Joint Stiffness: Complications Following Knee Replacement Surgery
In a relatively recent article 1 published in the Musculoskeletal Journal of Hospital for Special Surgery, Dr. Alejandro Gonzalez Della Valle et al reviewed the origins of and treatments for early onset stiffness, a common complication following knee replacement surgery. We’ll present a brief summary of the article here.
How Prevalent is Stiffness after Knee Replacement?
In a review of the literature, the authors state that stiffness occurs in roughly 6% of cases, making it the most common knee replacement surgery complication.
How is Stiffness Defined?
The researchers reveal that what is perceived as “stiffness” following knee replacement has evolved over time. Several years ago, a knee was considered stiff if the patient could not extend their knee beyond 25 degrees of flexion (that is, a flexion contracture of 25 degrees) or if the full arc of motion was less than 45 degrees. More recently, as surgical technique and implant design have improved and as younger, more active patients receive implants, expectations have changed. Today, stiffness has been defined as a 
flexion contracture equal to or greater than only 10 degrees or an arc of motion less than 95 degrees. The authors note that this degree of motion is what is required for common activities of daily living (walking, sitting, stair climbing). Practically speaking, a joint can be considered “stiff” when it limits the patient’s ability to perform such activities.
What Causes Stiffness after Knee Replacement?
The authors place the causes of stiffness into three broad categories:
Preoperative – These include things like post-traumatic osteoarthritis, patients with prior high tibial osteotomy and patient whose preoperative range of motion (ROM) is limited.
Intraoperative – Included here are what the authors termed “technical errors” during the procedure. Things like, improperly sized implants and poor “balancing” of the joint through improper bone preparation fall into this category. The researchers explain these as well as other technical errors in detail.
Postoperative - Following surgery, stiffness can be caused by additional factors. Some examples are by patient behavior (“poor patient motivation”) deep infection and inadequate pain management.
How is Stiffness Treated
The authors then outline the various ways in which stiffness can be treated following knee replacement. Manipulation of the knee by the surgeon under anesthesia is generally successful when used within the first three months after surgery. After this period, more aggressive surgical options should be considered since manipulation can result in fracture or soft-tissue damage. Some surgical treatments described are arthroscopy, tibial insert (or spacer) exchange and revision surgery (i.e. exchange of the femoral component typically to correct imbalance in the spacing between the thigh and shin bone created at the time of surgery). The authors also stress the importance of proper rehabilitation following knee replacement.
The original article is available online through PubMed Central.
1. Gonzalez Della Valle A, Leali A, Hass S: Etiology and Surgical Interventions for Stiff Total Knee Replacements. HSSJ 2007, 3: 182-189
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Had TKR on rt knee in ‘06; followed by an arthoscopy 3 months later to remove large amount of scar tissue which affected my gait to no avail. Had partial revision (replacement of patellar component & removal of still more scar tissue) in ‘07; despite physical therapy, acupuncture, massage, water theraphy and much effort, both times, additional scarring and stiffness which never has let up. I cannot see going in for another arthoscopy only to have this scar tissue reappear. I have no idea why I am plagued by this condition. I regret ever having this operation.
I was facing the same problem and had a severe pain in my knee but somehow managed to get rid of this problem with my physician’s help.
On June 1st 2010 I injured my knee and went to the ER the next day, where they gave me a diagnosis of a torn MCL and Meniscus tear, they immediately put me on a brace to restrict movement and also crutches. On June 14th i had an MRI done which showed a partial MCL tear and a medial meniscus tear. On June 19th i saw an orthopedic surgeon, i explained my symptoms as follows: My main issue was the inability to fully extend and flex my leg which was a symptom that developed immediately after the injury, and also the normal pain on the area where the MCL is located when twisting or basically any movement of my leg. The doctor’s response was that my MCL tear was partial and it would heal by itself on a period of three months and instructed me to keep wearing the knee brace adjusted to bend only at 90 degrees and he basically ignored my meniscus tear saying that it would not cause any difficulties, he said the reason for the loss of range of motion was the swelling and instructed me to come back in 6 weeks.
So i followed instructions and finally on August 12 i went back to the clinic and saw a different doctor to which i explained my condition all over again, at this point my inability to fully extend or flex my leg is still present, pain has dramatically reduced and it think the source of the pain is the torn meniscus as the area of the pain is different and lower intensity. This pain keeps me from trying to bend my knee past 90 degrees, when trying to extend the pain is more tolerable but still my joint is so stiff that i have had no success trying to improve my range of motion. As i explained this to the doctor he was leaning to surgery as an option to repair the torn meniscus which he believed to be the cause, but he had to talk to his chief surgeon before any decisions were made. The chief surgeon examined my knee and looked at the MRI and discarded my injury from being the cause of the problem and explained that my leg was so stiff and have to get it moving or I will never regain full range of motion, surgery at this point was not an option because it will make me even more stiff, he only prescribed physical therapy for the next six weeks to regain full range of motion.
