TKR has me wishing I never had it done.

Pretty much.  Lots of pain...very little pain.  Easy flexion...impossible flexion.  Done with opioids quickly...still on them months later.

In one incarnation of myself decades ago, I was a pretty good statistician.  Know that there is something called The Bell Curve...a line that starts low on the left, gets high in the center and then low again on the right.  Given enough data, you can develop a probabalistic model where anyone in the population will fall under some part of the curve.  

In a simplistic model where, for example, the mean (average) post-op pain level of the entire population is, say, 5 with a calculated standard deviation of 1, it can be projected that about 68% of people will have a pain level of 4 to 6 while 93% of people will have a pain level somewhere in the 3 to 7 range, all falling within two standard deviations of the mean.  Once we get to 3+ standard deviations (the "outliers", you are covering 99.99% of the population.

I've talked to people with pain levels of almost zero to 10 so everyone, you can say, is different...on a personal level.  However, they ALL do, as part of the "population", fall somewhere under the bell curve, and remember that pain levels are very far from objective.  I would rather model PT experience from start to full flexion as the elapsed time, number of sessions and measured flexion are all quantifiable data points.

My guess is that if you surveyed post-TKR patients, they would probably report average pain levels in the 8+ range with a very small standard deviation (espiecially if the scale is limited to a maximum of 10).  That guess would include a lot of data points in the 7-10 range.  Based on that theory, people with little to no pain post-op would be many standard deviations to the left (lower side) of the mean and would be considered either statistical outliers or incredibly lucky people.  I'd put them on a bus for Vegas and roll the dice with them...

Note: In a 2011 Canadian study on the effect of pre-op risk factors as predictors of 3-year post-op pain levels in over 1,800 hip and knee replacement patients, the observed risk factors (subjective pain level, bone spacing, differential diagnoses and more) accounted for only 20% of the variance in current pain levels.  In other words, the docs have no way of predicting in advance of a replacement operation if you will have recurring pain in the future.  However, they did find correlations between post-op pain and the presence of depression, higher body mass index, younger age, and female gender.  Since you can't do anything about the latter two, I'd suggest you stay as thin and happy as possible...and maybe be glad you're older.

A reasonable summary of normal distribution stats :-) If you have a normal distribution (and for this kind of thing you probably don't, quite) and a big enough sample 95% of people will fall within approx 2x std deviation either side of the mean as you say. The standard deviation is probably quite high and as you rightly say the measurement of pain very subjective. You think that's difficult try getting your head round the relative stats of risk factors for heart attack and stroke! It's done on groups of the population but there are so many variables I think they can be widely out for an individual.

Dave

It would be very hard to get a reasonable distribution of pain scores since they are so subjective.  Every time a nurse asks for my pain level, I respond: "Your scale or mine?"  Having had four kidney stones and now the TKR, your "pain scale" is definitely not your old one or even one that coule be considered "normal".  After the TKR, our "10" is someone else's 4,000.  That's why you try to use factors that are quantifiable and use them as surrogates for what you are really trying to measure.

Everything in my comment above was pure speculation (since no such data exists); I was just trying to make the point that although everyone truly has "their own experience", there are plenty of commonalities among the population of TKR patients that could be generalized, given the stories we have been reading for months and months...or longer.

Personally, I would rather have been better prepared for what I went through by reading what "most people" had endured than have gone into it with rose colored glasses and hit a brick wall.  Even then, my experience will still have been totally mine but at least I would have been aware of the "most likely" outcome.

Yes I agree  And apologies to others who aren't interested in statistics - being a retired scientist I can get a bit "nerdy" !

No apologies.  I was a statistician back in the late 70's...love to pull this stuff out from time to time...

Unfortunately you can't get any answers wth an MRI after tor as you just get a black blob. However, x rays should b done automatically every few weeks anyway. Dr's egos are the biggest problem .

I've got my post MUA appointment in two weeks, I'll wait until then to review my issues. The surgeon is a very hands off guy and relies on the PT almost 100%. I keep telling myself that yes I'm only four months out and this needs time to heal and begin to work like I'm expecting it too.

thanks for advice.

we did x-rays shortly after the surgery and the doctor said everything looked okay. I'm sure my surgeon has a fairly large ego so trying to reason with him won't be an easy process. I just would like a little positive result to build on as I continue my re-hab.

I'm so lucky my surgeon is approachable and answers my questions and has no contact with my pt at all .. he gets me to do a few things and then tests my ROM etc and is pretty hands on with the results of his work.  But totally know where your coming from when it comes to surgeons and their 'egos' and not listening.  Mine was a bit like that and I had a fall at 8days post op and got readmitted to hospital for 5days as I tore all internal and external stitches below the knee and he gave it to me and had me in tears .. he eventually realised he had crossed the line and since then he's been awesome!!!

Sounds like your lucky with doctor and rehab. My last visit to the surgeon he never even touched my leg/knee. He has never checked my ROM, I really don't have much, so he really can't tell where I stand on rehab.

Papapete this is not good your surgeon should be checking these things to make sure that they don't have to put you under and force a bend!  I never had rehab or physio until the 5mth mark when I started having hip issues as I was overdoing it.  From day 1 I was told to straighten my leg and also to do the smallest of bends to get it moving and gradually increase the bends but to listen to my knee as it would let me know if I was over doing it. 

I'm really sorry for you that you have such an arrogant and non caring surgeon .. I so hope that your dr maybe able to recommend something for you as you need your surgeon to care .. I visit mine every couple of months so he can check up on his work and where I'm at!

Take care and I so hope you are able to get the help you need.  Have you tried simple exercises like just sliding you foot up the bed to bend your knee I did this alot and still do as I want to get gain another 10% in my ROM if I can.

Cheers... Tracey

Be careful with those MUAs. I got impatient and let my doctor talk me into it 5 wks post op and I couldn't walk for 3 three days! They take the patients that responded very good to the TKR and feel that it's the norm but everyone on this forum knows that's hogwash. I Have a Therapist (thank God) that won't do any therapy that is painful or discomforting. You're in control and you have to let them know it. I told my therapist he ain't gonna strap me down and crank my knee. If you do the exercises it will get better. It just takes time.