MUA last week.....made progress but now losing ground........ :(

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Hi everyone. Quick background info - had TKR end of September, age 47, it went ok but have never achieved much bend. At 6 weeks via tele-conference surgeon wasn't worried because of my age, the surgeries I had had in the past, and the bad condidtion of my knee going into surgery. Said that it would just take me a little longer. But I got nowhere at all. It was blocked. Like there was physically something there - of course there was - scar tissue.

Waiting to read surgical report - but what is known is that he couldn't just do manipulation - he had to scope and clean out scar tissue. Before procedure he was angry with me and said I should have been one of the successes and that nobody can bend my knee but me. I told him I had done everything and much more to try to achieve ROM (I can straighten it though) and that my PT's could not figure out why I was making absolutely no progress and was stuck at 75 degrees. He said I wouldn't be there had I been doing everything that I should have been doing. He didn't believe me. 

Anyway - procedure went well - and I went to physio all week last week. Started at 90 degrees and by the end of the week had achieved 100 degrees. I was so excited and determined and continued to do exercises all weekend. I even helped clean the (horse) barn.

Saturday afternoon I started noticing the familiar tightness happening around my knee cap..........and that I wasn't able to bend it as far when doing exercises or bending my leg while seated.........and by Monday I knew for sure. I was losing bend! Today, in physio - I was devastated to realize that I was absolutely not achieving what I had last week - and I measured 88 degrees today. 

I am so upset! This has been such a long haul and I do not understand what is going on with my knee. I am wondering if:  a) it could be mechanical - too big, or too tight? Possibly spacer too large........and if so - could surgeon bend when I was under anesthesia? OR

b) Can I be doing too much and didn't allow for healing after procedure - especially since they had to go in and scope it? Maybe it's swelling too much - from being up on it a lot - maybe it's swollen in joint and affecting bend.........?

It just feels waaay too familiar. Same tightness, same pain that was not there last week. And I don't think scar tissue an be building already! I am so disappointed....last week thought that I was on my way!  sad

Anyone been through this? I tried to search MUA after TKR and got a lot of discussions that were about shoulders or just plain TKR's...........

Thanks for reading smile

Amy

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  • Posted

     I’m going through the exact same thing. I had like three surgeries before my TKR in 2016 and I had a MUA a month later then revision surgery 2017. Here I am in 2018 I still don’t have 90 degrees.
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    • Posted

      Oh no Phil that’s awful! I’ve had numerous surgeries through the years before my TKR.....and had only 90 degrees before TKR....was hoping to be at 100 or 105 at least after MUA....did you start out ok and regress like me after MUA? And revision was done due to lack of ROM? Did they tell you why they think MUA /Revision didn’t work...? 
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  • Posted

    Hi Amy, I do feel for you, going through all that...we mustn’t lose hope!  I had TKR sept 2017 at 50, 5 months later and, like you have made little progress. Surgeon was surprised to see me and have arranged MUA for Monday next.  I am stuck at 90 & had to go back to work, which I think hindered my progress, along with the other knee needing doing to!  Wish you all the best, keep doing those exercises!!

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    • Posted

      Thanks Sharon! It’s very frustrating to work so hard and achieve very little it?  Hopefully your MUA will help you a lot. At this point, after five months, your surgeon may have to scope and loosen and take out adhesions/scar tissue - which is what mine did. There were three others getting MUA done here as well and all have achieved about 110 degrees and are doing well. But they were earlier out of TKR - all were about 7-9 weeks post surgery. 

      Good luck and keep me posted 😊

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  • Posted

    Swelling.

    Overdoing it?

    Quite likely, by the sound of what you have written?

    I am sorry to hear about your experience with the surgeon...sounds bad!

    It might be worth focusing on reducing swelling and rest as well as exercises?

    As long as you keep it moving little and often and especially keep up the heel slides...

    Are you on pain relief?

