TKR Second TKR - First had Arthrofibrosis
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I "think" you are too far along for a MUA. I am six months out and between 105-110 and my straightening is about a 5 or so. Its not perfect but its functional. I think at this point just giving it more time will work the kinks out. I have seen a few who have done well just waiting it out. And thats what keeps me hoping I get further in time. And slowly but surely I see it coming along.
soSuesew
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Martha, I've come late to your thread and not sure I can add much, since you have already had some good advice from BoneSmarties and medical protocols are very different where I live. But I did want to send some supportive thoughts, as I am in a very similar position and equally frustrated.
I still struggle with stairs, have some clicking, discomfort and stiffness, and seem to be stuck at about a 105 bend six months after my tkr but, unlike you, have probably been remiss in my exercising.
All the knowledgeable folks here are saying to me that everyone has a different road to recovery and that, with some patience and some common-sense exercise, it will be better. And that the recovery period is a year or more. And, I must stay, that's what all the medical people here (in France) say. MUAs are rarely done, there isn't a rush for ROM and there seems to be a much longer term view (for example, I have no accurate idea of what my ROM is because nobody measures it on a regular basis).
So, that aside, I wanted you to know that you're not alone and the tkr world is not only made up of people who make brilliant, speedy recoveries. The tortoises get there too, in their own time...as my surgeon says 'il va venir (it will come).’
Sue in Aix en Issart
I still struggle with stairs, have some clicking, discomfort and stiffness, and seem to be stuck at about a 105 bend six months after my tkr but, unlike you, have probably been remiss in my exercising.
All the knowledgeable folks here are saying to me that everyone has a different road to recovery and that, with some patience and some common-sense exercise, it will be better. And that the recovery period is a year or more. And, I must stay, that's what all the medical people here (in France) say. MUAs are rarely done, there isn't a rush for ROM and there seems to be a much longer term view (for example, I have no accurate idea of what my ROM is because nobody measures it on a regular basis).
So, that aside, I wanted you to know that you're not alone and the tkr world is not only made up of people who make brilliant, speedy recoveries. The tortoises get there too, in their own time...as my surgeon says 'il va venir (it will come).’
Sue in Aix en Issart
skigirl
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Here are some articles from our library which might help you with your decisions. I think that you are really early in your recovery ---it is far too early to become frantic about rom.
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Thanks for joining my thread soSuesew - or is it just so-so??? 
You may not be able to add more information, but you certainly are welcome on this thread. We seem to be on somewhat parallel paths, if that can safely be said in this arena.
I just wish I'd had greater awareness of the recovery for knees before I had surgery. Yes, I'd watched the required DVD's, but it didn't begin to tell you about the possible pitfalls of aggressive scar tissue. I'd watched my husband through hip replacement, a spacer with IV treatment when infection set in, and hip revision all within 2 years of my knee so I thought I was pretty well prepared. I asked my surgeon if there was anything more that I needed to know, he didn't add a thing. I figured I'd be up and about in a couple of months like my husband. NOT so!
I'll check out the links, skigirl. Thanks. Watch for my comments soon.
For now - I seem to be able to go UP stairs better recently, but it still hurts and how it hurts varies from day to day. There is a tightness, there is a feeling like there's something harder than it should be in the joint - it pulls where the hamstring connection is on the inner side as it attaches to the calf and it is tight over the top - along my scar line. Is this common to all, most, or some TKR's? Is it scar tissue that needs surgical help breaking up, or will it in time break on its own?
My cousin's wife spent 10 years with an elbow that wouldn't fully extend. With some aggressive and painful exercise regimens in a month they were able to break it apart without needing surgery.
Time to head to the swimming pool.
You may not be able to add more information, but you certainly are welcome on this thread. We seem to be on somewhat parallel paths, if that can safely be said in this arena.I just wish I'd had greater awareness of the recovery for knees before I had surgery. Yes, I'd watched the required DVD's, but it didn't begin to tell you about the possible pitfalls of aggressive scar tissue. I'd watched my husband through hip replacement, a spacer with IV treatment when infection set in, and hip revision all within 2 years of my knee so I thought I was pretty well prepared. I asked my surgeon if there was anything more that I needed to know, he didn't add a thing. I figured I'd be up and about in a couple of months like my husband. NOT so!
I'll check out the links, skigirl. Thanks. Watch for my comments soon.
For now - I seem to be able to go UP stairs better recently, but it still hurts and how it hurts varies from day to day. There is a tightness, there is a feeling like there's something harder than it should be in the joint - it pulls where the hamstring connection is on the inner side as it attaches to the calf and it is tight over the top - along my scar line. Is this common to all, most, or some TKR's? Is it scar tissue that needs surgical help breaking up, or will it in time break on its own?
