doctor not happy with my bending after 2 weeks total knee repalcement

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I am so depressed. I went to the doctor to get staples out today (two weeks two days post op.) and doctor not happy with bending of knee. It is at 66% and when I left hospital it was at 50%. My home health therapist was happy but the doctor said if things don't improve in six weeks of out patient therapy he would have to put me back under and manually manipulate it then go through intense therapy. Should I be able to bend it that much more at this point. There is still extreme pain, stiffness and swelling. I have gone from a walker to a cane but walk real slow. I need encouragement. I am a 53 year old male.

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  • Posted

    Hi Mark 

    i had my op just over 2weeks ago 

    I went to physio and only had 60 degree bend by the time she'd done some manipulation it had reached 70

    she was quite satisfied at that. But I guess your physio expects more 

    just give it time and do the exercises...it will come eventually

     keep smiling or ( grimacing) with the pain like I try to do.

    take care 

    Jean 

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  • Posted

    Hi Mark

    Try not to get too downhearted, I am now 13 weeks Post Op and have probably got about 100 - 110 degrees. At 2 weeks I had little more than you, when there's lots of swelling flexion is really difficult and initially my Physio made me concentrate on getting the leg straight which results in a more stable leg. As the swelling subsides the bend will come but it can be a long slow process, hang on in there, take your pain meds regularly, exercise regularly and things will get easier , , , , honest. This op is so traumatic, emotionally and physically and it sounds like you're doing well if you're already on a stick, at 2 weeks I was still on 2 crutches so well done. I am a youngster like you and I think the tendency is for us to set our expectations a little higher because we have age on our side. I think patience and acceptance are the key, one day at a time whether it's good or bad and soon it will be weeks and you'll be getting there. All the very best

    Debx

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  • Posted

    The depression is normal, we have all been through that stage .they wouldn't let me out of hospital until I could reach 90 bend ... Use loads of ice to relieve swelling , Take max pain relief including anti imflamatory and try to push your bend as far as you can . It will hurt , you will feel as though the stitches will burst , but grit your teeth and keep trying bit by bit , push with your hands just a little further every time .. You can do it ,and you will improve very slowly . Good luck x
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  • Posted

    Hi Mark144830, I'm noy sure whether you are a UK patient or from elsewhere in the world? I am intrigued when reading the posts on this Forum because there seem to be so many different expected results, and the operations themselves seem to differ too, depending on where it's been done, or who has done it.

    I had both knees done at the same time. I am in Perth Western Australia, and because I'm a big girl with Atrial Fibrillation, Hypertension, Blood Clotting problems, and hadn't a decent leg to stand on, the surgeon opted for both knees to be totally replaced at the same time. It's not done often, but he felt I would cope well as I have a very high pain threshold, and he was correct. I run a business, am 65 now (63 at the time of the op) and he spent an hour explaining what would happen, what was expected of me, and what results I would get at what time post-op. The op was done, i was in hospital just 5 days. Physio was started the day after the op with me standing and using an elbow style walking frame so I could get myself to and from the bathroom etc. I was also expected to practice bending the knees as far as I could at least 10 times per session, 5 sessions over the course of a day, with supervision by the in hospital Physio for one of those sessions. This was all done whilst I still had drains and drips in place. My surgeon doesn't use staples. He uses soluble stitching which is done below the skin, and the knees are dressed with a non allergy dressing first, then cotton wool padding then crepe bandaging all to stop any injury occuring by knocking into something etc. The dressing and bandages stay on unchanged for 10 days unless there's leakage or the bandages get wet when showering. We have plastic pull on leg covers for showering which seal at the thigh so no water can get in....

    By the third day, I was off the elbow walker, and was on the Zimmer walker for half a day only, because my physio was so pleased with my progress, she said onto the elbow crutches. Once on those I was encouraged to do at least three sessions of walking up and down the hospital corridors, and, when the physio was with me, the length walked was increased and I had to practice going up and down a flight of five stairs! I hated that bit, as I felt uncertain, but I knew that unless I could show I could do it without her assistance, I would not be allowed home, even though we dont have steps or stairs at home, those were the rules! I also was expected to have 90 deg bend in both knees, and the legs should be able to be fully straight too, before leaving hospital. And that was indeed what happened. I was sent home on the 5th day, having shown I could do all that. I was expected to continue doing the physio myself at home for the next 5 days until getting the wound redressed and checked as an outpatient at the Surgeon's Rooms. At that point I was then told to make a weekly appointment with the physio and work on myself at home to increase the bend and strengthen everything.

