Dynasplint for Arthrofibrosis.....results anyone? PAIN?

[starpolisher]

My PT has spoken with a rep from Dynasplint.  I may or may not have used one for flex.....it was in 2005 after my first double tkr and whatever it was, it caused more pain.  I have heard the ones for extenstion (which is what I need) are not as painful but still have read they disturb your sleep and very mixed reviews on internet...even found something about an insurance scam with this company in 2010. 
I don't want to go ahead and try it without feedback.  I did find some old feedback from this site (archives from 2004) and it seems old scar tissue would be problematic and it is painful!  I can't deal with more pain.  Anyone use this?  Any advice? 
Thanks so much for any help.

[Decruz]

I didn't try Dynasplint but I own an Elite Seat for extension lack - I advise it.
Bye

[starpolisher]

Hi Decruz, I have an elite seat which also helped to an extent.....but not a lot.  What bothered me most was it's so hard on my back!  I have tried padding it with pillow and towels, but I also don't know if doing it on a bed (I don't have one of those firm leather tables they have in pt.....wish I did!) makes you sink in and kind of throws you off.  Since I started the astym I stopped the elite seat because of my back.  My back pain is gone now (though my pt has also worked on my posture with exercises) so perhaps I should pull it out and try it again.  I am going to try the Dynasplint for a short period of time to see if it helps and my pt is going to call Dr. Sevier and ask for suggestions.  I'll post if I learn anything new.  Also, does anyone know of any other piece of equipment for extension that is better? 

[captainruss]

I had my last TKR in September and scar tissue removed in October.  I went immediately into PT the day after leaving the hospital and did aggressive PT 5 days a week.  I could not get the flexinator which I wanted because my insurance will not pay for it.  I received the dyansplint about 4 months ago.  It is very painful for me.  I have it for flexion.  It is supposed to be a sustained low load stretch for flexion on my knee.  You probably would get the one for extension.  I really have a rough time with it leaving deep imprints in my thigh and calf.  I try to put it on at night and bomb myself with Soma/Xanaflex and either ambien/restoril so that I can sleep.  I normally get about 2 hours before the pain in my back, hip, and knee wake me up.

The dyansplint lady stated that I needed to keep it on as long as possible to the extent that the pain it causes subsides 60 minutes after taking it off.  First, my pain never subsides.  the pain from the dynasplint does increase and decrease, but it is hard to wear.  I was so outraged at this 2 years without working that I did 50 PT sessions (5 a week) and the dynasplint or CPM every minute I was not at PT.  I stopped in February as I could get no more than 60 degrees ROM.  I am now back to 40-50 and growing bone and scar tissue by the pound each day.  I can not weight bear for the first 15 steps with a walker and it is sheer pain every step after that.

As for insurance, I have excellent insurance.  The last 6 months of every year I am considered catastrophic because all my copays are met.  When I was issued the dynasplint (they only rent them to you) she told me I was convered in full.  I just found out I have to pay a deductible for every day from January 1st.  She did not tell me that up front and I don't even know what I owe.  I told her to send me a bill and I will put it with the rest of them cuz you can't get blood out of a turnip!

I cranked the thing up, but the scar tissue/bone would not relent.  I tell you this for what it is worth...nothing has worked on me in 2 years and I am thinking of chopping off my leg with a dull soup spoon to take my mind off the pain!  You may have better luck, but beware of the copays.

Russ

[starpolisher]

Thanks Russ.  I am very suspicious of this.....the sales rep didn't even know what AF was and I told her it may work for people without AF but very little works for people with AF.  No way am I going to have a contraption on my legs for a long time!  I told her up front I was sure I had a Dynasplint for flex several months after my  first operation and it was torture and I developed pain in my ankles, back, all sorts of places I didn't have surgery and wouldn't continue.  My PT checked with my insurance and had already gone ahead and had it approved in full .... but I told her I had not seen any positive reviews for it by anyone with AF.  The elite seat is 10 minutes.  She said to wear it on 1 for 30 minutes and go up a notch a day.  I did have it on the first setting and it was fine, but I really feel it is a waste. 
Does Dr. Noyes recommend any kind of machine for extension?  I had stopped doing the elite seat and when I tried it again, some months later, didn't like it on my bed and the back problems it caused.....even just using it 10 minutes a side....still have it....not sure if I remember how to use it.  Since my pain has eased, I thought it couldn't hurt to try it again.   I reread some of the info by the doctors and am focusing on exercises for extension.  I just wish the elite seat were more comfortable and not affect my back.

[Pdreamers]

The extension dynasplint is defintely no where near as bad as the one for flexion.  For flexion I would rather hang my leg over an elavated table with 10 pound weights hanging from my ankle before the flexion dynasplint ever touches my leg again.  But even though I have said I never would put one on me, I guess the extension dynasplint wasn't the worst thing in the world to tolerate.

