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TKR Please: Some advice for one week out..

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Leslie, you are not even at 5 weeks yet! Of course you are swollen and in pain! I was taking full dose of tramadol and paracetamol for a good couple of more months yet. In my opinion you ARE rushing it. Ice, ice, elevate, rest and more ice! Gentle stretching exercising and more ice! You'll get there. By the way my knee is still warmer than the other.
 
TKR surgery - WARNING: real life photos


Have you taken a look at what they did to you during surgery? Many of us did not realize how much surgical trauma was done to the knee---and, once we see what happened during surgery, we can then realize why the knee is so swollen, and why the swelling is so stubborn to subside.

This recovery gig is a marathon and not a sprint. Don't try to rush it, and do not try to push things---and the big one that all of us faced---do not try to worry about things. Be gentle, take your time, and be patient.
[Bonesmart.org] Please: Some advice for one week out..

Patience, Grasshopper, Patience
 
I'm glad Josephine logged in with you and that I could read her responses to my comment to you, too. It was one of my PT's that suggested scar tissue could lay down whenever the muscles were over heating. I've been wondering about it ever since and trying to decide if it made sense. I also appreciated the comments about - no pain, no gain. I've seen an assortment of PT's and they seem to have different perspectives on this.

I do hope that you've been able to put your MUA panic aside. It isn't worth panicking over.

I will gladly join you in prayer. Will you pray for me, too? I'm really hoping the second opinion this week will help me have better perspective on what I need to be doing.
 
I have only scanned your thread so pardon me if I'm off target, but I've been there and done that, and many many others have come on this forum with an almost identical story.

You cannot beat scar tissue if it occurs. Arthrofibrosis is a pathology that just happens to some of us (like, 1%). I got it and even the MUA didn't do the trick so it was removed arthroscopically.

I think the panic is that we go into TKA thinking it's the ultimate solution and land on the other side with a set of problems that we hadn't expected. Lack of bend is a huge discouragement. It's hard to know who to trust, too. I was in a major bummer state for weeks because of it.

If you have scar tissue, pushing will trigger formation of even more. If you don't have scar tissue, pushing will cause more swelling and deter progress. So can you see how pushing is a lose-lose proposition? It's very confusing when the "professionals" who are hired on our behalf give us advise that goes against our instincts (and makes us hurt!).

With a Jan. 23 surgergy, think of March 23 as a time you'd like to be more than 90. Then go for it big time! -- meaning, take it easy, do gentle stretches (pain < 3), ice and elevate, and let your mind wrap itself around Plan B which would be a possible MUA some time down the road just so you are accepting the worst while hoping for the best.
 
Thank you maryo52. This whole surgery was just more than I thought - more painful, more life changing,more everything! I am so very thankful for the people of bonesmart..honestly think this community has saved me..
 
Honest please..If you have had a MUA, what is it like? Scared to even ask it...
 
Hi Leslie01,
Your story is very familiar to me. I am now more than 4 month post my TKR and my last measurement of my ROM was 82! I am on my third PT and I had a MUA around 9 weeks after my TKR.
Before the MUA my knee and leg was so stiff I could barely walk. My knee and leg was in pain immediately after the MUA but it was short lived once I was given pain killers. The surgeon said he got my knee to 120 during the procedure. But a month later it was down to 60! True a lot of the stiffness in the leg was loosened up, but I still have difficulties in walking (I am very slow), getting in and out of cars and going up and down stairs.
Thanks to this forum, I changed my PT to one that does have a better idea on how to handle TKR patients. and is a person who believes in pushing to discomfort and not pain. Another lot of good advice is to let the knee dictate the recovery and nurse it well. Like icing, resting and elevating. It was suggested to use the pool a lot (I do use it at least 3 times a week) and to have leg massages which has helped as well.

But I do get frustrated and depressed. And I still have nights that I don't sleep so well. I am also on pain medication which my knee is telling me I need. I have just come home for my daughters wedding inThailand which was wonderful. It was a welcomed relief for me as all I seemed to think of was 'THE KNEE'.

My next course of action now is to get a second opinion from another OS. I feel my current OS has lost interest in my case . I had to ring him up to find out if he was interested in a follow up appointment after I was discharged from hospital after the MUA. My ROM at that time was at 75. He spoke to me over the phone and offered very little advice. He just said he wouldn't do another MUA and he would see me in 2 months time ( which is in April).
If the second advice is to have another MUA then I would certainly have it. The small amount of pain from it would be worth it if I could just get more ROM. I also think that my knee has had some time to heal a bit more and maybe the MUA will work more effectively.

Good luck
Suzie pi
 
Thank you Suzie for taking the time to write! My rom was at 88 today..going to the OS on Thursday to see what he has to say. It is 6 weeks now so not sure what he will say..So scared! glad to hear that the MUA was no biggie..I am in pain daily anyway..
Congrats on your daughters wedding!! I know what you mean about having something to take your mind off your knee!
Thanks again,
Leslie
 
Leslie.....just read through your posts with great interest! You are just one week ahead of me, and I, too, do not have a very good bend. I was just barely at 80 today at 5 weeks. I am scared to death of a MUA, and feel like it will just start this whole ordeal over again. I'm ready to get on with things, and not go back to the pain and discomfort of the early days! I see my surgeon on Friday, so I will know more then. I will certainly be watching your posts to see what your doctor says on Thursday.