At this point i am stressed out and scared that my leg will stay like this forever, I am doubtful as to if the instructions given by the surgeon are the most appropriate.
I had knee replacement surgery on Sept 16th 2010. My knee has been very stiff. I’m trying to get the stiffness out of it, but haven’t had much luck doing it. I’m wondering how long it will be like this. For the way that I feel right now I wish that I had never had it done. By doing some reading here on the internet they say it takes a year to recover from this surgery. That is a sure long time. I was never prepaired for what I’m going through right now. If, any one out there has more information for me regarding this surgery I sure would like to hear from you. I have alot of questions regarding it. How are other people taking this surgery.
Hi Sue, I’m having a TKR on Monday, 10/25. I’m very concerned, but hopeful as I am only 42, and have been bone on bone for about 8 years. Are you getting PT at least 2x per week? What does your doctor say?
Amy
I had tkr on 8-24-10. I’m having much trouble getting full range, my knee won’t bend much more than 90. I’m supposed to go in for manipulation on 10-29. don’t know what to expect, scarey, i just hope this works and i can get back to normal. They say its scare tissue. my knee was unbendable before surgery it was so bad i guess that has something to do with it. I had a hip replacement in Feb. and had no problems , made out just fine.
I had TKR on 9/29/2010, and cant seem to flex my knee more than 95 to 99 degrees. My knee feels like a brush burn on my skin , like I skinned it when I was a kid. My neighbor suggested wrapping saran wrap around my knee to get the knee warmed up before phys. therapy 3x a week. What kind of ideas does anyone else have?
10-4 to any of you who said you wish you would not have gone through this TKR. I had mine on October 14, and I contracted pneumonia and had to be transferred to a different hospital, where no one was addressing my newly opened knee. My health insurance was dropped because I got married and so I have only been to two physical therapy sessions. I am so concerned about the stiffness and the pain that I still have. I refuse to have anymore surgeries (let alone I could not afford it), but at this point I do not know what to do. I do my exercises faithfully but hope that this is enough.
I had my first TKR on June 6, 2006. Had to have scar tissue minuplated on July 18th to regain full range of motion. My knee fells great now!
I recieved my second TKR on June 1st 2010. Did wonderful!!! Never knew I had surgery practially! I used my walker 1st week, then my cane the next week never used it after 2nd week!! Been going strong eversince!!!
Hi ..My mum had a TKR in Aug2010 she has been doing ok …but now she feels stiffness below the knee not everyday but it does come ..any suggetions ??? Thankss
I had TKR in August, then had a manipulation on Oct 31,2010 had 12 weeks of physical therapy because of the manipulation, it has been a year and 2 months since physical therapy ended and my knee is as stiff as it was when I first started physical therapy, the stiffness really gets on my nerves, and makes it hard for me to function properly or balance and walk properly.
My leg still gets sore sometimes and I also hate I had the surgery, which I know I needed it badly. I am still not able to wear my high heels or do normal activities as of yet…I go to the doctor soon and I am needing some answers as to why I am still so stiff!
The doctor did tell me that they haven’t found a cause for the stiffness as of yet, that’s really not helping me at all!
i had my tkr 12-28-09 i am 53 and i am still bothered by the stiffness especially when i stand up from sitting to long it. just recently i fell down on the concrete i fell on the knee i had replacement. im going to see the doctor next week i hope he can order more pt i want to be able to walk without a limp and be able to sleep with out pain. can anyone relate??
Barbara Branchetti- I don’t think the saran wrap will do anything more than make your skin soft. I have had the most luck with walking, preferably on even ground( sidewalks etc.). I started off slow, maybe 2-3 short short walks per day until I felt like I could do more. The more I walked, the stronger I got and the more used to my knee I got. If you have someone to walk with it helps too. I eventually even went so far as to get a little dog, so that I would have to walk. Now the leg feels great and I rarely get pain, I’m even thinking about taking up golf(more walking). Hope this helps.
i had my first tkp 7 months ago and then had my other tkr 5 weeks ago,so now i have two sore knees,i was reluctant to go and have my second one done becouse i knew what to expect,and ive been depressed since the last one,i think i might have an infection in my recent tkr,(hope not)im keeping an eye on it,since my last tkr my knee feels so tight,is that normal?
