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Author Topic: Increasing stiffness after PKR?  (Read 7340 times)

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Offline esther_bunny

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Increasing stiffness after PKR?
« on: February 06, 2012, 03:25:41 AM »
Hello-
Was wondering if anyone else experience this? I'm about 3 weeks post op and have noticed that my knee seems to be going backward. The sessions in the PT office made me cry last week. This week, even doing the PT work at home leaves me in tears. This is with full pain medication in me. The flexion is fine.
My dr and PT guy keep saying if I don't start doing better they will have to go in and break up the scar tissue. I do not want this.

Did you do anything to help get rid of the stiffness? I'm terrified and tired of crying.

Offline esther_bunny

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Re: Increasing stiffness after PKR?
« Reply #1 on: February 06, 2012, 03:26:32 AM »
Did muscle relaxers help? I'm trying to let go and give in to the stretch but it's just not happening.

Offline esther_bunny

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Re: Increasing stiffness after PKR?
« Reply #2 on: February 06, 2012, 06:48:15 PM »
Got to 90 degrees today but it came with body wracking sobs and an incredible amount of pain.
I have 2 more PT sessions before I meet with my doctor. My doctor  will decide if I get more time or if it's time for surgery to break up the scar tissue.

The pain is incredible guys.

Offline KW

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Re: Increasing stiffness after PKR?
« Reply #3 on: February 06, 2012, 08:07:15 PM »
Try using a heating pad before you stretch. Sometimes muscles need to be warmed up a little before a good stretch. Also talk to your pt about different methods of stretching. Sometimes lunges into a step work or stretching in a prone position. Different things work for different people  Some pain and discomfort when working on flexion is kinda expected but true pain is not good.
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
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09/04/09 PFJR/Unscrewed

Offline esther_bunny

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Re: Increasing stiffness after PKR?
« Reply #4 on: February 06, 2012, 10:53:49 PM »
good idea, thanks KW!

Offline esther_bunny

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Re: Increasing stiffness after PKR?
« Reply #5 on: February 08, 2012, 06:07:06 PM »
I got to 92 degrees today! Chipping away but I'm getting there.
It's as if I'm the tortoise in that story of the tortoise and the hare  ;)

Offline UK Girl !

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Re: Increasing stiffness after PKR?
« Reply #6 on: February 08, 2012, 07:12:09 PM »
sorry you are having probs but to be perfectly honest 3 weeks post op is very very new - how can your doc be talking about breaking scar tissue, you havent even had time to get much healing/phsio done !
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline esther_bunny

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Re: Increasing stiffness after PKR?
« Reply #7 on: February 08, 2012, 09:22:38 PM »
I have no idea why he thinks it should bending faster. What do your (plural) doctors have expectations for as far as bending your knee?

Offline KW

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Re: Increasing stiffness after PKR?
« Reply #8 on: February 08, 2012, 10:02:28 PM »
My OS has not laid out specific expectations.  I was 4 weeks post-op yesterday and at 90* flexion and 0* extension.  Had my 1st out patient PT appt yesterday...while there was no high fives for my flexion my PT was not in the least worried.  He has always told me that as long as I am making some progress week to week then everything is good.  In 10 years of treating me he has never been wrong so I trust his judgement! 
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline Ciik

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Re: Increasing stiffness after PKR?
« Reply #9 on: March 31, 2012, 04:09:51 AM »
Depending on age and co-morbidities, most middle-aged patients have full function at 4-weeks following a PKR and many of these procedures are being done on an out-patient basis also.  There are many variables at play, but I'd be curious as to some of the factors associated with such a minimal ROM following a PKR at 4-weeks if it were a family member of mine.  Go to another OS promptly if this continues, is what I'd say to a family member.

Offline The KNEEguru

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Re: Increasing stiffness after PKR?
« Reply #10 on: May 24, 2012, 10:18:03 AM »
Hi esther_bunny
If you have not already done so, please read up about arthrofibrosis - http://www.kneeguru.co.uk/KNEEnotes/node/633
and maybe join the group discussing this http://www.kneeguru.co.uk/KNEEtalk/index.php?board=9.0 so that you are fully informed about issues prior to any manipulation.
KNEEguru
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Offline captainruss

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Re: Increasing stiffness after PKR?
« Reply #11 on: June 09, 2012, 07:58:53 PM »
Bunny,

Please read the links the moderator gave you above and search this site for the report by Dr. Frank Noyes (cincinnati OH) for AF.  If you are stiff because you have AF, you have such a small window to get it treated CORRECTLY before AF is a lifetime companion.

I am not sure who your OS is, but if he does not quote you very closely to what Dr. Noyes says, I would run the other direction.  I had scar tissue carved out of my first TKR during what was supposed to be my second TKR.  My first OS thought I was infected (hot, swollen, no ROM<50 degrees) so he was going to replace the first TKR. 

While I was on the table, he did cultures for infection which came back negative, so he left the original TKR in, but carved out pounds of scar tissue.  He did not give me aggressive PT and no followup for the scar tissue.  Not only did it come back, but it came back with a vendetta and swelled my knee twice as much.  I had so much swelling that both legs, my good one and bad one would swell so much I could not feel my toes.

So I went to OS #2 who swore OS #1 was a moron (for not removing the first TKR, putting in an anti-biotic spacer, treating with anti-biotics, and replacing the TKR in 6 wks) and promised me if I let him do TKR #3 he would tell me 2 wks postop what the infection was and the proper treatment for whatever it turned out to be.

My surgery was so horrendous I was calling 911 in  my hospital room at 3 a.m. because i did not know where I was.  The cultures came back negative (means no infection to me) but OS #2 and infectious disease doctors said I was infected, but could not tell me what the infection was.

He would not treat me any more and it looked like he let his intern close the surgery site.  This was not some amateur....he is the team doctor for the Orlando Magic and worked on (Shaq's knees).  He bragged several times how he had had done 4000 TKR's with only 20 infections.....well 21 if you count mine or more if you don't believe the man.

Anyway, if you have stiffness and it is scar tissue...ignoring it is the worst thing to do. 

You MUST go to an AF specialist.  I took Dr. Noyes report to OS#2 and he tossed it in the trash can.  He told me I could let Dr. Noyes  treat me or him......my bad....I made the wrong decision.

I should have hit him so hard his whole family fell down and scheduled a trip to Cincinnati before Florida 5-O shows up!!

Don't wait...don't hesitate...and don't go to anyone but an AF specialist at least until you get a solid diagnosis.

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Daisy888

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Re: Increasing stiffness after PKR?
« Reply #12 on: September 15, 2012, 02:06:06 AM »
I had excruciating pain for one month following my PNR.  Was not really progressing with pt much, but continued all the pt exercizes and recommendations.  Everyone kept telling me it was normal, but kept feeling like I must be crazy or something.  Had a manipulation, because the Dr. thought it was scar tissue.  That procedure did not change anything.  Turns out there was a tiny piece of cement left inside from the surgery. Found upon closer examination of the post op X-ray.   Had to have arthroscopic surgery procedure to remove it.  That  sharp pain was gone after that.  Other pain still continues.  Stiff and sore all the time. 















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