Question about flexion

[Lynne]

I've fairly recently started coming to this site and have been reading a lot, trying to learn amap before my July 13 TKR. But I'm confused about flexion. Right now my knee doesn't bend completely - actually it hasn't for many years since the time I had a tear/injury of some sort. It was never right again. And of course with the osteoarthritis, it's gotten worse, is bone on bone and distorted way out to the side which probably also keeps it from bending properly. I always have to stand and walk with my knees in a kind of bent position, never straight. After replacement, what actually keeps the knee from bending? I thought my bending (or lack thereof) was because of the joint itself, alignment and all. But with a new joint, why the bending problem? Right after replacement, the knee is swollen and needs to heal from the incision, so it's understandable that it can't bend completely.

I've ordered the "book" that has been recommended here, but in the meantime, I would really be glad for a little understanding of post TKR flexion and therapy. Is it the joint, muscles, tendons or what?

 

[loggon]

Hi and welcome

Flexion is how much your leg will bend backward toward your "butt"

Scar tissue ==swelling=== muscles too tight and many other reasons can cause it not to get a good bend or flex.

You will have a physical therapist and they will help you.

Don't worry you will enjoy having the new knee and I am sure
you will get a good flexion. Just have to pay attention to PT and do all the exercises they give you. Just don't over do.

Log on a lot and lets us know how you are doing.

Jo and Jamie will be able to let you know more.

 

[Josephine]

I'm assuming you are referring to the many posts where people are maybe going to need a manipulation. This is a complication that can arise from adhesions or, as the surgeons so often call it, scar tissue. If you want to know the detail, I can post a mini lecture about it.

 

[Texas]

Hi Lynne. Yes the ones Jo gave me has helped me alot. I am sure you will be just fine. Just make sure your house is prepared ahead of time for when you come home. That helps. I did have a manipulation, so If I can help, please dont hesitate to ask. Im sure we will all talk before your surgery. Welcome.

 

[loggon]

Lynne
Have not heard anymore from you. Please do post and let us know how you are doing.

You will do great!!!!!! Just ask and Jo can answer, she is so good.

 

[Lynne]

Sorry I didn't get back sooner. I'm just learning how this forum works and I was expecting an email alert. When that didn't happen, I just assumed the post hadn't been answered yet.

About the flexion - right now my knee doesn't bend nearly enough which I thought was because of the way it is deformed out to the side and misaligned. In other words, just the joint itself causing the problem. So after I get a new joint and realignment, where does the need for therapy to increase flexion come in? Will it be to make tendons & muscles, etc stretch further than they have in a long time - make them start working at full again?

Guess you can probably tell by my posts that the therapy part has me the most worried.

 

[Lynne]

Forgot to mention, Jo that I would like to hear about manipulation - all the whys and hows. I'd never even heard it mentioned before!

 

[backbay38]

Lynne - when muscles haven't been used properly for a long time they both lose strength and shorten. They will need to be stretched gradually so they can bend your knee properly. and if you haven't been walking properly for a long time, you will need to strengthen the quads and hamstrings or your new knee won't feel stable. Physical therapy is pretty straight forward; we all do much the same exercises - leg lifts with increasing ankle or thigh weights, balance exercises (a range as you get stronger) and lots of gending -- both by you on a daily basis from immediately after the first post op day and by the therapist. the only pain is from the pushing to get the knee to bend (flex) more. It's momentary and goes right away and most people take pain meds right before therapy until the pain subsides - which it does as you get more flexible. There isn't a great deal of muscle pain from the strengthening exercises but they can be difficult if you have never worked out. The better therapists are not too aggressive about bending the knee, opting for more gentle pressure but there has to be some serious effort or the bend will never happen. You need to be ready to work hard at rehab and you will see gains almost immediately. As yo progress your life will start coming back to you... and you will be so happy you had the operation and did the work!! So don't obsess about the rehab. Just take one day at a time and do what has to be done and you'll be fine. Oh -- and talk to your surgeon about pain mediation BEFORE the operation; Some surgeons still aren't very good at this and it makes a huge difference in the speed and comfort of your recovery. Good luck!!! keep us posted!