TKR Second TKR - First had Arthrofibrosis

[bottomshollow]

Actually, Martha, it's Google that has the all the visuals I use. They're just sitting there for folks to take advantage of if they want to. I do save a lot of it into my picture files to use over and over. Once Easter is past, I'll just delete all those and reload next year. And I frequently just go out and look for something unique for a member based on their posts. I enjoy doing it---for me it's a lot of fun. And I know nothing about graphic layouts.

And in response to ROM numbers, here you go:
Patients require a knee flexion of
- 65° to walk,
- 70° to lift an object from the floor,
- 85° for stair climbing,
- 95° for comfortable sitting and standing, and
- 105° for tying shoelaces.

 

[Josephine]

You can also find information here ROM (range of motion) information

As for how to do it - the only answer to that is "very carefully"! In other words, don't rush it. I often say "everything comes to she who waits .....









long enough" ........

 

[Ms.fixit]

Greetings martha and Hilltop; I've been reading your posts this morning with interest.
I am at the 3 month mark, with 0 extension and 90 degrees flexion. I have refused MUA twice because I just cannot accept that further violence to my knee is worth any gains.
This is obviously different for each patient, the decision to undergo additional procedures..but I have been reading a lot of MUA vs Non-MUA statistics at one year, and the difference is very, very small. So, for me,it's not worth the additional stress and pain.
Medical malpractice suits are common in my part of the States, and my own opinion from personal experience and my years as an EMT, is that there are times these procedures are pushed because the Doctors do not want to be sued. If they can show that they did an MUA in the face of complications, put the patient through a ton of PT, etc.,it shows a good faith effort and that they did"everything possible", thus lessening the possibility of litigation by a patient unhappy with outcome.
I know it sounds mercenary to think of medicine on this light, but it's reality. Also, bear in mind that booking the OR, anesthesia and subsequent PT, brings in a ton of cash for the hospital and medical practice. don;'t think for a minute that they don't also have their own interests in mind, even if they also care about your progress. Hey, it's not THEM having the surgery! (I think if every surgeon had to have a painful orthopedic procedure on themselves in order to treat others, what a difference we'd see in the recommendations!) Just remember it's YOUR leg, your life and you have choices and more innate wisdom than you may know!

 

[hhilltop]

Sure could have used a dose of your insights 6 months ago. Yes, I know we've been keeping the hospital system well greased and they've had reason to wonder after my husband's hip replacement became infected and needed a revision before I had my TKR and slow recovery that I wouldn't join up with a lawyer.

I agree, I think a lot of orthopaedics would have a much different perspective if they'd have a taste of their own medicine. I think they'd be a lot more willing to have helpful resources for recovery and whatever glitches arise if this happened, too.

 

[medan2012]

Ms.fixit, I 100% agree with you when it comes to a MUA! I refuse to have one & I have voiced my thoughts to my OS & PT. I'm slowing making progress but not at 120 flexion.

At this point in my recovery, I have elected to discontinue my weekly pt & pool therapy and continue to exercise on my own at home and by using the recreation center. I can use all the exercise equipment at the recreation center including the hot tub & pool and pay a lesser amount and not have to put up with my PT trying to push, push,push my knee!

I have been working on the stairs and can walk up the stairs without assistance at times (depending on how the knee is feeling) and am practicing on going down the stairs but I use my cane when going down and try walking down with my foot crossed over not taking the stairs one at a time. It hurts but not as much as the PT pushing my knee.

 

[hhilltop]

You are a brave one. I was stuck at 105 for 4 months. My PT wanted me to learn to go downstairs using a cane and using a normal stair gait. I was scared stiff as I looked down a full flight of stairs doing this. I didn't do it.

The ROM figures suggest 85 for climbing stairs, but doesn't mention descending stairs.

Despite my ROM figures (5, 116), though I can climb stairs, by the top of a long flight, I often hurt and really need the handrail. It sort of depends upon the day. too. Going down it very much depends upon the day and I rarely can do more than 3-4 stairs normally. That's better than I can't do them normally at all, though.

Any one have suggestions for getting to 0 for extension? I"m still 5 degrees shy.

 

[medan2012]

hhilltop, I gained my extension by laying on my stomach with my knee on the age of the bed and my leg hanging over the bed. Also, my PT had me to do leg raises, quad stretches and ham string stretches.​

​

There should be exercises somewhere in the Library. Or you can google gaining extensions after total knee replacement.​

​

There is a lot of good information on here (BS) and the internet.​

 

[pdx]

Agree on lying on your bed (on your stomach) with your legs dangling over, starting just above your knee. It likely won't be comfortable at first, but our ol' friend gravity does the work. Start with 3-5 minutes. Work up gradually. Or add ankle weights. Another good one: Prop your leg up, at the ankle, on a rolled-up towel. Again, just let your leg hang. Or prop your leg up on an ottoman/coffee table (shhh. don't tell the manners police) and again, let your leg hang. Make sure your leg is as straight out as possible. You can flex your ankle back, too, for more of a stretch. Hope one or more of these helps. Also, if you have access to an exercise bike, use that and gradually raise the seat for more extension.

 

[RunA42K]

I was at 135 ROM at 7 months. But eventually I went backwards. I am two years post op, can push to 127 ROM with some pain, but stairs even with an easy 118, 120, d I feel it going down every step. Going up is no problem but going down is always uncomfortable still. We're selling our house to get into a one story, so no more stairs...eventually. I hope that it gets better for you, but time and patience will get you there. 7 months is still very early.