just feel so fed up since my second tkr,carnt seem to get my head round this last op,its as if im just not bothered about doin anything about the recovery part,is this normal?plus i have other things goin on in my life,
Hello, I had TKR on 8-9-10. I am very upset as the second day at the hospital while trying to go to the restroom ( I had a femoral Block) my left leg was numb. The assistant helping me let me fall hard on my knee on a cement floor at the hospital. I couldn’t feel it at the time but I am wondering now if it could have cause some damage. I am having considerable pain. Medially when I stretch my leg I could scream. it hurts all the time. I am a flight attendant and they expect me to go back to work Feb 2, 2011 and I still can’t walk without limping and I don’t know what I am going to do. I had tw0 arthroscopies on the same knee before deciding tkr was probably the best thing to do but I am hurting and miserable. A am going to therapy and my dr thinks I am going to be ready to hit the skies with my job next month and I don’t know what to do. I went to the mall and walked for 2 and 1/2 hrs and couldn’t wait to sit down and get some heat on my knee….I am so discouraged….any suggestions?????
I can’t believe all the pain and stiffness you all are having. Movement is the key. Don’t sit around and complain! Get up and move the more you move the better your knee will feel. I have had 2 TKR’s and yes of course there is pain but keep going to PT and MOVE, MOVE, MOVE! If you don’t move scar tissue will grow back and you will become stiff. Do your exercises at home not just at PT.
I am very proud that I made the decesion to have TKR! Haven’t regretted it a day since. I am loving to be able to do things i couldn’t do.
Well Joyce,
I don’t believe I am sitting around and complaining as you put it. I am so happy you can do the things you couldn’t do before, but, no two people are the same when it comes to recovery. I am no longer going to PT and I know I have to MOVE, MOVE, MOVE. but I also know what is required of me when I return to work. I appreciate your suggestions, but, please don’t assume I am just sitting around and complaining…I have had 3 surgeries this past year and the injury happened 2 years ago so yes I am a little frustrated, plus I live alone and missing work. i am sorry I even posted anything on this site
Hello Mary and Joyce,
Well clearly you are having different experiences with you TKR.
Mary: A 2 1/2 hour walk in the mall is quite an accomplishment!! That is a long time even for folks without any joint problems let alone someone with a replacement within the last 6 months!!! Hang in there!
Regarding your visit to the site, I hope you did find some useful/interesting information. As the writer of the material on this blog, my frame of reference is as an Engineer who designed and developed knee replacement implants and instruments. I am not a medical professional nor a knee replacement recipient so I can only imagine how painful/difficult the road to recovery might be. I can’t say whether or not you are doing poorly due to any fault of your own-everone is different. I wish you luck as you continue your recovery and hope you do continue to visit the site and forum to share your experience with others and hopefully find some inspiration. In your last response you mentioned that you are no longer going to PT, do you have an at-home regimen that you are now doing? Maybe folks can offer some help/insight there?
Joyce:
Looks like you are doing great! Congratulations! Are there details of your at-home exercises that you might want to share with Mary?
Take Care,
Admin at http://www.totalkneeweb.com
Joyce and Mary,
I’ve added a Forum topic (link at top of page) under “Total Knee Replacement Post-Op Discussion” called “Post Operative Stiffness, Manipulation Etc” Perhaps you can continue your conversation and share you thoughts with others there?
Thanks,
Admin
Had a TKR on 11-2-10.. Have had 9 weeks of PT. My range of motion is good, but am having real problems with stiffness. I move a lot and do my exercises daily. I have had scar tissue problems with prevous surgeries and fear this is happening now with my knee.
My doc keeps telling me that my exray looks good, but scar tissue would not show up on an exray, right?
Does the manipulation really help? And, if the adhesions were cut away, would they not just grow back?
Any suggestions are appreciated.
Hello Phyllis,
I’ve posted your question in our Forum under the Post-op topic:
“Discussion Post Operative Stiffness, Manipulation Etc”
Regards,
Admin at http://www.totalkneeweb.com
Had tkr on 10-14-10 and have had problems with my range of motion and have had two manipulations (90 Degrees). I can get around 70 to 80 during pt but thats it. Pain at night has limited my sleep to about 2 hrs max. Is this normal for 60 days post op? I also had problem with blood clot in spite of blood thinners and had chest pain and ultimately had paralysis in left hand. Anyone had similar?
