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Author Topic: Poor ROM after 3 weeks post TKR.  (Read 5322 times)

Offline Wego4it

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Poor ROM after 3 weeks post TKR.
« on: June 06, 2005, 02:46:39 PM »
Well it's been 3 wks since TKR. I just have 62 Deg. bend if I pull with all I have, and 4 Deg Flat.
I don't think this is normal. I go to PT 3 times a week was told I have scar tissue problems.
Don't go back to OS untill May 16th. Should I be very concered at this point?

Anyone else have this problem?

Thanks for any comments,
Jim

Offline SuburbanLife

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Re: Poor ROM after 3 weeks post TKR.
« Reply #1 on: June 06, 2005, 02:59:02 PM »
Hi Jim,
Now way would I be concerned, you have a long road ahead of you. I am 4 months post op on my TKR and still working with PT and still not thrilled with my ROM. You have plenty of time to work on that, I wouldn't be so hard on yourself. Hang in there, work, work, work and give it some time! Good luck...Lisa
March 2005-Total Knee Replacement

Offline Wego4it

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Re: Poor ROM after 3 weeks post TKR.
« Reply #2 on: June 06, 2005, 03:37:09 PM »
Thanks Lisa,
For a little encouragement. It just seems like all I read that I am way behind the majority.

Thanks again,
Jim

Offline SuburbanLife

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Re: Poor ROM after 3 weeks post TKR.
« Reply #3 on: June 06, 2005, 04:18:51 PM »
Jim,
I cannot express it enough, the majority is NOT ahead of you. Generally, they don't release you from the hospital or rehab without a 90 degree bend. Did you ever have that much bend? I was released with a 90 degree bend, I am up to a whopping 105-110 with forced assistance from my PT. I am still about as far from straight as you are. Now for me, being 4 months post op, it's getting into the concerned time. I have had some set backs such as an infection, so no telling what if any that did to my ROM. I am in a group of women who all had our knees replaced around the same time in March. We have each had such different results, one even was released from medical at 6 weeks because she had totally regained her ROM back, she has had a flawless recovery. Some are using a special brace that they swear by for increasing ROM, you can find information on it here http://www.jointactivesystems.com/pt_home.html
You will need a prescription from your OS to get one, but that may be something to look into. We all are different and we all recover differently. You really should not be too concerned at this point, you really do have a long way to go, there is a wealth of information on this site, you are definatly not alone! Take care...Lisa
March 2005-Total Knee Replacement

Offline Wego4it

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Re: Poor ROM after 3 weeks post TKR.
« Reply #4 on: June 06, 2005, 08:18:07 PM »
Just came back from PT increased ROM to 67 Deg. Forced...Still at 4 Deg Flat.
Was in hospital 3 Days and was released with 45 Deg ROM then it froze up with swelling and I went down below 40 Deg.  have been working hard to increase it ever since. CPM machine seemed to be worthless was taken off it after 3 days at home. Went back to work after 10 days and driving after 13 days but is not easy.
Knee just seems to be very tight with swelling or scar tissue seems to be preventing the movement.

Oh well wish I had 90 Deg.

Thanks,
Jim

Offline Julie405

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Re: Poor ROM after 3 weeks post TKR.
« Reply #5 on: June 06, 2005, 11:19:27 PM »
Hey there Jim.......I wouldn't worry too much about it...at least right now.   Keep working at bending that knee.   It will come.   I know that they told me to keep moving the scar from side to side to keep the scar tissue from adhering to things that it shouldn't be.   Look over the TKR..Let's keep in touch thread.   There is much info on there.   We are all young TKR's.   One of the ladies on there uses a JAS brace.   I had never heard of it before.  She gave me the link to look it up.   You may want to take a look at it and bring it up to your doctor if you continue to have troubles.   I know that it has helped her range of motion very much.   http://www.jointactivesystems.com/pt_products.html
   Julie

Offline Jan_L.

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Re: Poor ROM after 3 weeks post TKR.
« Reply #6 on: June 07, 2005, 12:49:23 AM »
Hi JIm,

I am one of the ladies on the " TKR- march 2005 - Let's keep in touch" thread.   I also left a messge for you on another thread, I said I thought you were a little behind in your ROM and I still believe that.  If I remember correctly you went back to working full time and I was concerned that that was interfering with your recovery.  For all of the rest of us, all of our energy went into physical therapy the first few weeks post-op.  I was concerned that returning to work just 10 days after you had a TKR could delay your recovery. 

