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Flexion contracture

Posted , 7 users are following.

Kathrynt823
Kathrynt823

i had a tkr on my right knee on may 10.  After three knee scopes I finally found a doctor that I could trust and who would listen to me.  I had a 26% flexion contracture so bad it was effecting my hip, back, legs and feet and I was in pain 24/7.  My current doctor told me that I should never have had three scopes because it's what lead to the severity of my contracture and I needed my tkr done years ago even though I was only 55.  I'm finally at about  6-8% extension at ten weeks and getting better slowly with the help of a hinge type brace I use three times a day for thirty minutes to work on both my extension and my flexion but it is so painful.  I'm concerned about going back to work even though I sit about 60% of my shift because of the stiffness, pain and lack of sleep.  Has anyone else had a flexion contracture or used the brace to help?  I'm also quite depressed.

0 likes, 16 replies

16 Replies

  • CHICO_MARX
    CHICO_MARX Kathrynt823

    Posted

    Read the Post-Op Depression section...

    https://patient.info/forums/discuss/the-tkr-experience-or-wish-i-had-another-kidney-stone--524499

    Totally normal for ALL joint replacement patients.  Problem:  The docs NEVER talk about it.  Now that you know what it is, kick it out the door.  Drugs are NOT needed.  Jedi Mind Trick...really...

    Back to work...posted this elsewhere but here it is again...

    ------------------

    Less than 4 months?  Maybe not such a good idea...maybe.  After reading "billions and billions" (Carl Sagan) of posts, here are some thoughts...

    1. It's all very individual...some people can handle it at 4 months, most have problems.

    2. Depends on the job.  Desk work, although difficult sitting in one position for hours, is doable but still painful.  Nurses running the hallways is near impossible.  "I will b on my feet for 7 hrs" puts you in the latter category.  Teachers have the same issue.  Construction and factory workers...not a chance...maybe...there are individual exceptions.

    3. The mandatory requirements for returning to work are: 1. You are off the opioids; 2. You have done the PT to get your 0 / +120 ROM back; 3. You've done a significant amount of exercise to restrengthen your quads, core and glutes to support the new knee; 4. You are mentally strong enough to handle your workload.

    4. Those who go back to work too early report a lot of problems with pain and especially swelling.  Their work pushes the knee beyond what it can take at that point in their recovery.  So they report waking up, going to work, having increasing pain and swelling throughout the day, getting home in a lot of pain, icing and elevating as best they can and then having trouble sleeping because of the pain.  THEN, they wake up the next day and have to repeat the cycle all over again.  Not a pretty picture. 

    5. The majority of people report returning to work around six months, some a bit sooner.  At that point, pain and swelling don't occur as frequently. 

    Again...all individual.  We have had some people on the Forum who have gone back to work in the 3-4 month range, deal with their issues and get past it...they are not the majority who have tried it at that point in their recovery.

    For you, be prepared for the worst and hope for the best.  I'd be exercising my butt off right now to be as strong as possible.

    ------------------------------

    These might also help...

    https://patient.info/forums/discuss/the-tkr-recovery-bell-curve--563756

    https://patient.info/forums/discuss/tkr-and-ptsd-569521

    Click on my picture and the "See All Discussions"...lots out there...

  • j21370
    j21370 Kathrynt823

    Posted

    Hi Kathryn -- I use a brace for my bend and extension. I use the DynaSplint brace. I do ok with the one for the straightening the leg, but the one to bend the knee it makes my knee hurt more. However, I had my TKR 9 months ago and been having problems with the bend. I exercise my leg everyday- not the same exercise, but still can bend it no more than 105-110. I am going to continue to use the brace for another week or so and if my knee continues to hurt I am stopping it. This is after I see my surgeon and seek his advice. Hope you feel better. Your concern about returning to work -- it takes a while for the knee to heal. There are people on this forum that have done extremely well and back to work in a couple of months. I am still dealing with my knee and the pain. For me I still use ice even though it doesn't swell too much. Please keep us posted. Good luck. J-21370

  • jenny80029
    jenny80029 Kathrynt823

    Posted

    To be at 6 to 8 is brilliant, especially bearing in mind how things were pre op. I do feel for you. I had a 10 degree flexion contractor pre op. I limped a lot of the time, and it affected hips and foot. Much less in degrees than yours even.

