Revision TKR To Work or Not to Work?
- Thread starter JMB
- Start date
Jordon6
member
@JMB my implant came loose. In 18 months I had a replacement, arthroscopic surgery, two MUAs and finally a revision.
Before the revision, the knee never felt right. It was very unstable and painful! My ROM and extension actually declined. I saw 3 surgeonss but until the knee was a year old, they didn't want to definitely affirm that it was loose so I became a guinea pig- with"let's try this"
I finally researched and found a specialist that focused in revising knees and it was confirmed loose! It was loose at the tibia and femur components!
I feel that I'm on the right track now but my new surgeon reminds me that recovery may be a bit longer because of the history of my knee.
That's ok, I'll wait as long as I know it's fixed!
Thanks for asking!
Before the revision, the knee never felt right. It was very unstable and painful! My ROM and extension actually declined. I saw 3 surgeonss but until the knee was a year old, they didn't want to definitely affirm that it was loose so I became a guinea pig- with"let's try this"
I finally researched and found a specialist that focused in revising knees and it was confirmed loose! It was loose at the tibia and femur components!
I feel that I'm on the right track now but my new surgeon reminds me that recovery may be a bit longer because of the history of my knee.
That's ok, I'll wait as long as I know it's fixed!
Thanks for asking!
Minstrel
junior member
Hi JMB. I'm looking for other members of the "slow bending club". Though I am 10 weeks ahead of you in terms of a surgery date, seems I'm right along side you with respect to your recovery.
Wondering if you have found anything in particular that has helped you with increasing your flexion? I have even tried a couple of acupuncture appointments.
Wondering if you have found anything in particular that has helped you with increasing your flexion? I have even tried a couple of acupuncture appointments.
OP
OP
JMB
junior member
I wish I had something to add, Minstrel. I go to PT 3 times a week and ice/elevate at home. I do side leg lifts lying on the floor and heel touch step downs to strengthen my leg on days without PT. I'm just over 3 months and honestly I'm not seeing a lot of improvement yet. I'm worried there may be something wrong with the implant and people around me keep telling me to get a good lawyer. I really hope it's just my slow healing going on here and not a botched surgery. It's really getting me down. I have 10 weeks to get better.
I was not always a slow bender but have been since a set back in July that I don't seem to be able to recover from. I don't even want to know what my rom is, I think it's that bad. I can straighten fine but since July I can hardly bend it. I'm worried.
I have been advised here to stop all activities but essential for 3 weeks so I can rest ice and elevate as much as I can, so that's what I'm doing. I am 6 months post op.
I am starting to read posts about revision, just in case that's where I'm headed. I had a partial replacement and now wish I'd had a total. But my doctor felt this partial was the way to go.
I have been advised here to stop all activities but essential for 3 weeks so I can rest ice and elevate as much as I can, so that's what I'm doing. I am 6 months post op.
I am starting to read posts about revision, just in case that's where I'm headed. I had a partial replacement and now wish I'd had a total. But my doctor felt this partial was the way to go.
Please try not to put pressure on yourself to recover within a certain time frame. Complete recovery from a knee replacement does take a full year. Although you feel much better long before that, there is still healing going on under the surface. Recovery is a marathon, not a sprint.
And where you are now is not where you will be in 10 weeks' time, because your knee is still a work in progress, not the finished article. Remember, your knee is only just over a quarter of its way on its year-long journey to complete healing. You have plenty of time.
Doing stairs properly can take a long, long time - many people take 4 months, or even longer.
I don't think you need to do extra exercises on your days off from PT. Your leg will continue to strengthen gradually, with normal everyday use.
Also, try to ignore the friends who talk to you about getting a lawyer. Chances are there's nothing wrong with your knee, and it's incredibly hard to prove a surgeon was at fault. The only people who benefit from cases like that are the lawyers.
