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Six months after TKR and ROM still only 80%

Posted , 12 users are following.

dode
dode

Good morning all. I haven't posted on here for a few weeks now so thought I'd share where I am six months after my TKR. I've encountered problems with stiffness and ability to bend my new knee fully since the operation. I had to go into hospital a few weeks ago for a manual manipulation under local anaesthetic. This temporarily improved the movement to 95% but of course when I went home from hospital the situation couldn't be sustained. I do exercises every day, focusing mainly on bending the knee as much as I can. I can walk fair distances but still have difficulty with stairs and getting in and out of cars as a passenger (driving isn't a problem). The knee does swell occasionally and still feels very tight at times. I'm still taking co-codamol and naproxen now and again, the latter for my back problems and arthritis in the other knee! I just wondered what others might think about where I should be six months after my TKR? I don't see my surgeon again until mid-January and have just started a course of hydrotherapy. Cheers!

3 likes, 23 replies

23 Replies

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  • carol38467
    carol38467 dode

    Posted

    Omg! Your story sound like mine.  I am 1 year1 month on and have had MUA too, temporary improvement.  Had x ray at 1 year, surgeon thinks he did a lovely job but cannot help me so good bye!!!!

    i get very down but would like to hear suggestions.

    carol Scotland

    • dode
      dode carol38467

      Posted

      Hi Carol. Sorry to hear you've had problems too. I get down too and frustrated but my surgeon told me to be patient! My post-op physiotherapy plans were very poor and I've pretty well had to do the recovery myself. Sometimes I get down too wishing I could be 'normal' again and my other knee doesn't help. The one good thing is that the arthritis pain disappeared the day after the TKR. Keep positive and exercising but I feel I need to have some pain relief if I am going to achieve an improvement in bend. I see you live in Scotland so the cold weather doesn't help knees! As an exiled Dundonian living on the south coast, I don't miss that part of my homeland! Good luck Carol.
  • simon44437
    simon44437 dode

    Posted

    Hi Dode. My story is similar. I'm just over 4 months lost TKR and have a FROM of 67. I still get quite a bit of pain, but it's the lack of flexion that really bothers me. Stairs are difficult and even walking isn't that easy - I get very sore if I walk too much. I haven't had MUA but it has been suggested, and I'm seeing a consultant physiotherapist next week, so hope they can come up with a plan. Never thought it would be this bad. Anyway - good luck to you.
    • dode
      dode simon44437

      Posted

      Hi Simon. Sorry to hear you are having problems too. It is frustrating isn't it. I don't get pain when walking it is just the stiffness and swelling and other pains that hitherto I didn't have. Apparently scar tissue is the cause of much of the pain and stiffness. When I had my MUA it was bizzare as I watched the surgeon bend my knee to 100% and he was listening to the scar tissue snapping! Clearly the MUA is well-intentioned but you can't maintain that level of flexion and it is bloody sore afterwards. I am hoping my new knee will get to about 95% so that I can bite the bullet and get my other knee replaced sometime in the next year. Good luck to you. I'd say medication and icing help but the downside of medication is that it can make you feel terrible. All the best.
  • sueisobel
    sueisobel dode

    Posted

    Six months is still very early days.  For it to heal completely you have to think more of 18 months.

    Underneath your scar is another scar, this will also tighten if not exercised/stretched. After you have your operation and before they wheel you into recovery, your knee will have been bent, straightened, pulled all sorts of ways, (a) to see that it is correct and (b) to see what the eventual range will be.  When you go for manipulation the same thing will happen, this is why you are in so much pain after.  You know how it hurts when you bend too much, imagine what it would feel like if they manipulated  without knocking you out first.  They know what your knee can do, which is why they push you so hard.  By bending your knee will "stretch" the scar and undo any stickiness under the surface of the top scar.  Concentrate on working your quads (ligaments and tendons), walking up and down the stairs in an exaggerated manner is also good; just make sure you are hanging on the sides as you do it (if you are not confident enough to walk down the stairs properly, walk down backwards).  Swelling is the fluid that accumulates, it is your knee's way of protecting itself.  As you have arthritis in the other knee, the way you walk will be affected.  Try to sort out your back as that is also a main contributor to how you walk, how your knee will heal etc.  Try not to knock yourself out walking, you are not doing yourself any favours.  By working your quads (which you can do anywhere, any time, even when you are resting) will give you stability and help align everything else that goes over your knee, down to your calf.

    Take your meds on a regular basis as that too will help with the healing (who wants to exercise when in agony, it is a vicious circle as you have to work through the pain).

    Hydrotherapy is great. Go for it, Just don't overdo it, you will be amazed at what you can do in the water, so much so that you can actually do too much.  If you are in a group you will have an instructor so you can be guided by them.  Some of the exercises you will be able to do in the bath!  In a few months you will be able to cycle (if you so desire)

    Don't be in a rush, remember the tortoise and the hare fable 

    • dode
      dode sueisobel

      Posted

      Thank you so much sueisobel. A great post and lots of helpful information. Yes, I guess I am a bit impatient and frustrated. If I can get a good run at the hydrotherapy and keep doing my exercises I am sure I'll improve in the end. I have sponsylosis affecting my lower lumbar plates which is why I have back problems though I do daily back stretching exercises too. Some days the back is fine and others quite sore. Much appreciated and thanks again.
    • sarah87162
      sarah87162 dode

      Posted

      Don't give up!