My cousin's wife spent 10 years with an elbow that wouldn't fully extend. With some aggressive and painful exercise regimens in a month they were able to break it apart without needing surgery.
Time to head to the swimming pool.
Did I mention the arthroscopic removal of scar tissue I had?
There are people on this forum who had a manipulation as late as one year out.
I think you should discuss what your options are with your ortho.
There are people on this forum who had a manipulation as late as one year out.
I think you should discuss what your options are with your ortho.
soSuesew
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Martha, I'm amazed at how little awareness I also had before the surgery! I was just so relieved that there was a solution in sight and quickly that I just got swept along with it. Plus, as my good friend Donna says, there was a good dose of wilful ignorance. And she's right as, normally, I am the queen of internet research but, looking back, I was very selective in my research! She says she has a very strong memory of visiting me in hospital two days after surgery, finding me almost catatonic with shock at the level of pain and disability and saying 'But Sue, whenever we spoke about this, you never once mentioned pain!'
The location and sensations you report on stair-climbing are very similar to mine. Although I have been, and continue to be, slightly worried that it could be a symptom of something wrong, I'm becoming more sure that it's a case of very slow healing combined with, in my case, ineffective exercise. However, I've made an appointment with my GP for a reality check. We'll see what he says on Monday (snow permitting).
Since most of you are in the US, I'll say have a good weekend (although mine is half over).
Sue
The location and sensations you report on stair-climbing are very similar to mine. Although I have been, and continue to be, slightly worried that it could be a symptom of something wrong, I'm becoming more sure that it's a case of very slow healing combined with, in my case, ineffective exercise. However, I've made an appointment with my GP for a reality check. We'll see what he says on Monday (snow permitting).
Since most of you are in the US, I'll say have a good weekend (although mine is half over).
Sue
Kelly, I've read the article and the threads. I'd love to have responded to the survey about increasing ROM after 3 months, but it said I didn't have sufficient privileges to respond. My experience I suspect is unique.
I had my MUA at 2 months and gained flexion, but lost extension in the process. My 3 month PO visit was on the day Hurricane Sandy hit our area and I worried whether I'd be able to get there or have to postpone my visit. I measured in at (-15, 95.) I was very concerned about what my options were. My procedure was done at an instructional hospital, so all my chatting was with an interning surgeon. We discussed a second MUA, which is what I thought I'd need and was worried it would need to fit into another timeline as my surgeon had pushed me to have the first one before 2 months out. We discussed a dynasplint. Mention was made of scar tissue removal surgery - reopening along my incision and removing the scar tissue. That sounded frightening to me - what would keep it from rescarring? We agreed to try the dynasplint. Measurements were taken and one was ordered for me.
That night and into the next day my leg hurt terribly - for no real identifiable reason to me.
The next day at PT another measure was taken. I had gained 20 degrees from the week before and 15 from the day before. 10 in extension and 10 in flexion. I wanted to high 5 my PT, but he was pretty nonchalant about it.
Since then I've not gained much, though sometimes at the end of a PT session they gotten me to 112.
Anyone have any idea what might have prompted my overnight gains?
I had my MUA at 2 months and gained flexion, but lost extension in the process. My 3 month PO visit was on the day Hurricane Sandy hit our area and I worried whether I'd be able to get there or have to postpone my visit. I measured in at (-15, 95.) I was very concerned about what my options were. My procedure was done at an instructional hospital, so all my chatting was with an interning surgeon. We discussed a second MUA, which is what I thought I'd need and was worried it would need to fit into another timeline as my surgeon had pushed me to have the first one before 2 months out. We discussed a dynasplint. Mention was made of scar tissue removal surgery - reopening along my incision and removing the scar tissue. That sounded frightening to me - what would keep it from rescarring? We agreed to try the dynasplint. Measurements were taken and one was ordered for me.
That night and into the next day my leg hurt terribly - for no real identifiable reason to me.
The next day at PT another measure was taken. I had gained 20 degrees from the week before and 15 from the day before. 10 in extension and 10 in flexion. I wanted to high 5 my PT, but he was pretty nonchalant about it.
Since then I've not gained much, though sometimes at the end of a PT session they gotten me to 112.
Anyone have any idea what might have prompted my overnight gains?
soSuesew
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Hello Martha, from about-to-snow northern France
I've just been for a walk (yay for me - I need all the positive reinforcement I can get) and as I walked, I was thinking about your posts and how similar we are at this point (although we have got here by separate routes). I went back and read your posts and some words just jumped out at me; low, slow, stuck, hurts, stiff, tightness, concerned, frightening, worried. Words we all identify with and words that probably pass my lips almost daily.
