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TKR Post op 12 weeks TKR

poppypony

junior member
Joined
Jan 2, 2025
Messages
28
Age
70
Gender
Female
Country
United Kingdom United Kingdom
Hi, help please. Am 12 weeks and feel like i am a slow burner, taken me all this time to raise my leg off the floor up to 90 degrees in fromtnof me, and also raise my whole leg up off the bed, was told at 6 weeks my quads were not working by consultant.
My bend has never been more than 90 Degrees and some days only 70. Should i be worried, will they insist on me having a MUA? As would prefer no more surgery
Thank you
 
Hello @poppypony, I'm so sorry that you are unhappy with your recovery, but it sounds like what you are going through is normal. Fluctuating bending is to be expected for at least 6 months. It mostly has to do with swelling. After doing activity that your knee isn't ready for, it usually swells. A swollen knee will not bend easily because there is no room for it to move with all that fluid in the way! Ice for at least 45 minutes and elevate at the same time with your toes above your nose. This will help to get that fluid out.

Please tell us the exact date of your surgery and which knee it was. It will be added to your signature so we can easily see where you are in your recovery.
 
Each person is different, as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY 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.

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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:
the BoneSmart view on exercise
BoneSmart philosophy for sensible post-op therapy

5. At week 4 and after you should follow this
Activity progression for TKRs

6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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.
 
Thank you for your reply, very kind, it is the left need and 26th September 2024.
So me worrying about the bend, is not a concern? I see so many people at 120 dgrees week 3 and 4, and i find it quite depressing.
Thank you
 
see so many people at 120 dgrees week 3 and 4,
Getting to 120 degrees within a month is exceeding rare -- and, I suspect some of those folks are exaggerating. (I've had both knees done and didn't have that flexion with either knee so early.)

Even at 12 weeks post=op, your ROM is being blocked by swelling and inflammation. No amount of pushing and shoving will increase your ROM -- in fact, it will make the swelling worse.

Your knee needs rest, ice, and elevation to help get the swelling and inflammation to calm down and allow your knee to reveal the ROM that has been there all along.

And, to assure you that you are not alone, here are progress reports shared by a few members whose ROM returned slowly but surely.

Campervan’s ROM history
92 - 8 weeks post op
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

Bertschb’s ROM history
2 months - 80 degrees
4 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
12 months - 140 degrees

TortiTabby's ROM
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks: 120
 
Thank you for your surgical date and which knee it was. I have added you to the September Recovery Team Thread. There you can find others that have had their surgery in September and can go to their recovery threads and read about what they are going through.

Never compare your knee with anyone else's recovery. Each knee is different, even on the same body. Each knee has its own damage and amount of repair work that had to be done to it. Even bilateral knees recover differently. The key is to listen to your knee and not force it to do things it's not ready to do. If you do, you'll be sorry! Your knee will swell and be more painful. You can NOT exercise your knee to get a better recovery, but you can slow its recovery down by doing too much too soon. Slow and easy movements provide a much better recovery rate for the vast majority.
 
Getting to 120 degrees within a month is exceeding rare -- and, I suspect some of those folks are exaggerating
I can't honestly remember what my bend was at 4 weeks. I am in the UK and my surgeon didn't worry too much or measure it at my 6 week check. He just watched me walk and move and asked how I was getting on. I didn't use formal physio - just some private pilates.
I was always a bit hypermobile- so bend wasn't a worry for me. I have almost as good bend on my operated side as my "good" knee ( 150 degrees versus 160 plus) at 2 years plus. But I did get the last 10 degrees at over 12 months. So bend can improve long after surgery. My issues were overstretched ligaments causing some post-op pain.
 
see so many people at 120 dgrees week 3 and 4,
Getting to 120 degrees within a month is exceeding rare -- and, I suspect some of those folks are exaggerating. (I've had both knees done and didn't have that flexion with either knee so early.)

Even at 12 weeks post=op, your ROM is being blocked by swelling and inflammation. No amount of pushing and shoving will increase your ROM -- in fact, it will make the swelling worse.

Your knee needs rest, ice, and elevation to help get the swelling and inflammation to calm down and allow your knee to reveal the ROM that has been there all along.

And, to assure you that you are not alone, here are progress reports shared by a few members whose ROM returned slowly but surely.