There's no deadline you have to meet, to get good ROM, because it can continue to improve for a year, or even longer, after a TKR: Myth busting: the "window of opportunity" in TKR
Just to encourage you, this is what one of our members wrote about the slow development of her ROM. (Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time.
"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"
OP
OP
JMB
junior member
Thank you Celle. I needed to hear that from someone today. Several bad days in a row here. I always feel guilty not doing any exercises at home. I will try and take it easy. My PT insists I manually "rock" my patella or "glide" it several times a day. Says it will tighten up and become more stiff if I don't. Honestly, I don't think my knee could be stiffer. Have you heard about this practice?
In other news, I felt guilty missing the start of the new school year today. I know everything is being taken care of in my absence. That's just my nature. I have a tentative return date of November 13. I'll be catching up on my reading until then.
In other news, I felt guilty missing the start of the new school year today. I know everything is being taken care of in my absence. That's just my nature. I have a tentative return date of November 13. I'll be catching up on my reading until then.
KarriB
Former BoneSmart staff member
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JMB, I didn't do any exercises after my infection surgery a month after TKR surgery. My OS put me in an immbolizer, saying my soft tissues were too compromised for exercises or bending. After 4 weeks the immbolizer came off and I did very easy heel slides per my OS instructions. My knee was stiff, but it loosened up after a few weeks and I was able to get full rotations on the recumbent bike. I did not rock my patella at all.
As a newly retired teacher I understand how you're feeling. It's just one more thing out of your control.
As a newly retired teacher I understand how you're feeling. It's just one more thing out of your control.
Yes, I've heard of this practice and it seems to be something that PTs in the US get hung up about. It's completely unnecessary. I've never heard of it being done in the UK or in New Zealand, where I live - and our kneecaps mobilise themselves satisfactorily without this attention.
Leave your kneecap alone. It will loosen naturally, as your knee continues to heal. Mother Nature know what she's doing and she has been healing bodies for a long time, without this sort of intervention.
I've had three knee replacements and no one ever mentioned mobilising my kneecaps. They move easily and they track perfectly.
By the way, you are the boss when it comes to PT. Your therapist works for you, not the other way round. Whether it's directly or through your insurance, you pay their salary.
You don't have to please them. They have to please you.
They can advise, but you can choose whether or not to accept that advice.
Saying no to therapy - am I allowed to?
OP
OP
JMB
junior member
Hello again, friends. A quick update. Month 5 has passed since my TKR and 12 weeks since my MUA. Last Friday was my last day for PT. I begin work(teaching) on November 13. Well, I still don’t have full range of motion. I still cannot bend or straighten enough to use stairs or walk correctly. The limp in my gait is noticeable, and after about 20 minutes of walking I’m dragging my leg along. My surgeon keeps telling me I’m doing well and that I need more time. After calling 9 local surgeons for a second opinion, I found one that said he would take a look at me. My appointment is tomorrow. Do you have any advice for me? Any questions I should ask the doctor? Any words of encouragement? I go back to work in two weeks, and I’m nervous I won’t be able to make it through a full day.
Jordon6
member
@JMB I would ask what specifically could you work on to gain more range. My first OS told me to walk and walk ( and I did) but the doc that did my revision told me that the walking motion is really not enough to gain range because it only needs about 65 degrees to walk and that would not help me get more.
Keep us posted! I’m 4 months post revision and I have a sight limp because of my lack of range too. I’m anxious to also find answers!
Good luck!
Keep us posted! I’m 4 months post revision and I have a sight limp because of my lack of range too. I’m anxious to also find answers!
Good luck!
I think the most important thing to exercise in this recovery is patience.
It wasn’t until I was almost 7 months post op that I saw much better improvement, and I still have plenty of limitations.
Each body heals at its own rate and there’s nothing anyone can do to change that. No amount of wishing, hoping, worrying, or exercise will heal our body any faster.
It just takes time.
Lots and lots of time.