I was told to keep the swelling down because if the knee is really swollen you can't work on getting it to bend very much.  If you were gaining in your ability to bend your knee then I would think it was great that you are back to work and driving your car so soon.  But it looks like you may be doing al of those things at the expense of your knee.  For the first month post-op my main goal all day long was to get that knee bending.  I would work my knee, then elevate it , ice it and then a while latter repeat the process.  I spent very little time with my knee hanging down.  When I was sitting at the table for meals I kept it propped up to minimize the swelling.

I am also the one that had a scar tissue problem, it was horrible.  I had to have a revision. This is what your therapist is concerned about.  As the knee heals, it is only normal for scar tissue to form, that is how the knee heals, but if you haven't gotten the knee bending then the scar tissue can form blocking you from bending your knee.  So it is very important to get that knee bending as much as possible early on.  This is why a lot of doctors want you to be at 90 degrees before you leave the hospital.  I think you really do need to get that knee bending  NOW.  If not when you see your doctor in a couple of weeks he may want to do a procedure called MUA ( manipulation under anesthesia).  I had this done twice to treat the scar tissue.  While you are under anesthesia your doctor picks up your leg and forces it to bend and it snaps all of the scar tissue bands.  It is a brutal proceedure.  Last time I had this done the nurse said it sounded like limbs of a tree breaking.  My doctor scheduled one for me  when I was 6 weeks post-op but I worked as hard as I could and I got my knee bending so he cancelled the MUA.  So I think you should be spending hours each and every day to get your knee bending, stop working if you have to and keep the swelling down to a bare minimum.  It is so important you reach 90 degrees, after that it doesn't matter how quickly you gain in your ROM.  But your doctor and your physical therapist won't relax until you reach at leat 90 degrees. 

I am also the one that is using the JAS brace.  I think the CPM machine is worthless for regaining ROM, but the JAS is awesome.  That brace kept me out of the OR, I gained 30 degrees in two weeks, which is why my doctor cancelled the MUA.  Ask your therapist about this. 

I know that this isn't what you want to hear, but based on everything I have been through with my ROM problems and all of the research I have done, I think you need to get that knee bending as soon as possible.  I don't want to scare you, but I am assuming you want the truth, if you are asking.  Right now, in terms of your ROM, you aren't in serious trouble but you are behind and you need to get to 90 degrees as soon as possible.   It is important that you see some gains in your ROM each week.  I highly recommend the JAS brace!!   

Everyone posting under the "TKR -March 2005 - let's keep in touch" are all recovering from a TKR.  PLease feel free to join us and this way you can get several peoples opinions, all from people that have recently  had a TKR.

Jan
« Last Edit: June 07, 2005, 01:09:21 AM by Jan_L. »
1985 - auto accident- both knee went thur the dash.
1985 - 1990 Four scopes left knee
2002 - Fulkerson TTT
2003 - Scope Rt knee
2003 - Right  TKR
2003 - MUA, 2004 - MUA
2005 - Right TKR  revision
2006 TKR - left knee, 2 MUA
2007 2nd TKR  revision - Rt knee

Offline Wego4it

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Re: Poor ROM after 3 weeks post TKR.
« Reply #7 on: June 07, 2005, 12:36:33 PM »
Jan and Julie,

Thanks for information on JAS Machine I would love to try. Especially if it really works.
 Do ya'll know of anything that helps to rub onto knee to help breakup scar tissue?
I rub it all the time seems to be helping some. Heard it pop loose once it really made a big difference.
Hope it does it again soon.

Again thanks for all the comments.
Get Well Soon

Jim

Offline Josie1951

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Re: Poor ROM after 3 weeks post TKR.
« Reply #8 on: June 07, 2005, 03:03:11 PM »
Hi Jim
Hope you are feeling a little better, today, i was released with only 65 ROM and i  have been in PT for 3 weeks and i do have a lot of scar tissue built up since i had 7 other surgerys for this knee, well i have been sceduled for an MUA on June 21 i have heart pros and cons, about this well i thought it cant do any harm lets go ahead and see if it gives me more ROM.  Maybe thats what they will surgest for your knee, keep in touch

Josie
Jo Jo

Offline Jan_L.

