Revision TKR The second time is the charm

[kneeper]

I'm sorry you've been forced to do all this aggressive PT. I can tell you my knee was very swollen and it took me a good 6 weeks to get to 90. I did not "progress" for weeks---because of all the swelling.
For me it was ok to take the knee through its range a couple of times a day, but not intense exercises.
Once the swelling started to go down I made rapid progress.

I hope your "knee-cation"--no PT, lots of icing and elevating and not doing much else for a while will help.

 

[vjice00]

Norco 10mg/ one a day 10mg

Extension 70 Bend +2

My leg is connected to weights on a string that is 17.5 pounds where I bend and straighten my leg. (30 reps)

Heel slides are on a 3min timer at pt/once a day
Calf stretches are on a 3min timer at pt
Step ups and downs are also on 3min timer at pt
Band walks are at 12ft area up and down three times

@Josephine

 

[Josephine]

My leg is connected to weights on a string that is 17.5 pounds where I bend and straighten my leg.
TKE’s 17½lb 30 reps

I still don't know what these are. What does the acronym TKE represent?

 

[robert johnson]

TKE = Terminal Knee Extension. It's the movement of the leg, while standing, that takes the knee from slightly bent to totally straight. It's often done as a resistance exercise on a weight machine where a strap is around the back of the thigh just above the knee such that when you straighten your leg you lift the weights.

It can also be done against a wall without weights with or without a ball behind the knee.

 

[vjice00]

Thank you @robert johnson because I couldn’t quite explain that.

 

[Jockette]

How are you feeling today, Venus?

 

[robert johnson]

I almost posted a picture of it, because there's a lot on the internet, but decided to explain it instead. I did them in PT too.

 

[vjice00]

My pain is like 2 on a scale from 1 to 10. My Swelling has gone down to moderate or slightly swollen i’ve done more elevation with my knee which I think helped. Today I will try ROM exercises to see if it can bend more. I did some straightening exercises last night and then iced and elevated. I’ve only taken pain medication twice since Thursday. The outer part of my knee seems so tight which is preventing me from bending feels like plus I still have numbness on that side of my knee .

 

[Jockette]

The numbness can last a long time, I’m 2 years post op and while that area is no longer actually numb, it still does feel weird when I shave my leg.
https://bonesmart.org/forum/threads/numb-area-after-tkr-how-long-will-it-last.5931/

I’m glad your pain level is better.

 

[vjice00]

Hello group, so today my swelling is only moderate and my pain is not bad but my knee isn’t bending anymore then it was and I think the scare tissue has formed in front of my knee and preventing me from bending past 80 I’m truly disappointed as I thought it would bend more after the swelling went down.

 

[DLR]

@vjice00 sorry to read about your discouraging journey. I suspect even as yourate it moderate swelling that there is internal swelling there from the aggressive pt. I have been fortunate that my PT have always told me to back off and rest when I get really sore. I would encourage you to keep resting elevating and icing, it takes time. If you know a good chiropractor or massage therapist I found deep tissue massage and dry needling released knots that were impeding my ROM

 

[lovetocookandsew]

@vjice00 Wow-I'm so sorry you've gone through so much. Here's my opinion after going through many knee surgeries; some with PT and the last with zero PT. Lose the PT totally and just do normal daily activities and walking. It's obvious to me that PT is doing you a great deal of harm, both physically and emotionally. Therefore, it stands to reason that if something is harming us, we stop doing it; at least for a time to see what happens. I would suggest stopping all PT, and spend a lot of time each day icing and elevating that knee. It's swollen and angry and needs time to recover not only from the surgery, but from the abusive therapy it's had forced upon it by therapists! (The motto, "First Do No Harm" doesn't seem to apply to many PTs and some Ortho docs!)

This surgery is in itself a difficult recovery; add overly-aggressive torture to an already stressed knee and you have a recipe for disaster. I spent my days after surgery with my leg up and on ice-for hours and hours each day plus I iced all night long. I didn't elevate every night after a bit as I was more comfortable on my side so put my Lounge Doctor to the side most nights. This recovery was night and day from all my last ones, and I am 100% glad I skipped the PT totally. I was thrilled that this site was here and I learned that I decide my recovery, and no one else could take that decision away from me. I listened to my OS (naturally-mine is an absolute gem) but made all final decisions on my recovery based on what worked, what caused more harm and what I experienced over the many surgeries.

