TKR Update on Slower Recovery

[Mar]

Irongirl55 I’m so glad you answered as seems we have some similar issues. I too am hoping it’s just a fluke. I have followed more of a low carb diet for years to keep my weight down so hopefully by reducing meat and sodium and increasing fruits my levels will decrease. I was reading they don’t count GFR as chronic kidney disease untill you have 3 labs showing abnormalities as age can also play a role as well as dehydration and who knows what all. I wonder if any correlation to Ménière’s disease? I still don’t know if I have it but it’s looking that way other then hearing loss. Well prayers we both just had labs that were off due to something, but not kidney failure. Thanks for responding.

 

[Mar]

This sounds like a question for your doctor.

Yeah they just said will recheck in 6 months. Kind of unacceptable to me. I will change what I can with diet but want it rechecked sooner. Really don’t want to fool around with my kidneys.

 

[kneeper]

I agree. See if you can get retested after 3 months after having taken no NSAIDS. That's what I'd do, anyway. If it was dehydration or the NSAIDs I'd think your results would return to normal.

 

[maryo52]

Hi there, I went through the "block wall" experience, as you describe it, in 2010. I was stuck at 85. Never really any gain in flexion. I had MUA and then needed arthroscopic removal of scar tissue, which helped me turn the corner. In 2019 I had a revision and no trouble bending and then with this surgery (for acute infection), surgeon says he broke two adhesions below my knee during surgery although I thought I was bending well (around 110). That scar tissue is like the tendons you find when you eat chicken. It's tough. A MUA may be just the ticket for you. BTW I take Aleve x2 twice a day, like a miracle drug for me.

 

[Mar]

Well back from vacation. It was ruff on my poor knee. Las Vegas is a lot of walking. 16,000 steps on one of the days, at least 12,000 on the other two and of course my leg swelled as it was also 104-108 degrees. The other one did too just not as much. Fortunately once we got to California I was walking much less. But overall I think it went ok, considering. I guess it was good we left when we did as my daughter and grandson contacted Covid. Daughter is pretty sick with it so any prayers would be great. It’s sad it’s hitting younger people now as my grandson is only 11. Of course who knows as I’ve been on planes and all over the place. But so far feel fine.

I see my OS on Thursday to see about the manipulation. I’m so on the fence about it. Part of me is comfortable waiting, but there is a definite blocking point of where it stops bending. Where it feels like it will just never bend like my other TKR. But when I went to PT today she got it to about 107. So some very slight improvement. 105 before my trip. Not really to pain just uncomfortable. About 102 if you don’t push it at all. I did not do any exercising at all other then walking while on my trip. Just too exhausted. I’m 4 months out now. She did say she doubts even if I wanted to have the MUA that I could because our hospital has just closed to non essential procedures. They are inundated with covid patients. So I guess he will tell me that when I see him. I’m not canceling the appointment as I am concerned because I have had a rash on my knee for a month. It started with what I thought was an allergic reaction to the athletic tape PT was using on it but after 3 wks it still has not gone away. I’ve tried everything on it. When I was in Vegas the rash grew to where it was right up to my scar. About two 50 cent size areas. With cortisone cream it is smaller but still not gone. Also my whole leg is redder then my other leg but I don’t notice a change in temperature between the two. I recently had labs done for another issue but no sign of infection in the results. Anyone else ever get a rash????

 

[Jockette]

When you see your OS be sure to tell him how much walking you did on vacation, and the resulting swelling. That was par for the course, so if it was me, I wouldn’t worry about that swelling. I know I couldn’t have walked that much at 4 months.

I‘m sorry about your daughter and grandson, I’ll pray for a good recovery.

It will be good to get the rash checked out, maybe he’ll prescribe something for it.

 

[Irongirl56]

@Mar, I had my labs rechecked last week and everything was back to normal thank goodness. I am a vegetarian and do a lot of juicing ie lots of leafy greens, fruit etc. so have a high phosphorus intake which is something to monitor for kidney health. I have cut back on my juicing a bit because of this.
If you are low carb you are probably high protein and that can impact kidneys as well.

I have cut back on my protein intake especially since I am not actively training for an Ironman at this time and dont need as much to support my training. not sure if all this impacted my labs or maybe I was dehydrated before but for now all is normal. I am still taking Advil at least every other day at nite especially if I had an active day, ie 1-2 hrs of working out.
I hope yours returns to normal and you dont have Meniers but just vestibular issues like I have.
Prayers for your grandson and daughter.

 

[Mar]

Irongirl56. Thanks for your reply that is great news. I saw the PA today and got my labs from just before my surgery and and after and they were in normal range. So I’m encouraged that it was probably the NSAIDS. Besides ibuprofen I also took Celebrex but not at the same time. I have decided to go off low carb and decreased my protein. Now eating lots of fruit so we will see with my next labs. As far as Meniere’s I’m still not sure I have it but I haven’t gone into full on vertigo this time. I just get slightly nauseous and lightheaded. I saw PT and they couldn’t get me to dizziness with manipulating my neck so who know. I also don’t have hearing loss but do have constant tinnitus. Have totally adapted to it though, thankfully. Well I just pray my next labs like yours will be normal as well.

