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TKR Swelling at 11 months

Admin - please change subject to "Use of CPM" . Thank you.

I've noticed that several have used CPM after surgery. My doctor did not recommend using one. I'm curious to know how those who have used a CPM have done. How is your ROM/Extension ? Also, has anyone used one later in recuperating- i.e., 8 weeks out?
 
Research has shown there's no difference between those who've used a CPM and those who haven't. My bff used one, my dad and I did not. My dad had the best and easiest recovery. Are you having problems bending your knee? What is your ROM?

We'll change your title. :smile2:
 
Hi @hvtx51 , I used a CPM machine after my LTKR (2014) and did not use one after my RTKR (2015). After full recovery my ROM for both knees is the same, but I progressed better/faster after my RTKR- the knee that did not use CPM. I am now convinced that "active" motion (where you bend your knee yourself) is superior to letting a machine bend it for you.
 
Thanks @Clipless and @KarriB for your feedback, interesting. My ROM is 95 but my extension is at 6. It was a 4, then 5 and yesterday 6. PT worked a little too much on it and I had to say STOP which I wouldn't have done before. Today my knee is letting me know it did not like yesterday's activity....icing, resting and elevating.
 
My ROM is 95 but my extension is at 6. It was a 4, then 5 and yesterday 6. PT worked a little too much on it and I had to say STOP which I wouldn't have done before. Today my knee is letting me know it did not like yesterday's activity.
IT's not at all unusual for extension to take longer to achieve than flexion. Many people have found that. I think it's because, to achieve full extension, your hamstrings, tendons and ligaments all have to be stretched a bit. That is a slow process and you can't force it. Your PT was wrong to try and force extension, because that could cause damage. I'm very glad you told her/him to stop.

The secret is first to be patient, second to work gently at exercises to help with extension. There are some suggestions for helping with extension in this article:
Extension: how to estimate it and ways to improve it
Just choose one or two of these exercises and do them gently, always stopping as soon as they start to hurt. Like KarriB, I used to sit with my foot on a stool and let gravity work for me. Don't do the exercise with weights until about 4 to 5 months from now - but by then you probably won't need to do it anyway, because you will have full extension.

Lengthening your stride as you walk will help , too. Make sure you walk like this:
[Bonesmart.org] Swelling at 11 months
See how your back leg is straight as you push off with your toes.

BY the way, an extension of 4, 5, or 6 at your stage of recovery isn't bad at all! Your PT has an agenda for your ROM to achieve certain numbers, but don't let that worry you. Your knee has its own agenda.
 
I am 11 weeks and still slowly gaining rom. I was only about 85 at 6 weeks.My OS and pt thought it was fine. Now at 11 weeks I am 105 and gaining slowly each week up to 5 degrees with fairly light pt and everyday activities. It will come, don't get discouraged and don't go the mua path yet.
 
In answer to your question yesterday - My Os did prescribe me to have one during the first month and for about 2-3 weeks I used it but no more than maybe an hour a day - much much less than they had told me to use it. I liked to relax in it but I did notice swelling more afterwards. My hospital no longer keeps them because over half of the doctors no longer use them. In my opinion I would have been just fine without it. I believe my recovery is no better than others who have not used a CPM. I don't know my true ROM # because it's been 3-4 weeks since I had a PT measure it but back then it was 118. My straightening is around a 5. I know my ROM has improved because I've moved the seat up on my recumbent stationary bike by 2 holes and go around, after rocking, in about a minute. I've not read of anyone using one later in recovery, like 8 weeks out. I wouldn't.

I also know, when I was about at your stage, my ROM seemed to stall out for a good 3-4 weeks. When it finally started moving, it moved nearly 5 points in a week. But you know what had happened - some swelling had gone down. :)
 
By the way, at my 4 week OS visit, he also mentioned the MUA and said he wanted to see me in 4 more weeks. I truly felt it was just a statement he makes to everyone at that stage unless they have miracle flexing!
 
I just reread you thread---did you have the MUA? I hope not, because I don't think you need it right now. I struggled with extension with my right knee---I did not get full extension until week 14. I did not do too much, used to lie on my bed stomach down and let my operated leg dangle off the bed---maybe 5 min tops!! Mostly I was conscious when walking to let the heel strike and then roll forward onto the toes.

Lets see you are at 8 weeks, your rom is 95, extension is 5. Your doc wants you at 100---would you really go through a MUA to get 5 degrees of flexion? Right now, I wonder if you are doing a lot of running around.

