MUA Post Bilateral Knee Replacements/manipulation<

Mimi1616

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I am 13 weeks post knee replacement, both knees done at the same time. Left knee recovering well, right knee is not.

My ROM in left is around 0-110 and in the right 3-90.

I had 18 PT sessions ending in December 2017 so my PT is now at home. I would love any input on knee manipulation and to hear experiences, good or bad.

I should mention I am scheduled for MUA on the right knee on Feb 2 2018.
 
Can you please put your surgery dates in your signature? This information helps us if we need to advise you. Here's a thread that on how to create a signature. Give a shout if you need help!

Why would you want to have a MUA done this soon? No two knees are alike or heal the same. You might have had a whole lot more work done to the right one, thus it having more to heal and more swollen. Swelling is what holds back your bend. As your swelling goes down, your ROM will improve.

I will leave you our recovery guidelines. If you follow these, you'll have a much quicker and less painful recovery.
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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
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. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

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.
 
@Mimi1616, you don't have to quote a post to reply to it. Just go down to the bottom of the page and start writing.

I certainly understand your hesitation on doing the MUA. It sounds like you have weighed the pros and cons and are ready to make the decision that's best for you. Whatever you decide, we are here for you!
 
The MUA is really a personal call. Your flexion at 90 is not all that bad, though I hear what you say about no improvement in a month. :sad:

It's not unusual for bilateral knees to regain ROM unevenly. My right knee aced recovery and my left lagged behind. It was two months behind most of the way, but has mostly caught up now.

If you get the MUA, expect some swelling and pain as a result, so your flexion might temporarily go backward until the swelling resolves. Elevate, ice, and rest a lot just as you did before.
 
My ROM in left is around 0-110 and in the right 3-90.
I think your ROM is pretty good actually and that you really don't need an MUA at all.
Most surgeons won't do it if the flexion is 90 or over. And your extension is pretty spiffy too!

Before you dive into this, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
Mimi, it's unnecessary to quote a post just to reply to it. Just scoot on down to the bottom of the page and start typing! Unless there is some specific phrase you want to address, of course - like I just did! Then do it like this How to quote a post.

Thanks for understanding! :)
 
1. 1-2 most days both knees
Okay
2. Hydrocodone 7.5/325 twice daily, one am, one bedtime. Celebrex 200 mg.
Okay
4. Left knee 110/0 - right knee 90/3
Not bad
5. I ice after therapy or if I have been out of the house for a few hours, I ice about 15 minutes front and back of knee
You accomplish little or nothing in 15 minutes. Ice for at least 40-60mins and more than 4 times a day.
6. I elevate both knees 2 times a day at least. More if I’m in recliner watching TV
Elevate when you ice!
7. I cook, light cleaning
Okay

Stationery bike 10 min 2 times daily - okay
heel slides 3 times day 5 min - considering your ROM there is no need to do these
stairs 2 times daily - same again
walk 10 min daily - that's good
leg lifts, 30 count once daily - far too many. Besides which, once you can do a leg lift there reallty is no further need to do them any more

I can't help wondering if you are still doing these exercises out of habit, because you think you still need to or because someone told you to. Either way, it's not necessary to be doing them any more as your ROM is pretty good, you have minimal swelling and an almost zero pain score. I can't even figure out why your surgeon is suggesting an MUA because everything seems to me to be pretty good. The block you mentioned should settle itself out in time, especially if you stop doing all those exercises!!
 
What good news that your MUA was a success! And no pain...great! And sleeping well! It's all good!
 
Wow.. anxious to continue to hear of your progress. I'm facing mine on Feb 8th.
 
Thank you @Mimi1616! Swelling and such? Did you go right away to PT? I'm debating not going.
 
Sounds very good. Gives me hope as I just cancelled my PT sessions this morning. I don’t want the hassle of going there when my knee is swollen and hurting. Do u feel pain along the scar line itself or within the knee cavity? Any muscle pain? I know we all have different experiences but hearing others stories help so much. Thank u!!!!
 
Sounds like the MUA has worked for you. Glad your limp has improved, I’ll be glad to get rid of my limp.
 
Mimi, this isn't Facebook so it's unnecessary to quote a post just to reply to it. Just scoot on down to the bottom of the page where it says "write your reply" and start typing! Unless there is some specific phrase you want to address, of course - like I just did! Then do it like this How to quote a post.

Thanks for understanding! :)
 
Thanks for sharing your story @Mimi1616. I have been stuck in the low 80s since my first measurement in the hospital! My OS discussed a MUA with me at my 4 week check up. Glad you are doing well.


Sent from my iPad using Tapatalk
 
Today marks 2 weeks since bilateral MUA. I have progressed in my Rom, after my right knee being stuck at 90 before, is now 110 and my left is 117. Minimal pain during last 2 weeks. I still get stiff but time will help with that issue. I feel i’m on the road to full recovery. Back to work next week after 4 months at home. Still using pain meds, mainly at night. My goal is to only be using OTC pain medication once my current refills are done this month. I have found riding my stationery bike 1-2 times a day for 10 minutes helps with stiffness. I also put on ankle weights at night while lying on bed, leg straight up in air and slowly bend repeatedly for a few minutes and then let gravity help me bend slowly. This has really helped me improve my flexion and it’s not too strenuous as I control how far to bend and how long to hold it. It’s all up hill from here!
 
Hi @Mimi1616 I'm a week out from my MUA and my muscles are so stiff, swollen and painful that I can barely bend. I mean I'm down to only bending 10%. Did you experience this? I came out of the MUA only measuring 82 and I'd gone in around 75-82 so the MUA ANGERED my muscles alot and they just were not having it. Did your OS or PT suggest doing anything during your first and second weeks after the MUA? I was looking above in this thread for more of your experience, but many of the posts are missing or seem to have been deleted? Thank you for sharing more of your experience.
 
Sorry I had deleted some messages as I was going to leave the forem. But I decided then to stay. Right after my MUA I was sore and tight and didn’t have much flexion the first couple of days. I rested my legs at first but then gradually started riding my stationery bike. I felt the pain was tolerable and stayed on the same medication regimen. My soreness was not in knee cap area but mainly on inner SIDE of knees where the scar tissue was broken up. I haven’t had any pain for several days now and I’m moving around with no problem and my ROM is much better then first couple of days. Take your pain medication and gradually increase activity. Hopefully in a few days you will feel much better. I saw my surgeon yesterday and he was happy with my results, as am I.
 

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