I’m glad I had my tkr in August. I’m still a little stiff, but I walk a lot so I can conquer that. My knee seems to be doing fine, but I had complications during surgery. I came out of surgery with monster blisters from my knee to my ankle. None of the doctors could explain where they came from. It was so painful and required so much care that it interferred with my rehab. I was in the hospital over 15 days and came home still being treated for the burns. It is now January and I still have pain and burning in my leg, as well as sharp jabbing pains. My doctors took constant photographs and consulted with plastic surgeons, still no answers. I wondered if anyone else had this reaction.
I had both of my knees replaced (bone on bone) within two months of one another in 2008. I’m still suffering from stiffness but can walk and work three days a week on my feet.. My range of motion is acceptable by physio standards and x-rays show no problems. I exercise daily stretching with weights and also use a exercise bike and a rocker/roller. I am curious whether any of the supplements help to rebuild cartlidge or whether that would complicate and create more stiffness. I long to be able to have better motion and less pain.
I had my surgery in August of last year, had manipulation in October of last year and have the stiffness, but have been walking the treadmill and took someones advice and move, move, move, and it seems to be doing some better, it wouldn’t hurt also to add some weights on your legs to strengthen them, boy I am feelinig more secure about it, yes stiffness, but nothing like it was. Thank God!
I feel for all who have had this TKR surgery. I too had a TKR in May 2010. I thought I was alone in my pain. Because everyone close to me who have had the surgery are doing great. I have great range of motion. But at the end of my PT I could only bend to about 115. Partially because of my weight. I do my exercise routine faithfully at home and my husband ever so often bend and stretch me the way the therapist did. But I feel all of you out there. I am 55 and feel that age and inactivity before surgery affects many of us. Don’t give up those of you who are experiencing stiffness. I’m giving it a year. i need to have the other one done but seriously going to wait.
I had TKR after many years of pain, swelling, osteotomy, and arthscopy. That was over 5 years ago. Two days after the TKR I developed massive blisters-infections. Went back to the hospital and was put on antibiotics. The next day my orthopedist looked at the wounds and took me off the meds and lanced the wounds. My wounds did not heal(bled and seeped)l. I started rehab 3 weeks later. I was on rehab for three months when the knee got worse. I went in the hospital and the knee prosthetic was removed. A spacer was put in. I had three more spacers put in the wounds never healed. I developed several infections including staph, strep, murs… I spent months on many different anti-biotics. I changed doctors after 6 months. It took 6 more surgeries and two more knee replacements before all infections were gone. I can walk with a limp now. I sometimes need a cane. The knee swells most days. There is some pain and I have only 75 degrees of movement.
I warn people if things are not right fast, seek help. You may need to find another doctor. I think most surgeons are good at the replacement, but not good at dealing with surgeries that go wrong. Get an expert. It will save you much pain and suffering
I had my TKR 6 months ago yesterday. I am having a bad problem with heaviness in the knee. When I exercise or walk for a period of time, It feels like cement or a tight rubber band around my knee. My family doctor said 6 months. Its still here. The OS that did the surgery said 6 months to a year. Why doesn’t the doctors tell you all of this before they do it instead of aftwards. I have really lost confidence in my doctor. I wish I had never had it done. It has changed my life completely.I have a friend that had both done and 3 years ago. Hers are so heavy , she can’t hardly walk either.
If this doen’t make you re-think a TKR, I don’t know what will? I am a 49 year old male. I am healthy and not over weight. I had complete range of motion prior to surgery in June 2010. Post surgery, very little range of motion, so in August, I had a manipulation, which went bad. I had lots of pain a week after the “manip” and lots of bruising. I lost my streghtening and bending of my knee. In September, I had a total knee revision with removal of heavy adhesions. Now, Feb. 2011, I only have 45 degree bend and all doctors are telling me that it would best to leave me alone and hope for the best….I know that I am of a very small percentage of what could happen, but if I thought that this was a possibility, I would have lived with the arthritis pain in my knee.
I had sugery on 11/28/2010. I am not getting the range of motion no more than 93 plus stiffness surgeon wants to manually manipulate because of scar tissue. I am scared to death .Should I do it??? What is the success rate?
Carol, manipulation is a good thing. I had it done and my knee is wonderful you will be asleep and then go to theraphy that afternoon. You will be glad you did it! I was!!!