To my surprise, after this last surgery, I found my OS agrees with BS on PT, but has a hard time knowing which patients will become couch potatoes and which will move around as needed without PT.
Just make sure to move around as you normally would, rest when needed and spend a lot of time elevating and icing until you no longer need to do so. Good luck and keep us posted!

 

[vjice00]

@lovetocookandsew yesterday I seen the therapist but a different one in the same office and they all say my knee is hard and won’t move I’m sooo discourage when they say things like that but I am moving stretching and I even went to the pool today. I pray my ROM comes soon. I’m trying to ice more but I soon as I get up my knee is back swollen.

 

[Celle]

My leg is connected to weights on a string that is 17.5 pounds where I bend and straighten my leg. (30 reps)

Please stop using weights. They are bad for your new knee.

yesterday I seen the therapist but a different one in the same office and they all say my knee is hard and won’t move I’m sooo discourage when they say things like that but I am moving stretching and I even went to the pool today. I pray my ROM comes soon. I’m trying to ice more but I soon as I get up my knee is back swollen.

I'm sure your knee is hard and won't move.
I'm equally sure that's because of the inappropriate exercises your PT therapists have made you do. It's upset and irritated and your soft tissues are hot and swollen. No wonder it's tight!

Please give your knee a long break from going to PT. Just use it for your everyday activities, and spend long periods resting, elevating and icing that poor knee.

It's only just 2 months since you had major surgery. Your knee needs gentle treatment and gentle movement, not the boot camp it's been put through.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[vjice00]

How are you feeling today, Venus?

I'm feeling ok just icing and elevating my leg.

 

[vjice00]

It's upset and irritated and your soft tissues are hot and swollen. No wonder it's tight!

Yes my leg is hot most times was thinking is that normal? Waking up sometimes it's still has swelling after I ice & elevate

 

[vjice00]

Hello group, I've been away for awhile trying to get my knee together and it's been a long road that hasn't ended. Come to found out I'm that patient That develops a healthy amount of scar tissue in my joints (Arthrofibrosis) so the doctor went back in my knee to cut out all scarring which helped but Didn't quite do the trick my range of motion is at about 90ﾟ and my extension is -4. My pain has subsided greatly It's still there but I'm not taking any pain medication as it's tolerable. I just need this range of motion to come in. I'm scared because I think something may not be right as far as the prosthetic in my knee and I'm thinking about going to get a second opinion. I just had a second round of x-rays done and everything looks good and straight and tight in there so he think it may be the scarring that's preventing me from bending my knee. I still Do therapy 3 times a week and my knee is moderately swollen. I hope all of the PT Didn't hinder the healing process but I did try the other way as far as just doing exercises at home and my knee fell even stiffer so I'm just not sure at this point.

 

[Roy Gardiner]

In my medically unqualified opinion I suggest that it's unlikely that there's something wrong with the prosthetic as the x-rays show it's straight. Again IMO the cutting out of scar tissue is not a miracle cure, but it does make possible improvements over time. Your tissues are not stuck together, making improvement impossible, but swollen and traumatised making improvement a matter of time.

I would not deter you from getting a second opinion. Please try to find a doctor with no professional or social ties to your current one, for fairly obvious reasons.

 

[Celle]

Come to found out I'm that patient That develops a healthy amount of scar tissue in my joints (Arthrofibrosis) so the doctor went back in my knee to cut out all scarring which helped but Didn't quite do the trick my range of motion is at about 90ﾟ and my extension is -4.

@vjice00 - Please will you tell us the date you had this additional surgery to remove adhesions, so we can add it to your signature? Thank you.

I'm sorry you're still having problems with ROM, but I think that you need to cut back on going to PT. Three times a week is just too much. Your knee needs time to calm down after what it's been through.

What's more, I think it's highly likely that the intensive PT you had earlier (using weights etc) is at least partly the cause of the adhesions you developed.

You see, too much PT/physio done too aggressively can help to cause adhesions. What excessive PT does very effectively is cause the tissues to become over warm and even hot. This means that the structures are becoming dry within and dry structures (muscles and ligaments) will get stuck together, resulting in the dreaded adhesions.
That's what we're trying to protect you from, when we recommend less PT or more gentle PT.

 

[vjice00]

@Roy Gardiner funny you should say that because the doctor referred me to a colleague of his and I was thinking to myself why would I go to your friend for a second opinion But I am Definitely inclined to take your advice and all the other admins on the site that says it takes time and the doctor said by him going back into the knee that pushed back my date from January to June as I am not totally healed it still has swelling and trauma to the knee.