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Re: Poor ROM after 3 weeks post TKR.
« Reply #9 on: June 07, 2005, 10:55:58 PM »
Hi Jim,

The "pop" that you heard was probably a band of scar tissue breaking free.  Sometimes when they break you hear a pop and offen they can really hurt, afterwards you ROM may improve.   This is the basic concept of doing a MUA.

My doctor has my physical therpaist working on massaging my scar to help with the scar tissue.  You might ask your PT to do the same.

I went back and looked at your first message that I commented on and it looks like you have gained 10 degrees since then, that's great!  If you could get 10 degrees each week for the next three weeks that would be wonderful!

Jan
1985 - auto accident- both knee went thur the dash.
1985 - 1990 Four scopes left knee
2002 - Fulkerson TTT
2003 - Scope Rt knee
2003 - Right  TKR
2003 - MUA, 2004 - MUA
2005 - Right TKR  revision
2006 TKR - left knee, 2 MUA
2007 2nd TKR  revision - Rt knee

Offline Wego4it

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Re: Poor ROM after 3 weeks post TKR.
« Reply #10 on: June 08, 2005, 11:41:57 PM »
Went to PT today ROM only increased to 68 Deg. but, think we figured out one problem I am having is that I only take Pain Pills 45 min before PT sessions so most of the the I am in discomfort. It Hurts almost all the time so this afternoon I am staying on medication schedule and am able to work my knee a lot more.
Sounds simple but I reallly think it's working can't wait for ROM measurements tomorrow.
 Regarding scar tissue PT and I have been massaging it a lot but still really stiff and hard hopefully some will breakup soon.

Thanks for comments,
Jim

Offline Wego4it

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Re: Poor ROM after 3 weeks post TKR.
« Reply #11 on: June 11, 2005, 04:30:13 PM »
Well after 4 weeks still swollen but, Rom has improved to 73 Deg. (forced) and 4 Deg. Flat. Still seems to be lots os scar tissue from middle of knee cap down approx 3 inchs. Massaging it at least 2 hrs total a day. Hope it's helping. Going to OS tuesday hope I can get ROM up to 85 to 90 by then maybe I won't have to have a MUA or at what stage is thie usally considered?
Should I still be having pain after 4 Weeks?


Thanks,
Jim

Offline vicki

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Re: Poor ROM after 3 weeks post TKR.
« Reply #12 on: June 14, 2005, 10:39:41 PM »
Dear Friends.....I am so sad to hear all the ROM problems that are being had by so many of you.   I have been so very lucky.   I'm 19 days post op TKR and at 117 degrees flex unaided and completely flat at extension.   I have done so much physical therapy that I should have a leg like a football player.   I'm down to using only a cane when I need it.  Now mind you, I'm completely exhausted by 8 p.m. and head for bed then but I am so happy things are going well.   I just wanted to stop by and wish all of you well.  I hope all the scar tissue and stiffness disappear soon and you're all hip hopping down the yellow brick road very shortly.

You're in my thoughts ....

Vicki

Offline Josie1951

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Re: Poor ROM after 3 weeks post TKR.
« Reply #13 on: June 17, 2005, 01:24:17 AM »
Hi Jim hope you are feeling a little better, the MUA is not as bad as i expected, i am a little busied and i am very swollen on my quad mussel, but i am icing it and taking a anti inflamortory, and a pain med to help the PT i reach a 100 ROM today i was so excited.

Please let me know how you are doing and what the doctor tells you,,,
Josie
Jo Jo

Offline Wego4it

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Re: Poor ROM after 3 weeks post TKR.
« Reply #14 on: June 17, 2005, 11:59:06 PM »
Went to OS yesterday ROM was still poor @ below 70 unforced so get to get MUA Thursday 6/23/05.
 Hope it feels better afterward.
 Josie, glad to here you have such improvement!!! Thats great...Hope to have good results also.

Hope everyone is back to normal soon.

Jim