TKR New Knee New Me’s TKR Recovery

Newkneenewme

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Hello,
I’ve been searching and reading and learning from this forum, so first of all, thanks to all who share!

I am 38, had a left total knee on Sep 23, I have rheumatoid arthritis and need to also have my right knee replaced. I have had issues with extension pretty much from post op day 1. It was worse then, I was only able to ambulate with my knee bent and with my heel up. Now I am at -20 extension at last measurement. I have physio again this week so we will see if I have made any gains. I am doing good in terms of flexion, measured at 90 last week and I think it’s even better now.

I do my home exercises twice daily. Pain is pretty well controlled, sleeping fairly well, icing all the time.

It’s affecting my gait and my walking ability, being bent. I’m worried it’s not going to straighten, worried about further surgery, worried about “stiff knee” worried about everything in general. I feel disappointed with where I’m at and my inability to straighten my leg. I’ve been reading here about the knees ability to gain ROM for a year or two so I’m trying not to have so much anxiety.

Has anyone else been through issues with extension early on and made it to a straight leg?
 
Last edited:
:welome: to BoneSmart
I’m worried it’s not going to straighten
It will. The key is gentle stretching exercises.

My own ROM, Extension and Quad exercises http://bonesmart.org/forum/threads/rom-and-extension-stretches.13159

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Hello @Newkneenewme and :welome: ,

Was your knee bent before surgery? That sometimes has an effect on extension after surgery.

Extension can sometimes take a long time to achieve. That's because the strong muscles and tendons at the back of your knee need to be stretched slowly and gently. It's not unusual for extension to take longer to achieve than flexion.
There's plenty of time, though, so don't let anyone worry you by telling you that you must get there fast.

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
 
I did have extension in that leg prior to surgery but all my muscles in that leg are weak. I have been close to immobile the last few months and in such pain. There’s so much out there saying extension needs to be achieved quickly that I think I have had major stress and anxiety about it this weekend. Thanks for allaying my fears. Still looking for anyone who has struggled with extension and maybe had some success???
 
There’s so much out there saying extension needs to be achieved quickly that I think I have had major stress and anxiety about it this weekend.
No, what they're saying isn't true, so try not to worry.

Since you lost muscle strength and were relatively immobile before surgery, it makes sense that you won't bounce back to full strength and function as quickly as some people, but I'm sure you'll get there in the end.

The surgery takes away the damaged areas in your knee, but it can't cure the soft tissue strength loss. Your muscles and tendons are going to need time and gentle treatment, so they can heal too, and recover their former tone.

Just try to remember (and remind anyone who is impatient with your knee) that every knee is different and what happened before your surgery is bound to have an effect on your recovery. Your knee is going to be all right, but is just needs a bit more time than some knees do.
 
Try not to worry so much, you are still in the early days of your recovery. My extension was terrible for several months. I even bought a metal contraption on Amazon to try to help Straighten it. but it just hurt my upper leg. Even after 30 PT visits, the only thing that helped was taking longer strides, like I read on this site. Now 5 months later, my extension on both of my TKR’s is -2 - It is just going to take time, patience and lots of ice to keep the swelling down, so it can bend. Hang in there!
 
Try not to worry so much, you are still in the early days of your recovery. My extension was terrible for several months. I even bought a metal contraption on Amazon to try to help Straighten it. but it just hurt my upper leg. Even after 30 PT visits, the only thing that helped was taking longer strides, like I read on this site. Now 5 months later, my extension on both of my TKR’s is -2 - It is just going to take time, patience and lots of ice to keep the swelling down, so it can bend. Hang in there!
Crying reading this. I needed to hear this and be able to give myself a break. I know it’s common to feel impatient in the early stages of recovery but I had no idea how it was actually going to affect me. Knowing that I have time and can recover gives me hope. I didn’t have this bend before surgery so it’s freaking me out. Reading that I have time let’s me know I need to just chill out and recover.
 
There’s so much out there saying extension needs to be achieved quickly that I think I have had major stress and anxiety about it this weekend.
No, what they're saying isn't true, so try not to worry.

Since you lost muscle strength and were relatively immobile before surgery, it makes sense that you won't bounce back to full strength and function as quickly as some people, but I'm sure you'll get there in the end.

The surgery takes away the damaged areas in your knee, but it can't cure the soft tissue strength loss. Your muscles and tendons are going to need time and gentle treatment, so they can heal too, and recover their former tone.