I had TKR 15MONTHS AGO ,I HAD X2 INPT REHAB,EXTENSIVE OUT PT REHAB ,AND REHAB AT HOME,I AM STILL USING MY CANE ,MY MOBILITY IS VERY LIMITED,WEIGHT BEARING IS UNBEARABLE WITHIN 10 TO 15 MIN MY KNEE GETS VERY TIGHT ,FEELS LIKE IT IS INFLATING ,ACCOMPANIED WITH EXTREME PAIN,I HAVE NOT MUCH QUALITY OF LIFE (INDEPENDENCE) MY DOCTOR SUSPECTS I HAVE RSD (NERVE DAMAGE) I DO NOT HAVE THE CLASSIC SYMPTOMS,I HAD BONE SCAN WHICH WAS NEG. DR. SAYS THE XRAYS SHOW NO ABNORMALITY(LOOSENING ECT.) I KNOW SOMETHING IS WRONG ,I DON’T KNOW WHAT ELSE TO DO?
PLEASE LET ME KNOW IF THEIR ARE OTHER TEST TO TAKE A LOOK AT THE PROSTHESIS.I HAVE THE ZIMMER NEXGEN ,HOW CAN ONE DETERMINE IF THEIR IS A PROBLEM WITH IT THAT MAY BE UNBEKNOWEST TO THE MANUFACTURER ?
I am 43 year old.I had my tkr in oct 14th,2010.I walk better in 4 months.but still feel little heavy in side my knee.I still couldn’t bend my knee 100% but I can walk better.before my tkr i use pain killer everyday.I just message my knee with Baby oil.I feel great.
Amandeep Gill
Amandeep Gill So glad you are doing great wasn’t it worth it??? I am so happy with both of my TKR. So glad I did it! keep up the good work.
Finally made decision go have knee manipulated on Tuesday 2/22. I had tkr on 10/28 .Week of theraphy in rehab center of hospital plus 2 weeks of in home theraphy, then twice a week therapy since December. I am still not getting full range of motion knee feels stiff and painful. Will let everone know how it went!!!
I had my left knee replacement on 012411 (right knee done by same surgeon on 041010..no issues)..in 4 days it will be 1 month since this surgery and, maybe I’m expecting more from the surgery, the recovery time and effort I’ve put in (actually keeping my foot/leg up, stretching, walking, excercising a bit), but my upper thigh is KILLING ME! I hate to be on pain killers for any longer than I have to be and think maybe it’s time this time to request from my surgeon some deep tissue massage referrals…will keep ya posted on that…all is going fine pretty much. If I concentrate and REALLY tell myself I can walk with no assistance (and try to with a head clear of any pain killers), I can walk forever with no pain and no limp…this time around is a bit different but still, the surgery is DEFINITELY WORTH THE REHAB
I had previously written about concerns of adhesions and stiffness. I had aTKR on 11-2-10. Will be 4 months in 2 weeks. This has been a long, painful process, but I am hopeful now that it IS getting better.
My range of motion is very good. I attribute this to painful determination
and “tears” (Yes, I’ve cried a lot!),but have constantly been moving and stretching the knee. I believe if I had not been so persistant with this around the clock motion, I would not be able to bend my leg at all.
It’s very true – “No pain, No gain” So, don’t give up! Keep moving that knee! The first 3 months were torturous.. I am thankful that the pain and stiffness is FINALLY easing up. My doc told me that whenever the scar turns “white” it will be totally well. Mine is still somewhat purple, but I am feeling better each day. Hope this has given hope and encouragment to those of you going through a rough TKR.
I have two bad knees, bone on bone and arthritis and my doctor has given me injections that help somewhat and I even had the series of symvisc (did not help). I have to decide now to have the left knee done. But I am concerned about still having the same stiffness that I have now. And if so why bother. I am a diabetic and worry about infectons also.
Hi everyone. I am very thankful that I found this site! I am surprised by all the posters who regret their decision to have surgery. I am 54 and had serious trouble walking prior. Arthritis/bone on bone in both knees. Synvisc (sp) didn’t work and the only choice I had was living with it or surgery. I picked the latter on 1/26/11. I think everyone (including myself) should try to see the light at the end of the tunnel!
I was in the hospital for 3 days and then went to a rehab place for a week which was WONDERFUL! I left there barely using my cane and after 1 1/2 wks at home didn’t need it. As of today, my range of motion is 100. My knee is still stiff and I’ve screamed and sobbed during PT ( she comes to my house). The worst exercise is to lie on the floor with my involved knee on the wall and I have to bend it while sliding it down. One day she forced it down and I saw stars, screamed and sobbed! Any other exercises that might be more tolerable to bend it? Is 100 “normal” for almost 5 weeks? I am very worried that I won’t be able to go much beyond this. It is VERY painful!
