TKR Should I be able to lift my leg??

[Merlin803]

Probably a crazy question but in what position does your Dr. usually take your ROM measurement?

Just getting antsy about my 6 week follow up visit with my Dr. tomorrow.

My PT always has taken the measurement with my lying on my back and having me pulling pull my leg up and in as far as I can. I struggle to be able to bend it that way (my max was like 92 degrees after quite a bit of stretching first).

When just sitting in a chair (which seems like a more practical way to measure to me) I feel like it is much easier to get to and past 90 degrees.

 

[Jockette]

My PT and surgeon also always measured me lying down, but I agree, we get a much better/easier bend sitting in a chair.

 

[Mutti3]

@Merlin803
I saw my OS this morning for the one month follow up. Was SITTING on the side of the exam table. He lifted my leg and held it, then bend it UNDER a the table while sitting. Told me everything looks great! Never measured, just eye balled it.
Concentrate on activity of daily living, strength and ROM will show it’s self when ready. You can’t push your knee.

 

[lovetocookandsew]

I've never really had my ROM measured. I don't like it as a tool as it's not about a number to me, rather what can I do now that I couldn't right after surgery; am I progressing, even if at a slower pace than others report, etc. My OS would eyeball it, but never actually measured it.

If you don't want it measured, then ask your surgeon not to measure it, just look at it. IMHO, too many people get stuck on ROM numbers, when, especially early on, everyone's ROM will be at different places depending on how their particular body heals. When surgeons, (and PTs) measure it, often they do it because they have a set number they want every patient at by a set date. But, because everyone is different, some people will be ahead of their expectations, some will be behind, but generally your ROM will be right where your knee allows it to be. There is no set time or number for where everyone will be by any predetermined date. Yes, there are some general guidelines, such as somewhere around three months most people are feeling much better, although their knees still have healing ahead; but we all heal at different rates. As long as you're using your knee by doing daily activities as your knee allows, and not just practicing your couch potato skills, your knee should flex more and more as it heals and the swelling recedes.

Also, everyone's end results differ to some extent too. Some may get to one number, others may flex a little more than that, still others may not have quite those numbers and so on. But, IME, most people are much better off after the surgery than before, are quite happy not to have the constant, bone-on-bone debilitating pain they had before surgery and are thrilled that they can take their lives back.

 

[Merlin803]

Yeah, I wouldn't be surprised if my Dr. just eye balls it and doesn't measure. He seems like a very practical Dr. who will be more concerned with how it is working out in my everyday life.

By "everyday life" measures, I can do everything. I even slept through the night for the first time since the surgery, the last two nights!

I am ready to get away from the structured PT and moving to using the bike and pool at my gym, while continuing to do the usual few stretches/exercises daily at home.

 

[Merlin803]

Well, Dr. was not pleased with my 90 degrees of bend and wants me to go to PT for 4 more weeks so I guess I'll have to decide whether I want to go that route or go my own route at my gym and the exercises at home.

 

[sistersinhim]

Swelling is probably keeping your bend from being higher. But at 6 weeks, your bend is good. Most OSs expect 90 degrees at your stage and you are right there. I believe that more PT will just keep your swelling up and your bend down. Why not just do normal daily activities for the next month and watch that swelling go down and the bend go up?

 

[Layla]

Hello and Happy Friday Merlin,
I agree with, sistersinhim's, suggestion above. If the idea of stepping away from PT for a month feels daunting to you, set a shorter goal of two weeks, or three weeks, engaging in some easy walks along with the activities of daily living and you may even notice a difference that quickly. Consider regular icing and elevation also, if you're not already, to assist in reducing the swelling and increasing mobility. Best of luck to you!
@Merlin

 

[Merlin803]

Hello and Happy Friday Merlin,
I agree with, sistersinhim's, suggestion above. If the idea of stepping away from PT for a month feels daunting to you, set a shorter goal of two weeks, or three weeks, engaging in some easy walks along with the activities of daily living and you may even notice a difference that quickly. Consider regular icing and elevation also, if you're not already, to assist in reducing the swelling and increasing mobility. Best of luck to you!
@Merlin

Thanks! It sure is scary and really depressing to have your Dr. say that your ROM is not where it should be and needs to be pushed past the pain to try to get it to bend more now before it is too late, if it already isn't too late.

