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TKR too soon for MUA?

russny said:
Thank you! I did wonder why they used only one type of ROM as criteria. RTKR 4/23. I’ve been doing so well - managed pain with only acetaminophen since three days after surgery, been walking ok with cane snd walker, lost a half inch in swelling last week after telling PT I refused to do anything that hurt, been able to do stairs, etc. My knee did get stiffer last week but for the first time ever did not hurt all week. Been paying attention to this forum and seem to do better following the advice here - I learned yes an MUA can gain ROM but set me back to day one in soft tissue healing. But lost confidence in myself and own experience after post op visit. Even let PT hurt me. So now am in worst pain and swelling ever since leaving hospital because doc and PT tried to force bend this week.
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STOP ALL PT AND FOLLOW TYE GUIDELINES FROM BONESMART!! Everything is a myth they’re telling you. I just returned to work (RN) in May working 12 hr shifts… only because I never let PT touch or hurt me again! I was in chronic pain for 3 months because I let them push and pull on my knee. I quit doing all exercises like Bonesmart instructed, rested, elevated, and iced …. And my pain went away almost immediately! I started water aerobics and I’ve been back to work for over a month in a half doing absolutely great! Oh ya, and I’m no young chicken..61 and holding on for retirement.. Good luck and listen to your knee… if it hurts, you’re doing to much!
LaRue
 
Hello russny, Happy Two Month Anniversary!

Good to read you received a nod for travel from your OS.:ok:
Wear compression socks to prevent a potential blood clot.
Get up and walk every 30 minutes or so.
Stay hydrated by drinking water and avoiding alcohol and coffee.
Stretch and flex your muscles often while seated. Do calf squeezes and ankle pumps
Check on a bulkhead seat if there are no available isle seats and first class is not an option.

A few travel tips that Jamie from Admin left someone awhile back that you may find useful -

* Pack light. One medium size bag you can check and a carry-on. Make sure the bag has good, sturdy wheels. Be sure and pack pain medications in your carry on luggage.

* Have someone take you to the airport and pick you up after you're back home. They can drop you at your terminal gate. Find out which airlines have curbside check in. You might want to book with that airline.

* When you book your tickets, ask for handicapped assistance. This should be a wheelchair and a porter to wheel you and your bag. You just sit. The porter will check your bag in for you and take you to the gate. You'll board first and can take the wheelchair all the way down the ramp if needed.

* Try to book a direct flight so you don't have to change planes. Otherwise you'll need wheelchair assistance at every airport where you must change to another airplane.

* Aboard the plane, ask your flight attendant to make sure you have a wheelchair waiting at the gate when you arrive. Take some zip lock bags and ask the flight attendant for ice to use in flight if that would make you more comfortable.

* Once you arrive and get your wheelchair at the start of the ramp, the porter will take you to pick up your luggage and to whatever point where you'll be picked up (do have someone pick you up at the airport).

Safe travels and ENJOY!
Once you're back home, please post any pointers on travel you picked up along the way for the benefit of those following behind you.
@russny
 
I decided to put off my trip ‘til I’m stronger. I was just getting cabin fever staying cooped up in a small apt. It took 3 weeks to get back to where I was before PT caused so much damage. 21 days of isolation because I already learned the hard way that the 28 stairs from my apt to the street impede any attempt to recover. 19 days where only tiny incremental gains were made. Many moments of doubt and despair. Suddenly in past two days substantial changes - can finally sleep on side without pain, gait is less wonky, slight knee pain when weight bearing is gone, the need to ice dropped 70%, knee more stable, am back to comfortably doing heel slides, incision less tender. I’ve read that scar tissue can actively pull on muscles etc so maybe that’s why aggressive PT is do devastating?
 
russny said:
I’ve read that scar tissue can actively pull on muscles etc so maybe that’s why aggressive PT is do devastating?
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Yes, after surgery we have scar tissue, which is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. We aren't tight because our muscle is underused and needs to be stretched and rehabbed. We’re tight because our tissue has been disturbed and is healing...and full healing takes a full year or more.

Some PTs put all “scar tissue” (normal scar tissue and adhesions) into one category and think aggressive actions will fix it. Time/healing is what fixes it.
 
russny said:
Suddenly in past two days substantial changes - can finally sleep on side without pain, gait is less wonky, slight knee pain when weight bearing is gone, the need to ice dropped 70%, knee more stable, am back to comfortably doing heel slides, incision less tender.
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This is great news!
 
You're back on track for a good recovery!!!
 
Hi there @russny
Wonderful news on the change you've so recently been enjoying.
May it only get better! :thumb:
 
I'm so sorry your PT broke your trust a few weeks ago and hurt you. :( I've been there, and it feels like a complete betrayal. I've now had 2 PTs wait until I'm distracted, then push my knee/leg back further to get more ROM. Both times I was flat on my stomach and couldn't break away. I was trapped! This was after I had explicitly said they were to never do this again. It's these types of experiences that make people leery of medical professionals . When trust is broken, it's nearly impossible to get back.

As for the MUA- Back in 2016, my surgeon suggested/performed a lysis of adhesions (LOA) surgery to remove "scar tissue" at 11 wks post-op. That wasn't from a TKR, but a different type of knee surgery with a 7-inch incision. What's awful is my ROM was already 98-102. I didn't know this was actually a GREAT measurement for that point in recovery. But then I had forceful PT 3X that week (for 2 hrs each time) to supposedly keep it bending. NOPE--- It caused the knee to balloon up and not bend at all for 2 days without force. I I screamed/cried while doped up on Percocet and valium, but my numbers kept dropping due to the severe swelling (Imagine that!!).

