Post-Op Trochleoplasty

Another good PT session today.

I'm walking around the house now with no crutches without much pain. Managed to get my bend to 100 degrees today!

Hopefully, things continue to improve.
 
Congratulations on losing the crutches at home and on getting to 100 degrees!

Slow and steady wins this race, I'm sure things will continue to improve..... best wishes! :flwrysmile:
 
Did they recommend using a CPM machine for your recovery?
 
It’s been one month to date since your procedure. Happy Anniversary!
Enjoy the month of May! :flwrysmile:
@HR1994
 
Most of the newer OSs don't order CPMs. Most don't believe they help and are an unnecessary extra expense.
 
Been a while since I posted last month. I've had a couple of hydrotherapy sessions now, which have really helped.

ROM has increased to around 108°. I saw the consultant this week and he said my ROM will probs max out at 130° - which is consistent with journals/studies I've read in regards to this surgery - so another 22° or so to gain!

My passive extension gets to 0° but actively it's around 5°. I've been told to continue to work on this by doing a couple of excercises.

My biggest area of work is my quad muscles. They are still significantly wasted (which makes my knee look slightly big but not much swelling) although, it is an improvement of what it was a couple of months ago. But I'm sure with quad excercises this will hopefully come along and grow.

I'm still having weekly physio excercises to keep building my quads and work on flexion/extension but consultant said he doesn't need to see me till another 6 months (to check up on progress and potentially discuss my other knee) unless the physio thinks I need to be seen before then.

Walking wise, I don't use crutches anymore (unless I'm in a public area, I use one crutch to give myself some space). I'm starting to get more of a normal gait whilst walking but not fully there yet as there's still a bit of heaviness and tightness in the knee. Hopefully a couple more weeks of walking and practicing more often, it'll get there.

Things are improving and I keep reminding myself it's almost 4 months into a 12 month recovery, so plenty to work with!
 
Great update, HR1994! Thanks for taking the time to share.
You seem to be progressing nicely at a steady pace.
Keep up the good work and stay in touch!
@HR1994
 
Hi all, another monthly update - reaching almost 5 months since my surgery.

I've been going out the house a few times a week now with friends and family for leisure. Things are improving, getting better and I can do most things around the house. I don't use crutches anymore really. It's only when I go out, I'll take a crutch to assist with steps in restaurants/buildings or sometimes when I'm walking downward slopes. Probably getting in 2k-3k steps a day.

In terms of my ROM, it has reached 115°. It's slowly coming along, hopefully by the end of the 12 month period, I can get to 130°ish. Extension wise, I think I've still got 4/5° to work with this to get it to fully straighten, so some work to do.

Knee strength/quad muscles is still behind at this stage I think. I suffered significant atrophy and couldn't move around much for the first 6 weeks post-op. It's slowly coming back and I'm building that strength back up. Physio said progress is a little slow on knee strengthening side of things but it'll come. Is there anyone on here that knee strengthening issues following surgery due to muscle atrophy? How long it did take you to get to a point where you were happy with your knee strength? When can I expect to be comfortable?
 
6 month update:

- I'm now fully off crutches. I stopped using them at home around the 3 month mark but kept one with me when outdoors. I stopped using them outdoors now completely. I'm still a bit slow walking though but pace when walking will come. Some days, I've managed to walk past 10,000 steps even! I should note there is still some heaviness in my knee but PT noted that can take 1-2 years to go sometimes.

- My flexion has improved to around 123°. It was 100° after 3 months, so the myth online can debunked that it doesn't increase after 3 months. My PT always kept me encouraged. My consultant said I'd probably reach around 130° due to the nature of my surgery, so almost there.

- I can go upstairs leg over leg using one hand on a railing. Going down I'm still going one step at a time as pressure on my knee doesn't allow leg over leg yet.

- My excercises mainly consists of home workouts using makeshift and ankle weights around 3 times a week, swimming once a week and physio session a week.

- Quad, VMO and calf muscles are strengthening but still weak, so work to do but I can start to see gains. I'm feeling stronger and stable and the difficulty and intensity of my excercises are increasing, so positive signs. They're already bigger than they are pre-op.

A couple of issues I'd like to solve over the next few months:

- My active knee extension is still lacking by 3-5° and I can't fully straighten yet. I initially had full extension a couple of months after surgery but this regressed a little. My PT has noted it still goes to 0° as he pushed down on it this week. The lack of knee extension does cause me to slightly limp when walking. PT noted hopefully with continued quad strengthening and some extension stretches (seated leg raises and supine low load durations), it should hopefully improve but one to focus on.

