Revision TKR Stubborn New Knee<

[Sportin89]

It is definitely worth a shot. So normal day to day activities with increase in ice and elevation? Change from Aleve to Tylenol 1000mg 4xdaily?

 

[Josephine]

That's about the size of it. Let me know how you get on.

 

[Sportin89]

This past week has been rather difficult. Entire leg would swell by middle of the day and be very sore. PT has stopped and all the other exercises have stopped as well. Been elevating slightly at work with ice and high elevation when I get home with ice. Doing nothing more than walking at work. Still no increase in flexion, stuck at 90 degrees. Extension is at 0

 

[Josephine]

Well you should be prepared that this situation isn't going to improve in a few days. It could take 3-4 weeks before you see any change, maybe even more.

 

[Fire wolf]

@Sportin89, things definitely got worse in some ways for me when I returned to work at 11 weeks. Bionic Spence (my tkr) did not like sitting like a normal person all day, or the absence of the frequent ice. I had cut out all other exercises per @Josephine recommendations, and it has made a difference. Unfortunately, nothing on this journey, at least for me, comes as quickly and easily as we may like. Hang in there!

 

[Sportin89]

Just an update as to where I am at this point. 35 physical therapy visits, MUA and adhesion removal on 10/27 and still unable to get past 95 degrees unassisted. With two therapist, I can get 102 and I am crawling out from under them.
Saw a second doctor for another opinion. Implant does not look loose by xrays. Drew blood from joint to check for infection, test result back in a few days. If no infection, he wants to place me on a steroid to slow and loosen scar tissue around the joint. Said some people have gained a few degrees from this. If this doesn't help, and NEXT FALL I decide to proceed with a revision, we will talk about completing the procedure.
Problems I am having at this time: stiffness after walking or standing for a short period, pain on outside and inside of joint, swelling has went down considerably but joint line still measures 4 cm bigger than other knee. And as I hit around the 90 degree mark, I can feel presure on my hip joint. So the hip is starting to flare up and car rides are terrible.
Doesn't want to open it up for one year because of the surgeries I have had this past year.

 

[Celle]

I'm sorry to hear things still aren't going well for your knee.
Did the MUA deal with the adhesions, or did the surgeon have to operate inside your knee?

Usually, if you have adhesions, you need to go gently at PT, so as not to irritate your knee and cause it to get inflamed.

 

[Sportin89]

The surgery dealt with adhesion removal only. I had some impingement in my joint and there was some internal bleeding going on. All that was taken care of. Knee feel better but the MUA did nothing for my ROM.

 

[Celle]

I'm sorry, @Sportin89 , but I still don't quite understand. Did your surgeon cut your knee to remove the adhesions and haematoma, or did you just have an MUA?

Either of those would have set back your recovery a bit.

 

[Sportin89]

Both procedures were done at the same time.

 

[funkymuse]

Both procedures were done at the same time.

Gosh I don't know how they do both at the same time. I had a Hematoma removal and they did an MUA as well.. I would think that would really upset not only the internal healing but the incision!

From what I have read an MUA is brutal to the internal healing that is taking place - ripping it all apart again.
My ROM a week after the MUA and Hematoma removal was only 45!!!! Little did that help!!!

 

[Celle]

Both procedures were done at the same time.

@Sportin89 - You're still not answering my question.
So did he cut your knee open? Or did the MUA deal with the adhesions and you didn't have your knee cut open?
All I'm trying to find out is if you had two procedures or one. I understand that everything was dealt with while you were under the one anaesthetic.

 

[Sportin89]

There was a 2" incision to remove adhesions as well as scope insertion openings. It was also manipulated during this procedure.

 

[Celle]

Thank you!
So you had an Open Lysis of Adhesions and an MUA.
I'll change your signature to reflect that.

The usual treatment after an open lysis of adhesions is to start exercise very gently, so as not to further irritate the knee and cause more adhesions.

 

[Josephine]

35 physical therapy visits, MUA and adhesion removal on 10/27 and still unable to get past 95 degrees unassisted.

When I read all of this I wasn't in the least surprised by the last bit!

With two therapist, I can get 102

This is an important bit of information - the ONLY measurement that counts is the one you can achieve on your own. a) having 1, 2 or a dozen therapists pushing on it doesn't count!

he wants to place me on a steroid to slow and loosen scar tissue around the joint.

Don't think so!

Problems I am having at this time: stiffness after walking or standing for a short period, pain on outside and inside of joint, swelling has went down considerably but joint line still measures 4 cm bigger than other knee.

There are many forms of pain which include soreness, burning, stabbing, throbbing, aching, swelling and stiffness. Your knee is 4cm bigger than the other knee meaning it is swollen! And about swollen, stiff knees - Swollen and stiff knee: what causes it?

but the MUA did nothing for my ROM.

I am not in the least surprised! Why not? Because above all, you need to address the swelling. That's your primary problem.

Gosh I don't know how they do both at the same time.

It's easy. All they need is an anaesthetic and they can do pretty much anything! Most likely the surgeon would do the MUA first and then the surgical bit so he didn't risk tearing sutures or anything.

 

[Spex10]

I'm amazed that you and presumably the OS thought that your ROM and flexion was bad enough to require MUA! I'd have dreamt of flexion of 90 at your fairly early stage.
Take it easy!

 

[AnnieC]

When my PT asked me what my pain level was on day 4 after surgery 1-10? I said 15!!!!!


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[Sportin89]

My job duties requires for me to have more than 90 degree. Things like climbing ladders and stairs efficiently and able to egress if there is an emergency. That is why we have been pushing to get the knee past 90. If I was close to retirement, I would probably be okay where I am.

 

[KarriB]

But by pushing to get to 90 you’re probably holding back flexion and causing more swelling.

 

[Josephine]

Just what I was going to say, Karri!

@Sportin89 I can promise you that you WILL get there more quickly than you will by pushing it!
It's not a car that needs a jump start!