ROM won't improve at 12 weeks post op total knee replacement

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It's been 3 months since my TKR and my Range of Motion has remained at -20 degrees to 95 degrees. It hasn't changed since the operation.  I go to physical therapy 3 times a week and do the exercises at home twice a day as they recommended.  I also use a Dynasplint for 5 hours every night. Therapists are totally confused by why there is no change.  Doctor says I have to fix the 20 degree extension but he can fix the 95 degree bend with a MUA.  So I'm stuck.  If the therapists can 't straighten my leg to 0, how am I supposed to fix that?? And the thought of a MUA scares me.  FYI , I had a TKR on my other knee 5 years ago and it's been OK.  Any ideas??

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  • Posted

    Hey Bob.   I am eager to hear what people have to say.... I'm in the same boat.  I'm at week 16.  My straight is at -10 degrees.  My bend is pretty much sitting at 96 degrees.  Last week after the physio manually stretched my bend we were able to get a bend of 100.  Since then I'm back at the next two visits at 95 degrees and 96 degrees.  I'm walking OK. but everyu day I awaken i have such tightness around my knee till I get it moving.  When I sit to start on the exercise bike I can barely get it to bend to pedal around.  The first 20 25  times around Ive almost got tears in my eyes ... Then I get going around and i can do 15-20 min no problem.  Feels so frustrating??? Will it get better?  I heal with keloids and I wonder if that is adding to scar tissue problems and causing the lack of bend??? My brother had his surgery (same RTKR 8 weeks following mine.  His first physio appointment he had a bend of 100.  My first physio the bend was 60.  I know they say don't compare but its really hard not to.  Looking forward to your replied comments..........

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  • Posted

    Hi Bob I'm 5 months post op my flexion is about 90 degrees normally, if I stretch and massage and force the rom I have had it up to 120 so I think mine is muscle related. I can feel my quad is really tight when u try to bend it. I'm having regular baths with Epsom salt in, I've now tried having Thai massages which really made my eyes water😂 I'm convinced it will improve. As for extension mine has been fairly straight since the op. I was encouged to keep my leg straight when resting it in. Putting my feet on something but not having anything under my knee so that gravity does the work. I rest ankle weights over my knee now which helps push the knee further down in a straight position. If you haven't got ankle weights get an oven glove and put tins in either side and rest that over the knee. Some people lie on the bed face down and hang the leg off the bed when the knee is right at the edge again if you can put ankle weights on to weigh it down, stay there as long as you can tolerate. I hope you get it sorted, you don't want to end up with a limp x

     

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  • Posted

    Hi Bob- it's discouraging but there are factors preventing extension and flexion like swelling. At 5 months post LTKR, due to complications, my extension was stuck at -45 and flexion at 95 despite PT 3X week and doing exercises the best I could daily. I didn't want more surgery so I got a new PT and started seeing a massage therapist once weekly who was experienced in sports massage for very gradual stretching and massage. They both used a Gua Sha tool with magnesium lotion to break up scar tissue. I got a JAS brace to gradually extend my leg, it also increased flexion. A former boxer advised me to do Epsom salt soaks daily and stretch in the warm/hot water and wear leg warmers 24/7 to keep muscles supple. To reduce swelling after exercise, I elevated, iced and rested then applied heat to increase circulation and reduce stiffness. Now it's been 10 months post op and my extension is -2 and flexion is 115. Because of the bent leg I was in a wheelchair but started walking with crutches about 8 months post op when my extension and flexion were enough to do that. I have 6 more PT sessions. My surgeon and PT are amazed at what I accomplished woot surgery. I am 67 and a retired RN who worked with Brain Injury patients. I am now prepared for the other knee replacement later this year. 

    I hope my experience helps you continue to heal!

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  • Posted

    I can’t comment on extension as mine is ok but I have experienced a ROM of 90 that just won’t shift. I was 3 months when it got stuck, I’m now at 6 months and I’ve just had an MUA. Apparently the consultant got my ROM to 135 in theatre, but it’s nowhere near that now. I’m trying to exercise to get the numbers up, I think it’s more like 115.  I have to say though, the procedure wasn’t too bad at all, very quick and I’m only now feeling a little sore, 3 days later.  In my case, it sounded worse than it actually was.  I am glad that I’ve had it done. Good luck to you whatever you decide. Sharon 
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  • Posted

    Thanks to all who responded to my post.  I will see my doctor in 2 weeks.  But in the mean time I am going to try some of the things mentioned.  I'm starting with the Epsom salt bath tonight.

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    • Posted

      I was stuck at 97 and had MUA at 11 weeks, I'm now 4months po and at 110 to 115. The MUA was rough for me but I also had joint implant of the large toe joint same leg at 5 weeks po. My left leg is now hurting alot. Dr said the tightness from my RTKR from the knee to upper thigh is a tight IT Band. Now stretching for that and still walking with a cane. Trying to increase my work hrs up to 6 hrs per day and still taking pain med, Tylenol with codeine.

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