January 3rd TKR. How are you Molly and anyone else with a new tkr?

[rozzzie]

Indian mom,

Sorry you're having such a hard time.  Is your leg more swollen than it was at first?  There is a chance of a DVT behind the knee or higher in the groin.  Have you told you OS that you are having this much pain?  He may want to have a Doppler scan to check for DVT.  He also may be able to offer pain control options. The recent ulcer if it's healed should not prevent you from adequate pain control.  I found Ice helped with pain control.  You need to get the pain under control to really do your PT including walking.

Good Luck  Stay in touch and let us know how you're doing.

Rozzzie

[pooch120]

Hi everyone,
I'm new to this site.  I am a 55 year old woman and I had total knee replacement and new kneecap done 5 and a half months ago.  I found it to be a quite painful surgery and it actually took five weeks before I considered the pain manageable.  I live in Canada and maybe our physio is different here but I was in p.t. immediately.  I still go to massage therapy 2 times a week because of excessive stiffness and lack of bend.  My bend is still only around 90 degrees, more if they push me.  I saw my surgeon last week and she wants to do manipulation on the leg.  They put you to sleep then force your knee to bend.  I am very scared to have this done,  the pain of the original surgery is too fresh in my mind I guess.
I would love to hear from anyone who has gone through any of this.
             Thanks to all, Margaret

[Mitidai]

Hi Margaret,

I had my tkr January 3rd.  I too started pt immediately.  I'm having
problems with extension (straightening my knee).  They are really
working on it in pt.  It is just so painful to straighten.    For some
reason I have awful pain at night.  I think it is because I'm laying
still.  I'll be glad when that quits so I can get a good nights sleep
without the pain meds.

Hang in there and keep us up to date on your progress.

JAN

[chalkie]

To Indian Mom

Quick reply

Pain is normal after TKR no need to panic,but your DR should provide at least some relief.

How about Paracodal for example anyways ur very early days since your op,it will improve for sure week by week Best wishes David

[chalkie]

To Pooch 120

Go for the manipulation it is totally pain free.

I had the same doubts but was amazed how easy it was Good luck Margaret from David.

[Jan_L.]

Hello Margaret,

At five and a half months post op I would NEVER agree to a manipulation!!  I have had this procedure (MUA) done twice.  I have been told by two OS that the cut off period for doing a MUA is normally 3 months.  I would get a second opinion before agreeing to this.  Scar tissue can actually become stronger than bones, ligaments and tendons so that as your doctor is forcing your knee to bend instead of the scar tissue breaking free your bone, tendons ligaments and/or the implant could break.  Do you homework on this procedure.  A MUA can be very helpful after a TKR if it is done early.  There have been a couple of people that have posted here that had a MUA done late and had complications.  BE CAREFUL!  PLEASE GET A SECOND OPINION!

Part of the reason I think you ended with limited ROM ( range of motion) is because your doctor did not control your post-op pain.  It is so important to get that knee bending right away.  In order to do that your pain has to be controlled.  When a doctor doesn't control their patients pain he is setting them up for a poor outcome.  If it hurts too much to do PT people stop doing their therapy.  Pain management is necessary.

This procedure (MUA)  was NOT pain free for me by any means.

A 90 degree bend is not very good, what are your other options?   You  might want to see a doctor that specializes in joint replacements.


Good luck,

Jan

[Jan_L.]

Hello Iindian_mom,

It is normal to have pain after a TKR, but your pain should be controlled by meds.  If the pain is severe then CALL YOUR DOCTOR!   You could have a DVT like Rozzie mentioned.  Or you could have an infection or the implant could have come loose.  All of these could cause severe pain.  If your doctor is unavailable then go to the ER.  If everything is fine with your knee then at the very least you need different meds.  If your pain is not kept under control it can interfere with doing your PT which is important to having a good outcome.

Good luck,

Jan

[indian_mom]

Thankyou Jan, David and Rozzie!

Know what, I went and saw my doc who performed the TKR. He saw everything and also as it was 14th day POD, he removed the sutchers. He gave me some painkillers and muscle relaxants which were stomach-friendly  and also rabaprozol to control any possible trouble that might happen to my stomach... so, it is extra safety for my tummy!   

He said that there is no problem and that the wound is healing gr8 and no complications like DVT, etc., but just that my PT was coming over at 7a.m. and as it is too early, I was not taking any medicines, painkillers, etc., to take care of the pain associated with the PT. Now he has strictly warned me to have my breakfast, take my painkillers and muscle relaxants at least 1 hour before I start my PT. He also gave me the TED anti-embolysim stalkings to wear.

And I had a nice sleep last nite after I started taking my new and improved medicines and also the pain has subsided by tons! Also, my sutchers are gone and have healed pretty much. The only thing now for me is that I gotta do PT regularly and also I feel very weak for which I better start eating in right proportions and stop skipping my meals 

Would keep you all posted, but any suggestions to get back to normalcy fast? I still am not confident and unable to stand or walk or even go to the toilet all by myself!

[pooch120]

Thanks for all the info everyone.
You'll all have to bear with me for a while, I'm not good at knowing where and how to post on here.  I'll figure it out eventually.
David,  I wonder if you could tell me if you had a TKR or some other surgery before your manipulation and how long after the surgery you had it done?
Jan,  I wonder if you could let me know your info as well.  Your words of warning seem to be the most common things I hear and I need to know for sure.
I'm booked for my MUA next thursday and I'm so tempted to cancel.  When I mention it to my PT or anyone else with experience they think it's a bad idea but when I voice my opinion to the surgeon she asked me how many TKR's they have done.  I hope I'm not just being caught up in her ego trip.  I think it will be too high a price to pay for me.
Thanks to all, and any info between now and thursday will be greatly appreciated.
          Take care, Margaret

[Jan_L.]