Campervan’s ROM history
92 - 8 weeks post op
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

Bertschb’s ROM history
2 months - 80 degrees
4 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
12 months - 140 degrees

TortiTabby's ROM
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks: 120
Thank you, that gives me hope. Question, so when i am told once the scar tissue sets in, you cant move it and wont improve, your kind stats suggest your bend ROM can improve over time, so thank you for that
 
Bless you, so its never too late to
Improve bend, why do so many have an MUA if its not needed. Thank you
 
Hello poppypony and Welcome!
why do so many have an MUA if its not needed.
Influence from their OS or PT I'd say as number one. Also, attempting to meet unrealistic goals and timelines and comparing your recovery with that of others that may have experienced surgery around the same time as you, but are further along. Fear of limited ROM never improving is another reason, which can cause anxiety and frustration. Natural improvement typically comes with time and patience, so no need to seek a quick fix. Swelling and inflammation are normal and the ROM usually improves as the swelling goes down and muscles regain strength.

I will leave a couple accounts from current / recent members on this topic.
Thanks for joining us! :) Happy New Year!
 
JusticeRider's post -

"I just want to add, for all those coming along, a note on ROM. I want to share this because nearly all of us have a tremendous amount pressure put on us to increase our ROM by certain deadlines, or else.

Mine has been extremely slow coming. First I had to wait out the swelling, which in my case took more than 5 months. Yes, months. At that point I began to see real progress. It has continued to this day. I have seen improvement in the last 2 weeks. It’s still going. A this point I think the limiting factor is tight muscles, ligaments, and tendons from 3 yrs of very limited ROM and actually about 25 yrs of somewhat limited ROM. Those tissues are slowly stretching.

I have had to be willing to let my flexion improve at a glacial pace, be very patient, and tune out the dire warnings of my surgeon, PA, previous PT, and some well meaning acquaintances. I refused painful PT and refused a MUA. I have absolutely no regrets. I know my body, and I believe those things would have caused a domino effect of swelling and pain that may have derailed my recovery long term and even possibly have torn soft tissue, etc. I now know I have the added challenges of hypermobility and an immune condition that causes an inflammatory reaction. I think a MUA would have been very harmful to me.

Instead of forcing it, I have relied on weekly massage and using my stationary bike as a stretching aid every single day. I have been very active, but I have ramped up really, really gradually. I have not measured my flexion, because honestly I feel almost a PTSD type of reaction around it. All I care about is function and what I can do. My knee is very functional now, and still improving. I love my new knee. I’m glad I let it heal on its own timeline even though it was so much longer than everyone (most of all me!) would have liked."
 
VolLady's post -

"I want to tell everyone that has went though TKR that it is a long journey to heal. I am going this spring to have my other knee replaced.

Please do not get discouraged and I know you will because I did with my first one and cried more than I had in a life time. Scared mostly.... Surgeons will not tell you everything that you will experience during your healing. It took me 7 months actually to feel more normal but not 100%.

For the ROM I only got to 112 at 4 months and still cannot bend it all the way back to reach 130. But I can drive, sit at a table, put my shoes and clothes on great without a ROM of 130 or 120. There is no swelling at all at 8 months but I still have some stiffness at times but I deal with it and walk. I also still ride my bike with no trouble.

I am telling everyone this because your body will heal without PT and pushing your limit beyond to the point there is more swelling and pain. I have decided when I have my other knee fixed this spring, that I will do my own PT since I have all the equipment and items that they use anyway.

I had a MUA at almost 6 wks., and regretted it from day one. Simply because it did not help me anymore with my ROM but it did set me back on healing. The swelling was awful. I will not have another MUA even if my ROM was 95 at the time.

I will go in with open eyes on this other knee comparing on what I went though with the first one. So, with all that said, I wish everyone a happy healing and let your body decide with healing than someone trying to push you until you scream with pain. Also don't worry about the ROM, it will come -- it might take a year or more, but it will come. I am 67 years old and I don't expect to get past 120, but I do what I want to do at 67. Oh! and I can even bend down with the knee need to kneel on it..... Best wishes everyone!"
 
i am told once the scar tissue sets in, you cant move it
To start, let's clarify the terminology here because it is the source of confusion for a lot of us.

There is a difference between normal scar tissue and adhesions:

We need normal scar tissue. That's what holds the incision together, and it's part of the normal healing process. Without it, you'd always have an open wound.

Excessive scar tissue -- more correctly called adhesions -- is actually very rare. Adhesions are often caused by overworking the knee until the tissues becomes inflamed.

