TKR Threw my therapist out of my house today

[Slainte]

I am five and a half weeks out with my second knee. I'm having trouble with flexion too. Not sure would call it a hard stop, if I lie back and put my leg in the air then let my knee gently been down it does gradually stretch a bit. But it hurts! I will see my pt for outpatient eval next Tuesday. I'll let you know what he says. I like being back at work too. Takes your mind off your knee!

 

[webbie73]

I had an experience with a very aggressive PT also. So aggressive that she sent my leg into 6 hours of constant muscle spasm. Agony!!!

I feel that experience set me way back. I have horrible flexion, lucky to get 70. It seems like I can get 70 with help but it is extremely painful, then the next day I can only get 60-66. The knee just does not bend. At this point I just want some degree of normal function.

So you are not alone. I don't have a clue how it will improve. I just was released from a rehab center and will begin home PT this week. Hoping I get a gentle PT.

 

[Bikesouth]

Time my friend time & gradual effort.

I suffered a tibial plateau fracture in 04, took years to get flexation. Ultimately I was able to squat like a bear so to speak. If I stretched my hamstrings & quads I could touch my heels to my calves. Cannot do it now but I will get it back over time.

Set a goal like 1/2° of improvement every 10-14 days. While kneeling gently push your butt towards the floor until you feel it stretching. Hold it & repeat a few times.

 

[Clipless]

Six weeks after my first TKR (last year) my flexion was barely 90°. MUA was offered but I declined because I had a lot of swelling. It did take a while to achieve comfortable bend- as in months. However, by 11 months post op I was road and mountain biking, hiking, and jogging up & down stairs. The only thing that held me back was my other knee, which has since been replaced! I cannot squat fully like a baseball catcher- doubtful I'll ever achieve that much flexion.

If you have access to a stationary exercise bike or "spin" bike, cycling is a great way to gradually loosen up the knee. Start with the saddle very high and initially just rock the pedals back & forth until you get that first full rotation.

 

[newlybionic]

My therapists pushed me hard to get my ROM set to THEIR desired schedule. I also pushed myself too because I felt like I was failing. It wasn't until I found this forum that I came to realize there isn't an exact schedule to meet. I also had a substitute therapist one day who reminded me that my ROM was very limited preop and I was already beyond that and it was going to take longer to my optimal putcome.

 

[Brian17]

So my ROM still seems to be stuck at 85 degrees. Cants get the swelling down but even with PT I still can't get past the 85 mark and I'm now just over 4 weeks out.

My question now is about walking and using crutches or assistance. I still very much have the need to use crutches due to the overall feeling of being comfortable with them. I would have thought by now that I would have at the very least progressed to a cane.

I can certainly take steps with and without a cane but also feel that when doing so I am walking improperly and truly "walk" better with the crutches.

Any thoughts would be helpful. Thank you.


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[Slainte]

If you feel like your gait is correct with the crutches, stick with them. I used a walker at work until recently, now on cane. I am 6 1/2 weeks out. I did not walk particularly correctly with the walker, but I needed a lot of support. I find that now if I walk without the cane my hip starts to hurt as I Frankenstein around. So better not to throw out any other joints, I am thinking. I might have tried crutches, but my OS seems to think that walker to cane is the progression.

 

[Clipless]

You're fine. It's your comfort zone, so do what feels best. A couple of weeks ago (4 weeks post op) I was still using the walker for similar reasons. Then I tried to switch to the cane, but it threw off my gait so I went freestyle. I'm slow but getting there.

 

[Celle]

I am five and a half weeks out with my second knee. I'm having trouble with flexion too. Not sure would call it a hard stop, if I lie back and put my leg in the air then let my knee gently been down it does gradually stretch a bit. But it hurts! I will see my pt for outpatient eval next Tuesday. I'll let you know what he says. I like being back at work too

Be patient! You're expecting rather a lot of your knee at only 5+ weeks and back to work already. It won't be a hard stop. What it will be is swelling, made worse by the extra strain of going to work.
Try to do lots of rest ice and elevation when you get home from work - and nothing else at all.

So my ROM still seems to be stuck at 85 degrees. Cants get the swelling down but even with PT I still can't get past the 85 mark and I'm now just over 4 weeks out.

Give it time, Brian!
85 degrees at 4 weeks isn't bad. My surgeon never expects 90 degrees until 6 weeks, so you're right on course. It will be the swelling that's still preventing ROM. do less exercise and more rest, ice and elevation.

I'm beginning to sound like a broken record, aren't I?

 

[kneeper]

^what Celle said. Also with you working, your leg is probably down more than it would be if you weren't and things swell up when your leg isn't elevated. You can have swelling even if you can't really see it.
I remember my sister (who was my helper) saying--yes, you're really trying but it just won't go any farther. But then as the swelling went down, the bend increased.

 

[Brian17]

Hi Everyone,

Been a while since I've posted an update.....first thank you to everyone that has shared their experience with me, it has really helped my mind set.

So, here is where I am currently: Walking much better, with and without a cane. In the morning I need the cane to get around but by mid day I feel comfortable enough without it. Still very stiff and ROM is "stuck" at 85 degrees.....I've been at 85 degrees since roughly 2 weeks out and I'm currently 6 weeks post op. I say stuck because I have had zero progress with therapy and home exercises, I just can't seem to gain any range of motion no matter what I do so I have a MUA scheduled for 12/11. I'm pretty excited about it because I had one before with my Tibial Plateau Fracture.....my symptoms are almost identical to when I had the TPF, was stuck at 85 degrees then and now. After the MUA with the tibial plateau I went from 85 degrees the day of manipulation to 120 degrees at therapy the next day. I'm seriously hoping for similar results.

Now I have a question with some new pain I developed over the past week. It is a sharp/stabbing pain on the right bottom side of the knee......below and to the right of my knee cap. It happens mostly when I am laying down at night and in the morning when I am actually still and not moving. It seems once I loosen up in the morning and walk it mostly goes away but at night while sleeping it wakes me up out of a dead sleep. It is a pretty sharp/intense pain.

Has anyone experienced that before and what was the diagnoses?

Again, thank you for your responses in advance.

 

[Celle]

I hope the MUA works for you. Do let us know how you get on.

I'm going to ask @Josephine for her advice about your new pain.

 

[Josephine]

new pain I developed over the past week. It is a sharp/stabbing pain on the right bottom side of the knee......below and to the right of my knee cap.

Perhaps you can you tell me the exact site of your pain using this chart?
Please note the instructions in the smaller image

 

[Brian17]

@Josephine

I would say DRF1/DRF2 down to ERF1 and ERF2


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[newlybionic]

I hope your MUA is successful and you also get an answer to what it causing your the pains you're having.

 

[Josephine]

Is this your pattern?

I'd be inclined to say this is more likely a neuropathy.
Did I see somewhere that you are on Gabapentin or paragablin?

 

[Brian17]

Is this your pattern?

I'd be inclined to say this is more likely a neuropathy.
Did I see somewhere that you are on Gabapentin or paragablin?

Yes, that was about where it was. It's actually gone away now but it seems like every day I have a new type of pain? Maybe I am just a hypochondriac too

Saw my doc yesterday because I have what looks like a stitch abscess and possible cellulitis so I am being prescribed some antibiotics for that. Hopefully it is just a surface infection and the Keflex will take care of it.

Still the same flexion....fingers crossed for my MUA next Friday

 

[PolarBear60]

Probably no to the hypochondriac. As part of the healing process, aches and pains seem to migrate. At least that was part of my adventure.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005