All said, my next one is scheduled for 4/28. The alternative is worse for me as I long to be able to walk free of pain after so many years in agony.
Any thought or ideas on different knee bending exercises?
I had my first TKR on my left knee 1/26/11.
Hello, I am back, I was the one who fell 1 day after tkr…FOr your information the knee is not getting any better. I am still not back to work. My surgery was November 9 and its very frustrating. I am having pain at night when try to sleep, I use Ice, and heat. The knee is larger than the right knee. I can be in a dead sleep and it will wake me up with sharp stabbing pains in the medial part. I still walk with a limp and don’t know what i can do. I have to return to work april 2 and i am not sure I can do my duties. I have recurrent ground which means jumping 6 feet from an airplane during mock evacuation. I walk up stair sideways as I cannot bend the knee to walk like a normal person. I have to bend down on the floor to put away supplies and I cannot put pressure or weight on the bad knee. I life bags that weight 40 lbs or more and I am on my feet 12 to 14 hrs days and unless we have a delay thats standing the whole time. My leg cramps, hurts all of the time. I still feel it stems from falling on day 2 on a cement floor at the hospital. I had a femoral block and could not stop from falling. I know a lot of you understand but I also know a lot of you will have something smart to say. to you I say don’t judge until you walk in my shoes. I am happy for those who have had no problems. If you have any suggestions as to what I should do I would appreciate it….it not..keep your opinions to yourself. I have asked my Dr. for an MRI to make sure everything is ok but so far he says no. my short term disability runs out at the end of March so that is another stressful situation I am carrying. thank you to all who are truly concerned and helpful.
Mary, feel for you I had the manipulation surgery 2/22 first couple of days I thought Wow I am getting more bend .Today I am back to square one. My thigh muscle hurts so bad I can hardly sit down on the commode and have trouble getting in and out of a car. I am continuning with therapy but, I am contemplating going to another doctor for a second opinion, I sincerely think that something did not go correctly. I am still hurting. It has been 16 weeks since initial suergery and I feel no better.. Oh yea my thigh will give out on me. I almost fell several times.
I had a tkr on Sept. 9th, 2010 it has been one of the hardest things I have ever went through. I keep hoping the stiffness will go away. The stiffness is hard to deal with,it makes it hard to walk. My rom is about 111 and 114. I keep thinking I wish I didnt have this done but maybe it will get better soon. I have to go back to work in April I need to be able to walk a lot better as i am on my feet all day any suggestions. I need to have the other knee done but unless things get a lot better I dont see that happening.
Had partial conformis (mfgr) replacement in both knees Jan 12, 11. Like most, put off surgery via injections heat, ice, for years. Was bone on bone re both inside compartments. Post op have more stiffness/ pain/swelling in right knee than left, but rom Ok in both thanx to PT advice, and daily use of stationary bike and treadmill. However, skin sensitivity over and around both patella(s) is impossible to turn off. Tried creams and even a home made “sleeve.” Pain wakes me up regularly. Advice? How long does this last? Am, I expecting too much in terms of recovery after 2 months? When is it likely to walk free of pain..assuming no post-surgical complications like scar tissue?
This is the first time I’ve read actual testimonies from people who have had knee replacement surgeries. I am shocked and relieved that there are people out there with the same problems that I am having. I am 45 and had my surgery on 120110. I’ve had nothing but problems since the surgery. I have a lot of pain and stiffness and my range of motion will not go passed 45. I’ve recently had manipulation under anesthesia and that seemed to be promising for about 3-4 days but I was so sore after the procedure I could barely move or walk, let alone have the physical therapist touch me to try and bend my knee. Now I am back to square 1 with ROM at 40-45 with constant pain and stiffness. I recently (3 days ago) got a splint from Dynasplint which has seemed to help stretch and bend the knee. For those of you with the same problem, I suggest you check into the splint (Google the name), if your insurance will cover it it may be worth a try. I know this may sound strange, but I also use a small rolling pin to help break up the scar tissue along the top of my scar on my knee and I also roll it along my thigh just passed the knee. It’s painful but it helps to break up and soften some of the muscle and scar tissue before I stretch as those muscles tend to be so guarded and tight.
Hello Karen,
It is unfortunate that you have been having so much difficulty. In general, knee replacement is a highly successful procedure, although that probably does not mean much if your own particular situation is challenging.
Keep in mind that as you read testimonials here at this particular article, it is likely from folks who were searching for information related to the topic of joint stiffness or other knee replacement complications so you may be seeing a “subset” of folks who like you, have had some issues, but this may not be representative of the whole population of knee replacement recipients. Again, this doesn’t mean much if you are one of the unfortunate folks with a problem.
