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Manipulation scheduled. I'm apprehensive.

Posted , 36 users are following.

joansgarden
joansgarden

I saw my surgeon yesterday and he took one look at my bend and said he would manipulate it, but not until I was at 12 weeks so that is in another 3 weeks from now. In the meantime I've stopped physical therapy so that I will still have some left for after the manipulation. I had got to 105 under force, but I think that under my own steam I'm only making about 90. My apprehension comes from the fact that his nurse told me they do it under a general rather than an epidural - because it's such a 'rough' procedure. My heart doesn't do well under general anesthesia.

I'm so tired of all the ups and downs - a big up because I made 105 and then a big down because I couldn't keep it. Feeling up because the medication is working one day and then down because the pain is back the next. And now I don't know whether I should be up or down - up perhaps because it might finally get bent and down because of the anesthesia worry.

I don't really have a question. I just know that you are the only people I can talk to who understand.

5 likes, 140 replies

140 Replies

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  • veronica91735
    veronica91735 joansgarden

    Posted

    I have seen people on here not get to the required "bend" until 18 weeks, so please try & carry on as you are doing, & in that 3 weeks - you may well get there. I am 11 weeks+, I have "0" straight but a useless bend! I have very high blood pressure, so I will refuse a MUA, it is more dangerous than bending the flipping knee! I too, keep having up, then down days - & I'm normally known as "the strong one"!! My physio has told me I would go back to being very bruised, & very sore after manipulation, & that she will help me get there without - & that is what I am hoping for. Too much pressure is being put on us to be text book - see how you go in that 3 weeks, & if told they want to do it - think long & hard - we all repair at different speeds according to this forum (which is my salvation!). I have some very good straightening excercises which I can send you if you need them? - Veronica
    • joansgarden
      joansgarden veronica91735

      Posted

      Veronica thanks, but I have never had a problem with the straightening - thank god for small mercies. All along it's just been the bending that's the problem. Britta said in her post that after manipulation the knee was not painful but her leg was very tired - as though she had run a marathon. I imagine that the muscles will stretch right along with the scar tissue.
  • david88779
    david88779 joansgarden

    Posted

    Hi Joan & fellow recipients of TKR's.

    I would like to know what is the best we can expect regarding bend angle. (Flexion)? My surgeon told me there is a physical/mechanical limit of bend angle due to the construction of the metal & plastic joint.

    But he didn't elaborate, I'm at approx. 12 weeks post TKR and am reaching quite a decent bend, but I have no idea what it is or whether I could maybe push a bit harder and get an improvement as climbing and decending stairs is slow due to not enough bend.

    My March 2014 TKR is slightly better re; bend but not much. Whilst out walking it is very awkward climbing stiles and the occasional five bar gate is a traumatic and painful obstacle.

    Maybe I need to spend a while in the tool shed and manufacture a measuring device (2 bits of batten a screw and an old school protractor might do it) as physio' have discharged me now. I'm a good bit over 90° so perhaps I should not be too curious, it would just be nice to know if there is more to had?

    • CazDesmond
      CazDesmond david88779

      Posted

      Hi David, someone said there is an app to measure the bend. It's called a goniometer. I found a few on the iPhone store for free. The one that was spoken about is called knee goniometer and it costs. The person who posted said it was good.

      if you google image you can get a diagram of the knee bend degrees too.

      i hope this helps.

      Caz - 16 weeks post TKR Pom in Perth Australia

    • peter73207
      peter73207 CazDesmond

      Posted

      That was me that posted the app. Its called knee goniometer available at the apple app store. I been using it on the Ipad and while it can be accurate it takes a bit of fidgeding to get it right.

      Since the I have purchased a real Goniometer. It only costs 8 dollars so no big deal. The app cost 5. I have also used two wooden 15inch rulers together at 1 end and secure them with wing nut. This method is extremely accurate. 

    • CazDesmond
      CazDesmond peter73207

      Posted

      After telling David about the ap I bought it, it is accurate, but fiddly until you get the hang of it.

      Thanks, where did you buy your real goniometer?

      Caz x

    • peter73207
      peter73207 CazDesmond

      Posted

      Hi caz,

      Got mine off amazon. Loads to choose from. Think mine was 8 dollars + shipping. Still waiting for it to arrive. In the mean time I made 1 using 2 rulers. This was just for fun of course but its very accurate.