    So, you can see why I'm intrigued that you only had a 50 deg  bend when you left hospital and now have it at 66 Deg. Because I have such a high pain threshold I can't really comment on your pain, but my Surgeon strongly advocates getting the pain under constant control so that the patient WILL do the exercises needed to get the best result from the surgery. Even though I do have such a good pain threshold I was on OxyNorm and Tramadol pain meds when I came home, and after finishing the OxyNorm I remained on the Tramadol three times per day for around three months and then just twice per day after that.

    It's important to do the exercises set for you at least three times but preferably 5 times per day. Get the leg up high afterwards, and ice it for 15mins per hour  to get the swelling down. My first session was always before taking any meds, and as soon as I woke each morning when my legs were at their slimmest, having been rised high each night. I always got the best bends of the day first thing smile.

    Don't get depressed Mark, get moving instead and track your own results. Measure your swelling each day with a dressmakers tape and note it. Do it first thing, midday and evening and see how it varies. Try to get the leg up as often as possible, and make the getting up and down from chairs/toilet etc as easy as you can for yourself as possible, as doing squats puts enormous pressure on the knee joint, and my physio tells me to tell anyone to B Off if they want me to do deep squats!  If you've read any of my other posts, you will see the op was not all plain sailing for my right knee, but it certainly was for my left knee which really is as good as new ! Good luck Mark, don't get depressed, we all repair at different rates, and attitude is a huge factor.  It's not a quick fix op. it takes up to twelve months to be 'normal' and that's if there's no major problems, but believe me, if you do the work, it is really good to walk without pain (which is true for my left, and will eventually be true for my right knee too). Go for it mate, (Aussie speak biggrin and let us know how you go. It's good to read other's journeys too, but don't get bogged down by it.... Cheers,

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  • Posted

    How is the flat. My therapists and surgeons have always been more concernedd with getting it back to zero. Try pain meds about an hour before you start the therapy sessions and ice all the way around the leg, not just the top of the knee. Perhaps the therapist needs to re-evaluate your routine.Whe I had my 1st go around 10 yrs ago, they made you ride a bike for 20 mins then lay down on my stomach and the therapist got on my ankle and pushed my heel toward my head. I can tell you that brought fist pounding, tears, swearing and threats. 10 yrs later, whole program out the window.keep working keep icing
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  • Posted

    Hi Mark. I am also 53 and 7 wks post op. My knee is so swollen still (6 inches bigger than my good one) and I have only 90degree bend. It has been that since I came out of hospital after 6 days!! I got so fed up a couple of weeks ago after doing loads of exercises and ice packs for it to make no bend improvement. However, my physio therapist (or terrorist depending on your view lol) told me that with the amount of swelling I shouldn't really expect much better until it goes down a bit. I can straighten to zero which is something I suppose.  Try not to worry too much. Exercise and ice - as everyone keeps saying - and you will get there. Unfortunately it does take an awfully long time. You are still very early into you recovery but doing so well to be on 1 stick. I  still use 1 if going outside as I am nervous about falling - had several tumbles before op. Take your meds an hour before excercise and ice well after. I really do know how you are feeling and sympathise with you. Push that bend as far as you can stand it but don't over do it. I'm off to physio knee class this morning and hope for at least a small bend improvement but hey oh if not I'll keep trying! Good luck Mark and keep at it. All the best x
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  • Posted

    Hi mark I too am feeling particularly useless today. I had my staples out on Tuesday at 2 weeks post tkr my bend is at 80-90 degrees but after a very bad night my knee is really really stiff and more achy than it has been really don't know what to do with myself today ice isn't helping and it's really getting me down. I'm a youngster too at only 44 I feel completely trapped in my flat at the moment. 
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  • Posted

    Hi Mark, My staples come out next Tuesday, the district nurse  is coming to do them. I had to reach 90 before I was let out of hospital but I'm sure I couldn't do it now.It was really forced to get there and hurt like h.... My surgeon was more concerned with my straight leg and that's what I'm concentrating on becuae it was permanently bent before the op. Straight is the way to go.
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