TKR Nine weeks out and still limited ROM

[PolarBear60]

I'm so happy things are looking up for you. It's been a long road to reach this point. Quite a few people have had MUAs on the site. From what I can recall, they've experienced mixed results, but I suspect that's due to the factors Josephine discussed with you. In your case, it sounds like your doctor has sound reasons for wanting to do one (and home the same day sounds good), but I completely understand your indecision. I think you will gain more ROM over the next few weeks, but could it be even better? I don't know. You tagged Josephine, and I'm sure her experience will be invaluable when you read her response.

 

[Gilina]

Sorry--just read in another person's thread not to put a bunch of tags at the beginning of a message. Won't do it again, but not sure changing it now would help.

Gilina

 

[Gilina]

I'm so happy things are looking up for you. It's been a long road to reach this point.

You know, in an odd way, it seems to have gone really fast. I had a couple of weeks where I felt "blue"--bored and unmotivated--and of course, plenty of pain at the start, though the repeated GI illnesses were much worse and more of a problem. I am actually surprised to feel as good as I do already. But, as someone who has had migraines for 46 years and put up with knee pain for over 2 decades and had some other leg/muscle issue that was truly horrible for 8-10 months a couple years ago, feeling better 3 months after major surgery probably does seem like a short span of time in comparison! Not sure I would be feeling so good had I not found this forum. It's the old, once you know what the problem is and realize you are not alone and not crazy, the "adventure" seems less daunting.

Gilina

 

[Josephine]

As for bend--he said I had gained 30 degrees since my last appointment a month before! (Would that happen if I have adhesions?)

No it wouldn't! And it confirms that your low ROM is mostly due to swelling.

So, will I gain more ROM in the next few weeks? And, if I do, does that mean I can skip the MUA.?

Yes and yes! There's no hurry. Even if it should be adhesions again - which I think it MOST unlikely - waiting another 4-6 weeks won't make a scrap of difference.

My OS did say that the fact that I am functional is good, but that doing the MUA would improve the outcome of the surgery and improve the quality of my life.

Oh brother! Why on earth is he in such a hurry about this? Makes no sense at all to me.

Can you tell I keep changing my mind about doing the MUA.

Well, in the end it's your decision of course, but if it were me ....

 

[PolarBear60]

There you have it. It sounds like there's no need to rush to an MUA at this time. If I were you, I'd give it another six weeks at least.

 

[Slainte]

Oh, tough decision. You need at least 20 - 30 more degrees to be fully functional, as I understand it. The question is can you get there on your own? And at what time do you have to decide? Do you have the option to work (very gently) at stretching that bend out slowly and see how it goes?

 

[SDkate]

I It was probably the only nice thing she had to say to me--she even criticized me for wearing Birkenstocks. Sheesh.

Tell her don't mock the Birkenstocks! That's what I've been wearing and my PT hasn't said anything. Now, my Earth shoes with the negative heel, I could see where those might be a problem.

 

[Gilina]

Oh brother! Why on earth is he in such a hurry about this? Makes no sense at all to me.

Actually, he was pretty laid back about it (his PA is another story). He sort of does have a time limit where he feels it is most effective, but wasn't pushy about it. He's very nice. @Josephine --you once remarked that you thought the fact that my ROM changed from day to day indicated it is a swelling issue and that still happens, though outwardly, there is no longer any visible swelling, I do know that that doesn't mean there isn't still plenty inside. Plus the IT band tightness across the knee (I am pretty sure I feel that esp. when walking) is different than an adhesion issue.

I remain undecided. I live in a "summer resident" type area, though I am here year round, so if I want help with transportation if I have an MUA, I need to arrange that while my friends are still in town. So, I sort of have a time limit. Decisions, decisions...

Gilina

 

[Gilina]

Tell her don't mock the Birkenstocks!

I love my Birkenstocks (though the quality seems to be slipping :-( ). My sister gave me my first pair in the 1990s when I was having plantar fasciitis [sp?] in both feet (and a job where I stood 8 hours) and the sandals fixed that, where meds and orthotics had not. Been wearing them ever since, and only have boots for winter and snow. I do not even own a pair of regular shoes!