Just wanted you to know you are not alone.....
 
Hi Leslie,
I went to my GP yesterday full guns to get a second opinion. But instead, he gave me some good advice that does not require a MUA! At least not for now.

He suggested to sit on a dining table or something so that my legs above the ground and move my operated leg back and forth for some time . I should only rock the knee to discomfort and not pain . Do this as many times in the day as I can. Like before and after meals and morning and afternoon tea.etc. I should do it for 2 weeks and see how I go.

As he said this exercise will break the adhesions up naturally. It would improve my ROM and I could avoid having a MUA! This sounded great to me. And I have read this advice also in this forum. As it has worked for other people. I'm pretty happy about that as its a less painful process. And a lot less expense.

But it's still early days for you. My advice is hang in there and rest, ice, elevate, take pain medication. The knee is in control and it dictates how long it will heal. Good exercise is important but it should never be painful. One of my early problems was an aggressive PT who believed in applying pain to a very swollen knee in order to get more ROM. This just made my knee worse and my knee and leg just stiffened up in protest. After the MUA I moved on to a better PT. Maybe if I had had a better PT I probably would not have needed a MUA in the first place?
Good luck again
Suzie
 
leslie01 said:
If you have had a MUA, what is it like? Scared to even ask it...
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Leslie, why are you asking about an MUA? You are only 6 weeks out, far too early to be thinking about such things. Has your surgeon said you need one?
 
Sorry I did not respond after Bottomshollow asked us who have had MUA's to respond. I have not been on for sometime. I had my MUA about six wks after my RTKR. I was unlucky in the pain department. Much worse for me after. But I do have to say it improved my ROM. Would I do it again? Probably not! I would have followed the Mantra better and changed PT's to one less aggressive. Maybe the need for MUA would never have come up and my ROM would have been fine. I am glad it doesn't look like you will need one. Please make sure you have a PT who doesn't push too much. I changed and my new PT is wonderful.
 
I am seeing my surgeon tomorrow..Thank you for writing back!
I went to Physio yesterday..my rom was 88..seem to be stuck..Wow 6 weeks after you got a MUA..that seems early..I am hoping that living life will continue to give me more rom over the next year, but I will see what the surgeon says..Thank you to everybody for posting..Love this forum!
 
Josephine: I guess I was asking because my physio has talked about it with me and I am not getting my rom to move from 85-88. Going to my surgeon tomorrow for ex-rays and then to speak with him, so am really anxious to hear what he has to say..
Thank you :)
 
Suzie..Thanks for posting! Will def. try that exercise..You get to the point where you will try anything..
My emotions are so up and down..
 
Suziepi thanks for sharing info! I am now sitting on the table swinging my leg. My ROM went from a high of 121to 112 so I was worried about adhesions because I feel a pulling inside my leg. I ride the bike every day 3x but I stiffen up an hour later. I finally got my extension to 0 but losing the ROM has been discouraging. I am going to keep swinging and when I have PT on Friday check the ROM. Thanks for the tip!
 
I think a lot of people worry about this MUA thing for nothing. Part of the problem with not being able to bend in addition to swelling is that your muscles hurt, your ligaments and tendons hurt. You have to work through that discomfort to get a good quad and hamstring stretch. It may "hurt" but it isn't going to hurt you. Even when moved gently it will hurt but you will know when to stop and when to take some nice deep breaths and go a tad farther. Suck it up. You got through surgery you can get through this. Some days will be better than others.

There are plenty of exercises that you can do to achieve little gains without going over the top. For flexion, try sitting in a chair and doing your leg slide when you get to the point where you don't think you can go any farther, lift your heal off the floor, you will get a stretch in a slightly different muscle and you may be able to slide another inch. Work on it and give it a try. Do this several times a day.

For extension, lay on your bed or sit in a chair and put a rolled up towel under your ankle and stay there for 5 minutes. Do this a few times a day. Another angle is laying across the bed on your belly and letting your leg hang. It won't hang far but you will feel it stretching. Stay this way for a minute or so and work to 5 mins. It will be difficult to get out of this position because it will be uncomfortable but do it anyway and bend it slowly when getting up. Do this a couple times a day. Patience, perseverance and time along with those handy dandy pain meds.

You, me, and all of us suffered an inordinate amount of pain prior to this surgery and can handle a little bit of pain to work through an exercise or two that will benefit you beyond belief in the long run.

This is my 2nd TKR, I'm 11 weeks out and my range of motion is 125 - 0. I probably won't get beyond 125 but frankly my dear I don't give a .... darn. I'm a fast healer but that doesn't mean it didn't hurt like heck doing some of these things and that I don't still have pain, healing takes months but you put yourself through the surgery now do what you need to in order to gain your life back.

Harsh, I know but life is harsh and we are our own worst enemies and biggest advocates. Only we can get this done. Stop worrying about something being wrong and focus on what's right. If there is something really wrong I believe you will know it.

When all else fails - have a cocktail! :yay:

P.S. This message isn't intended for anyone in particular and no disrespect intended.
 
leslie01 said:
I guess I was asking because my physio has talked about it with me and I am not getting my rom to move from 85-88.
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So what? You're only 5 weeks out. You can expect to have low ROM at this stage. You've plenty of time to get it up to a more respectable number so long as you don't push it too much.

Read this article MUA: the ineffectiveness of early MUA (JBJS).
 
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