There is another website that I’ve seen that has some good patient discussion that you might be interested in. It is the “on our feet” forum at Robin’s Total Knee Replacement:
http://www.hieran.com/knee/
Regards,
admin (author) at http://www.totalkneeweb.com
i had knee replacment 6 weeks ago feels very tight not sure if this is normal, walking around my village without aids unless going up or down hills,my phiyso says i am doing well, not sure myself, still cannot go up or down stairs only both feet on one step at a time.also walking with slight limp due to tightness. cant wait to be walking normal or back to work ,dont know when this will be.
To Suzie, there is a small majority of us who seem to have joint stiffness . It has been almost five months and I still have joint stiffness and swelling especially in the morning. Still limping and cannot walk down stairs normally. How is your rom? Check for scar tissue which may be a factor .
I had my TKR 5 months ago and am still having problems with daily stiffness, occassional swelling & pain.
I had P.T for about 8 wks. My R.O.M is good and I am continually moving my leg, in fear of forming adhesions.
My sister had a TKR 2 weeks ago. She is doing better than I was after 3 months! She doesn’t have to do P.T and is already driving and out shopping, ect. She doesn’t even have to take pain pills around the clock like I did. She is older & heavier than me. I am small boned and of average weight. Not sure if it would have mattered, but we did not have the same doctor.
I am thankful that she is doing so exceptionally well.
But, I am just puzzled as to “Why such a difference in our recovery?”
I keep hearing that some people naturally does better than others.
I can vouch for that!
My question is, If anyone reading this has had a TKR and had a problem with stiffness, how long did it take for complete recovery and for the stiffness to end?
Philis, I had my tkr on Sept. 9th of last year. My knee is still stiff after almost six and a half months. My rom is about 115 but I still am having a lot of problems, I get depressed sometimes. I suppose to go back to work in April, I only hope I can handle it. I guess we just need to hang in there and hope for the best.
Hello Mary,
I totally understand what your going through. I had my TKR done Dec. 28th I was in so much pain I thought I was going to go crazy and then my knee would not bend it was so stiff I could not sleep the pain was horrible none of my pain meds was working. My therapist tried to bend it and could not he told me that I really needed to have a manipulation done. I had the manipulation on the 24th and I am still in pain but today my knee bent to 90 degrees it hurt like you know what and I wanted to get up and run out of therapy but everyone keeps saying you will feel so much better. But thats what the Ortho surgeon said to me before I had the tkr and honestly I wish that I would have never done it I’m worse off now than I was before. I just keep praying that God will see me through this and think positive but its hard when your in so much pain. I will pray for you Mary.
I had my TKR Nov. 2008 and to this day am still having issues! I am very active but the stiffness in the knee prevents me from doing some activities. The more active I am the stiffer the knee gets which then causes issues in my thigh and hip. The last appointment I was to have was a 3.5 hour wait and I never did see the surgeon. He is not readily available as he does a crap ton of TKR’s and only sees follow up patients 2 days a week so follow up appointments are always at least 3-5 hour waits I am extremely frustrated with the whole experience. After reading these comments I’d say that women tend to have this issue, wish I’d known
I have had 3 orthoscopy both knees total , in june 2009 had tkr 2yry pt ,followed by 1/2 kr in august 2010. My tkr is only 90 range with some pain and stiffiness , so very upseting back to pt again trying to get better range. any suggestions for improving range on the tkr any other things any procedures that can be done ? Do they do laser treatments to breakup scar tissue in the knee? My 1/2 surgery knee is like my old knee but good.
Any suggestions sure would help , i dont know what to do .we all need prayer
thanks
?Joyce I HAVE MOVED MOVED MOVED since I had a double knee replacement. Done P/T until I exhausted 2 years of allowed visits. In water also. Exercises at home. Wellllllllllllllllll My knees are stilff and get stiffer the MORE I move! Have 3 ortho doctors who are clueless as to what the problem is. AND 2 P/T places that also can’t figure it out! So I think I have a right to complain! (Did I mention I even drive a standard car…with pain and stiffness!)
I had TKR x 2, Feb. 25th 2011. One would think that rehabilitation would be accomplished with equal efforts provided for both. Not in my case. My doctor informed me the next day that the left knee required considerable more attention and was put together a little tighter than the right. As a result, I am learning how to deal with the left knee’s complications as the right one rehabilitates quicker, and without the number of, or the intensity, of pains and problems.