At 8 weeks my doc told me to take two hours rest for every one hour that I was up. the rest was elevation for my knee.
Elevation is the key to controlling pain and swelling

I really never did much exercise at home---I have two corgis and so I walked them for short walks twice a day. Spent a lot of time lying around reading and watching amazon prime. I think that you will see a change soon---but make sure the therapist is not causing any pain to your knee. Too much bending and forcing bending all make the knee swell. Walking around too much, make the knee swell!! Basically the knee is cranky right now and wants you to rest so that it can heal!!

Here are some of the things I did to pass the waiting time!!

Here is some of what I did; I learned to knit on you tube, bought stuff on line and had it delivered. made hats for all the granddaughters! Watched Downton Abbey from day one. Looked at videos of Jane Austen.

I looked up some videos of old tv shows that I hear people talking about that I never have time to watch. Then, I got books from Amazon on my iPad and read a lot of mysteries.

I just looked up some kayaking videos on you tube because my daughter had one in front of her house---they were helpful. I watched a lot of ski videos on you tube. and started watching a show called Britain's got Talent on you tube--so many of the try outs are hysterically funny.

I had friends who took me out to lunch once a week--even though I had to put my foot on a chair. I walked my dogs---1/2 mile at a time.

I did a little bit of jewelry. I watched some Soccer games---ugh, it all sounds so silly when I write it down. Most of all, try to keep yourself going with something. You really do need to sit and elevate for the first two weeks. I made myself do that and almost all of the swelling was gone when I started PT at week three.

Here are some things that will make things worse. A PT who pushes your need to get extra rom!! This is a biggie, the swelling can last for weeks. For me, it was being on my feet in my studio---one night I was in agony--my knee needed more rest. So, at week 3---two hours down for every one hour up.

You are doing something good for your body, you are healing. So many people try to rush this stage and some frantically exercise so that they can be first to recover---we ususally find them later with tendonitis---you simply cannot rush these first three weeks.

take a topic and research it---Kayaking in Australia,in New Zealand. Beaches in Hawaii, how to change the oil in your car---you get the picture. Your computer is your friend right now.

I even got some audio books so that I did not have to hole the ipad!! Have you listened to the HElP? or Lord of the Rings? or Pride and Prejudice.

I am a reader, if you are not watch videos. Amazon prime was a good friend for those weeks when I had to order stuff on line since it was delivered in one or two days. I studied some art--oh yeah there are classes on Craftsy---cake decorating, knitting, sewing, quilting, painting---I took 4 on acrylic technique--oil painting, drawing. Now is the time to indulge your brain and find something new to learn.
 
Subject: 3 months - Ankle/Foot Pain

3 months out....I'm still progressing although slowly. Trying to keep my patience....which sometimes is difficult.
I'm at about 105-109 flexion and 0 extension (yay). I'm still going to PT and having returned to work have found it difficult to get in exercises. I have a desk job and keep my foot propped up, best I can, and put ice on. Still having lots of swelling. I'm not able to take anti-inflammatory meds, we're trying a topical ointment which helps some.

This past week my foot and ankle has started hurting, PT thought it may be part of the healing process from my leg being straightened. Has anyone else experienced this? Any ideas on how to make it feel better? I'm riding a bike now and wonder if I may have stretched it too much.

Best to all.
 
I'm at about 105-109 flexion and 0 extension (yay). I'm still going to PT and having returned to work have found it difficult to get in exercises.
Now you're back at work, you don't need PT. Work, and life itself, can be your PT from now on.
Your ROM is good - congratulations on full extension, by the way - and it can continue to increase for at least a year, whether you go to PT, or not.
So, instead of going to PT, come home and treat your knee to extra time resting, icing and elevating. That will help to bring down its swelling.
This past week my foot and ankle has started hurting, PT thought it may be part of the healing process from my leg being straightened. Has anyone else experienced this? Any ideas on how to make it feel better? I'm riding a bike now and wonder if I may have stretched it too much.
Ease off the exercise a bit, and try icing your ankle, as well as your knee. It's possible that the ankle and foot pain are also the result of increased activity.
 
I had RTKR 2/13/17 so I'm almost 1 year. After a rough start I've been doing pretty good and enjoying my new knee. About 2 days ago I started having some swelling and its getting worse. I feel a knot on the back of my knee and it feels a little warm. Also, my calf is sore. Has anyone experienced this? I'm icing, elevating.
 
@hvtx51 ,
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 
Pumpkin - wanted to let you know you were right on target! I saw my OS on Tuesday, swelling was down somewhat and "bump" behind knee was much smaller. Said it was a Bakers Cyst... just will go away. Knee looked perfect. Thought the cold weather and lack of walking may have contributed , but not really sure. Much better this week. Guess it is something that can always occur. Thanks for responding. Have a great day.
 
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