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Author Topic: Stiffness in straightening knee 4.5 months after tkr  (Read 3075 times)

Offline aretha

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Stiffness in straightening knee 4.5 months after tkr
« on: January 24, 2011, 06:15:18 PM »
Hi, I am an English female aged 65 living in Henley on Thames in Oxfordshire.  I had my right TKR (and the first) back in September 2010.  Everything was going great although the PT was almost non-existent here in the UK.  Had almost none in 5 days in hospital, and on my second visit to the PT 4 weeks after TKR she said that I was doing fine and didn't need to see me any more!!!  My flexion is only 95 deg and my extension +2 so I really didn't think it was that great, but as I only had 90 deg before the op was quite happy with this.  However, now 4.5 months on - am back to 4 times a week aqua classes and boy are they helping - or I thought they were.  This last week I am uncomfortable when sitting down for a period of time.  Knee seems to be stiff to extend within the kneecap itself and above it, but not quite so stiff to bend.  My scar above my knee feels like a tree root, and it feels like its tethered to the muscle below as it puckers somewhat when stretching out and feels lumpy!  I am not sure what is causing this, there seems to be so much that can happen and am getting worried and frustrated and sitting of an evening is not at all comfortable. I do not take any pain killers, except maybe a Paracetamol with one Tramadol at night sometimes to feel more comfortable in bed.

Does anyone else feel this tightness too, it hasn't always felt like this.  I love this website its been a big help to me with all the sleepless nights since the op..
« Last Edit: January 24, 2011, 11:33:06 PM by aretha »

Offline mudruninjury

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #1 on: January 24, 2011, 11:55:43 PM »
Hi!  I HAVE NOT had a TKR.  I just had an injury (ACL avulsion that did not require surgery) 4 months ago tomorrow and I still have a SUPER stiff knee and a whole lot of problems with extension and a little of difficulty with flexsion.  So, my guess is...since a TKR is much more serious...that it is normal what you are experiencing.  Hope this helps.   :)

Offline emergRN

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #2 on: January 25, 2011, 12:29:54 AM »
Aretha,
If you are finding it MORE difficult to extend your knee then you were before the classes, I think you should get this checked out.  Was your OS fine with your level of extension and flexion?  From your post it sounds like you only had 2 sessions with a physiotherapist.  This does not sound like a adequate amount of physio after a TKR.  Personally, I would follow up with my surgeon, and find another physio.  I had an ACL reconstruction in August(I know that they are quite different), but the main focus of my physio for the first little while was all about the extension and flexion.  Has your scar felt "like a tree root" since your surgery, or is this new as well?  I hope someone here who has actually had a TKR will weigh in on your situation.  My motto is that it is better to be safe than sorry.  If you are concerned enough to post on KG, then you should probably be seen by someone.  We can give you all the advice in the world, but we cannot see your knee, nor are most of us qualified to tell you what is wrong, or if there is anything wrong at all.  Please keep us posted!

W
Rt.knee scope-1990-91Dx with Partial ACL tear
Rt. ACLr with hamstring graft-2010
Rt. knee scope- partial lateral menisectomy and plica excision 2010
ACL revision quad tendon graft- 2011 
Rt. Knee partial lateral menisectomy, debridement 2012
Rt. knee partial lateral menisectiomy, debridement 2014

Offline aretha

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #3 on: January 25, 2011, 12:28:09 PM »
Hi, thanks so much for those replies, its so uplifting to hear from you guys, and makes me feel a whole lot better.  I have made an appointment this p.m. to see my own doc and see what she says. The movement of the knee seems fine, I can extend fully and bend reasonable well but its the stiff feeling that I feel that is freaking me out especially as I did not have this degree of stiffness until the last week or so. Could it be that I am overdoing the activities, I do work quite hard in the water and do not ice and elevate much any more.  Could it also be that the feeling is returning to the right hand side of my knee which was pretty numb up till now and now it feels like the numbness is going and the feeling is returning? Checking out with anyone is pretty difficult here in the UK. Only saw someone at the hospital (a head physio nurse) 8 mweeks after TKR and they were pretty happy with my results and X-rays were fine too.  Next appointment I have is in March to see my OS for my 6 month check, not sure how I would approach him to see him earlier, have only seen him once since TKR in hospital day of release, and then he just asked if I was OK and signed me off!! Guess I will see this afternoon what my own doc says and hope for the best. Will update tomorrow.

Offline emergRN

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #4 on: January 25, 2011, 05:22:09 PM »
Aretha,
I am so glad you are going to see someone.  I think that is the right thing for you to do.  Let us know how you make out!

W
Rt.knee scope-1990-91Dx with Partial ACL tear
Rt. ACLr with hamstring graft-2010
Rt. knee scope- partial lateral menisectomy and plica excision 2010
ACL revision quad tendon graft- 2011 
Rt. Knee partial lateral menisectomy, debridement 2012
Rt. knee partial lateral menisectiomy, debridement 2014

Offline aretha

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #5 on: January 25, 2011, 11:51:38 PM »
Thanks for the post.  Saw my doc this afternoon, she was a young doctor who really didn't seem to know much about TKR's.  She said that as I could bend my knee and straighten it to that she didn't think the stiffness etc. was anything much and to stick with it for another month or so and see if it went away of its own accord.  Tonight I was really massaging my scar especially above the knee as this appears to have tree root feeling scars that are hard and feel tethered further down in my leg that seems to restrict the movement somewhat.  Other than massaging often is there anything you can do to lessen or soften the scar tissue and prevent it from getting worse.  I asked about stopping my water activities and she said not to as all excercise was good for the knees healing!

