TKR Stiffness 9 weeks out

[IMV]

I had RTKR June 17 and have stiffness that prevents me from walking normally. My ROM is 120ish and no longer have pain but the knee feels heavy and I still have inflammation.
I thought I would be further in my recovery at this point in time. I got to PT three times per week.
Is this normal?

 

[leejaa]

Yes, it is normal to have inflammation for quite a while and inflammation makes the knee feel heavy. Your knee is strong but the soft tissue is still healing and will continue for up to a year. Time and patience is needed for full recovery. Also, continue elevating and icing. Are you still doing PT? It seems like you had quite a bit of PT which also can cause the inflammation. Sometimes the hardest thing to do is to give it time and rest.

I am including some recovery articles that will help explain many things regarding recovering from this major surgery.
KNEE

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this

Activity progression for TKRs
6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Rockgirl4]

With a bend of 120-ish at 2 months, you are doing WONDERFULLY. Many of us are and would be very jealous!!!!

I bet the constant PT 3X a week is adding to the swelling/inflammation, as that is A LOT of PT on a knee that needs a full year to get back to normal after such a brutal surgery. Time is what you need, not more activity.

Actually, my surgeon flat out refuses to give people more PT if they are >100 at 6 wks post-op. He only let me go for 11-12 weeks because I was having so many soft tissue problems. Also, a bend of 120 is more than enough for daily activities and most sports.

Lastly, you could be setting yourself up for chronic inflammation if not careful. My surgeon sees many patients plateau or stay chronically inflamed when PTs keep adding weight and more unnecessary exercises. It's NOT a sports injury recovery and shouldn't be treated as one. He hates seeing patients like you at 8-12 weeks after a TKR, still "battling" when they should be "recovering." I think you would see a marked improvement in swelling and range of motion if you stop the PT and just get back to life. We see it with patients here ALLLLLL of the time.

 

[kneeper]

Once you know a few exercises and are resuming more normal activities (at a paced level) I found I didn't need PT. (by 6 weeks) After the first couple of months it really seemed just trying activities (and scaling them up or down as the knee permitted) is what led to progress for me.
I progressed even while the knee remained a bit puffy (but decreasingly so.)
The knee continues to be the boss for a long time.