Just try to remember (and remind anyone who is impatient with your knee) that every knee is different and what happened before your surgery is bound to have an effect on your recovery. Your knee is going to be all right, but it just needs a bit more time than some knees do.
I’ll take this mantra to my PT session today. Thank you for the encouragement and info, patience patience patience is something I need to keep invoking.
 
2 week update!
I have gained some extension, from 20 to 15. Flexion has gone from 90 to 115. It’s nice to see some improvement but the bend in my knee definitely makes moving hard. My physiotherapist is really great, sessions so far have just been some neuromuscular stim while doing my regular at home exercises, some laser and icing.

I’m definitely feeling deconditioned overall. My preop health was quite poor, both knees bone on bone so I was barely walking. I find I can’t stand up for longer than a few minutes now, my posture/alignment feels off. Walked to the mailbox today which is about half a block but it wasn’t an easy stroll. The knee is definitely stiff.

Overall I am okay with where I’m at 2 weeks post op. I wish the knee moved more freely, I am seeing my OS next week so will see what he thinks of where I’m at.
 
@Newkneenewme Early days! Please don't stress about the stiffness. You knee needs time to settle. Are you icing and elevating regularly? Icing will decrease the swelling that is causing stiffness. Patience prescribed!
 
That all sounds very normal for 2 weeks post op. The energy drain of healing really takes a lot of effort and leaves us easily exhausted after an activity. That will improve over time as you heal, in this year long, on average, recovery.
 
@Newkneenewme with my first knee, aggressive PT set me back.. ROM was good fairly early but extension lagged. After reading here to walk with longer stride I did and got to zero somewhere between 8-12 mo. I actually forgot about it, decided to check it and was absolutely flat!
 
Patience and time....those are the requirements!!!
 
You're only a few weeks out. Stiffness is part of the picture, unfortunately. As others have said, it just takes time. Standing and walking for any amount are tough for most of us in the first weeks.

And it does sound like you're making good progress. :friends:
I didn't have problem with extension but it took me 6 weeks to get to 90 degrees bend due to lots of swelling.
 
Hello @Newkneenewme

I was in the same pre-op condition as you were -- out of shape and bone on bone. But you will get your muscle strength back and as you walk longer, your overall conditioning. Patience and time -- just keep moving -- slow and gentle. Come here when you are feeling down. It really helps.
 
Icing
Hello @Newkneenewme

I was in the same pre-op condition as you were -- out of shape and bone on bone. But you will get your muscle strength back and as you walk longer, your overall conditioning. Patience and time -- just keep moving -- slow and gentle. Come here when you are feeling down. It really helps.
thank you for the inspiring words. I expected the knee pain but I wasn’t anticipating the full body pain of new body alignment and change in weight bearing. Trying to keep moving and coming here definitely helps. We aren’t alone
 
3 week update!
Some hope for anyone worried about extension like I was. Making progress, down from -20 when I left hospital to -9. Feeling more hopeful now about regaining full ROM. Flexion up from 115 to 125.
Incision is well on its way, my surgeon uses glue so no staples to be removed. I saw him this week and he was happy, said I had a great result. We filled out the paperwork for knee number 2.
Pain is more in my unoperated knee, I think it’s jealous. Controlled with ibuprofen, ice and Tylenol for the last 2 weeks.
Bruises (more like pooling of blood) around both sides of my foot is unsightly. PT did some K tape on my thigh bruises last week and it really helped so she did the same with my foot this week.
I’m able to stand for longer periods, feel like my body is getting used to my new gait/weight bearing pattern. Tried to order new sneakers online but that was a fail! Will have to brave the shops at some point for new sneakers that can grow with my new way of walking.
Hope all the other September Sapphires are settling into their new knee(s)!
 
Some hope for anyone worried about extension like I was. Making progress, down from -20 when I left the hospital to -9. Feeling more hopeful now about regaining full ROM. Flexion up from 115 to 125.
The incision is well on its way, my surgeon uses glue so no staples to be removed. I saw him this week and he was happy, said I had a great result.
It sounds like you are having a great recovery!
Pain is more in my unoperated knee, I think it’s jealous.
This is quite common. I believe it's because the old knee is doing much more of the work now than before your replacement. Mine gave me a fit, but as the new knee was able to do more, the old knee got better. I hope yours does, too.
 

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