 

[medan2012]

pdx, yes, those are great exercises. There are so many possibilities!

 

[medan2012]

hhilltop, I was googling scar tissue after TKR & ran across this link: https://orthopedics.about.com/od/kneereplacement/qt/stiffness.htm. Very good information. I think my problem is scar tissue because I have had 2 scope with lateral release before my TKR.

 

[hhilltop]

Nanners said:
I am 7.5 mos out from a LTKR. When I stopped going to PT my ROM was 105 and 12 for the extension. I have slowly but surely got more bend and more straightening. While I am not perfect I am still getting more and more just as time goes on. I do not do PT now, or even home exercises. All I do is live everyday. I am not walking 8 miles a day, or going to a gym, nothing. But I am still gaining ROM. Just want you to see that you don't have to go crazy with this. Jo did much the samething and is doing well too. This is not a weakened knee that needs to be strengthen, it is a injured knee that needs time to heal. Good luck to you!

Well, we are only 2 weeks apart it appears. I've been toying with the thought of doing something along these lines. Maybe I soon will.

I do need to comment - it took me 2 weeks to be able to lift my leg normally into bed without a leg lifter after my TKR. At 6 weeks a PT gave me her electrical simulator to use for 2 weeks because she felt my quads were acting like a biceps and not firing properly. When I first tried to do stairs, I didn't begin to have enough umph to get up. Is it any wonder that I thought I was weak kneed?

Thanks for the article Mary Ellen.

 

[maryo52]

Great testimony, Nanners.

Martha, I couldn't lift my leg either for a while. At the time it seemed like headline news. Now it's only a dim memory.

 

[kneeper]

It took me at least 6 months to do downstairs comfortably--my muscles were really weak-- but it came. Just try some regularly. Like you say--do everyday living.

 

[Nanners]

I still take stairs down one at a time. On a good day, I can try a few, but still get some achiness if I push it. I go up okay, somedays it hurts a bit and I really need the rail, and other days I do it no problem. Depends on the day really!

One thing I am REALLY noticing, is alot of pain thru out my body, becuz I am no longer getting my knees shot up every 3 mos like I use too with cortisone. Seems those shots helped to keep the inflammation in my body down. Last two sed rates have been high. My non surgical knee is really not hurting, so I have chose not to get it injected. But I am suffering a bit for it. Both my fibro and osteoarthritis are not happy these days. So going all crazy in the exercise dept just causes more pain for me. I am happy though, that the ROM is still coming along slowly but surely. Hugs!

 

[hhilltop]

Sorry to hear you have other issues going, Nanners.

I'm going to discuss taking a break from PT and regular exercise routines and just go about life without making a focused effort on my knee tomorrow with my PT. Some days I do stairs better than others, but never without a handrail. Still feels like there's something in the knee joint that makes it hurt.

I helped my husband muck out the barn and put down fresh hay so we are ready for birthing, which should start happening in a couple of weeks. My knee wasn't real happy this morning, but neither were other parts, but it's okay now.

 

[hhilltop]

Yesterday, I received the best ROM numbers yet!!! 122 on my own and 130 with my PT pushing and 2 in extension. Since 130 was what my OS got after my MUA in late September, I don't expect to hear much better than that. Hurrah!!

So what can any of you say about swelling? My right knee is STILL more swollen than my left and I'm getting close to 9 months post op.

What about this, I can walk around pretty well now, but there can still be an element of ignorable pain?

And stairs? - When I do stairs it still feels like there's something in the knee joint that makes it hurt as I put weight on it.

Can any of you who've been on the slow pace recovery route or have medical backgrounds comment on this?

Dhare63, bottomshollow, Nanners, Josephine, maryo52,KathyH, Orthodoc

 

[Josephine]

and 2 in extension

Plus or minus? Plus (red flag) means it's still a little bent up off the table and minus (blue flag) means it goes backwards from straight.

So what can any of you say about swelling? My right knee is STILL more swollen than my left and I'm getting close to 9 months post op.

According to your signature you've only had one knee done?!! If it really is only one - the right - then why are you surprised it's "still more swollen than the left"? Knees can keep on being swollen for a year and more. Besides which, you should now start your counting from the MUA which means you're only FOUR months out!

What about this, I can walk around pretty well now, but there can still be an element of ignorable pain? And stairs? - When I do stairs it still feels like there's something in the knee joint that makes it hurt as I put weight on it.

"an element of ignorable pain"? That's still pain and perhaps you should be medicating for it. As for stairs, since you are only 4 months out (!) you should expect this and take meds for it ... something like Tylenol (1,000mgs 3-4 times a day)

 

[Suziepi]

Congratulations hhilltop for getting 122. Perseverance does get results.
I hope that eventually the stairs aren't an issue for you too. I am only just starting to do stairs normally. It's a big hurdle for me to do them especially down stairs. I just got to bend the operated knee more as I go down. It feels very strange.
Suzie

 

[maryo52]

Great news about your ROM! As far as the other questions, Josephine seems to have answered them all. I seem to remember that when I was in PT trying to gain ROM, I had similar complaints. And BTW my TKR knee is quite a bit bigger than my other knee and will always remain so. I used to have beautiful knees.

Are you far enough along to take a breather from PT and "trying" to gain ROM? I'm curious what your knee experience would be like after a one-week knee vacation.

You remind me of myself in that first year. The bumpy road made me a hypervigilant. I guess it's all part of the process.