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Author Topic: MUA after a TKR and still have problems  (Read 274 times)

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Offline TimBukTu

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MUA after a TKR and still have problems
« on: November 18, 2019, 04:51:03 PM »
Hi I had a TKR in April 2019 and MUA in July but I am still having problems with ROM and pain. After the MUA I had around 110 degree movement I had physio twice weekly and rented out a CPM machine for 2 months but still my ROM got worse,only 80 degrees and pain bending now although walking I feel fairly strong. After a 10 minute walk my knee looks swollen. I had early exterior knee infection/reaction and the whole leg was swollen this stopped me making much progress in the first month. I am now 7 months on and I am not in a good place at all and I have pain and limited ROM. When I last went to see my consultant he told me it was unfortunate that I had so much trouble as most operations had a successful outcome and I was in a category where about 7 percent of people have troubles. That was a few months ago now and I was given the opportunity to see him again if I needed to.  I think it is fair to say that most of the decisions about my treatment are left to me to decide as all things come with a risk and that seems to be theme, but I am not a consultant how would I know what I need?  I have booked to see the consultant and would ask help here in knowing what to ask him to progress from here.  I am 65 years old and have led a fit life up to this point and I am prepared to have other procedures as I do not wish to be left with this much pain and low ROM.

Offline Vickster

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Re: MUA after a TKR and still have problems
« Reply #1 on: November 18, 2019, 06:02:38 PM »
Perhaps see him, but you could also get a second opinion. You'd be best doing that I would think with a surgeon who is expert/specialised in revision surgeries of TKRs. Just getting a second pair of eyes can be useful to confirm all is well, properly positioned etc

What country are you in.
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline TimBukTu

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Re: MUA after a TKR and still have problems
« Reply #2 on: November 18, 2019, 06:31:32 PM »
I will see him and ask what can be done now and pending his response I will ask for a second opinion. I am in the UK

Offline Vickster

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Re: MUA after a TKR and still have problems
« Reply #3 on: November 18, 2019, 06:32:33 PM »
Good luck. You may need to do your own research on who best to see for a second opinion, as although most knee surgeons do TKRs not all have expertise for revisions. Are you reliant on the NHS or potentially able to go the private route (not all of the most experienced still have an NHS practice)
« Last Edit: November 18, 2019, 06:34:46 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline The KNEEguru

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Re: MUA after a TKR and still have problems
« Reply #4 on: November 19, 2019, 11:07:59 AM »
Stiffness after TKR is most often related to arthrofibrosis (AF). See https://www.kneeguru.co.uk/KNEEnotes/knee-dictionary/arthrofibrosis

Your MUA may have been done when the knee was rather active, and this may have stimulated more fibrosis (internal adhesions and scarring). It would be good if you could inform yourself well about AF and see if you can consult someone who is more confident in managing it, with surgical releases such as Lysis of Adhesions (LOA) and good pain relief during any subsequent rehabilitation.
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Offline TimBukTu

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Re: MUA after a TKR and still have problems
« Reply #5 on: November 20, 2019, 06:21:17 PM »
Thank you both for your replies 8) 8)


I am lucky to have insurance and seeing the consultant privately not NHS although he does also work in the NHS at the local hospital. I have been seeing him for several years with ongoing problems with the knees prior to having the TKR. I do have faith in him but I will keep as informed as I can as they say knowledge is power.

I saw my consultant today and explained where I am right now.

He examined my knee which is also clicking at the moment and he said go and get an x-ray and come back in to see him, on returning to his office after the X-ray he showed me a before and now  picture and he said there were no problems with the knee alignment but he noticed something else happening which was that there was a small gap between my bone and the Tibial tray at one side and also a couple of  small darker areas around the tibia Bone.

He said the gap had been caused by the bone shrinking or moving away from the tibial tray/cement and that the darker areas were where the bone was softer. He is going to investigate whats going on initially by blood tests and taking a fluid sample from the joint area to check for signs of any hidden infection in or around the joint.  I will be booked in to have this done within the next few weeks as it will need to be done in operating theatre to ensure that it is in a sterile environment. I will be awake during the procedure and I feel a bit more confident today knowing that something is being done albeit that it is still early stages.

I am open minded as to the causes of my problem and having a good look at AF as originally that was there diagnosis of my problems pre MUA.