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    • Posted

      I know, I really should have stayed away from the barn....my surgeon is all about “not babying” your knee but that was probably too much too close to procedure....

      I don’t have a ton of swelling but do have some - and imagine some in joint itself. It’s not more than expected though after procedure so not sure if it’s the reason I’m not bending as much as last week. But I can’t imagine scar tissue can build up fast enough to be impeding bend...? 

      But that very tight constricting band is back and the pain is too....last week band wasn’t there, and pain was in quad muscles and not in joint. Really wish I could see inside my knee!

      This week I have promised to stay out of the barn except to say a quick hi to my horses. But haven’t gone out in two days. Lol. Keeping knee elevated and icing when not exercising. And not overdoing it at home. 

      I am on some good pain meds again as surgeon seems to be determined that I just can’t handle the pain and push through 🙄 Have to admit physio was pretty tough today and I was glad I’m on them. Tho sometimes wonder if pushing that hard just creates more scar tissue....? 

      Thanks for responding and for your support 😊

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  • Posted

    Hi Amy I can’t really answer your question but I really feel so sad you have been through all this and you’re only 47.

    I am 6 weeks post tkr and I am having real problems bending my knee and I keep reading how well other people are doing at this stage.I’m in N.Ireland and you aren’t offered any physio post op just a sheet of paper.I haven’t had my review with surgeon either so I don’t know If I’m doing anything wrong.

    For a doctor to be angry and blame you I think is totally unacceptable,I’m sure and certain you are doing everything you can to help yourself.

    Hope you get sorted soon and wish you all the best for a good recovery.You’re not on your own.x

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    • Posted

      Thank you so much Pat! I appreciate your support 😊 I’m sorry that you’re having difficulty bending as well. It’s hard hearing how well others are doing at your stage when you’re behind - as happy as we are for them. We want to be just like them! In physio I have been in the “knee group” with three different TKR months...and they’ve all graduated from physio and moved on. I’m actually part of a baby pool (guess birth weight and day) for a member of the physio staff who is having a baby. Because I’m like staff. I’ve been there so long 😜😂. 

      That must be tough not having anyone to help you with your exercises....have you gone thru some of Chico Marx’s past posts?  He’s got lots of info and exercises to help. 

      Best of luck to you - keep on keeping on and let us know is it goes. 🙂

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  • Posted

    Hi Amy, yes you've done too much! You just had another procedure, you should be back at icing, elevating & exercising & resting!

    At 16 months po on right TKR I still get swelling if I do too much. I would consider cleaning out a horse barn far too much! Your help should have been in an advisory capacity!

    Try to relax, the more tense you get over all this, the harder it will be to do (bend the knee). Go back to basics after all you are still only 5/6 months out of what can be a 2 year recovery! You will attain a decent rom if you give yourself a chance & don't try to get it all at once!

    I barely got to 100 by the time I saw my consultant at 8 weeks after the 1st TKR. I didn't have MUA just kept on plugging away slowly. Am now at 124 which is way over what I could do going into TKR, so I'm thrilled! I got there 1 degree at a time!

    TKR no2 is easier on the bend but was more painful in the beginning. Haven't got there yet but well on the way.

    Bear with me on this, but what anaesthesia did you have & what pain relief after?? The reason I ask is I had spinals for both my TKRs (Oct 2016 & Dec 2017) but the difference with the 2nd was I refused iv morphine. I had that with the 1st & was so ill on it! Kept falling asleep & was sick all the time until they finally took it away at 2nd time of asking! Oh yeah I had no pain!!

    I have a theory that my recovery from this 2nd op has been quicker as I was alert & up & about from the day of the op & started physio straight away. I was discharged after 2 nights in hospital, so only 1 clear day after the op as an in patient.

    As for your consultant! What can I say! Change to a more sympathetic doctor! 

    It does seem that younger people struggle more after TKR, we had a few on here who had similar issues, don't ask me why! You'd think it would be the other way round!

    Keep us posted as to your progress.

