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Author Topic: Regaining ROM after TKR  (Read 1764 times)

Offline shylitlkitten

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Regaining ROM after TKR
« on: October 23, 2008, 12:05:14 PM »
Hi I had total knee replacement on Sept 18, 2008. The surgery went well but I'm having trouble with my rehab. I have been in thearpy for 3 weeks now and can not regain my range of motion. I have reached 65 degrees and can not get any further. My physical thearpist has suggested I have a manipulation done but I am not sure. I have followed all my excercises regularly and have no idea as to why I cannot regain my ROM
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Offline Stevejw

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Re: Regaining ROM after TKR
« Reply #1 on: October 23, 2008, 12:36:09 PM »
I know the feeling. What was your range of movement before surgery? Are you using a CPM machine? I had two TKR's (same leg) and I had 'stiffness' issues post operatively as well. I did get to above 90 degrees using physio and hydro therapy following my first TKR - for my second I did have a'manipulation' which helped although you will need to work hard at it following the procedure to retain the gains achieved on the surgeons table. Good luck.
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ACL carbo fibre repair and three revisions. 12 scopes, Primary TKR November 02, revision TKR August 07. Post surgery staph infection, debridement, MUA.

Offline shylitlkitten

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Re: Regaining ROM after TKR
« Reply #2 on: October 23, 2008, 01:08:59 PM »
Thanks for the advice. My ROM before surgery was 130 and for the past week I cannot get past 65 I keep getting so discouraged and want to give up but thanks to my wonderful hubby who won't let me give up I keep going. I have talked to a few people who have had the manuplation and have found that may be the best route for me provided my Or agrees.
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Offline digginit

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Re: Regaining ROM after TKR
« Reply #3 on: October 24, 2008, 12:51:34 AM »
My first day home from the hospital, I got on my indoor bicycle and literally FORCED my leg around.  Was rough, but eventually it got less painful.  I figure it'd be tough for you to do something like that at this point, though, unless you got yourself good and tanked first...lol.  Ain't nothing wrong with a few shots of Patron.  :) 

J/k
Dig
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Offline Janet

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Re: Regaining ROM after TKR
« Reply #4 on: October 24, 2008, 08:16:36 PM »
It is not all that uncommon to need a manipulation after a TKR. If you have scar tissue that is maturing in there, there is NO WAY you can force through it on your own. And it's not your fault, nothing that you did wrong. It just happens sometimes.

I have a history of arthrofibrosis (excessive scar tissue formation), so we were watching carefully for it following my TKR. I knew all the proper things I was supposed to do and did them all. Things went pretty well until about ten days post-op, when all of a sudden I was losing flexion and my pain was increasing. I was stuck at about 65-70 and nothing we did in  PT would make it budge. Because my pain had gotten out of control, I was first referred to pain management. Once I was properly medicated (LOL), I had a MUA at five weeks post-op with marvelous results. I woke up in a CPM. I stayed in the hospital overnight with a morphine PCA. I had a peripheral nerve block pain pump in my femoral nerve to block the pain for three days. I had PT five days a week for two weeks, then three days a week after that. I used the CPM at home for 10 hours a day for a couple of weeks. The day after the MUA I could easily get to 90, then I got to 110 within a week. I eventually got to about 114. I only had 120 before the TKR (because of prior surgeries/arthrofibrosis), so I was happy with this result. I was really, really nervous about the MUA, but with proper pain control and rehab, it made all the difference. I would never have had a good result without the MUA.

Janet
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Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline shylitlkitten

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Re: Regaining ROM after TKR
« Reply #5 on: October 28, 2008, 12:32:20 PM »
Well I saw my surgeon yesterday and he advised that in my current condition we are going with MUA. He told me it is not uncommon in younger patients and that I will greatly benifit from the procedure. I appreciate all the encouragement. I will be having the MUA on the 11th of Nov. He is sending me home with a CPM machine so hopefully all will go well after. I am keeping my fingers crossed.
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Offline yuntigrl

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Re: Regaining ROM after TKR
« Reply #6 on: October 28, 2008, 04:06:24 PM »
Shy-

Will be thinking about you with your MUA.  Keep us posted.  Kathy
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Tore ACL March 1992
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Offline shylitlkitten

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Re: Regaining ROM after TKR
« Reply #7 on: October 29, 2008, 01:12:23 PM »
Thanks, I have been doing my research and have talked to several people who have had to go through this same procedure and I know that everyone is different but I feel confident that this will help me in so many ways. I know I still have a long road ahead of me and I will need all the support I can get. Again thanks.
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Offline bavage

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Re: Regaining ROM after TKR
« Reply #8 on: November 01, 2008, 01:23:03 PM »
Hi,
Welcome to the TKR club.

Is your knee still swollen? OS seem to fixate on their work and miss the "forest for the trees".

I had a MUA at 2.5 months that got me up to 125degrees under anesthesia but could not come close to duplicating in PT. Then I asked the OS I thought that if the swelling could be reduced I could bend the knee a little more. He gave me an RX for anti-inflammatories.

Two weeks later the swelling has gone down and I am at 121 degrees flexion and 3 degree of extension,improving rapidly ( finally & thank God).

They don't know everything

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Offline Janet

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Re: Regaining ROM after TKR
« Reply #9 on: November 02, 2008, 11:06:56 PM »
Have a good conversation with your OS about pain control! You don't want to be in a lot of pain that keeps you from your rehab. What plan do you have for PT after the MUA? The MUA by itself won't solve the problem without a combination of good pain control and extensive PT, so make sure you have plans in place. Don't wait until the day of the surgery to ask your OS. Make sure you ask before the surgery so plans can be made.

It will still be hard work after the MUA, but I trust it will help you reach your goals. Good luck!

Janet
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Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline yuntigrl

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Re: Regaining ROM after TKR
« Reply #10 on: November 03, 2008, 03:44:49 PM »
As soon as I weaned myself off of vicodin and started taking motrin 800's my swelling went down significantly.  I had thought that the swelling was keeping me from better flexion, and it has gotten so much better.  I have found that I don't have to ice as much either.  The only drawback...motrin has to be taken with food, and I forget sometimes, which has a tendency of catching up!!!  Kathy
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Tore ACL March 1992
Fixed ACL Patellar Graft March 2005 (That's right 13 years later)
TKR Sept 08

Offline shylitlkitten

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Re: Regaining ROM after TKR
« Reply #11 on: November 05, 2008, 02:08:45 PM »
Well I do have my PT in process. My first visit is the day after my MUA and 3 times a week. As far as pain control I have been on mortin and vicodin and it seems to work most of the time.y swelling is down to a minimal now but still no further ROM. I really can't wait until my MUA since this is so discouraging.
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Offline Janet

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Re: Regaining ROM after TKR
« Reply #12 on: November 06, 2008, 06:52:59 PM »
Will you stay in the hospital overnight? I did with a morphine PCA. Will you have a CPM? I woke up in one and didn't come out until I left the hospital the next morning (except for bathroom breaks). Will you take one home? I used it at home for 10-12 hours a day for a couple of weeks. I also went straight from the hospital to PT, then had PT five days a week for 2 weeks, then went twice a week.

Janet
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Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.
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