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17 weeks post TKR and only 67 degrees

Posted , 6 users are following.

simon44437
simon44437

Hello all.

I had left TKR 17 weeks ago, have had 16 sessions of PT, do daily exercises and have only got 8-67 ROM.  I've had two reviews with the surgeon - first one suggested I might need "manipulation under anasthaetic" fairly soon if PT made no progress, second suggested waiting a year after the op to make a decision.  PT have told me today they can do no more, and are likely to refer me back to the surgeon.  I still get quite a bit of pain, but main problem is ROM - which makes walking uncomfortable and challenging.  Just wondered if others have had similar experiences and - if so - whether you have any advice to offer.  Thanks so much for this forum, by the way, a great resource.

0 likes, 15 replies

15 Replies

  • irish_linda
    irish_linda simon44437

    Posted

    hi simon so sorry to hear you are struggling abit with the bend ..i think you may do well going for MAU ,its still early days for you and so you might not have too much scar tissue at this stage ,where as if you wait till next year the scar tissue would be harder to break ,ive been in your position but i had a broken leg from thr op so your in a much better position than me ,i wish you the best one bit of advice dont be fobbed off make them listen !!!
    • simon44437
      simon44437 irish_linda

      Posted

      Thanks very much.  I understand the point about being "fobbed off" - thought as a non-clinician it's difficult to evaluate the advice given in hospital.
    • irish_linda
      irish_linda simon44437

      Posted

      there are alot of us on here that have been in your position or similar , surgeons dont tell you all the facts hopefully it will just need an MUA ,but sometimes it has been put in misalighned ,it dose not show up on xray or scan , well mine didnt it took till they opened it up to do it again that it showed . dont worry about that at the moment as it might just need the MUA to get the bend going .been in physio fot that many weeks i bet your exausted from trying so hard when i was where you are i put up with soo much pain trying to get some kind of bend and some days it improved but in no time at all i was back to square one with no bend mine was 70% and after physio hard session 80% if i was lucky and it didnt last how old are you ??
    • simon44437
      simon44437 irish_linda

      Posted

      Yep, I am exhausted. Seemed like wasted effort. I'm 53, keep generally fit, but also have chronic kidney disease which adds to the fatigue. But I'll battle on.
  • AngieJC
    AngieJC simon44437

    Posted

    Simon44437 I had surgery 3 1/2 weeks ago had therapy in the hospital for 3 days came home then went to out patient therapy had 4 sessions ROM is 105% bending and straightening it out is 22%  therapist does my knee cap rolling it feels good hang in there keep me posted 
  • mystical
    mystical simon44437

    Posted

    I had a total knee replacement aug of last year.   By Oct it was clear that PT could not go any further and I very poor ROM, I also had and still have a bowed out knee, which makes walking hard.   My surgeon took me in the OR and did MUA in October.  There is a definite window of opportunity for this procedure, or so i was told by several ortho surgeons.   Its typically 8 weeks post op being ideal.   My MUA did not do any good, in December they did a knee scope hoping that if they broke any scar tissue it would help with ROM, it did not help.   Now that I am 15 months post op from my TKR, my condition is concerned permament.   I cannot straighten my leg at all.   When I entered the hospial the day of my TKR, I could walk without any assistance device, now I need a wheelchair.   I have had three opinions from Ortho surgeons with regards to doing a revsion of the TKR with hopes of being able to walk.   I have two that say it would be a mistake to do it and one says he gives me 50/50 odds it will work.  I dont tell you all this to scare you, but to give you information so you know this has potential of being serious.    Do take it seriously and make sure you get other opinions should the MUA not help you.  I wish you all the best. 
    • simon44437
      simon44437 mystical

      Posted

      Thanks for your comments - and I'm really sorry things have worked out so badly for you.  My PT has advised me that my condition may now be permanent, but one of the surgeons I have seen thinks it may get better.  I have now been discharged from regular PT and referred to a consultant, who I am seeing in a week's time.  I am worse off at the moment than before the TKR, but still able to walk using a cane - though very limited compared to what I used to be able to manage.  I have damage in my "good" knee but - after this experience - will be very wary of having another TKR.  I take your point about getting other opinions.  Thanks, once again.
    • irish_linda
      irish_linda mystical