Gilina

 

[dtmbf]

Too funny about the Birkies. I got reprimanded by my PT for wearing my boat shoes to rehab - and I've lived in my boat shoes for years. In fact I dedicated a specific pair of boat shoes to each of my 3 recoveries. I needed not to think about what pair of shoes to put on each day!

 

[Josephine]

you once remarked that you thought the fact that my ROM changed from day to day indicated it is a swelling issue and that still happens, though outwardly, there is no longer any visible swelling, I do know that that doesn't mean there isn't still plenty inside. Plus the IT band tightness across the knee (I am pretty sure I feel that esp. when walking) is different than an adhesion issue.

Exactly so.

So, I sort of have a time limit. Decisions, decisions...

I cannot add more, I'd just be repeating myself. I think you may have to just trust your own reservations since you clearly have some. The lack of a driver is not a good reason to jump into this.

On the other hand, even if I am right and he is wrong, it's not really going to do you any long term harm. I just hate to see you undergo a general anaesthetic for no good reason - there are risk involved.

 

[Campervan]

I think its time you say this - its my ROM progression for my right knee which is now 3.5 years old. My left knee is now 12 weeks old, has ROM of around 120 but does go up to 125 sometimes, and drops sometimes as it stiffens, swells up and gets warm if I do anything for too long, including sitting in my recliner.

92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months

 

[Celle]

Thank you for posting that again, @Campervan. With your permission, I've used it several times.
It shows so well that ROM can continue to improve for a long, long time - and gives the lie to people who insist that there is a limited time frame in which to achieve ROM.

 

[Nana moon 27]

I'm watching your thread with great interest as I am under threat of MUA. Personally for me, I think it's too soon. I've decided that when I next see the OS I will refuse the MUA at this point. He'll be sending for me soon. I'm two weeks behind you in surgery dates.

It's only my personal opinion, I'm not medically qualified to make a diagnosis but if my rom increased by 30, I would be inclined to put it back leaving your options open.

You sound very unsure about the procedure. I cannot tell you what to do but you did ask for others thoughts. However, they will be different xxx

Good luck
Love Nana moon 27 xxx

 

[Gilina]

@Campervan Always good to see continued progress. I'm saving that info--thanks!

@Nana moon 27 Yes, I am in some ways still undecided. And maybe it is the humidity the last week, but I seem to have lost ROM and in fact have some pain again, so that is all confusing me even more. I do have a ride though, if I decide to do it fairly soon. Have you had any updates on your situation? Did you decide?

@Josephine Yes, the anesthesia aspect is always a worry. I have decided I need to make up my mind in the next week (so that I can have help available). I haven't gained any ROM--in fact feels like I lost some. I can still make the knee pretty mad if I try to get it to do more than it is willing to do. But, your comment that (other than the anesthesia aspect) an MUA won't do me any harm even if I don't have adhesions is, in a odd way, very reassuring.

I suspect the OS is correct since I remember quite clearly when I realized (at about 4 weeks) that my knee bend suddenly felt "blocked" and I had been very ill shortly before. I guess I really have no way to be "positive." I wonder if they ever do an MUA and say afterwards, "Well, turns out there were no adhesions."

The decision is weighing on me, so I need to just decide, one way or the other, and be done with it.

Gilina

 

[Josephine]

Oh I very much doubt they will ever say that! Can't let you think you had it for nothing, can they?
But if you ask him was it 'easy' to get it bent and degree of flexion did he achieve, the you will be able to guess!

 

[Gilina]

@Josephine Yep, thought so. So how would I know from the degree of flexion achieved after MUA whether or not there actually were adhesions? I'm not clear on that.

Gilina

 

[Wrangler]

If the OS does not need to use a lot of force and the knee bends easily that means there were little or no adhesions. If the OS can get a high degree of flexion without much fuss that would also indicate little or no adhesions.

 

[tigz]

My OS said I was one of the more difficult MUAs he had done but he managed to get me to 120°. He said he took his time getting me there. Prior to the procedure my ROM never got to 90°.

Sent from my Nexus 7 using Tapatalk

 

[Josephine]

What Wrangler said!