 

[Mar]

Can you change my title to “Please reassure me canceling my MUA was the right thing to do”
After seeing the PA today I was surprised that they would still go ahead with the procedure on Monday. For one I was 107 at PT on Monday. He thought I was still around 90 +. But maybe I was stiff. He said it depends if I’m satisfied where I’m at right now. Well as long as pain gets better Could I live with it like this. I would like to be 120 like my other knee so I could do more things. The other reason is I was told by PT the hospital was closed to non emergent cases. But he said I was still getting the green light for the procedure. Problem is if I decide to do it in say 3 weeks most likely the hospital wouldn’t ok it. We have a huge spike in covid cases. He said it’s totally up to you. You have to make the decision. I would have liked it better had the hospital cancelled it because now I’m second guessing myself. I won’t really be happy if it doesn’t bend better then it is. I know you all say it will but ugh, what if it doesn’t. I was 120 at this point 4 months with my first TKR. On the plus side he was surprised I gained that much flexion in a month. Also as I was leaving he said “I think you’ll do fine”. Wouldn’t it be nice to have a crystal ball

 

[GiantFinnegan]

My PT said they probably wouldn't consider an MUA for me because I'm past 90deg (he said that's their usual cutoff) and still making progress. If I was "stuck" not making any gains then maybe, but just maybe they would consider it. It sounds like you are in a similar situation as me - you're still improving, just not super quickly.

I'm at 114 right now, but I get a few degrees more each week. I have confidence that I'll keep improving, especially with it feeling better and better, so I assume you will, too! I don't think you should be second guessing yourself. I think you are giving yourself more time to improve on your knee's own time.

 

[Jamie]

I changed your thread title, but shortened it just a bit so that it fits better on the index page.

I think you made a wise decision. There is plenty of time for you to gain more ROM.

 

[eaglemom]

Time, time will help your ROM. Please don't allow yourself to be roped into a procedure that you do not want. The healing time for a TKR is different for everyone, however, everyone continues to gain ROM for quite sometime past your surgery date.

 

[Jockette]

My ROM continued to improve well into my second year post op, as my whole leg continued to heal and relax.

I agree with your doctor, I think you’ll do fine, too! I know it’s hard, but try to relax. So much emphasis is placed on a ROM number, when there’s so much more than that to this recovery.

 

[beesknee]

If I was at 4 months and under 110 and seeming mostly stuck I would go for the MUA while I have the chance and move things along faster. But I guess it depends on what you want to do. You were able to walk several thousand steps on vacation so your knee at least carts you around. Maybe that is all you kneed.

 

[Mar]

So at this point what exercises if any do you think would be beneficial? My knee does not appear to like anything which is frustrating. I’m afraid to take any NSAIDS as my last labs showed some possible kidney damage from them. But I still have pain. Tylenol doesn’t really help much. Ice seems to hurt more now for some reason but I do keep my legs elevated whenever I’m sitting. Not sure if I should just stop everything and just walk? I will continue my twice weekly PT which is primarily just massage, ice, and electric stim.

 

[FCBayern]

My ROM was very slow to increase as well @Mar. I just walked and did daily activities of life, no PT. I did some gentle stretching but no exercise, and by the end of a year I was at 120. At the end of the second year I reached around 140. I think you made the right decision, you are still early in a 12-18 month recovery.

 

[kneeper]

If you're sitting in a chair or recliner, remember to put an extra pillow under your leg to get a really good incline.
Walking and heel slides and/or a little time on the exercise bike are what I found useful for gaining bend. Just some every day, but not boot camp levels. I would do some heel slides when sitting and watching tv. Maybe 10 at a time a couple of times a day. And when you do daily activities that require you to bend that counts as activity too.

 

[Mar]

Just an update! Close to 5 months out now. I didn’t have the MUA and also have not gained any new ROM. Still on the fence about should I have gone ahead. Especially since no improvement in over a month. But I felt I couldn’t risk my kidneys by taking anymore meds. I can get to 110 with force so I don’t do it except when needing to give update for insurance. Can get to about 102 comfortably. Swelling seems better but knee is still very tight. I am doing dry needling for my IT band and down the inside of my calf. Both are just very irritated and sore despite doing daily stretches. Still doing mostly massage at PT. Leaving for Myrtle Beach, SC today so praying that my knee will behave so I can enjoy myself. Will be a long flight across the US but a stop in Chicago will brake it up. Should be a laid back vacation

 

[Mar]

Haven’t been on for awhile. Trying to forget about my knee. I’m 8 months out now. Haven’t gained anymore ROM. I can comfortably bend to 105. Can go to 110 but it’s uncomfortable. I still have more pain then what seems reasonable, but how do you gauge that?? Still a bit painful to get onto my left side at night but it settles down quickly. Still a bit difficult to get out of the car. Does this seem reasonable at 8 months? They say it takes a year. I don’t do any PT anymore, and I’ve followed a gentle approach with my recovery. I know my RTKR was pretty comfortable by 6 months but I suppose it’s because I have 120 ROM. I don’t think I will get there with this one I have a feeling 110 is going to be the max as no change in 3 months. But since I can do most things I’m ok with that but I’m worried the pain will never go away. I think the pain is because I accidentally move it past the point where it doesn’t want to bend. I do get a lot of very uncomfortable burning sporadically behind my knee. I never had that pain with my right. Anyone never get further then 110 but eventually don’t have pain?
I see the orthopedic surgeon on January 6 as my right hip has partially dislocated 2 times in the last month. I fear I’m headed for a hip replacement next! But I’m just guessing, as I can’t find any information here on that issue. So it’s a wait and see what the doc and X-rays say.
Moderator Can you change this thread to “Update on Slower Recovery” Thanks

 

[Jaycey]

I see the orthopedic surgeon on January 6 as my right hip has partially dislocated 2 times in the last month.

Ouch! Sounds like you will join the hip side of this forum soon.

Nothing wrong with a slow and steady recovery from your TKR. It's not a race. Plenty of our members continued to improve ROM after one year or more.