This article explains the difference between scar tissue and adhesions:
MUA (Manipulation under Anaesthetic) and Adhesions

Most of the time the only thing needed to improve your bend is more time for that swelling to go down. When the swelling goes down the bend improves. Time is the best healer.
 
Thank you for the acceptance to this group, i am
Finding this so helpful and supportive.
I suppose its very hard to know if you are doing the correct amount of walking? Exercising? Pedalling? Resting, icing? To enable your recovery. I am more than happy to wait and be patient.
I work full rime at a desk, swlf employed and was back at my desk day 4 after the op. I so raise my leg and ice and try and walk every hour for 5 minutes. But in the afternoon i often fall asleep for an hour in a chair. Never had a sleep in the day before. Any advice? Need to earn money, sadly. Thank you again.
 
Hi @poppypony !

You're just over three months post op. It's quite common (especially for us seniors) to need extra sleep and rest as so much of our available energy is still being directed on a cellular level to repairing and rebuilding.

Many people slack off from icing and elevating around three - four months mainly because they are "over it" and want to feel as if they all better. The reality is, if the knee is warm, swollen, aching, or painful it will still benefit from two to three long daily bouts of elevation and icing.

Everyone is a bit different on how much activity they will benefit from. At three months I benefited from walking five minutes every half hour to deal with very uncomfortable stiffness. I took an easy walk daily and challenged myself with a longer walk every two or three days (I used a timer to make myself turn back to the house at the half time; if I overdid it one day I cut back by 1/3 the next time and then increased in smaller increments).

I did minimal exercising at three months in order to ensure that my tendons and ligaments healed first. I continued doing the quad sets I had started the day of surgery and seated heel slides.

The rest of my activity was activities of daily life - when I was healed enough to do semi squats, I resumed scooping the cat litter, and later on I could do a little deeper squatting as part of moving about the garden doing timed 10 minutes of yardwork - never the same day as a longer walk! I started walking on some small local hills - not too far - to build endurance and muscle tone.

Again, your knee will emphatically tell you, same evening or next day, if you've overdone things. Take a couple of days of real rest, increase ice and elevation. The thing you overdid? Reduce distance or time by 1/3 for a week, then increase in small increments as tolerated every few days.
 
Dear poppypony I am in the same fix as you, don’t have much bend, lots of stiffness. I am pretty discouraged, and impatient to feel better. I am retired so don’t have to worry about working- I feel for you. My OS offered me a MUA, I declined, as I was worried about a fracture (I have osteoporosis). And I felt I would go backwards. I’m just trying to hang in there. I’ve been doing an online PT class that’s 15 min 3x a day- some bending plus a peddler bike. I think it helped a little. I have a hard time riding/driving in car so that’s discouraging. I’m also very tired, even though I’m sleeping ok at night. Maybe we just need to elevate/ ice and wait. My RTKR was OCT 21
 
Hi Old ped,
Bless you for your response.

I am exactly the same, yes i am still working. I have osteoporosis too and will refuse an MUA , i am hoping and praying it comes along slowly and well. I am finding the whole process quite depressing, its so hard and debilitating. Wish someone could tell me when i may feel close to normal.!
I have bought an old automatic car as LTKR and changing gear on a manual car was too tricky.
I get really tired, can fall asleep at any time, feel very fatigued.
Sleeping is off and on, but only sleep on my back, used to sleep on my side but i cannot find a way to be comfortable on my side now. Prop up on two or three pillows.
Is your lower back or buttock muscle on the opposite side, causing you issues? I seem to have sciatica. My right foot goes numb. Oh crikey, sorry i sound like i an whinging.
Good luck.
Do you have the name of your on line class, i may be able to find it?
 
Sleeping is off and on, but only sleep on my back, used to sleep on my side but i cannot find a way to be comfortable on my side now. Prop up on two or three pillows.
A few more tips that may help you feel more comfortable...

I'm with you on the pillows, they certainly help me get comfortable in bed, making it easier to fall asleep. You can experiment with different arrangements to find what works best for you. I surrounded myself with them so I could rest a leg, or arm easily enough, whatever felt comfortable. Doing whatever you can to basically set the scene for sleep may be worth the effort. Make up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness.

Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down.

No apologies needed for venting, we all understand. There are good days and bad days on the journey.
Chin up, brighter days are on the way! :SUNsmile:

[Bonesmart.org] Post op 12 weeks TKR
 
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