And when the time is right, our knee will bend much better. Where we are now is not where we will end up.
It wasn’t until I was almost 7 months post op that I saw much better improvement, and I still have plenty of limitations.
Each body heals at its own rate and there’s nothing anyone can do to change that. No amount of wishing, hoping, worrying, or exercise will heal our body any faster.
It just takes time.
Lots and lots of time.
And when the time is right, our knee will bend much better. Where we are now is not where we will end up.
KarriB
Former BoneSmart staff member
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We’ve had quite a few TKRs here that have taken a full year to get a good ROM. Celle left you the vitals from someone in post #66 and we have a gentleman who also took a full year. Jockette is right, patience is what it takes. It took me over a year to have good ROM, but it came when I wasn’t exercising, just living my life and riding a recumbent bike (0 resistance) 10 minutes a day.
Homeport
senior
My first tkr on right knee was slow and sometimes I thought would never get there I persevered with static bike and cried first time I got a full turn albeit seat was high it is just over two years now and it’s good
OP
OP
JMB
junior member
Jockette - those are very inspirational words that I will take to heart. I needed to hear that.
KarriB- thanks for your advice.
Question: Have any of you here gone back to work still not being 100% recovered?
KarriB- thanks for your advice.
Question: Have any of you here gone back to work still not being 100% recovered?
Probably, most people have.
It takes a full year for complete recovery, but most people are able to work long before that. We recommend taking at least 12 weeks off work and then a
Phased return to work
Your knee will still be recovering, but by 12 weeks most people can manage light work. Heavy work needs more time before you go back.
SusieShoes
Former BoneSmart staff member
Most people go back to work before they’re fully recovered. Full recovery takes so long few can afford to wait for it —nor do they need to. After about three months most TKR patients have regained enough function and have low enough levels of pain and stiffness to be able to manage desk jobs or jobs where they don’t have to be on their feet all day, or have to do heavy manual labor. No matter when you choose to go back, you will be dealing with how to balance work with your continued healing.
A job teaching is pretty on-your-feet, but maybe you can swing some help in the classroom? Find ways to be off your feet more? Be able to ice and elevate during breaks? It helps a lot if you can baby your knee (and also yourself) at work.
A job teaching is pretty on-your-feet, but maybe you can swing some help in the classroom? Find ways to be off your feet more? Be able to ice and elevate during breaks? It helps a lot if you can baby your knee (and also yourself) at work.
OP
OP
JMB
junior member
Well, I went for a second opinion today. The surgeon sat with me and went over the X-rays he took. He explained how the femoral component of the replacement was not the correct size/fit. He showed me a properly implanted knee and my X-ray side by side. He also said all the stretching and PT in the world isn’t going to allow for full extension. It’s a mechanical issue. The doctor stated that my knee is still warm because it’s angry...I’m walking around all day on a flexed quadricep. Not good. That much I knew. He sent me for blood work to rule out any infection and possibly an MRI the next time I see him (in 6 weeks) for further evaluation. In the meantime he suggested just riding my exercise bike with the seat extended and to continue ice and elevation. Don’t do anything crazy. Also said to find a gym or some place with a pool and try aquatic exercise/therapy. I need to keep moving it so it doesn’t stiffen any worse.
SusieShoes
Former BoneSmart staff member
Did the surgeon say what the remedy to your problem might be? I'm thinking revision, but what did he say?
I'm so sorry you have to go through this, but at least now you have an explanation. You know it's not anything else over which you had any control. Your knee is not right.
Keeping the leg strong and flexible until you can get the problem fixed makes sense. You can find a balance that keeps you strong without making you hurt. I hope you get a resolution soon!
I'm so sorry you have to go through this, but at least now you have an explanation. You know it's not anything else over which you had any control. Your knee is not right.
Keeping the leg strong and flexible until you can get the problem fixed makes sense. You can find a balance that keeps you strong without making you hurt. I hope you get a resolution soon!