      It took me about a year to really begin to feel the benefits of TKR.

      It is a long hard road, but for me it has certainly been worth it in the end.

      Take care and keep in touch

      Sarah

       

    • dorothy41374
      dorothy41374 dode

      Posted

      Hi i am just over 4 months and i still have problems i cant walk properly as this is what is getting me down i can bend it so far baxk and i still get swellimg in it i have no pain so off all medication i went to see the doctor and her said we wont see a result until a uear so hope every thing goes ok for u xx
    • sueisobel
      sueisobel dorothy41374

      Posted

      If you are getting lots of swelling, when you rest, prop your leg as high as is comfortable, when you walk try putting your heel down first then roll onto your sole before bring your other leg through, sounds weird I know, but once you get into the rythym it will be easier + you will be using your muscles int he "right order".  The swelling is there for some reason or another, so rest as much as you are exercising
  • patsyrose
    patsyrose dode

    Posted

    Hi Dode

    I had a similar issue with my second TKR...at 6 months I had an MUA, but my leg was still not straight.  I was told to keep on exercising it, but it got steadily worse.  My surgeon advised me a further 4 months on that it would be excess scar tissue and would probably need to be addressed at the year stage.  I had my knee opened up again in Sept and my leg was straight.  Unfortunately, 9 weeks on it's beginning to stiffen up again and I can no longer get it fully straight.  It is better than it was post-Sept though.

    • sueisobel
      sueisobel patsyrose

      Posted

      It is your scar that is stopping you from straightening your knee.  Keep on with exercises.  If you are working or sitting a lot at a desk, here is what I do.  Bend your knee back to a comfortable position, then every so often, with your other leg, push your leg further back, just enough to feel a slight twinge (not pain), keep it in that position for half hour or so, then push again, this way you will find that you and your leg will have relaxed enough to actually feel the benefit.  Even if you only did it a couple of times a day, after a week or two you will still feel the benefit. Whilst you are doing this, push don on the sole of your foot, as if you are trying to push yourself up, you will feel your muscles tension, hold for counts of ten (more if you are brave).  These are great if, you don't have time for exercise, going to the gym or it is too painful to walk, you can do it by pushing the whole of your foot on the floor, but with your knee pushed back under the chair it can be a tad uncomfortable.

      Once you have a decent enough bend, without the pain, you should/might find that you can also straighten better.

      The main thing is to work on your quads, they are the main muscles that dictate everything you want your knee to do

  • RethaT
    RethaT dode

    Posted

    Hate to hear of your pain!  I am 2 months post PKR and will have my second knee done in two weeks.  I'm no expert, but the best thing I have found, and heard from other people, is using my stationary bike.  It helps the stiffness so much!  Good luck to you!
  • AngieJC
    AngieJC dode

    Posted

    Ok guys I'm 5 weeks post op TKR how long does it take to straighten so I can walk and get off my walker please help  my dad wants me to say to the therapist lets take a few steps with walker what do you say guys 
    • sueisobel
      sueisobel AngieJC

      Posted

      At five weeks you should be able to walk with a cane. As for being able to  straighten your leg, you need to have been working on your muscles.  The main one; your quads is the most important, by working on these will eventually give you the ability to straighten and bend.  If you are careful, you should be able to start now.   Lay (or sit)  on the floor/bed/sofa and see if you can lift your foot up, may only be a little bit and your leg will wobble as your muscles are weak.  The same for bending, it will HURT.  But all this is natural.  Yes you can take walk without your walker, and if your stitches are out, bend your knee, but saying all that would be irresponsible of me.  I don't know your history or what the consultant/ physio therapist has told you.  What you (and your dad) have to remember is that you have had major surgery.  It is nothing like fixing a broken bone.  Your tendons and ligaments have been hauled around, nerve endings damaged; this all takes time and there is no quick fix. 
    • RethaT
      RethaT AngieJC

      Posted

      I don't understand....I think most people are walking with a walker before they leave the hospital.  I was taken to physical therapy and taught how to use the walker, as in going up and down stairs and sitting down and standing with it.  Were you not walking at the hospital or do you mean you're just not walking well?  My doctor required that I use a walker for six weeks but I was more less walking on my own just having it as a stabilizer at 4 weeks.  I couldn't wait to get rid of it at six weeks!  Make sure you are doing your exercises and if you have a stationary bike, that is great for helping your bend and building your quads.  Also, sitting in a chair and bending your knee under you is a great way to stretch.  
    • sueisobel
      sueisobel RethaT

      Posted

      I guess then it must depend on areas/country as all I had was a cane. The walker was used only for the 1st day out of bed.  Should imagine using the walker all the time around the house must have been a bit cumbersome :-( 
    • RethaT
      RethaT sueisobel

      Posted

      Yes, it was!  I didn't like it at all but my doc said he is somewhat conservative but if I did what he said, I would do fine, and I have.  I know lots of people with TKR & PKR are just using a cane right away but I wanted to follow the docs orders.  I was afraid to quit using it, then something happen and I'd have to tell him I wasn't using my walker!  smile
    • patsyrose
      patsyrose RethaT

      Posted

      At my hospital (in the UK), you only use a walking frame the first day you get out of bed, then you are on crutches well before you even leave hospital...including being taught how to go up and down the stairs with them.

      after a couple of weeks you can probably manage without either at home, but would still be walking with crutches outside.  Then working down to one crutch, and then a stick or cane.

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