Hello Margaret,

Here is a copy of a post under this section.

The thread is titled 'Manipulation after TKR & Broken Femur"

3.5 months after my TKR I had manipulation under anaesthesia to improve flexion in my knee.  I suffered a broken femur during the manipulation and then had ORIF surgery to insert a rod in the femur.  Doing ok, still not as much flexion as I need but it's coming along slowly.  Questions: Dr. does not know why femur broke - no osteoporosis or other problem seen.  Can some types of knee prosthesis tend to cause this outcome?  Should I ever consider manipulation again (I will be getting a TKR for the other knee at some point)?
[/quote

Your doctor is right, none of us are doctors.  Did your doctor offer to help you get an second opinion?  I really think you should talk to another doctor.   A MUA can be a really helpful procedure.  And it could have helped correct the problem you are having if it had been done a couple of months ago.  I don't understand why your doctor didn't offer to do this sooner.  I have been told the cut off is 3 months because after that the risk of complications goes up dramatically.  If your doctor was very gentle then you might be alright.  But your choices at this point probably come down to living with the problem as it is, having the MUA or having a complete revision.  None of these are great options.  I would definitely call my doctor and ask her to help arrange a second opinion prior to the date of your surgery.  Is your doctor planning on keeping you overnight.  I hope so.  A MUA can be a very painful procedure for the first 24 hours and it is nice to be able to get morphine for pain.  My two MUA went done as out patients and now I would insist on being kept over night or at least have the option to stay if I felt I needed it. 

Last year after my TKR revision my current doctor was thinking of doing this procedure which would have been my 3rd MUA, he said he would keep me overnight going home the same day wasn't an option.

There have been several people that have posted here that have really been helped by having a MUA.   This is a difficult decision and I only think that another doctor is qualified in helping you decide if YOU would be safe in having a MUA at 5 and 1/2 months post-op.

Should you ever need another TKR, I suggest you talk to another Doctor about how they would handle your post-op care.   It doesn't sound like your doctor managed your post-op pain and when that happens it is no surprised that someone ends up with a stiff knee.  If it hurts to move then you don't move and you don't work as hard as you need to to get the knee bending. 

I live in Michigan and here we have doctor's that specialize in joint replacements.  When my first TKR did not go well I tracked down a specialist for my revision.  THIS IS BY FAR THE BEST DECISION I COULD HAVE MADE! 

Good luck!

Jan

[Mitidai]

Hi everyone,

It seems we have two Jan's posting so I'll finish all mine with Jan Y.
Jan L. you really offer a lot of insight to everything and I don't want
to take credit for it because you really do seem to know what you
are talking about.  All of this is new to me since I had my tkr Jan.
3rd.  My question to any of you is when your tkr is new is it normal
for it to feel crowded and wierd?  I swear when I bend my knee I
can feel the new knee in there and it's creepy feeling.  My pt said
it's because of swelling and also my body perceives it as a foreign
object so I'm more aware of it.  She said it takes about three
months for this feeling to go away and your body to perceive
it as "Your own knee".  It just kind of worries me (and I know
this sounds goofy) that they put too big of a knee in.  I can't
even describe how strange it feels when I bend my knee too much.

Any insight would be good.
JAN Y

[mollyCT]

Hi Jan and friends,
I had a death in my family last Monday and immediately travelled to Boston.  I went with a walker, wheelchair and cane and a bottle of Dilaudid, iron, ecotrin etc.   My home health aide etc and PT was cancelled for the week. I had to make arrangements with and be there to support my sister.  I'm so glad I could be there with her. The funeral was yesterday and I returned home about an hour ago. My PT is coming in the morning to close me out and transfer my case to an outpatient facility.  I'm anxious to get back online this evening when I can read and catch up with how you all are doing. My knee feels tight but I'm walking pretty good and can walk on my own in the house.  I feel good.  Sorry to not read your updates and post.  Just wanted to take a minute.  I hope things are OK for everybody.

[Mitidai]

Molly,

Sorry to hear about the death in your family.  It seems that things
can have a tendency to pile up.  When it rains it pours. 

I'm getting around my house really well now too but I'm getting
stir crazy.  I have gotten out to church and the grocery store and
out to eat.  I just want to get back to a normal routine.  Just have
to be patient I guess.  My knee feels tight too.  Like it's all crowded
in there.  The pt said that will get better but it really bugs me
sometimes.

Hope you continue to do okay and that things settle down for
you.

JAN

[chalkie]

Hi all

Margaret have to be quick 2 posts gone into thin air already

Jan L,s advice is worth noting she is usually spot on with it,however I would remind your OS of your fears if you decide to go ahead.

Had my TKR 20th April 2005 MUA 2 months later gained 15% on flexion up to 90% now at 95% still not happy and will persivere.

Hope you have satisfaction whatever you decide to do David.

[chalkie]

Hi Indian Mom

delighted to see that ur having good pain relief,I included u on 2 other posts but i lost both .

they were quite lenthy posts,so i am keeping this short.Good luck keep posting David.