    Marilyn 

    XX

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    • Posted

      Hi Marilyn! I know - I really did do too much in the barn....but I had a lame horse and my husband had the flu and I felt I needed to help. But I’ve stopped I promise 👍🏼

      I do think that your theory may be right! I had a spinal and felt great until it came out. Then  I was in a ton of pain and the Tylenol 3 they were giving me did nothing at all (I guess we were supposed to get morphine too but it wasn’t on the order). So my pain was so great and hard to get under control (3 meds later) that it was a full 48 hours before I was up walking and doing physio exercises. And maybe this impacted my recovery and ROM.....?

      As for my consultant, unfortunately we live in a small town and the surgeons come from the city. You don’t get much of a choice. Though if I get a second opinion in the next while I will be heading to a different city/different surgeon. 

      Thanks for responding and take care. I will keep you guys posted. Today in physio no tears - yay!!! Got to 90 degrees with lots of help from pt. But st least no lower! 

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  • Posted

    Hi Amy we had our op around the same time and we are the same age. The last time I saw my consultant was back in January and my ROM was only 90 when I saw him both of us felt that it would continue to improve overtime with exercise and it has. Last night I really pushed ROM exercises and got it to at least 120 even though this morning id be lucky to get it to 90. Now the only thing that can possibly be preventing me getting 120 all the time is either swelling or tight muscles. Knowing this, overtime the swelling will get less and less and the muscles will loosen off resulting in a good ROM in the long run.

    have you tried loosening the muscles off around the knee especially the hip flexor and quads? I use a massage stick, massage the muscles with tiger balm and have Epsom salt baths which work a treat x

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    • Posted

      Hi Snoozy 😊 I’m glad to hear that you’re getting more bend as time goes on. If I had gotten to 90 they wouldn’t have made me get scope/manipulation....I do think you’re right - as muscles relax and swelling gets less that bend will start to happen for most - unless you create a lot of scar tissue and I think that’s part of my problem. That being said....maybe it’s fluid as much as tissue, and in time it just starts to work. 👍🏼 here’s hoping!  

      Thank you for the good advice - plan is to start using a roller on muscles in hip and thigh area, plus going to go to 

      For myofascial release therapy too. 

      Take care!! 

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  • Posted

    Hello Amy.

    ?Thanks for that .I had the exact same start after my op.Did all the correct excersizes and kept them up as much as I possibly could.I went in after 3 months to have MUA and the surgeon said that he had bent it to about 110(which isn't that much really) He said that he had no trouble bending it but I am to keep up the excersize regime which I did.I am still now after 18months trying to bend further,trying different things out,but I cannot bend it anywhere near what I thought I would have with all the excersizes that I did.I did ask the surgeon after 1 year what he thinks and he said "it is about what I would expect". It feels like a complete block after a certain degree and no matter what I do it doesn't increase any.

    I asked about the same thing whether the knee was too big for me (because it still looks bigger than my other knee) but he said that it is within millimetres of the original knee and very close to the exact size.

    I have come now to have to accept that this will be the case, and that I cannot bend it any more than I have.

    ?Others that I speak to have the same thing- cannot bend enough to kneel etc. I think its a very common problem and that loads of people are worse off.I was 58 when I had it done and active. I can still do the things that I used to but it does swell after being on my legs too long, but the pain is different to the pain that I had before the op.

    Swopped one pain for another!!! Hope this helps,but I understand it is so frustrating!!!

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    • Posted

      Hi Dawn,

      Sorry to hear about your struggles as well! So hard to understand why some have such a hard time while others do so well. Wish we all could fly through this surgery! 

      I know exactly what you mean about feeling like you have a complete block after a certain degree! That’s where I’ve been for four months and I’m afraid I’m feeling it again only a week after MUA! Argh! Can’t figure out what it is....fluid? Adhesions...? Very frustrating. But I suppose it could be much worse. And no more arthritic pain at least. Ha!

      Take care and thanks for responding 😊

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