TKR RTKR

[Layla]

It sounds like you had an unfavorable experience and I certainly don't perceive you as a cry baby.
Thankfully you found a better match for PT, but please refrain from engaging in movement that causes discomfort as well as allowing anyone to manipulate your leg to the point of pain. It must feel like it defeats the whole purpose of the therapy. As you are doing, if something hurts, tell them to STOP. You're the boss and the one that has to deal with the pain. I hope you have a lovely weekend, Birdie!
@Birdie23

 

[Birdie23]

Thanks again for all your input.
I only go to PT now 2x/week. I haven't been able to bend my knee more than 95-degrees more or less, since Nov 1st. I still have severe pain, stiffness and swelling of the knee and on one side of my knee now. I do some minimal stretching exercises at home, plus ice & self- massage w/vitamin E oil. I don't think PT makes any difference anymore.
I think I may want to do MUA at this point.
I'm going to see my orthopedist this Thursday, 3/7 and will keep you posted on what he says.

 

[Layla]

I am sorry you're struggling with severe pain, Birdie, amongst all else.
Best wishes for the appointment you have on Thursday. Please let us know how it goes.
@Birdie23

 

[Birdie23]

I saw my Orthopedist today. He is sending me for an MRI to see if there's scar tissue in the knee. He'll determine if I'll need an MUA.
He said to continue gentle PT, only 2x/week, don't go overboard on PT.
He has been in touch w/my physical therapist as well as my psychiatrist. He said he wants to treat me as a unique individual -- not just regarding my physical pain, but also as a neurological and emotional human being. He was very calm and comforting.

 

[sistersinhim]

Your OS sounds like a one-in-a-million! You are blessed to have someone so caring and is concerned about things other than the implant.

 

[mendogal]

You've got a keeper there!!!

 

[Birdie23]

I'm scheduled for an MUA procedure on April 2nd. My regular OS doesn't do this procedure, so he referred me to another OS in the practice. He agreed with my OS that the MUA was the best option for me now. An MRI showed no scar tissue or adhesions, so he said the procedure won't take that long. However, he wasn't making any big promises about a return to 100% full activity level prior to surgery. But, I won't have the same pain anymore and I'll have fuller ROM. I'll have pain from the procedure and PT, but that should dissipate within a couple of weeks.
I'll go to PT the following day, and then it's aggressive PT and a lot of work on my part to keep my knee at full ROM.
Interesting-- I was told that once my leg has full ROM, my brain will realize that- oh, I can move my leg properly and so then there's no reason for the pain anymore.

 

[Birdie23]

Caveat- I didn't have 200% activity prior t o TKR, as I was limited due to arthritis and pain. Th OS meant that I won't become superwoman after the MUA.

 

[Birdie23]

100%
Sorry, my typing

 

[mendogal]

Interesting-- I was told that once my leg has full ROM, my brain will realize that- oh, I can move my leg properly and so then there's no reason for the pain anymore.

Um. No.

I had excellent ROM shortly after surgery and I hurt plenty.

Pain after surgery is from wounded soft tissues and from inflammation/swelling, NOT a miscommunication between brain and knee.

The only time that kind of miscommunication happens is in chronic pain syndromes which is a specific diagnosis and there's no reason to think applies in your situation.

 

[Jamie]

I’m not sure who told you that your pain will disappear when you have full ROM because your body will suddenly “know” that your leg is okay. As mendogal indicated, that’s not really how pain works. I do hope you realize some benefit from this procedure, even though your MRI didn’t show any adhesions (the main reason why an MUA is performed). Do be a little careful with “aggressive” PT as overdoing things can do the opposite of what you’re trying to achieve and cause more pain and swelling.

 

[Birdie23]

Thanks for your responses.
So, I'm confused as what to expect regarding level of pain & ROM (of course it depends on individual) after MUA procedure.
( My rehab was horrible, hence I never regained full ROM and was caused stiffness, swelling and pain, never beyond 90-95 rom at knee).

 

[Jockette]

( My rehab was horrible, hence I never regained full ROM and was caused stiffness, swelling and pain, never beyond 90-95 rom at knee).

I'll go to PT the following day, and then it's aggressive PT and a lot of work on my part to keep my knee at full ROM.

How is doing the same thing as before going to give you a different outcome?

I walked away from painful PT at 4 weeks post op, and left PT at 8 weeks. My numbers at PT and at my follow up appointments with my surgeon were good, but only because my surgeon pushed my knee to a painful place to get a number he liked. (From which today I have some PTSD) I could not get those numbers on my own. After a tough first year with ROM, it improved a lot, all through my second year, as my whole leg continued to relax and heal.