      I overlaped two rulers on the end. Drilled a small hole in each then secured them with a wing nut. When you loosen the nut, the two pieces move like scissors. Just adjust it to your bend. Transfer the angle to paper and measure it with protractor. You have to do something when your up all night!

      haha

    • MCanada
      MCanada david88779

      Posted

      Hi David, My first replacement is now 11 months old and at 125 degrees flexion. This is nearing the mechanic limit of the hardware according to my surgeon. The good news he tells me is that the limit to the ability of my knee is dependent on how much slow steady work I put into the recovery. He said that running and jumping will wear out the knee and downhill or water skiing, tennis and any other sport that requires jarring and twisting motions could be an issue to the longevity of the knee. I do not intend to do these. But building muscle, cycling, classic skiing, swimming, hiking and the like are great as long as I build up to them. I am heartened by this news and I can confirm that this has already been the case with knee #1. Knee #2 has been slower in recovery but the journey is moving along the same road. I hope this helps you out. Keep smiling and keep improving!
    • CazDesmond
      CazDesmond peter73207

      Posted

      That's very inventive Peter. 

      When the physios used to walk up my drive, the sight of that thing in their hand used to make me cringe!

      Its going to be very hot today. They have forecasted 38 degrees.

      Caz x

    • peter73207
      peter73207 CazDesmond

      Posted

      Hi caz,

      its 9:15am here. Had a typical night. 90 min sleep 2 hrs awake, repeat until sunrise. Haha

      sure do envy that 38 degrees. Can you send a few my way? Its 22 below zero here today with Lots of snow and ice. Burrrrr

      just doing my exercises. When do these get easier?

      have a great day Caz. Keep up the good work!

  • peter73207
    peter73207 joansgarden

    Posted

    Hi Joan,

    I haven't posted to much over the past week or so because of the really wonky ups and downs you mention. I just don't understand the inconsistencies in the way diff PT and surgeons deal with patients in regards to their recovery from this op.

    Im at 4 weeks and 3 days and Got my bend to 90 this past tues. thought I was doing well but my surgeon put the thumb screws to me. He Feels that everyone should be at 120 in 6 weeks. As a result, even though I know better,  I push the exercises until it feels like my leg will actually snap if I go any further and needless to say, that keeps me in a

    tremendous amount of pain. 

    yesterday I go to PT. she says "remember people, exercise pain free. Don't ever push yourself until it hurts. Listen to your body and the knees will heal in time"

    so you hear those extremes and everything in between. Who do you listen to?

    No wonder this is such a frustrating op.

    To be honest, I'm at the point where I feel like telling them all to hit the road.

    I don't like to be bullied into things and have always believed that we should listen to our own bodies anyway. I like the slow and firm but take it easy approach.

    This op has put our bodies through a great deal of stress and if we are faithful to exercise reasonably, our knees will bend when our knees say its time to bend and

    not before. For some thats sooner and for some later.

     

    Stay strong Joan and don't worry abut the manipulation if you have to have it done. 

    Just do the best you can. No one can ask for more and you will come out a winner

    • joansgarden
      joansgarden peter73207

      Posted

      Who to listen to - that IS the question! In the end I think we have to come to our own conclusions. So mine is, that I don't believe in overdoing the exercises to make the knee so hot, swollen and sore that the exercises are too hard to do the next day. But I also think that I need to see some progress. I know 2 people who remained stuck at 90 forever (years anyway) after their replacements and I don't want to go through the rest of my life with just 90 degrees of bend. 

      I suspect that if I can't get a better bend after 12 weeks, it may not come without manipulation. So yes, I'll do what I can, knowing that it may not be enough.

    • peter73207
      peter73207 joansgarden

      Posted

      You sound like a very sensable lady Joan. i wholeheartedly agree with the exerxise. You definitely want to push hard enough to see consistant progress but not hard enough to force yourself to agony.

      Id like to caution people not to get trapped in the psycho war That I have.

      my surgeon gave me 4 days to get from 85 to 120. The anxiety that alone caused was brutal. Long story made short, I say listen to your own body.

      Work hard and rise to your expectations, not someone elses.

      I have no doubt you will get there in your time.

      my surgeon called today and wants to see me next thurs for an assessment. It will be interesting to say the least! Haha

      All the best

      I now listen to my body

  • lynn00032
    lynn00032 joansgarden

    Posted

    Hi Joan,

    Went to see my surgeon Wednesday, he measured my bend at 105 which he said is good enough for now, he is adamant it will get much better , he told me to be patient and I would get there in the end. I asked  if he would manipulate it under anesthetic, but he said no not yet, he only did it as a final resort if the bend was bad & knee very stiff, he said mine would get there eventualy  if I kept up with the exercises, we all heal differently he said, some quicker than others. So I'll carry on & hope  the bend will get better in time. Actually, today I managed to do full turns on my exercise bike, that is a first for me, meybe things are looking up.

    Keep us informed about your manipulation, if you go ahead with it, all the best

    • joansgarden
      joansgarden lynn00032

      Posted

      Sounds like you are on the way Lynn. My problem is that the physio got it to 105 with LOT of forcing but there was no way I could get it back to that. The physio thought that on my next visit he would get it past 105, but no way - he could barely get it back to 105. I think once you have got a full turn on your exercise bike you will improve quickly.
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