He said that he doesn't want my current 90 degrees to be what I am stuck with permanently.

Yes, he said that.

 

[mendogal]

He's wrong. Many ortho surgeons believe this line, probably because they really aren't masters of soft tissue injuries and defer to what PTs tell them.... which is wrong and flies in the face of both physiology and abundant evidence based outcomes.
It IS true that a person whose response to a TKA is to get into a recliner chair and sit there will not do well. But doing the regular walking as tolerated and some light exercises like quad sets and gentle heel slides while incrementally increasing ADLs as tolerated (as in it may be a tad uncomfortable but it does not cause pain and increased swelling) is a long term plan towards success.

 

[Merlin803]

He's wrong. Many ortho surgeons believe this line, probably because they really aren't masters of soft tissue injuries and defer to what PTs tell them.... which is wrong and flies in the face of both physiology and abundant evidence based outcomes.
It IS true that a person whose response to a TKA is to get into a recliner chair and sit there will not do well. But doing the regular walking as tolerated and some light exercises like quad sets and gentle heel slides while incrementally increasing ADLs as tolerated (as in it may be a tad uncomfortable but it does not cause pain and increased swelling) is a long term plan towards success.

I truly hope that you are correct. I let the PT know today that I would not be back.

I went to the gym, rode the bike a bit (full rotations for the 1st time), did some walking and swimming in the pool and then took the grandson to the apple orchard.

My ADLs are pretty much back to normal, time will tell I guess if I can get this knee past 90 degrees.

 

[mendogal]

Posting activity milestones here is a good way to be sure you're on the right track!

 

[Jockette]

time will tell I guess if I can get this knee past 90 degrees.

Yes, you will get past 90 degrees but it will take time, and that’s ok. There is no Window of Opportunity , my ROM continued to improve well into my second year.

 

[Merlin803]

I am almost at the 2 month mark since my knee replacement and am feeling much better.

Sleeping is much better, I don't have to be careful about twisting/turning my leg any longer for fear of sharp pains and while I haven't had my ROM measured, I can comfortably sit in a chair at 90 degrees+ whereas a couple weeks ago that was my max and I couldn't comfortably sit that way for long.

I have also noticed when sitting in a chair that I sometimes go back to my pre-op habit of crossing my ankles and it seems even easier to pull my surgical leg under the chair than if sitting normally.

 

[sistersinhim]

It sounds like you are doing quite well for only 2 months out. Way to go!

 

[benne68]

I have also noticed when sitting in a chair that I sometimes go back to my pre-op habit of crossing my ankles and it seems even easier to pull my surgical leg under the chair than if sitting normally.

I did the exact same thing crossing my ankles under my chair. And the fact that I could so it was a big milestone of recovery for me!

Isn't it funny how "little things" can become BIG things during recovery?

Sound like you are on your way!

 

[Merlin803]

It sure is. I notice something (usually small) every week that I can do!

 

[Layla]

Happy Two Month Anniversary, Merlin!
Sounds like things all falling into place for you and you're doing very well. May it only get better.
Best wishes for a great rest of the week!
@Merlin803

 

[Merlin803]

Thanks and same to you!

 

[Merlin803]

Just an update - I had my follow up today (which I have been dreading because he was so grumpy the last time about my ROM...) and it went very well!

While he didn't measure ROM, he was very happy and said it was much improved and that I would only need to come back if I felt it was necessary!

I have to say that the last time I was there, I sat in a low chair and even today I sat there again at first and my ROM was not very good. It is much harder for me to pull my leg in when the chair is low.

So, I moved to the patient table and could easily pull my leg underneath the table. I would be surprised if I had much more than 110 degrees still but he was happy and I can do all my normal everyday things, so I am happy at where it is at today, knowing it will take months to fully heal.

P.S. He strongly recommended that I continue with PT the last time that I saw him and he didn't agree when I told him that I was thinking about not continuing (which I did not continue). Today when he said "looks good, so you are all done with PT?", I just said "yep". I didn't intend to lie, lol, I just didn't elaborate.