TKR Stiff knee after TKR

[Catwoman07]

I had a total knee replacement in October 2013. While I had some long-term PT, I don't believe that my therapist was aggressive enough during therapy. looking back and talking to other people who had TKRs, their treatment seemed to be more painful than mine. No, my therapist never pushed my knee to the point that it was horribly painful.

I had my rotator cuff repaired a couple of years before my knee replacement and the PT for the shoulder was much more painful. I did knee bending exercises like sliding my foot on the floor and pushing it back as far as I could while sitting in a chair. I read your suggestion about a second opinion.. How would I find someone who does revisions?

My recovery was long and somewhat complicated because of inflammation of my sciatic nerve. I reached 90 degrees flexion immediately but never progressed beyond that regardless of extensive PT. My surgeon considers this adequate and doesn't want to do anything else. Since it has been a year and a half are there any options out there for me? 90 degrees makes walking somewhat difficult and painful. I am assuming this limited ROM is the result of scar tissue. Suggestions?

 

[Pumpkin]

Catwoman07,
Sorry to hear you are still having trouble with your TKR. Since your OS does not seem to have any answers for your limited ROM, it is time to obtain a second opinion from an OS that specializes in revisions. They see many troubled knees and are best positioned to determine what is going on in your knee.
What type of exercises and activities did your PT have you do? Did they push painfully on your knee to try to bend it?
Please put your surgery date in your signature, hover over your username top right, a drop down menu will appear, click on signature and add your information there, Thanks!

 

[skigirl]

I agree with you that 90 is not an acceptable rom. The question remains---what is the problem. You will need to find someone like a revisionist who is used to solving problems with knees.

If you look at our clinic locator at the top of the page, you can click on your city. When You open a clinic it will list its doctors. If you click on their bios, you will see the one in each practice who specializes in revisions.

 

[Catwoman07]

What types of procedures can be done to remove scar tissue after a TKR? My ROM is only 90 degrees and although my knee is mostly pain free, the restricted ROM does not allow me to do the things I did before surgery – – like ride a bike and do a lot of hiking. Are they able to remove scar tissue through arthroscopic procedures and does the scar tissue usually return?

 

[Angel1978]

That would be a question to ask @Jamie or @Josephine

I am experiencing that my self. Know I've had partial knee in dec. And I had lots problems. So I had to have partial converted to full in March. On my scar is a few bumps. So there talking about scopeing it. But won't be until my August left knee replace. If I do it then. My Rom bounces. But knee replace it is a rollercoaster. Xxx to you!!! Good luck.




FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015

 

[Josephine]

Hi and welcome to BoneSmart!

I don't believe that my therapist was aggressive enough during therapy - my therapist never pushed my knee to the point that it was horribly painful.

A newly operated upon knee should never be pushed to the point where it is "horribly painful", nor even mildly painful. All that does is to created lots of inflammation and pain which is usually what's responsible for the problem. More on this later .......

I had my rotator cuff repaired a couple of years before my knee replacement and the PT for the shoulder was much more painful.

Oh yes, shoulder are indubitably more painful than knees! That is a given but doesn't mean knees therapy has to be painful as well.

I reached 90 degrees flexion immediately but never progressed beyond that regardless of extensive PT. My surgeon considers this adequate and doesn't want to do anything else.

Okay, I may be able to offer you some advice/hope but first I need more information. So I'm going to ask you some questions but to complicate matters, I'm going to ask you to answer these twice.
First set of answers please make for the period of 8 weeks after your surgery
Second set for now.

Sorry to ask this but it really is essential I know this much so I can give you advice which will help.

It would also be very helpful if you would answer each question individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what were/are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications were you/have you been prescribed, how much were/are you taking (in mg please) and how often?

3. how often were/are you icing your knee and for how long?

4. did/are you elevating your leg, how often and for how long?

5. What was/is your ROM - that's flexion (bend) and extension (straightness)

6. what was/is your activity level? What did/do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home were/are you doing? How much and how often?

Can you please detail exercises like this
At PT:
First description - 5 reps x 2 sets
Second description - 10 reps x 2 sets

At home:
First description - 5 reps x 2 sets x3 session a day
Second description - 10 reps x 2 sets x3 sessions a day

 

[Josephine]

Almost forgot - I removed the text from your signature and put it in your first post as it seemed to be more appropriate there.

We prefer signatures just to show our surgery dates though some do show other information in a limited form.

 

[Catwoman07]

has anyone had scar tissue removed arthroscopically after TKR? My range of motion is only 90° and I am considering going to a surgeon that does revisions to see if he will remove the scar tissue. My TKR was 18 months ago so I'm too late for manipulation under anesthetic but my limited ROM is really causing issues.

 

[Pumpkin]

@Dhare63 , and @RunA42K , have had scar tissue removed arthroscopically.

 

[Catwoman07]

First set of answers. 1). Pain levels – 7-- swelling, aching, etc. (now) pain level 1-2 aches at night. 2.norco 500 mg every 6 hours. (Now--alive 2x per day.
Icing--a couple of times a day (now) rarely 4. I kept my leg elevated several times a day (Now) sometimes at night5. Flexion was 90 degrees I can't remember the extension but it wasn't straight (now) same 6. Activity level was good. I had to go back to work so I was cleaning my house, waking with a cane, but very active even with the pain (now) I do everything unless it requires me to bend my knee past 90 degrees 7. Pt. I can't remember the repetitions but I attended 3 months of pt because I was not progressing much past 90 degrees. At home, I did 2 sets of 15 repetitions every day. And rode a bike for 30 minutes every day Now, I still ride 30 minutes a day but no improvement in my ROM.

 

[referee54]

I merged your two recovery threads---our forum guidelines indicate that there should only be one recovery thread per member.

This makes it much, much easier to track your progress and keep track of your issues---as well as to look at where you are in recovery---we do not have to bounce from thread to thread, but can look at how you are doing in one recovery thread.

Thanks so much for your understanding!

 

[Dhare63]

I had limited extension issues and had adhesions removed, but it was an open surgery, not by scope. Much of my problem was behind the knee and therefore required opening the TKR incision, removing the spacer, and cleaning out the adhesions which were all over the place. While the first few days were very difficult, the actual recovery itself was much less painful than the initial TKR. I was very gentle in my approach to pt after this surgery. I followed the less is more approach and iced a lot. This helped me control swelling, manage pain, and gain the rom I was missing. I am very pleased with the outcomes and now have 125 pr more flexion, and near zero extension, which I have been able to maintain.

I encourage you to seek a second opinion and not settle for a limited lifestyle. Keep us posted and let me know what questions you have, we are happy to help!

Dawn

 

[Josephine]

2.norco 500 mg every 6 hours. (Now--alive 2x per day.

and does that do the job?

7. Pt. I can't remember the repetitions but I attended 3 months of pt because I was not progressing much past 90 degrees. At home, I did 2 sets of 15 repetitions every day. And rode a bike for 30 minutes every day Now, I still ride 30 minutes a day but no improvement in my ROM.

That's not quite enough detail. Remember I said

Can you please detail exercises like this
At PT:
First description - 5 reps x 2 sets
Second description - 10 reps x 2 sets

At home:
First description - 5 reps x 2 sets x3 session a day
Second description - 10 reps x 2 sets x3 sessions a day