P-

[starpolisher]

Pdreamers......but does it work.....the one for extension?  I put weights on my thigh just above my knee and elevate my feet on a foam pillow.....10 lbs.  Do you think the Dynasplint for extension does anything?  I hated the one for Flex......just hurt me everywhere and crippled me more. 

[Pdreamers]

When I used the dynasplits it was post surgery 18 months ago and my knee was so fibrotic it is tough to tell if it works or not.  I can definitely say it is very uncomfortable, especially for flexion when you have a knee that is locked at 90 degrees and it extremely arthrofibrotic. 

For extension, I am a proponent of putting weight around your kneecap and manual therapy, plus I will see how the graston treatments help over time.  My extension is pretty good, but for the past 18 months I put my heel on a chair and hang 10 lbs beneath my kneecap while sitting in a chair with my leg straight out.  I find that effective.  Not sure if there are restrictions where you can put weight due to your TKR.

The other thing that I do to help mobilize my kneecap, which is basically frozen, is that I use a plunger on it 15 minutes a day which does actually enable me to move my kneecap side to side a little after I plunge.  Amazing what the novel idea of putting a suction cup with a handle enables you to do to help move your kneecap.  PT therapists are thrilled when I do this before PT since it gives them a head start when they work on mobilizing my knee cap. 

Over the past 18 months, the gains have been very slow but this is a marathon salvage project and as long as it gets me into my 50s before I have to do a TKR I will be better for it.

P-

[Decruz]

Hi Decruz, I have an elite seat which also helped to an extent.....but not a lot.  What bothered me most was it's so hard on my back!  I have tried padding it with pillow and towels, but I also don't know if doing it on a bed (I don't have one of those firm leather tables they have in pt.....wish I did!) makes you sink in and kind of throws you off.  Since I started the astym I stopped the elite seat because of my back.  My back pain is gone now (though my pt has also worked on my posture with exercises) so perhaps I should pull it out and try it again.  I am going to try the Dynasplint for a short period of time to see if it helps and my pt is going to call Dr. Sevier and ask for suggestions.  I'll post if I learn anything new.  Also, does anyone know of any other piece of equipment for extension that is better? 

You have to use the EliteSeat on the floor, absolutely not on the bed...
Lay on your back on a carpet...that's it.
Bye

[captainruss]

The dynasplint did not work on me, but I not only have AF but HO which is bone that inhibits flexion of my knee.  My PT would physically try bending my knee with it hanging off a table by sitting on it, laying across it, and physically using all her strength (she was tough) and could not get me past 60 degrees.  She and I could feel the scar tissue tearing, but it would let up.

If you have just had surgery or are not hugely infected with AF, I think the dynasplint would work.  NO, it is not the most comfortable...but I would hate for you to not try it if your insurance is going to pay in full.  What works for me does not always work for someone else.  I believe you must try everything for yourself.

Russ

[starpolisher]

Decruz, It's impossible for me to get up from the floor.....my knees are that stiff.  I've tried....impossible.  My OS said my rom make it impossible.  I am doing weights on my thighs in bed with feet elevated and seems to help.  I've used a yoga mat on my mattress with a board between mattresses, but it really needs to be firmer.  My rom has always been very poor and the sad part is my original OS never once measured my rom before surgery, so have nothing to go by. 

[captainruss]

I found an exam table similar to what you see in PT clinics.  It is at waist heighth and I do my CPM on it and any other needs like the elite seat etc.  I can't bet my fat butt off the floor without extreme effort.  My shoulders are shot and it is very difficult to power myself off the floor.  I had to adapt.

Russ

[starpolisher]

Russ,
Where did you buy it?  How expensive?  For now I am up to 10 minutes with 10lb weights on my thighs and ankles and feet elevated.  I am noticing a difference just in this short time.  I'll ask my pt if she has other exercises specific to better rom.
Thanks so much. 

[captainruss]

Star,

My wife found it at a flea market and paid $35 for it.  It is nothing special.  You could actually probably use a rubber maid table from Sam's Club.  I used them before to stand on and put up dry wall.  I am quite large and they supported my weight.  I would simply attach egg crate foam pad that you can buy for your bed from sams club or walmart.  You could also have someone nail together a table out of plywood and 2 x 4's and put the foam pad on it.

Russ

[LoveFall]

I have been using the Dynasplint for flexion and extension (one for each) for 5 weeks. (TKR Oct 25, 2011, MUA Dec 16, 2011, diag w/AF). The rep told me there should be no pain when using the splints, but that is not true. I had no pain until I progressed to 3 to 4 hrs per day on each splint. Also, pain increased as the tension was increased after each week. The extension splint is less painful, but difficult to walk after use since the leg is in the brace for 4 hrs. My body frame is small and every time the tension is increased it is difficult for me to pull the straps completely tight and I do have some pinching. In 5 weeks I do believe the extension splint has helped my degree of ext. Prior ext degree 8 now 3 degrees. The flexion splint has not help as much. As others have stated - I do have some pain in my akle, but not sure it is due to the splint. Good luck with your decision.