might need somethng done with your knee but a revision is ridiculous. Maybe an MUA or a scope to remove scar tissue. Has your OS done any type of testing to find out what the problem is? I did not have any extension problems but to see NO improvement and still working at it makes me think something isn't quite right there. I am 18mos out now but if I was not seeing improvemnt, even if just very small, you can bet I would have been all over my OS about it. You might want to start looking for a second opinion DR. or two. A new set of eyes is always good.
 
Nanners said:
Are there any longtimers who had issues with their extension? I am 3 months out
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Nanners, the first thing you must get your head around is that 3 months is NOT a long time, it's still early days and you still have a lot of healing to do.
Nanners said:
I still have lots of straightening issues (stuck between 12-14).
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-12/14 degrees is not good and needs some remedial surgery - though not a revision! Have you done what I suggested and searched out another surgeon?
 
[Bonesmart.org] Nanners adventure to the other side
 
Hi Nanners,

I have been exactly where you are at. I know exactly how you feel. it's extremely frustrating to keep doing the same things and have the results bounce around. My experience was largely the same, and all related to extension.

At three months I had an MUA. I feel certain now that if I had not allowed aggressive pt immediately after it, I would have had great results. Unfortunately, I allowed the aggressive pt, which caused major swelling and I could never get the leg straight. After that I tried many things; massage, hanging off the bed with weights on ankle meditating, etc. none of it worked. I had what was called a revision in August this year, almost exactly one year after my tkr. It was quite involved but not like the revisions we think of here.

They went in through the TKR scar, removed the spacer and then removed the scar tissue from behind the knee, which had calcified. My OS said it was like concrete and a real challenge for him to remove. They got whatever scar issue they could all the way around the jont, put in a new spacer and sewed it back up. They did not replace the prosthesis. The first 3-4 days were awful and then bam, it was like a miracle. I saw immediate results and have maintained the gains. My extension is about 2 and my flexion is 120. I can live with that.

I am not suggesting you should go this route, but perhaps start with a second opinion. Consider the MUA, as it may be the key to helping you. If you need to go through the scar tissue removal like I did, I assure you it was no where near as bad as the TKR. I was prepared for the worst and got a much better than expected outcome. My thread is long but you will see much of what you feel written there I think.

I get the frustration, I really do. Jo is right though, 3 months is still early days, as she said the same to me many times. I know it doesn't make you feel any better though. It feels like you can't escape your own body and this issue that seems to never get better. I am living proof that it can get better. You just need to find the right solution for your specific physiology.

Please let me know if you have additional questions or if I can help in any way. I care greatly for those that are still struggling with these issues, especially the ones I myself had to go through. It will get better, I promise.

Take care, we are all here for you!

Dawn
 
Josephine I made a separate post becuz I want answers from other folks who are further out than I am and for my question to not get buried in my post and no one to see it.

I realize I am still in the early days. My question was did ANYONE ELSE have issues in these early days with extension and then over time and with more healing occurring get better extension.

The thought of ANY more surgery is abhorent to me. I can't do it and just was hoping that someone would be able to share that yes their extension improved. At this point I will live with what I have. Just was looking for a little hope, thats all!!
 
People will see it, don't worry. And I still prefer everything to be in one thread.

The surgery I was referring to was just arthroscopic as others have had, such as Kelly and Maryo.
 
Awww, Nanners, you have done just about everything humanly possible to get that leg to extend that you could. If your extension was at 3-4' then maybe time and more stretching would work it out. I know you had a very rough time post surgery due to your health issues, and I would not want to have another surgery ever!!!

If you are OK living with what you have, then you go girl!!! You have to do what's best for you. I'll keep my fingers crossed that you WILL get more extension in time. Who, knows, one day you could get up and that knee will be straighter!! But please, keep an eye out on that knee and if your extension gets worse, try to keep an open mind about an MUA or scope to remove scar tissue before it gets to the point it can't be removed well!!

Please take care, and know that we are thinking of you and we want the best for you.
 
Toni, my OS said its too late for MUA, which I totally think is BS. Maybe he says that becuz my bend is not that bad. If he can do something arthroscopic maybe I will try that, but thats as far as I will go. I saw him at my 3 mos check up and he said to come back in 3 mos and we will discuss things. But he was talking about a revision and honestly I just shut him out at that point becuz I didn't think it was time for that. He could even have been talking about if it came to that, but just the thought of more surgery makes me want to puke. I don't think my guts can take anymore. Thanks for your thoughts though, they are appreciated. Hugs!
 
Josephine It seems like some threads are more "popular" than others and, I am not saying Gail's is not one of the popular ones, but if some people don't regularly read her thread then they won't see it. So is there any harm in putting it as a separate thread? I know I don't have time to read every thread and sometimes just gravitate to those people whom I am familiar with or sometimes the newbies. Just a question.
 
