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TKR TKR please help me!

MammyD

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I am new to this site, although I have watched it for a while to get encouragement.
I had a TKR on left knee January 24, it is the one thing in my life that I regret more than anything in my life. December 17, 5 weeks before TKR I had a spinal fusion on my back. My doctors claimed that I would be fine to do them so close together. I am far from fine.I was just getting able to walk without being in pain in my back when I had my knee done. My insurance only paid for 29 visits for my knee. I am now 4 months out and still between 100-105 flexibility, I go see my back and knee doctor next week and I am petrified that the knee doctor will want to do a MUA. I do not want to go through the pain again.
should I be considered that I am nit at 120 flexibility yet. Is it too late for me to get to it without a MUA?
I am doing exercises daily at home and stretching it as much as I can. I still have pain and lots of swelling every day.
 
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MammyD

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Meant to say insurance on paid for 20 visits. I should also add, depression has been extremely hard for me, dealing with the pain is horrible.
 

Sara61

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@MammyD :welome:to BoneSmart.
Everybodies knees heal at a different pace some get the bend and extension quicker than others, I would certainly wait before allowing your Surgeon to perform a MUA as you are still early days in your recover, and with time and patience you will get a better range of movement.
Stretching and daily exercise will cause your knee to swell and in turn give you more pain which will hinder your recovery.

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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


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 a 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 history before providing advice.
 

Celle

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Hello @MammyD - and :welome:

First of all, stop worrying about your knee's flexion (bend). In spite of what you've probably been told,
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

100 -105 degrees of flexion at 4 months is really not too bad and you have plenty of time for it to continue to improve if you allow it to relax and don't keep hurting it with painful exercises.
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 knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase.

We have had plenty of people whose ROM developed slowly, but who achieved a good result as time went by.

Second, stop worrying about having an MUA. Most surgeons don't do one, once flexion has passed 90 degrees. If your surgeon is unhappy that you haven't yet reached 120 degrees, don't get talked into having an MUA. Just say that you want to wait a while. It's your knee and no one can do anything to it without your permission. Your surgeon can't do an MUA without your consent. He/she cannot make you have an MUA.
Saying no to therapy - am I allowed to?

Instead of continuing to go to PT, where i am sure you are pressured to do exercises to increase your ROM, sometimes to the point of pain, I suggest you take a break from PT for a month and just use your knee normally, during the course of your everyday activities of daily living.
Spend more time elevating and icing your knee, instead.
 

Celle

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Here are some examples for you from people whose ROM was slow to develop, but who eventually did well:

This is what Campervan wrote about the slow development of her ROM. As you can see, her flexion continued to improve for a long time, even as long as 6 years.
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "
And then, a post from TortiTabby:
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL (Activities of Daily Living) and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
Finally, one from bertschb:
I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!
Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees
I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.
 

eaglemom

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Surgeon's are trained / programmed for specifics, a timeline. Your knee isn't - it has a mind of its own!!! I think we all put too much pressure on ourselves to please the surgeons. (At least I know I've done that in the past.) Anyway my last surgery I was absolutely determined to do it the BoneSmart way - and I have. Just because your written a prescription for PT does not mean your have to use it. Just being home and moving around is about all you need to be doing. I'm afraid all that you are doing isn't helping you heal, but holding you back with swelling.

I will say the depression is a very real thing. Wanting to feel better is a very real thing. These are things that will, over time, get better. Look at your healing as your 'job.' Your 'job' requires you to elevate & ice - that's about it. Walk around the house, but don't do much else. Rest frequently, yes this far out - your body is healing and will be for awhile. The BoneSmart way is to allow your body to heal on its time frame - not a calendar.

I'm glad you posted - keep doing so. We're here to help and encourage one another. Slowly it will be better.
 

sistersinhim

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Many of us never took formal PT or did exercises. I am one of them. I had 12 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing. I used my knee as it was intended to be used by walking around to take care of my daily needs. As I healed I was able to do more. Icing and elevation was a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing and elevating helped. Your knee knows how to rehab itself without being told what to do.
 

bikinglynn

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I had my 4 month checkup and the doctor was happy with my progress. I can straighten my knees, but my flexion is only around 115. He reminded me that I'm not even half way through the healing process. I stopped PT, when I felt it wasn't helping and I was dreading the appointments.

Walking has been the best thing for my extension and mood. Lots and lots of leisurely strolls, enjoying the scenery, walking carefully with long strides, heal to toe.

I've started gently biking and that has helped with flexibility and strength. Plus, I love to pedal around and look at everyone's flower gardens.

Rehab should be fun, in my opinion. Find something that gives you pleasure. You're going through a lot with your back and knee.
 

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