But I also thought about having the surgery, an MUA, fairly intensive exercise and PT, the obvious desire you have to improve and understand your progress and thought, well, if I were Martha's knee, I'd be recalcitrant too. Please understand, I'm not saying you shouldn't exercise and be keen to make progress but I wonder if we get so caught up in the medical process, our expectations and fears that we stop listening to anything else our body is telling us. We need a time out to draw breath and just work out what the heck is going on and, perhaps, to be less demanding of ourselves.
I'm in the reverse situation to you - I've very recently realised that my body is saying 'do more' and I've been ignoring it, so it cuts both ways.
Don't settle for less than you want but, perhaps, give yourself permission to get there by a different, slower route.
Hope you don't think this is presumptuous - funny what you muse on when you walk!
Sue
I've just been for a walk (yay for me - I need all the positive reinforcement I can get) and as I walked, I was thinking about your posts and how similar we are at this point (although we have got here by separate routes). I went back and read your posts and some words just jumped out at me; low, slow, stuck, hurts, stiff, tightness, concerned, frightening, worried. Words we all identify with and words that probably pass my lips almost daily.
But I also thought about having the surgery, an MUA, fairly intensive exercise and PT, the obvious desire you have to improve and understand your progress and thought, well, if I were Martha's knee, I'd be recalcitrant too. Please understand, I'm not saying you shouldn't exercise and be keen to make progress but I wonder if we get so caught up in the medical process, our expectations and fears that we stop listening to anything else our body is telling us. We need a time out to draw breath and just work out what the heck is going on and, perhaps, to be less demanding of ourselves.
I'm in the reverse situation to you - I've very recently realised that my body is saying 'do more' and I've been ignoring it, so it cuts both ways.
Don't settle for less than you want but, perhaps, give yourself permission to get there by a different, slower route.
Hope you don't think this is presumptuous - funny what you muse on when you walk!
Sue
skigirl
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Sue, that was such a good post. Martha, I hope you are able to read her post and be thoughtful about your progress. Exercising two hours per day on a newly operated knee is stressful for the knee itself. I think your poor knee has been pushed and shoved to its present position.
MaryO gave you an interesting suggestion---I also wonder what two weeks of a more restful life would bring to you and to your knee. K
MaryO gave you an interesting suggestion---I also wonder what two weeks of a more restful life would bring to you and to your knee. K
Sue said it all. The dynasplint gave you the potential you had at the moment. When we stretch using PT methods our muscles are not relaxed. Put yourself in a dynasplint and you can really let go of any muscle holding or tension and it will stretch further. If you continue the dynasplint, put it on a very mild setting. It should not hurt you.
Truthfully I cannot quite fathom where you are because your post jumps around a little (I'm the same way). You're getting to 112 on flexion and you know what? No matter what they say about ROM needed to do this and that, I think our knees need to be able to go beyond and 110 is in my book the finish line. What is your extension?
You are at 6 months and I bet you're at 120+ at one year. You can get there the easy way (gentle) or the hard way (PT push). Either route will end up with the same ROM, my dear. "Trust in the Force, Luke!"
Orthos are not aiming for more than 120 so it's time to start looking at your knee as a success story.
Truthfully I cannot quite fathom where you are because your post jumps around a little (I'm the same way). You're getting to 112 on flexion and you know what? No matter what they say about ROM needed to do this and that, I think our knees need to be able to go beyond and 110 is in my book the finish line. What is your extension?
You are at 6 months and I bet you're at 120+ at one year. You can get there the easy way (gentle) or the hard way (PT push). Either route will end up with the same ROM, my dear. "Trust in the Force, Luke!"
Orthos are not aiming for more than 120 so it's time to start looking at your knee as a success story.
A nursing friend told me that anesthesia can affect memory, especially in older patients. Mom just had a TKR 2 months ago. We're noticing more than normal memory issues since. Is this at all common? Anything that can be done to assist her recall?
Yes, Sue, Kelly, et. al., I've been thinking along those lines some. My OS pushed me into being concerned when he gave me 2 weeks to get to 90 at my one month post op visit before scheduling an MUA, which happened at 8 weeks when I only had (-5,70. ) Up until then I was mostly content to take it easy, trying to do what my in home PT told me to do.
