Can someone tell me what degree of bend is aimed for when?

Thank you Cheeky:-))))  That's really helpful to know - to just push gently until it's slightly uncomfortable sounds really accurate instructions - just what I needed:-))))  That's brilliant that your consultant was so pleased with you too!  That is so rewarding, isn't it:-))))  Well done!:-))))

Right, good to know that 120 is what we're aiming for.  I hope your pain eases as soon as possible.  Yes, you're right in that we're all different and I've seen that the same person can have a very different experience from one knee to the other, so it can vary hugely!

Aim for more if possible, but I believe 120 is counted as a 'success' . . . 

I saw my doc at six weeks and was -5 / +110.  Took another six weeks of PT to get to -1 / +123.  Just takes work and determination.  But some people cannot reach the 0 / +120 goal or even close to it and need the manipulation.  Remember there are advances, setbacks and plateaus...the worst.  I was stuck at -4 for weeks before breaking through.  I think you'll be fine.

No he hasn't. I see him again in 2 weeks. Gosh I hope I "pass"!!

I went as far as not going to pt last week. And had my best week in 3 months. Unfortunately I overdid it with sitting over an hour without elevating and that set me back a couple of days. I am going back to pt today. I am seriously considering telling him if he hurts me today I am changing therapists.

Thanks Martinarvelo.  To be honest my worry is about hyperextending rather than getting it flat.  For the first day in hospital it felt as though it was going too far back and the physio said not to do the exercise pushing the back down for a few days and even now I'm only doing them a couple of times a day and not too many repeats.  The foot actually comes up off the bed when I push the knee into the matress.  I don't really want more than that.  It did feel as though I had a thick dressing round the back of the knee at first as I pushed down because of the swelling but that's going down a bit now.  The physio I saw at the hospital seemed to expect me to go at a slower pace than I'm actually acheiving, and I'm not pushing anything at all, but just doing what feels comfortable.  I agree - why make things more difficult to achieve something faster when patience will do it without pain:-))))  I will do it gradually but be consistent with it.  My aim really is to be able to walk without a limp or sticks at 6 weeks and get reasonable flexing then, so they'll put me down for the next knee about 7 or 8 weeks after that:-)))))  But knowing what the expectation is of degree of bending helps hugely!

We went out for our first treat today and I walked eight minutes each way to get to the place that does lovely cakes:-)  Good motivation:-)  It's back to the ice and elevation now:-))))

That sounds almost barbaric Milla!  I would find that offputting too!  I think you're right to think about changing therapists!  It makes me glad I just saw one at the hospital who issued us with instructions and then left us to get on with it - that's definitely better than someone pushing too hard!

ah very wise . . a negative extension is definitely not what you want!  I have that on my 'good' knee, and if it ever needs a replacement (heaven forbid please!) I believe it makes it difficult, if not impossible.  120 at six weeks would be exceptional!  You can get a goniometer for measuring bend on amazon . .very cheap, four or five pounds . . I found I was over estimating the bedn before I bought the goniometer.  it's just a bit of plastic really!

Thanks Chico!   You're right - I want to be the best I can be and I don't need to compare to others, but it helps to know what to aim for:-)))  I've no doubt that it is going to be the quads that need the work!  Living in a bungalow for 30 odd years and not doing stairs at all for 10 years, I KNOW there are weaknesses there, but I'll do my best to improve it.  When I read the other day that when both knees are done I should, after exercise, be able to stand up without leaning on arms of chairs, that was one of those mind blowing moments!  I suspect, because I have joint hypermobility, the bending issues  won't be my greatest problem, but the need to build up muscle more probably is, even though I was doing the treadmill and recumbent bike most days before the op.

Here's how you get your quads back...

https://patient.info/forums/discuss/post-tkr-exercising-565527

Designed especially for us by a real pro with credentials to die for...

Ah but,  how long after the op is it reasonable to expect a gain from pain of bending.?

in other words,does there come a time when it is not possible,even with the best will in the world,to achieve any more "success"?

mike

"Will" is only part of it.  There's the physical structure of the implant and surrounding structures.  Some people can't get the bend the surgeons want so manipulation under anesthesia is sometimes performed.  It's all very individual.  If someone cannot achieve optimal 0 / +120 ROM or even close to it, further procedures in PT and by the surgeon are available after consultation.  I don't know the percentage of people who have this done but there are contributors on the site who can tell you more about it.

For me, personally, it took 10 weeks of PT @ 2x/week plus all the home exercises to go from -14 / +84 to -1 / +`123.  Lots of pain and hard work but it paid off.  There are advances, setbacks and plateaus...the worst.  I got stuck at -4 for weeks before I broke through that barrier.  Don't quit on yourself.

Ok,so I suppose the rule of thumb is , if one is still achieving progress,however slowly,then the knee is still responding to dedicated exercise.

i just wonder how long the knee might respond in this manner ie post op.

But you've certainly cleared up a lot of my query so thank you.

rgrds

mike

If you're less than 6 months post-op, you still have to work at this...a lot.  Even after that, there's work to do rebuilding all the muscles to support the knee...

https://patient.info/forums/discuss/post-tkr-exercising-565527

For most of us, this whole thing takes a year.  I'm one year right now and still working at it.  

As far as pain is concerned, this is a HUGE generalization:

- 0 to 3 months: Major pain, opioid use, no  work, little or no driving, little sleep, painful PT ROM work

- 3 to 6 months: Decreasing pain, minor pain killers, maybe go back to work if you're lucky, more driving, learn swelling control, increased exercise

- 6 to 9 months: Little pain, should have the swelling under control, good exercise routine, definitely back to work

- 9 months to 1 year: Almost zero pain and swelling, regained strength, virtually back to normal

- After a year: Could have stiffness, a tight band feeling plus clicking, clunking and popping sounds for up to 18 months or more, ability to go up and down stairs unaided, no real pain.

Again, a HUGE generalization...all depends on the individual.  Lots of people will report fluctuations within those categories but most everyone's done in a year.  The problem is that you have no sense of time while you're in the middle of it...you just want it to end.  When you're past it, you can look back and see the milestones for yourself.

Please don't think I'm bragging here - I KNOW I've been lucky and I know the other knee may not go as well (but here's hoping!) But it's my new knee's two week birthday today (or as Husband calls it, Denise).  I used a wooden yardstick to measure how far back the knee is going when straight and it hits the yardstick all the way.  There is still swelling, so who knows,when the swelling has gone there may be a gap.  But at the moment it's flat against the stick.  I can just about get the bend, when sitting, so if I hold the walking stick straight up from the toes, it hits the knee, and am working on that more.  The pain aspect for me has been absolutely minimal - nowhere near the pain of the arthritis.  Last night the meniscus ligament was a bit uncomfortable but I put that down to my first walk out yesterday so today is resting and icing and elevating.  But every day I'm passing new little milestones which are cheering me on.  I went from crutches to sticks two days ago and that's working fine.  I've certainly had my moments of anxiety but so far it's been amazing!  I wish the other knee was as good, but hopefully that will be done before long!

I think there probably is. . that is why I don't believe you can wait for pain to disappear before trying to get a good bend.  By then, muscles and flesh will have grown together, tendons will have shortened, and a good bend is likely to be pretty impossible.  Indeed, i know someone personally who took to her bed and refused to move because of the pain,  .and she is still there three years later.  She is morbidly overweight which probably hasn't helped!