God I am so frustrated about feeling like this, and wondering if this knee is getting worse, or am I going to be one of the few that get massive scar tissue or even arthrofibrosis, can't bear to think about it really, soo am going to bed now with a Tramadol and hope that I can sleep through the night and not worry too much.  I know there are a lot more of you out there with far worse problems and I really don't want to complain too much, but bless you anyone who posts me its so great to "talk" to anyone and get some answers, and know that you are not alone.  Thanks.

Offline emergRN

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #6 on: January 26, 2011, 12:04:37 AM »
Aretha,
Keep massaging that scar tissue!!  I will tell you that I had some scar tissue after my latest procedure in Dec.  My physio has been very diligent in massaging the scar tissue.  He did it a lot harder than I was able to.  I would not put myself through pain, but I would let him do it.  My knee felt tight as well, but now it is much better.  He also used ultrasound on that part of my knee as well.  I LOVE my physiotherapist!!  Is there a physio that you can go to get some proper exercises and some treatments?  It is well worth the money!

W
Rt.knee scope-1990-91Dx with Partial ACL tear
Rt. ACLr with hamstring graft-2010
Rt. knee scope- partial lateral menisectomy and plica excision 2010
ACL revision quad tendon graft- 2011 
Rt. Knee partial lateral menisectomy, debridement 2012
Rt. knee partial lateral menisectiomy, debridement 2014

Offline aretha

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #7 on: January 26, 2011, 04:07:34 PM »
Hi, thanks for the message.

I do religiously massage the scar etc every evening with Vitamin E cream almost until it is sore, and although it helps the "tree root" section is still there the next day.  I am going to book another appointment with a private physio, trying to see an NHS one will take about another 4 months wait, and see what she says.  I am not sure that she has an Ultrasound facility though, but it would be great if she can just aleviate the worry that I feel.  Been swimming today and it helps in the water to be sure, but now I can feel it tightening up again, and dread the sitting down at night as that is when I can really feel it., and its so difficult to relax when its at the back of my mind all the time.  Its not too bad sitting at the table on my laptop and I keep stretching my leg out and bending it back as often as I can. Anyway, thanks for keeping a check it does help toi know someone else has been through this, but getting really worried that scar tissue is going to be real problem somehow.

Offline Stasha83

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #8 on: January 27, 2011, 01:40:59 PM »
Hi Aretha

Sorry to hear about your problems, I can understand how frustrated you are. I have not had a TKR, but did have surgery last June and was diagnosed with arthrofibrosis in December. I am lacking 10 degrees of extension and have only 90 degrees of flexion so my leg is pretty useless at the moment!

The only advice I can give you is that you know how your leg feels and if you are worried you should push to get the answers. Perhaps if I had pushed harder and not allowed myself to be fobbed off I wouldn't be in the awful state I am in now although hindsight is a great thing! If you do have AF symptoms it is worth looking in the AF section on this board as there is alot of information there and lots of helpful posters.

I would recommend private physio if you can afford it, my NHS physio was useless and impossible to get enough appointments.

Sorry I cant help much, I just wanted you to know that you are not alone in your frustration  :)

June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline aretha

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #9 on: January 28, 2011, 04:02:28 PM »
Thanks stasha, I appreciate you spending time writing to me.  Leg still feels a little sore, and I have let up on the aqua programme just to see if I am overdoing it at all.  I really need to ice and elevate more as apparently people say that 4.5 months is early days yet and I have to be patient!!  Am trying to take just Paracetamol at night now but last night had a problem with my leg feeling heavy and really aching half way through the night although I slept on my back with my leg extended so not sure what all that was about either!

I will see what the weekend brings, and maybe ring my OS if I can get through to ask for his advice, although not sure I can get through to him myself but willing to give it a try anyway.

Are you due to have a TKR in due course or can you hold off for longer?  Great hearing from you, wishing you a pain free weekend if thats possible.  Bye for now Rita

Offline Stasha83

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Re: Stiffness in straightening knee 4.5 months after tkr
« Reply #10 on: January 28, 2011, 04:38:37 PM »
Finding the right balance is tricky, I think you just have to listen to what your leg tells you. If it hurts more than usual you know you have over done things.

I'm only 27 so no plans for a TKR at this stage. I have just come home from hospital today actually, I've had some treatment with my pain specialist which included 12 injections into and around my knee! The injection into the joint was Synvic One so I shall be interested to see what results I get from that.

Luckily I was sedated so don't remember much of it although I have alot of pain and swelling to show for it now. I am also scheduled for an MUA on 25 Feb so I will have to wait and see what the next few months have in store for me.

Best of luck to you, I hope you manage to make some improvement and get the answers you need.
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation