6 weeks out after TKR

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Hello everyone Im Manny 52 years young and i had a TKR about 6 weeks ago and have only reached 75 to 80 degree. Surgeon is mad cause its not 90. I go to therapy 3 times a week and they work me hard with lots of pain. I use the CPM machine at home. Sleep with it going 60 to 70 all night. In the day I get it up to 95. Don't understand why I only get 75 to 80 at physical therapy. Very nervous But pain under control at home. At therapy not enough pain Meds for that. Should I worry or am I going on schedule. Any suggestions out there.

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15 Replies

  • Posted

    Good morning willdo. Do you do you physio at home between trips to the Physiotherapist? Personally,I would try to keep on top of this and use any help you can to improve your bend. I speak from experience as I am 18mnths post op and although my bend was good and getting better, that all changed and now I only have 90 degrees,lots of pain and looking at revision surgery! If you are relatively pain free,try using your stairs to do lunges.
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  • Posted

    HI my name is Sarah I'm 53 live in UK and had PKR about 15 weeks ago now...I didn't do any physio for the first 2 week's as just too much pain(and I'm good with pain usually!)then had to do physio myself as none available...thought my bend was useless so when I saw consultant at 6 weeks was expecting to be told I needed MUA but no...He didn't even measure it said that looks good about 90°....I have since done a bit of physio at hospital and got to 115°...However leg still not straight. The best exercises I found that helped was sitting on a normal dining chair with another in front of you and putting leg up allowing gravity to pull the knee down...yes it hurts but persevere it does help and then sitting on dining chair and sliding your foot backwards as far as it will go and then back again...I have laminate flooring so with my lovely socks on it worked but if not a lady at a class I went to said she uses a mini skateboard and it worked well...I'm sure you will get there it's a long process....good luck
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    • Posted

      My PT told m to sit on the tailgate of our truck with legs hanging down.  Swing leg out and down.  It is great just being outside watching nature exercising that leg.  You don't even realize youre exercising.

       

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  • Posted

    The longer it takes the harder it gets. Not very encouraging is it. I'm just at 6 months. I really have no idea what degree my bend is. It goes straight pretty well (sitting with my legs out straight has made that possible). One of the things that helped me when I wasn't with the PT was sitting on the edge of my bed (you need something with enough height, but not too much) bending my knees naturally below me (like you are sitting, with feet firmly planted on the floor) and then sorta scootch to the edge of the bed, forcing my legs to bed. I'd do it until it was uncomfortable and hold it for about a 10-15 count. Return to the starting position and then start again. Hopefully, you will be able to push a little further each time. And if you need to, readjust the initial bend so you get all you can out of it. I still do this when sitting. The more flexible you get, the more it will be present for the PT to see as well.
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  • Posted

    I have been using a cpm machine also at home, I could not understand why I could reach 90 on the machine but when I got to physio it was nowhere near, the physio told me that the cpm bend is passive excercise and that to reach 90 in"real life" I would need to acheive 120 on the machine. Like you I am at almost 6 week. Mt physio told me to stop the cpm and begin a more active excercise regime, hpoe this helps stay in touch
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    • Posted

      I used the cpm thing in the hospital and it said 101 . . which was absolute rubbish because it couldn't have been more than about 70!  I don't think they are very accurate. . a good idea, though, when you first come out of surgery!  I only got two half hour sessions, so I don't really think it was a lot of good!

       

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  • Posted

    Hi Manny, you've had some great suggestions for home excercises already, but I'll add my 2 cents worth anyway. As some of the others know, I can drone on and on about hydrotherapy, but for me it's been a life saver. The water temperature (about 34 degrees) enables you to relax while excercising. The first few times, you'll most likely feel exhausted afterwards, and possibly hurt as well, but the gains are amazing and after 2 or 3 sessions you'll only feel tired when it's over. You never push so hard that it hurts, and if it does, then you stop. The physios at my local hospital's hydro pool have helped me reach 132 degree bend at 13 weeks. I also excercise at home and visit a physio on dry land once every few weeks or so.

    I'm in Australia, and I only needed a GP's referral to get into the hydro sessions, so I don't know how it works where you are. It just might be worth while investigating, seeing as the pain seems to be a real issue with your physiotherapy. And try not to worry too much about where you are with your bend. As everyone here knows, we're all different and heal at different rates.

    Best of luck

    Denise from Oz

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  • Posted

    Lots of support and advice for you in these comments, but looking at what you have posted I wonder if you need to look at your pain relief regime as you say the pain is OK at home but not at physio.  I think we all have to accept that this stuff can be excruciating. I certainly found that some exercises when first introduced literally made me cry, but they are necessary. So, how about ramping up your pain relief ahead of physio sessions so that you can really push it? Afterwards you can rest and ice knowing that you have really given the session everything.  Once you know that you can cope by managing the pain well it is so much easier to really use the physio session rather than fear it.

    best wishes.

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    • Posted

      Hi Sparklyrockgirl. I take one (1) 10-325 Percocet every 4 hours and when I go to therapy I take two (2) 10-325 Percocet and a 10mg Valium tablet per surgion order and I'm still in lots of pain. Of course they puch a lot more than I do on my own.
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  • Posted

    Exercising is so important for improvement.  However, you need adequate pain relief to exercise efficiently.  I am now 7 weeks post op BTKR & saw my GP on Friday to get some slow release oxycondone again as the milder meds where just not doing if for me & I was not progressing.  She understood & agreed that it is important to have adequate pain relief supplemened by paracetamol. 
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  • Posted

    Sparklyrockgirl is so right, Manny. I'd forgotten how important extra meds are before physio!
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  • Posted

    I want to say when i first posted this i thought i was at 6 weeks. I was wrong it was 5 weeks now im 6 weeks.

    Well thanks to everyone's advices. I've tried most to all and I got to 86 degrees from 70. I am on more pain then before so still taking my 1 Percocet 10-325 one every 4 hours. I take 2 Percocet 10-325 and 1 Valium 10mg when i go for physical therapy and it doesn't take away any pain. Don't know what else to take. I am still very swollen they gave me a knee rap to push the swelling up and away from my knee with no little help. They gave me new med for inflammation Celebrex 200 mg and don't feel any difference. My appointment is on the 27 May with the surgion and it looks like he may go the manipulation way. I am very worried and fustrated. Starting to think why I did this.

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    • Posted

      I was just under 90 at the six week consultation . . I don't understand quite why you are so worried?  Don 't just let the surgeon have his own way . .think about it yourself. It's up to you what you do.  If you are still in a lot of pain, and inflammation, that may very well be part of difficulty in the bend. I'm now at 120, and working slowly at improving.  At 12 weeks I was still at about 100 . . and gradually improving.  I don't believe in this magic 'six weeks' business. . . as if you have to have achieved something specific  by that time.   Don't let anyone bully you! 
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    • Posted

      I think most of us understand the frustration of wondering why you did this. But you are still in the early stages. It's a long road ahead. I'm just over 6 months and last night I sat with ice on my swollen knees. I'm moving up and down stairs (walking them normally, but not running them), and even managing getting up and down from a sitting position on the floor (not really a pretty site, and using a lot of upper body strength), but I'm functioning really well. But there are still struggles with stiffness and odd pains and swelling. But my life is so much better than it was before the bilateral TKR. It's easy to get into that rut, and luckily you have this great group to help walk with you and pull you out.
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