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TKR Straightening knee

Paulcat

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I had my TKR on May 8th. I can bend my knee fairly well, but I can't fully straighten it. My surgeon said that I only have 2 weeks from the date of surgery to straighten it, but my leg is so swollen and painful and tight, I don't know how to manage to do more than the simple pt exercises I have been doing since day one. Trying to straighten it, even on pain meds, is excruciating! Any advice?
 

Jockette

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Hi and Welcome to Bonesmart!
My surgeon said that I only have 2 weeks from the date of surgery to straighten it,
This is absolutely not true. I don’t know why a surgeon would tell a patient this.
my leg is so swollen and painful and tight,
This is why you can’t fully straighten it.
Trying to straighten it, even on pain meds, is excruciating!
Please stop trying so hard.

You are in early days of recovery. This surgery caused a lot of trauma to your body. We at Bonesmart believe in treating the new knee gently so it can heal, instead of pushing a lot of exercises on a brand new knee.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Pay special attention to the Cautionary Articles.

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
5. At week 4 and after you should follow this
6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

DLR

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@Paulcat until the swelling goes down you won’t get full extension. My first knee I didn’t get full extension until 10 weeks.
 

Pumpkln

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Paulcat,
The swelling and inflammation is blocking your extension, trying to increase ROM this early in recovery will only cause more swelling and inflammation.

Your extension will be there when the swelling goes down, spend time resting, icing, elevating and taking your medications on schedule as prescribed.
You are still in the very angry knee stage, time to let you knee heal from this major surgery.

You can do these two gentle ROM activities 1-2x a day, painfree.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .
 

Jamie

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Please do take a deep breath, read the articles that were posted for you and also check out some of the recovery threads here on the forum. You'll see that you don't need to be in such a rush to achieve someone's arbitrary goals for range of motion. Your first priority is to try to stay out of pain (pain and inflammation cause swelling and just keep your soft tissues that are trying to heal very angry) and to reduce swelling.

Be sure you are icing as much as possible in accordance with the article in the post above. Ice is a great pain reliever and it helps reduce swelling when coupled with good elevation. Also be sure that you are taking something on a regular schedule for pain as long as you have it. You want to stay ahead of the pain in these early weeks of recovery.
 

Irish471

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@Paulcat , it amazes me what some surgeons tell their patients! I am approaching nine weeks and still haven’t gotten full extension. From what I’ve read, extension takes longer to achieve. Right now, concentrate on icing and elevating to get the swelling down. Everyone is different and we all recover at different rates. The forum moderators know what they’re talking about :)
 
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Paulcat

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Thank you, everyone, for the information and encouragement! It helps so very much!
 

KarriB

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Don’t be worried about a window for ROM. I was still gaining ROM at 18 months post op. As far as extention, for many it comes later when you’re walking and stretching out that leg. As Jamie said, your first priority is get the swelling down and keep it down with ice, elevation and staying away from pain (isn’t that a marvelous idea).
 

Bionic

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@Paulcat
It amazes me that you were told you only have 2 weeks from the surgery to get your knee straight.
I am now 11 weeks post op and my knee is straightening all the time. To be honest my flexion is worse than my extension.
Both my physio and my OS have reminded me, several times, that both my flexion and extension were bad pre op so it's going to take time for them to improve.

I am sure yours will improve too once your soft tissues have had time to recover further.
 

sugarjo369

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Hi @Paulcat - mine was May 6 and I'm not straight either but there's lots of good advice on here already about that! This site has been a wonder for helping my mindset and gathering info. Yesterday I read that someone's PT told them the insurance company requires that certain benchmarks are met or they stop paying for PT :chinstroke:- no wonder these people are always pushing. Healthcare is messed up by the insurance companies but that's another topic. Anyway - hello and wishing you an easeful recovery from a fellow May Marvel!!
 

Jodingers

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Hi @Paulcat , I'm 8 weeks and saw my os for the first time post op yesterday! I don't have full extension yet either. My os said it was not a problem, he said it will come with time, may take a year even, but I was not to worry or try to force it as that would be counter productive. Each week my extension improves and I only walk and cycle.
I feel I've been very lucky with my pt and os. It must be difficult if you are given such conflicting advice, the Bone smarties really know their stuff, be confident in following their advice.
 

lovetocookandsew

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I have to throw down the penalty flag on that doctor! Extension usually takes longer to achieve than flexion, but putting a limit of 2 weeks on achieving it is LUDICROUS! If he has to put a limit on achieving it, then 2 YEARS should be his mantra! Not that it takes 2 years to get a good ROM, I'm just saying that ROM can continue to improve for a year, or two or even longer. His expectations are for his own ego, not for your well-being, IMHO. Relax, spend a lot of time icing and elevating, and watch how you improve over time. Good luck!
 

rustic

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Two weeks is a ridicucilous statement. For one, it depends on how your extension was before surgery. Mine wasn't straight before surgery, so it has been a slow road for me. I'm still making improvement more than seven months after surgery. I wish I had worked on it more in months 2-6 though. I was more focussed on flexion (and got that to 138).
 

Josephine

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My surgeon said that I only have 2 weeks from the date of surgery to straighten it
That is totally ridiculous! You were only one week out at that time. Both my knees took around 12 weeks to get to that stage and they were normal before surgery.


I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

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