ROM before and after TKR

[Lynne]

Hi Everyone,
I found this forum through a Google search last night and just registered today.
Back in 1991 I did a simple twisting around motion which resulted in a "Separation of prepatellar & prefemoral fat pads - joint effusion, tear in meniscus". At the time I was an over the road trucker and the pain eventually went away so nothing was ever done surgically. But from that time on I have been unable to bend my knee completely. I also have inherited from my Mom the "arthritis gene" according to my Ortho and both knees are now shot, so over the years the ROM has decreased even more. I'm scheduled for TKR in May (if I don't chicken out) and am wondering how much of an increase in this ROM I can expect to achieve after TKR. I can live with the pain (for now with the help of pain meds and warm weather) but the stiffness and lack of range of motion is what severly limits me and makes me want the replacement now.

Blessings!

 

[Josephine]

Hello, Lynne, and welcome to BoneSmart.

The intention of any joint replacement is to restore normal function. Therefore you can expect to get back normal ROM in your knee. Of course there are little problems that can seem to get in the way at the beginning but most are temporary, such as swelling or adhesions. Some of the time, what you get is in proportion to the amount of effort and hard work you are prepared to invest in your PT but don't let that make you into an obsessive-compulsive person!

 

[Jamie]

Hi, Lynne....we're so glad you found the BoneSmart family. We'll be here to provide as much support as you need during your journey to a new knee. I won't kid you by saying the surgery and recovery are a walk in the park. It hurts and (as you can tell from reading posts here) the recovery can take a while. But in my opinion the results are WELL worth the effort you must put in to get your ROM (and your life) back. Please post any time that you have questions or concerns (or just to say hi too) and we'll be here when you need us.

 

[Simon]

Hi Lynn

My post op ROM was in the low 90's for both knees and had been that way for more than 20 years. The OS did not think given all the previous surgeries and the length of time I had bad knees I would gain much postop. Well after 7 months of PT and continuing exercise I did get the right one to 120 and the left to 123 and the left is at 0 extension and the right one about -2. So there is a good chance you will get back the ROM you lost. Nothing is a given but just getting rid of the pain will improve your quality of life.

Simon

 

[Josephine]

Well said, Simon! And well done.

 

[Jamie]

Wow, Simon....THAT'S impressive. And a great story to pass on to everyone! Way to go!

 

[Texas]

Lynne Hi when in May is your surgery ? Kim

 

[ship4]

Welcome Lynne!
Hopefully you go ahead with your surgery and get your life back so you can do the things you used to enjoy!
I had BTKR last June 18th. I was in pain and had started to limp, could not walk around the block, could not ski, could not garden........
Now, I can do all of the above and plan to increase my stamina to hike again. Your muscles, ligaments and tendons have atrophied some with the loss of ROM over the years. Your PT work will help strengthen them all and as Simon did, and Jo stated, the ROM is there in the new joint waiting for you to put it to work.
Getting both my knees done at the same time was the best thing I ever did! Go for it.
It is scary, exciting, nerve wracking before the surgery, but Oh so worth the time, effort, and energy you put into it.
My advice get the book from Amazon! It is a step by step guide thru the process and so very helpful.
Best,

 

[Lynne]

Hi Everyone! Hope you are having a wonderful day!

Sorry to say, I did chicken out for the May TKR, but did later reschedule it again for July 13. I have so many things going on that I constantly change back and forth from yes, lets do this to no way! My knees are so bad and I am so physically limited - can't do steps unless I go down kind of sideways and going up have to literally pull myself up with my arms, can't stand or walk for any length of time without terrible pain and unsteadiness (have started using a cane), lately have not been able to drive comfortably because of the pain up the back of my right knee and thigh and also difficulty braking. So I have more than enough reason to go ahead with the surgery. But then my mind runs through all the reasons not to go through with it. First, I do have some days when I get around pretty well with limited amount of pain. Then, I've had breast cancer that has had a local recurrence this past summer. There's a big long story to this, of course, but what it boils down to is that the recurrence was a more aggressive cancer so chemo was recommended but since there was no evidence of any metastasis anywhere else in my body, I refused the chemo. It would only have increased my survival rate by 4 or 5% anyway. So I have that lurking over my head making me think I shouldn't do my knees in case the cancer comes back. Also, I haven't shown myself to be very dedicated in the physical fitness department and am quite overweight and out of shape. At this point I think the muscles in my leg have already kind of atrophied so I'm very worried about therapy. My mind keeps telling me that I probably won't have enough gumption to work at therapy and so will be no better off after surgery. So there you have it. I'm trying very hard to focus on just having the knee replaced and keeping the other stuff out of my mind, but it certainly is not an easy thing to do!

Sorry to get kind of off topic here, but I felt that I couldn't give my surgery date change without an explanation.

Blessings!

 

[Jamie]

Hi, Lynne. Sorry to hear that you opted out of surgery this month, but glad to know that you rescheduled it. I know it is a scary prospect, but you will not get better otherwise. Use the forum for strength as the new date approaches. The more you wait, the more difficult recovery can be. Focus on all the things you will be able to do AFTER surgery that you can't do now. The replacements are life-changing. You do have a lot on your plate, hon, but we will help you get through it all!