Nanners, I think it's time for you to see another ortho surgeon for a second opinion. I think you could find one that would be willing to try an MUA. I don't think 3 months is too late!! The sooner you go in and get a scoping and remove that scar buildup, or adhesions the easier it will be.

This new knee was supposed to give you a more mobile life, not leave you in worse shape,than you were before!! You deserve a good result.
Maybe a new ortho surgeon and a little scar removal will make all the difference in the world.
 
I have a question for anyone who may see it. When I first started PT after my gastritis fiasco the first therapist I saw was the head guy. He measured my extension at 10. Afterwards, he put a hot pack on the back of my knee and had me do the dangle the knee off the bench and it went down to 7. I was so happy! But now with my current therapist, the lowest I have gotten it is 11 lastweek. Do you think something she is doing could be making it worse? I know after my sessions I feel beat to heck the next day and have to really rest afterwards. The reason for my separate question was I was thinking maybe if I stop formal PT and just work on it on my own, maybe things would improve. Thoughts?
 
Hi Gail,

3 months is not too late for MUA. It's a very practical amount of time to do one as you have given the swelling time to go down and it's not rushing into it. In fact others have MUA long after the TKR, many months and gotten good results. If you can get a second opinion, it would at least provide an independent perspective to consider.

I understand you don't want more surgery due to other health issues. Please dont think i am pushing the idea of surgery. I just know that we each need to seek a remedy that works for our specific case. Just don't give up.

It seems there is a great deal of variation in pts so maybe try a different one. Also, if you can get into a warm pool, you should do it. I have been going to a therapeutic pool for about 6 weeks now and it has helped my extension and flexion. The warmth of the water and gentle resistance is quite good. You might also try deep tissue massage to help stretch your muscles. I tried so many different things with a variety of outcomes.

Trying to help,

Dawn
 
Nanners, you can try that. Maybe the heat on the back of the thigh and knee will loosen the muscles up a little bit and make extending the leg more comfortable for you. And maybe stopping the the formal pt can ease the discomfort

But, please don't put off seeing your surgeon or a new one now..not in 3 more months. I know you don't want to have any more procedures, but don't grasp at straws sweetheart. You sound sooo desperate to just make this all about doing the right PT, or finding a new way of therapy, when in reality, it may be beyond that now.
My heart just aches seeing you this way.

Please, see what a good ortho has to offer you...and soon. If it is scar tissue or adhesions, waiting will only make getting rid of them harder on you.

You know we only want the best for you and hate to see you struggle so.
 
Gail, another thought. I have been having a problem with plantar fasciatis in my right heel, the non TKR leg. Skigirl suggested I try kelso earth shoes. The heel of the shoe is actually lower than the toes. They have great arch support as well.

Here's why I mention them; due to the lower heel, it has the effect of stretching the calf muscle and sort of forcing you into extension a bit, almost like a runners stretch but in a subtle way. I can feel it in my TKR leg definitely.when you walk and strike with your heel, and really focus on heel/toe, it is helping the extension.

Just another idea to consider.
 
Gail,
If I may ask why are you so against an MUA. It seems that would be the first course of action from any OS (not yours of course). There is no real SURGERY, they just put you under for about 10/15 mins and really bend the knee, doesn't seems like there is near as must discomfort after as with the original surgery. Arhtroscopic does require a small incision, and I really don't remember what anyone has said about the pain after. We all just really want you to have a great outcome from this and in your case may just need some extra measures to get there.
I do think that you need to find someone who will really check out the knee and tell you what is going on in there. If there is something stopping your extension(scar tissue etc) no amount or type of PT is going to help.
Hope all are info helps you out with a decision.
 
Karmigirl, I have too many issues after any surgery becuz of my Crohns Disease. It tears my stomach up and the pain meds just make things worse. I NEVER have a normal recovery. Even my Gastroenterologist told me the other day not to have any more surgery for now. He says my guts need to heal too. My system is really delicate and things get thrown out of wack with surgery. I still have swelling and heat to my knee which leads me to believe that hopefully within time things will improve. Jo keeps telling me I am in early days, so just going to try to be patient and see how things go. I will admit I am going thru a blue spell, so that may be the problem too. Hugs!
 
Nanners,

I haven't read through all of your previous posts, but from what I am seeing you have a flexion contracture of about 10-15 degrees?

Have you tried using an extension splint? I am not specifically endorsing this particular product, but it is worth discussing with your OS/PT (broken link removed: https://www.dynasplint.com/product/knee-extension-splint/).

MUA can still have success at your stage of recovery as well.

A second opinion is always reasonable.

Orthodoc
 
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