All the PT you have had has not helped, so why not try something different? Just walking will give your knee the gentle bending movements it needs to heal. Your knee cannot heal by continually “working it” to do more than it’s ready for. Give it time. Though I’m sure the past 5 months seems like forever, but in reality, you are less than halfway through this year long healing process. And some, like me, need that second year.

Having the MUA and back to aggressive PT is your choice, but armed with the knowledge I have now about this recovery, I would not do it myself. I saw for myself, in my own recovery, what time can do for healing, and that it can take a long time.

We are here for you because we care.

 

[Jockette]

Not counting ROM, how is the rest of your recovery going? What is better today than it was on December 31? What can you do now, that you couldn’t do then? Has your stamina improved? Is pain better? Stairs can be tough for quite a while, but are you handling them better now? All these thing count as improvements. Our medical team can make such a big deal about ROM, but it’s really only a part of the equation.

 

[Layla]

Hi Birdie23,
As you are contemplating all, here is a link to the threads others that have undergone the procedure, if you're interested
MUA
I wish you clarity in making decisions and the best of luck with whatever you decide. Please know that we're here for support always!
@Birdie23

 

[Birdie23]

It's not only ROM, but pain.
I am in pain 24/7. All day and all night.
I want to know if the MUA will relieve my pain.

-I've been at a steady level 6 pain since about December (according to the pain charts). Down from an 8 post-surgery.
-I graduated from a walker to a cane, which is positive.
-I cannot use stairs.
-I have difficulty getting in and out of cars (sedans and SUV's)
-I can't fully rotate on a stationary bicycle.
-I cannot walk or stand more than 10-15 minutes without knee pain and pain on the side of my knee.
-I experience pain when I clean my apartment, or stand and cook. I have to lie down and ice and massage my knee for 20 minutes.
-I lean on my good (left) leg a lot. My posture is terrible now. My gait can't complete a rotation.
-I can sit in a chair with my knee bent at 90 for about 15 minutes and then need to stretch my leg.
-I can do a few more exercises than I could a couple of months ago.

That's about where I am post-surgery Oct 31. I just want no more pain.

Thank you for listening to me.

 

[NeedaThneed]

I’m sorry. I hope it helps you!
I’m curious how straight can your leg go? And where exactly in your knee is most of your pain? Being stuck with a bit of bend all the time puts a lot of extra stress on the kneecap. Being able to fully straighten takes the pressure off and lets the kneecap “float better”. I say this because I’m living it; I have a lot of pain due to buildup of extra tissue around front of kneecap and inside the joint. It prevents me from getting straight because it gets pinched and flares up after trying hard to straighten. So I switched to just trying to maintain what I have until I have my knee scope. After then I will be putting my focus on getting a straight leg….to get all that extra pressure off that kneecap! The sooner the better for me. But it will be awfully hard if the tendons behind knee are tight, so I’m working on keeping things as stretched as I can (several times per day, pain free).

 

[Jockette]

It's not only ROM, but pain.
I am in pain 24/7. All day and all night.

I’m sorry you are in such pain.
What pain relief do you take?

I want to know if the MUA will relieve my pain.

To consider your question, remember what you wrote previously:

( My rehab was horrible, hence I never regained full ROM and was caused stiffness, swelling and pain, never beyond 90-95 rom at knee).

I'll go to PT the following day, and then it's aggressive PT and a lot of work on my part to keep my knee at full ROM.

My personal opinion is aggressive PT does not work for everyone. It did not work for me. I believe it is better to treat the knee gently.

Sending hugs as you read other threads and messages from others, and decide what you want to do. I know it’s hard to read and hear conflicting opinions.

 

[Jockette]

MUAs were designed to break up adhesions.

You said:

An MRI showed no scar tissue or adhesions,

Sending you lots of hugs!

 

[Birdie23]

I'm 71-yrs old. I've been in pain since October 31st. Waiting 2 years to heal and for pain relief is a long time for me. My quality of life is suffering.
I guess both of my OS's feel that MUA is the last resort to get better rom and pain relief.

I’m curious how straight can your leg go? And where exactly in your knee is most of your pain?

Straightening is getting pretty good actually. Most of the pain is slightly above the kneecap, the bend of the right side of the knee, very localized.

I do stretching at home. Calf stretching, quad squeezes, I can touch my toes (I have hyperflexion of my hamstrings),
Stretches feel good. Standing side leg raises, calf raises, all good.
Heel glides cause the worst pain. I try to do them using controlled breathing. Doesn't help.

I take Acetaminophen, (Naproxen makes my hair fall out, in addition to stress). I can't take other meds like Ibuprofen, because of intereaction with other meds I'm taking.
I don't want to take any strong oxy drugs or anything.
I use Lidocaine and Voltaren creams.
Actually, ice and massage w/vitamin E oil helps, but only temporarily of course.