 

[Texas]

You know Lynne what ever you decide is great with us. We want you to be on here no matter what. I am truely sorry about the cancer. I sure hope there is something they can do. And ya know you are stronger then you think. You had the cancer before and you got thru it, please give yourself great great credit. You are pretty amazing in my eyes !!!! Please post even if you just want to talk we are there for you no matter the problem....Prayers are certainly going your way.........Kim

 

[Judles]

Lynne! Welcome! These are decisions that only YOU can make! Hope you take time to make your decision and do what you think is right for YOU! Best of good luck! !

 

[Sticker Lady]

Lynn-
It sounds like you are between a rock and a hard place. It must be so hard to even consider surgery for your knees with everything else you are dealing with. My surgery is this coming Monday and my mind keeps whispering that it's not too late to chicken out. I won't, though, because I have too many things I want to do again. This is something I can do to improve my quality of life.
As far as the PT goes--it isn't anything I would choose to do but I know I can make myself do what I have to to reach MY goals. I want to be able to climb the stairs without pain, to be able to play on the floor with my grandkids(and be able to get up again) and to be able to travel with my husband and not worry about finding a place to sit all the time. If I can get back out working in my garden, it will be an extra bonus.
What are YOUR goals, Lynn? Will the knee surgery (and the dreaded PT) help you reach them? Will living with the pain help you reach them? Only you can decide.
Blessings,
Irene

 

[Josephine]

Also, I haven't shown myself to be very dedicated in the physical fitness department and am quite overweight and out of shape. At this point I think the muscles in my leg have already kind of atrophied so I'm very worried about therapy. My mind keeps telling me that I probably won't have enough gumption to work at therapy and so will be no better off after surgery.

Well, you have got a plate full and no mistake! But let me assure you about the therapy ..... I've nursed terribly over-weight patients who've had knees replaced and were not at all committed to their therapy but they did just fine! Even some basic exercises will do the job as I have proven for let me tell you, there's no-one more lazy or uncommitted than me but I've done just fine! See, we don't go in for the intensive therapy that you do in the States but overall the results are pretty good anyway.

What does make a difference is the state of your muscles/legs before surgery. I got in and had my knee done early and have reaped the rewards as a result. On the other hand, my sister, for various reasons, waited till her knees were in a dreadful state and yet 2-4 years on, she too is absolutely fantastic! Only problem now being that her hips need to be done but she is delighted with the outcome of her knees.

Short answer then, so far as knees are concerned, anything is going to be better than what you have now, don't you think?

I'm so very sorry about the cancer. You must be terribly disappointed about that, God bless you, and there's not much I can add as I never worked in that field. But if all in all, your medics agree you can get your knees done, PLEASE do get them done. You won't regret it. And don't be scared of the pain or the therapy. If you can get through chemo you can get through anything, bless you.

 

[Texas]

Hi Lynne just checking in to see how you are doing. Please post anytime. We are here for you ...Take care...Kim

 

[Lynne]

Well, I hit the wrong key and what I'd already written just disappeared, so here goes again.

Hi Everyone

Thank you all for your kind words and willingness to help. When I'm on this site, I've been busy reading other threads and forgot to get back to this one.

YAY, I haven't canceled my July surgery! Biggest issue now is trying to decide which knee. My right knee has been the one with pain and lack of full ROM for several years now and is so distorted to the outside that it of course makes my body feel shorter on that side. But the left knee has started catching like it gets out of place and seems less stable with increasing pain, even down in my shin. I'll have pre-surgical testing, informational class, visit with PT and surgeon a week before surgery so will figure it out then I guess. I spoke with my surgeon about bilateral, but he's not too fond of them as he feels it's pretty hard on the patient. My deciding factor was that with one knee instead of two, I can come home sooner and not have to go directly to a PT facility when released from hospital. So, I've been learning and sort of preparing my mind to get this done.

As far as the breast cancer, there is currently no evidence of spread anywhere in my body and so am considered to be in remission - never cured. The only recommended treatment (besides surgery) for the type of tumor I had the second time around is chemo and this is often given just in case there are cancerous lesions too small to be seen by tests. But I felt that while it is/was possible for those cells to be there, it also is possible there were/are really NO cancerous cells anywhere else and I would be poisoning my body for nothing. There is no way to know for sure. But I do know that with my knees the way they are now, I'm not living a life I'm happy with. If the cancer would ever come back yet again and I would find chemo absolutely necessary, it would be better to have 2 strong and stable knees to get around on, right? First one, then the other! I CAN do this!

Blessings!

 

[Texas]

I am glad to here that the cancer is in remission, and hope it remains that way forever. So July it is. Good for you . I think you will be happier like you said just in case. They never gave me a choice on the classes,I never knew they were given, till I got on here. Lil upsetting, but I learned alot on here. Well you sound like you are getting things ready. I am sure you will be fine...And I know about the typing and then all the sudden your post goes away..haha .I have done that I dont know where it goes. Take care of your self and dont over do it.....Prayers are with you........Post anytime...........Kim

 

[Jamie]

Lynne, bless your heart for being such a strong woman. You have the right attitude and I hope this waiting period goes by quickly for you so you can begin that new, pain free life! You deserve it!!!

 

[Josephine]

Yep - amen from this corner too, Jamie!