It was the PT's that told me I should be doing 2 hours daily of exercises and made a chart of the exercises for me to record my efforts. When I wasn't making ROM gains I was asked if I was doing the 2 hours. Since the chart didn't give me a place to record my pool exercises, I had put them on the backside of the chart. When they doubted my efforts towards my recovery, I transferred all the data to the front and said - see - here's my 2 hours. I continued to do 2 hours daily and made my own charts to bring in to them. I have done this for months. Everyone around me was pushing for ROM, and I did very much want to have the new ROM I thought my new knee would be giving me. So it didn't take much to push me. But after 3 months of 2 hours daily, without noticeable improvement, I was waning.
Since the new year, my insurance pushed me to consider a different PT, I chose to take a different approach. This one advocated a gentler approach and made no demands on how long I exercised. I did let days go by without much exercise out of my normal routines, which do involve stairs daily. My leg did start feeling better - less tight, more willing to let me try doing stairs, but then I met with my OS and heard scar tissue removal surgery as something I should be thinking about. It has set me into another round of frenzy.
Sue, thanks for musing about me. I've got some appointments this week. I hope I end up with a clearer picture of what course I should be taking - your input is very timely, and may well be the course I pursue.
I think I'll go drown my thinking in the pool for now. I went snowshoeing with my sister a couple of weeks ago and put out syrup taps yesterday. The buckets are doing well this year. My favorite exercise arena though is the pool. I can be a more laid back in the winter months, but I am someone who likes to be active.
It was the PT's that told me I should be doing 2 hours daily of exercises and made a chart of the exercises for me to record my efforts. When I wasn't making ROM gains I was asked if I was doing the 2 hours. Since the chart didn't give me a place to record my pool exercises, I had put them on the backside of the chart. When they doubted my efforts towards my recovery, I transferred all the data to the front and said - see - here's my 2 hours. I continued to do 2 hours daily and made my own charts to bring in to them. I have done this for months. Everyone around me was pushing for ROM, and I did very much want to have the new ROM I thought my new knee would be giving me. So it didn't take much to push me. But after 3 months of 2 hours daily, without noticeable improvement, I was waning.
Since the new year, my insurance pushed me to consider a different PT, I chose to take a different approach. This one advocated a gentler approach and made no demands on how long I exercised. I did let days go by without much exercise out of my normal routines, which do involve stairs daily. My leg did start feeling better - less tight, more willing to let me try doing stairs, but then I met with my OS and heard scar tissue removal surgery as something I should be thinking about. It has set me into another round of frenzy.
Sue, thanks for musing about me. I've got some appointments this week. I hope I end up with a clearer picture of what course I should be taking - your input is very timely, and may well be the course I pursue.
I think I'll go drown my thinking in the pool for now. I went snowshoeing with my sister a couple of weeks ago and put out syrup taps yesterday. The buckets are doing well this year. My favorite exercise arena though is the pool. I can be a more laid back in the winter months, but I am someone who likes to be active.
Hey, I have to tell someone - guess you all are elected. FINALLY - in today's PT the measurement has shown movement gained since Thanksgiving. It was (-5,110) without pushing and 120 with pushing. I've been doing both Graston technique and Red Cord PT for the past month both once each week. I plan to scale back to alternating them once each week since I have to travel an hour to get to either of them, but it definitely helps tip the scales towards waiting to decide if I need scar tissue removal. I'm still not comfortable doing stairs. I can go up, but it still hurts. Going down is pretty wobbly without handrails on 6 inch stairs. But, I'm starting to feel like there could be light at the end of this long dark tunnel. Hallelujah!
Dhare63, soSuesew, bottomshollow
Dhare63, soSuesew, bottomshollow
soSuesew
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Martha, so pleased to read about your progress! Lovely to read someone's good news on getting up in the morning...
I hope that you are beginning to feel less...desperate is the word I reach for, hope it doesn't offend...about your progress now you can see light at the end of the tunnel.
Best wishes from Sue, in slightly spring-y Aix en Issart
I hope that you are beginning to feel less...desperate is the word I reach for, hope it doesn't offend...about your progress now you can see light at the end of the tunnel.
Best wishes from Sue, in slightly spring-y Aix en Issart
Dhare63
post-grad
Martha, what great news!! That is so encouraging and shows that you may be able to conquer this knee without further surgical intervention!!
Please keep me posted and celebrate, you really deserve it!
Cheers,
Dawn
Please keep me posted and celebrate, you really deserve it!
Cheers,
Dawn
bottomshollow
Former BoneSmart staff member
Take care and keep us posted. We care.
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Thanks for the round of encouragement. There's been a long spell without much to rave about - it's been 4 months since I've seen added ROM. I guess I won't know just what caused the breakthrough. I think both of my therapists would like to lay claim to it.