- I still have a slight quad lag when trying to do an SLR. PT noted as quads continue to strengthen this will hopefully come but I suspect it's due to the nerve block I took for my surgery as it took a long time to my quads to fire after the surgery.

All in all, life's significantly improving, my knee feels stable and strong in comparison to pre-op. I no longer fear my knee dislocating or losing balance (as I did pre-op) and I'm pretty much back to normal daily life activities. Hopefully, I can iron out the last couple of issues mentioned above but understand I'm only halfway through a year long recovery and understand gains can be made beyond that! :)

Hope everyone else is doing good. If there are any tips re extension and quad lag, please let me know!
 
Last edited:
Have you tried pilates for gentle but effective leg strengthening?
My pilates teacher has loads of free classes on YouTube. Google Katja pilates and they will come up.
She has a 15-20 minute glute strengthening one for post injury as it is side lying with no squats. I did that most days and it really helped with leg strength.
I can now do more strenuous classes as well.
Going downstairs normally didn't come for me until 6 months.
For extension try just lying on the bed on your tummy with your leg just hanging off a bit.
 
Thanks. Yep, for extension, I've also added that exercise in too. Usually after 15-20 mins of stretching, my extension gets closer to 0° but then after 30 mins or so, it's back to normal. All about consistency I guess, so I'll keep on top of the extension excercises.

I'll check out the pilates video. I've got a couple of side lying excercises already incorporated into my routine workout anyway, so should be beneficial!
 
I've got a general question. A bit of context - so as mentioned my knee extension (after tensing the quads) is 1/2° and I've still got some heaviness/tightness in my knee. I've noticed my gait is perfect when walking uphill but when walking on flat surfaces, there is a little bit of a limp there. Downhill, I'm very slow as it puts pressure on the knee.

Is this normal to see perfect gait walking up hill but not quiet seeing that on flat/downhill surfaces?
 
I've got a general question. A bit of context - so as mentioned my knee extension (after tensing the quads) is 1/2° and I've still got some heaviness/tightness in my knee. I've noticed my gait is perfect when walking uphill but when walking on flat surfaces, there is a little bit of a limp there. Downhill, I'm very slow as it puts pressure on the knee.

Is this normal to see perfect gait walking up hill but not quiet seeing that on flat/downhill surfaces?
YES. Downhill, even *without* the surgery, is generally worse for those of us with arthritis!
 
Thanks. Yep, for extension, I've also added that exercise in too. Usually after 15-20 mins of stretching, my extension gets closer to 0° but then after 30 mins or so, it's back to normal. All about consistency I guess, so I'll keep on top of the extension excercises.

I'll check out the pilates video. I've got a couple of side lying excercises already incorporated into my routine workout anyway, so should be beneficial!
I have had exactly the same problem with stretching - extremely short term benefits while creating significant discomfort. However I have found relaxing into a combination of passive and active range of motion to be very helpful.
To do that on extension what I do is, sitting up, extend the leg out as best I can, its weight on butt and heel, not trying to touch the back of my knee to the surface.
I then let all the leg muscles relax and with both hands cradling above and below the joint I very gently and quite rapidly shake the area up and down within a small area, well within its current range of motion. It doesn't hurt at all and it seems to let the tightness release.
 
When you say gently and shaking the area up and down, do you mean rubbing the knee or physically moving the joint up and down? How many times a day and for how long did used to do that?
 
When you say gently and shaking the area up and down, do you mean rubbing the knee or physically moving the joint up and down? How many times a day and for how long did used to do that?
Literally moving the joint up and down by shaking lightly and only a very small up and down. Thumbs lightly alongside patella, fingers cradling underneath, no grasping, grabbing, or pressure at all.
It shouldn't be at all uncomfortable (don't do it if it's uncomfortable!) and the leg, upper and lower, remains totally relaxed. At nearly 8 weeks post op I continue to do this 3-4 times a day just for a couple of minutes while reading or watching a movie. Sometimes - now! - seated on a comfortable chair that supports my upper thigh and my heel supported on a coffee table.
I have had a lot of massage therapists use very gentle shaking and rocking as a way to release tension, so that's what gave me the idea on my first TKA.
 
Last edited:

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011
  • EalingGran
    Staff member since January 23, 2024

Members online

Forum statistics

Threads
65,180
Messages
1,597,061
BoneSmarties
39,364
Latest member
All2Gd88
Recent bookmarks
0

Latest posts

Back
Top Bottom