That resulted in the surgeon scaring me into an MUA a week later at the 12-week mark----again saying I'd never walk right again otherwise. My numbers were only bad because the LOA surgery 7 days prior had traumatized my knee again, which was exacerbated by the forceful PT. After the MUA, my measurements were lackluster at best, and it took ANOTHER 4-5 months to get my full ROM back....but it DID come back to 126. The whole year was just miserable through and through---ruining my trust in PTs. For reference, anyone who says an MUA is a piece of cake is lying. The MUA was so painful/traumatizing that I needed 7-8 lidocaine injections into my quadriceps muscle. It had swollen to nearly twice the size of my other quad/knee and stopped working. In the end, I needed a 10-day round of steroids, plus a 5-day prescription of Toradol (the strongest anti-inflammatory) just to get my leg where I could put pressure on it and take a step. The word "nightmare" doesn't even begin to cover it.

Basically, I'm saying that MUA set me back MONTHS with extra pain, swelling, needing crutches again, and needing narcotics again!!!!! I truly believe an MUA is a money-making tool for some of these surgeons, and they use scare tactics to get us to agree when we don't know any better. I still feel like the biggest fool for letting myself believe those people.

Last but not least--I'm about to have my 2nd knee replacement in September. My first TKR surgeon was awesome in 2019, but this guy is just as great. He was so gracious and understanding when I told him I couldn't handle any kind of forceful PT again and would NOT go if he made me. He informed me most of his patients just use a special bike/peddler at home--nothing else in those first 4 weeks--then no PT at all. This bike adjusts to the strength in your post-op leg, so there's nothing forceful about it. It's just to help keeps things moving a bit and help with mobility---but there's no one around telling you "more, harder, faster" etc. After 4 wks, he advises to just slowly get back to life and LIVE. The rest will come in time. It was such a breath of fresh air.

Best of luck to you, and I hope you are still experiencing improvements.
 
Rockgirl4 said:
Last but not least--I'm about to have my 2nd knee replacement in September. My first TKR surgeon was awesome in 2019, but this guy is just as great. He was so gracious and understanding when I told him I couldn't handle any kind of forceful PT again and would NOT go if he made me. He informed me most of his patients just use a special bike/peddler at home--nothing else in those first 4 weeks--then no PT at all. This bike adjusts to the strength in your post-op leg, so there's nothing forceful about it. It's just to help keeps things moving a bit and help with mobility---but there's no one around telling you "more, harder, faster" etc. After 4 wks, he advises to just slowly get back to life and LIVE. The rest will come in time. It was such a breath of fresh air.

Best of luck to you, and I hope you are still experiencing improvements.
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I totally agree with your surgeon. My last knee surgery 4-24-24 was a lot better than the first get go, which I had a MUA and it set me back for weeks, which I said I would not get another one again. Second surgery with right knee, had a bad experience with first day of PT,less than 24 hours after surgery. Surgeon was livid, almost caused a clot, and looked at me and said no more PT. Rom was already 111 and he said since I knew all the protocol of exercises and this wasn't my first rodeo, then I could do it on my own. 9 wks right now, walk very good, do my ADL's great, drive,go up and downs stairs great. Less swelling due to the fact I don't have someone trying to push my knee up into my stomach! I will take it slow and easy. My first surgery knee is now at 17 months and doing great. No two knees will be alike in healing,I assure you that. God Bless to all out there!
 
It’s been 5 long weeks since that PT drove my bend down from 65 to 52. Weeks of helping knee to heel. Knee wasn’t healed enough to restart heel slides until 1.5 weeks ago. Still stuck at 52. I have been in such despair. Working out I would get it up to 55 or 56 but the next day it would be back to 52. Then one day It wasn’t. It was 56. Just in the last five days I got it to 58. Today I got to 63! It’s been a long time coming. The misery and despair in the past weeks, wondering if maybe I should have gotten that MUA. Terrified at how it relentlessly stayed at only 52. And now, real hope and joy!
 
Hang in there!!!
It looks like you may be one of slower track members, but many (including some staff) have completed it at your pace with good outcomes.
We're with you for each bit of improvement, and fingers crossed, no setbacks.
 
What is your leg’s pain level since the injury? Maybe you should ask for an MRI or some other test to look for specific damage from the injury. Has anything like that been done? I’m so sorry you’re going through this. :console2:
 
Wonderful news! A good reason to feel hopeful and thankful.
No cookie cutter recoveries here. We each heal at our own rate. Hang in there and slowly but surely you’ll get there. :thumb: Thanks for the update!
@russny
 
Forgot to say my bend while sitting down in a chair (passive ROM) was knocked down by the PT from 70 to 59. It’s now at least 75. Fairly painfree but does hurt a little now that am transitioning from back to side sleeping unless I use pillows under leg. Even then I have to get up repeatedly to rearrange the pillows and sleeping position - doesn’t hurt at first but after an hour or two gets uncomfortable. This pain is less each day;) On my way.
 
russny said:
“Says I could try PT for a couple more weeks but doubts that it will be effective because “it’s too late” because of scar tissue. My leg felt like cement in the hospital and I wasn’t able to lift knee into a bend while lying down at all until two weeks after surgery.”
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Scar tissue at four weeks? In my opinion that is a false statement.
 
On Tuesday I got my bend to 63 and today to 70 degrees! Have adjusted my expectations accordingly, now hoping to add 10 degrees a week instead of 5. This measure of ROM is while lying down (heel slides).
 
Hmmm... How about focusing on functional milestones rather than numbers per week?

I suggest this only because for many members, focus on function really was a stress-buster. I realize that some folks do better with different approaches, so whatever works for you - go for it!
 
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