MUA Renee's TKR, ROM challenging

[Renee52]

Hello, not sure if this is where I start my first post! I had a TKR on 8/13/19 of the right knee. At 7 weeks, I had a MUA due to not progressing past 85-87 degrees. That was in Oct. 1st. I went to PT daily for ten days. This coming week will be 4 weeks since manipulation. I go back and forth between 108-110 degrees. PT is only pushing me as far as I can go. I guess I am wondering if I am on the right track. Some days my knee feels like it is and other days it doesn’t. I go back Nov. 4 to see my surgeon and am hoping he will be satisfied with my progress.

 

[Pumpkin]

@Renee52
You'll notice that I have moved your newest post and started your recovery thread. For several reasons, we prefer that you have your own recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• With your own recovery thread, you will see the posts and advice others have left for you.
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

Renee52,
Your ROM is fine for 2.5 months from your TKR. Between 108 and 110 degrees there is no difference, there can be a 5 degree variation in ROM accuracy.
My surgeon said he would be happy with 90 degrees at 3 months, your ROM is already greater than 90 degrees.
Your ROM increases naturally as your knee heals and the swelling goes down, revealing your ROM that was there all along. Suggest you slow down on the aggressive PT intervention, and ask them to help you get your swelling down.

Please post your MUA date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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:

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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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Pumpkin]

Two of our members who slowly gained ROM were kind enough to post their progress. You can see that their ROM finally increased over time.

Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
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 and still this now at 1yr 10 months

Bertschb’s ROM history
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

 

[Didot]

My surgeon said he will only consider a MUA around 12 weeks if bend is nowhere near 90. I’m a candidate, as I cannot get 90. He says that doing it any earlier does not allow for adhesions (if they are there) to be strong enough to break and it could achieve nothing. Only set you back in the recover. Does this make sense?

 

[Renee52]

Thank you! My MUA date was 10/1/19. Any and all advice is welcome. I started back to work on 10/23/19 only have days. Monday the 28th, will begin back to full days. Just a little nervous!

 

[Renee52]

Hello, I am back to work and things are going ok. I am lucky enough with my job that I can elevate and ice. I am still going to PT, but it is pretty much gentle exercises. I do some stretching, work on the new step and exercise bike. I am able to get to 108 degrees on my own now. I feel like I am bending my knee while walking, but others say, as they see me walk, that I am not. Any advice here?

 

[Pumpkin]

Most likely you are bending your knee when you are walking. Unless the "others" commenting on your walking are trained at assessing gait, they are probably missing the subtle softening of your knee when you are walking.
Have your PT work with you on your walking, they will be able see what you are doing and coach you how improve your gait.

Here is a list of how much ROM you need for various activities, as you can see you already have ample ROM for the listed activities.
These degrees of flexion are required for the following activities:
- 65° to walk,
- 70° to lift an object from the floor,
- 85° for stair climbing,
- 95° for comfortable sitting and standing
- 105° for tying shoelaces.

 

[Jockette]

You are still early in this year long recovery. Your walking will improve a lot as you continue to heal.

I found that early on, yes my knee could technically bend to those numbers that Pumpkln listed, but I couldn’t do those activities well until I had healed more. I actually got better function in my second year post op, as my whole leg continued to relax.

 

[Renee52]

Hello, it has been four and a half months seen my knee replacement and thee since my MUA. Everything has been going good, except the outside area of my knee. It is very tender, sore and continually tingling. Is this normal? Also the stiffness in the knee? Thank you in advance!

 

[sistersinhim]

Yes, this is normal. You are only halfway through this healing journey. Remember that this is an up and down recovery. Some days you'll feel better than others. As time goes on you'll have more and more of those good days and few sore days.

 

[Renee52]

Thank you!!