    So remind yourself that even though this experience presently is still very hard, you are on a road to improvement now. Just beginning. I would have thought you have a lot of anger about the past...I certainly did, and still deal with some at 5 months post op. Counselling may be a good idea, or journaling, something to help with coming to terms with things. Not being listened to when in pain and disabled is very distressing. When are you due to go back to work? Are you in UK? Maybe going back part time is an option?

    • Kathrynt823
      Kathrynt823 jenny80029

      Posted

      I have a lot of anger at my first orthopedic surgeon and the fact that he just kept doing scopes and ignored the problem with the flexion contracture and still wanted me to wait five more years.  
  • Need1knee
    Need1knee Kathrynt823

    Posted

    Here is my splint story... At my 6 week check up, my bend was OK but my leg wasn't straight enough. It was -8. I cried when the doctor told me I needed a splint and I cried when the representative came to my house to fit it on my leg. The doctor said, "in six weeks I want your leg at zero", and "just wear it for 6 hours a day while you sleep"...yeah......riiiiiight. What made him think I was sleeping??!! But, I started wearing it on a low setting. I kept a journal and wore it every day between 1-4 hours spread out over the course of the day and night. That's all I could do. My pt said she felt a positive difference, that my tendons and scar tissue were softer. So, yesterday was my 11 week check up. My leg straightens to about a -5. (-4 on a good day).

    Still wear the brace. The doctor said to use it for 1 more month an pt for 1 more month. And I'm going back to work tomorrow!! I. don't know if I will ever get my leg to zero. I'm trying not to worry. But I have to say that I climbed three flights of stairs yesterday without double-stepping, stopping or limping! Not crying anymore and sleeping a little better. (just not with the splint on).

    Good luck to you all!!

    💜

    • jenny80029
      jenny80029 Need1knee

      Posted

      One idea may be to try a sauna! Just mentioning because nice moist and warm heat. I used to go in the sauna pre op and do quad sets...pushing knee down as flat as I could and this did improve things a bit...relaxed all muscles well. I still stretch and bend my leg in the sauna after doing some exercises in the pool and jphaving a bit of a swim. If you have access to one, I highly recommend!
    • Kathrynt823
      Kathrynt823 Need1knee

      Posted

      How are you doing now?  My knee isn't responding well with the brace with my extension but my flexion is getting much better.

    • Kathrynt823
      Kathrynt823 jenny80029

      Posted

      sounds lovely but I'm still not cleared for a pool, sauna, hot tub or bath.

  • Kathrynt823
    Kathrynt823

    Posted

    I had my last therapy session Monday and my therapist wasn't happy with my extension since I got the brace..she said when I go in next month for my next post op visit he'll most likely want to do a surgery called "manipulation under anesthesia."  It sounds perfect for my situation.  Has anyone else ever had one?  If so, how were the results?  

     

    • Need1knee
      Need1knee Kathrynt823

      Posted

      Hi Kathryn. I was just measured yesterday again at pt. I was at -4 on the extension and 116 on the bend. I wish it were better.

      My doctor said that extension between 0-5 is functional so he didn't recommend a MUA. What are your measurements for bending and extension??

    • CHICO_MARX
      CHICO_MARX Need1knee

      Posted

      Please note:  These "measurements" are NOT objective.  They are strictly subjective because the person doing them has to "eyeball" the number on the gauge.  Ten people can measure you and you'll get 10 different sets of numbers.  Which one is dead-on?  No way of telling.  -4 / +116 ain't bad; still more PT to go to get it better but those numbers are a great baseline to work from.  Remember...  I started at -14 / +84 and finished 10 weeks later at -1 / +123.  At 16+ months, I'm 0 / +133 from more work after PT.  Just keep going...the numbers will come in time. 

    • Need1knee
      Need1knee CHICO_MARX

      Posted

      Thanks Chico. It's great to hear that my measurements can still improve over time and even without going to pt. I just finished my first week back to work. Teach 4th grade. Was a little swollen and very tired each day but continued to ice and elevate in the evenings. I'm hoping my measurements will get better in time, just as yours did. I have six more pt sessions and then I'm on my own. (Well, not really! I have all of you!!! 💜wink Thanks!

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