      Posted

      hi mystical i know how you feel as i was in your position not too long ago, its a very lonely place to be .i too had a few opinions on getting a revision alot of surgeons ran scared to fix a fu*k up knee ,the surgeon that i went with gave me a 15% chance of improvement .i went with it as 15% was better than none .!!! im now 15mths post revision ,while im far from perfect it did improve my bend to the point i can sit without putting leg out in front of me ,my problem before the revision was lack of bend and awful pain .after revision bend is 20 -25% better but yes of course there is a but my straightening is not fully straight annoying as it was fully straight before .so there is for and against a revision .am i sorry i had a revision ?? no im not ,i wish it was a better outcome but i tried and otherwise i would have wondered !!! i wish you the very best
    • mystical
      mystical irish_linda

      Posted

      Thank you for the post.   Its always good to hear from someone that went ahead with the revsion.   I am still so very unsure of what will be the best course for me.   Looking back I see some red flags going into my TKR that I wonder if the surgeon should have ever proceeded.   I had a knee scope in March of last year, five months before the TKR, the hope was the scope would buy me some time, a few years even but it did not work.  However, sometime between May and June my knee "bowed out" funny.   Its locked in that position too.   However, the surgeon said when I woke up from the TKR the leg would be straight, that never happened.   Its so odd to have a leg that feels like its not part of me anymore, that problably sounds odd, but it wont straighten, and if someone tries its like trying to move concrete.   The worst is losing my independance, having to rely on a wheelchair, that is what keeps me thinking about a revission.  If I get the knee well enough that I could walk again, little to no pain, stable where I am not falling, that would be wonderful!   Anyhow, thanks for the post.   BTW, was your revovery the second time around alot worse, I was told to expect worse, and PT would be much more grueling, intense.   
    • irish_linda
      irish_linda mystical

      Posted

      i wouldnt say that the recovery was worse !! because my first knee was done as a bi lateral (both knees done together ) during the op the surgeon broke my leg putting in the implant so after the op i had spent two days in ICU and when i came home i literly hadnt a leg to stand on , the revision was done august 2014 so im 15mths post op its been a long recovery but in saying that the first thing i noticed when i had the revision was how stable the leg felt my bend had improved , as for not feeling that the legdose not feel part of you ya i felt like that id say most would for awhile anyway but since the revision it did take longer to feel mine i put that done to the extra rods put into it to stablize it .dont let the thought of being worse put you off the op what i would say is get a second opinion or even a third one only go ahead when you find a surgeon that you trust and that has a good record with revisions some surgeons are not confident to take revisions on .i changed my surgeon for the revision as the other surgeon broke my shin bone  so i had no confidence in him and you have to have that in my case i had no choice i couldnt accept the way i was coming up to 57yrs and to young to stay the way i was ,you say your having to use a wheelchair thats hard to take so maybe you should look into a revision good luck to you
    • mystical
      mystical irish_linda

      Posted

      Like you I have no confidence in my orginal surgeon.   Finding one that will do a revision, and one I trust is a challenge.   So sorry to hear about the complications you had, glad you are doing better now.  

      I am 49 years old, and yes, far to young to spend the rest of my life in a wheelchair, wondering if it could have got better with a revision.   Best of luck to you...

    • irish_linda
      irish_linda mystical

      Posted

      at your age its your only chance go and find a good surgeon even if you have to travel  you deserve a life lets us know how you get on
  • elent
    elent simon44437

    Posted

    There is a significant body of information that doesn't support MUA in that the results are misleading.  I have read that the majority of the MUA only retain about 10 of their initial number (increase in ROM).  You might want to ask the surgeon before it happens.  

    I can't speak from experience though.  I used a FastTrack system from the day following the surgery.  I wasn't given PT until 2 weeks after surgery.  Only work was done at home.  Ended up very successful -- Maybe pushed too much, but not to a damaging degree.  the logic was to do the most work while under the most medication.  16 days -- 130 and 0.  TKR at 70 y.o

  • simon44437
    simon44437

    Posted

    Saw my consultant PT and surgeon last week.  The surgeon told me that even MUA wouldn't be sufficient to improve my ROM - so I now need another (fourth!) operaton on my knee to remove the scar tissue.  At the moment, still stuck at around 65 degrees ROM, so I hope the further operation can make a substantial improvement.  I would really welcome an end to this seemingly never-ending surgery.
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