Stiffness is a problem I see here that almost everyone encounters, and I am no exception, in both. Swelling inhances stiffness, especially if there are more complications. I had an infection on the incision on my left knee and had to have anti-biotic I V infusions for 10 days in the hospital, and 31 more days after being released. That kept a lot of fluid in my body that turns into swelling. A nurse at the infusion center told me to elevate my legs while I slept. I use pillows, 2 under my knees, three under my calves and feet, adjust for comfort and enough bend in the knees to avoid locking in extention mode. The first morning after, I was amazed at how little swelling there was in either knee. The left had more, of course, but I have defeated much of my stiffness problem just by learning what works best for me.
I have had and conquered other problems that I have encountered and I will be back soon to share with you all, if you care to hear it. I will also answer any questions that I can. You all know how hard this can be and I think if we help each other, we can all get through this.
A little over two months into P.T.rehab. I thought I had experienced all the different pains until last weekend. Thursday, I was going for the gold on a stair climber, my quads were feeling good. Flex to extention strength was very present and each step was around 45 degrees with minimal use of weight bearing by my arms. This went on for 4 minutes when the machine timed out. The knees felt a bit used but otherwise not bad. Friday, a bit sore but still made it through P.T.
Saturday morning…tendons running along the ouside edge of both petelas were swollen, hot, and felt as though bursting was eninent. Immediate ice, on 20 minutes, off for two hours for the next 10 hours, elevated at all times, was the only thing that I could do.
Sunday, pretty much a repeat of Saturday, except the look of pity from my wife turned into, “I hope you learned something from this”. Yes, I did.
I learned that just because I thought I could do it, doesn’t mean I should. It’s like anything else, know the safe limitations that it requires to rehab quickly and properly.
Please, forward any lessons learned, or progresses attained during your TKR experience. I wish someone had warned me to be more careful in this still infant stage of healing.
Coming up next…I’m pretty sure I experienced the breaking loose of an adhesion point, which as we know is a good thing.
Hello Again,
I had my tkr on 11-9-10. I have to say I am very unhappy with the results. I am supposed to return to work next week and frankly I am so afraid I can’t do it. I am having pain and stiffness around the patella and when I am walking. I still have problems going up and down stairs. The knee throbs at night when I try to sleep. My last visit to the Dr. who performed the surgery was April 7, 2011 and at that time he informed me the knee was fine. I have some problems with my back and he is saying all of the pain I am feeling in my knee is from my back. I have tried to talk to him about the knee pain and he tells me its all in my head because the KNEE IS FINE…when I call his office he will not return a phone calll and even the ladies in the office stated and I quote” Your surgery was in November and there is no reason for you to still have pain in your knee, you have had plenty of time to heal”. Now, in the last few days, my knee has been stiff and painful. It is also slightly warm to the touch. I know there is no reason for me to call the Doctor because he refuses to listen to anything I say about my knee. I just don’t know what to do now….I guess I am going to be living with this pain from here on out and no where to turn. I wish I had never has the surgery now….I am wondering if there could be infection in that knee after this amount of time. I fell in the hospital the second day after surgery. The aide got me up to help me to the bathroom and didn’t put the belt around my waist to hold on to me in case I lost my footing…well, I had a femoral block and didn’t have any feeling in the leg…..and the minute I stood up using my walker I could feel myself falling and there was nothing I could do to stop it…I have mentioned that to the Dr.,asking him if that could have caused some damage and he says no….but, I fell hard and right on the bad knee…..I am so discouraged.
Hi MJW,
I just read your entry, and I honestly could have written this!
Sounds like we had the same doctor.My TKR was done on Nov.2.’10
I am reminded everyday with constant stiffness and pain!
My doctor told me I am fine and even took me in another exam room and introduced me to one of his other TKR patients and said, quote,”See, this patient had the same procedure and is doing great”
And, I’m standing there thinking ~ this has NOTHING to do with me!
Then, he later comented that Americans were whimps and could not handle pain! I told him then that I had , had brain surgery and it was a picnic compared to this knee surgery.
I refuse to go back to this doctor or even try to comunicate with his nurses.
I am wondering if I am having adhesion problems and possibly may need to have the knee manipulated. My knee is also still numb to the touch. It kind of feels like your jaw would after a trip to the dentist.
I am so glad there are people on here that can relate to what I am going through. I know my family gets tired of hearing my complaints.
But, I speak out in desperation, hoping someone can help or advise me what to do.
to mjw I would definately go to another ortho or your primary care dr and tell him your concerns about infection your right my dr checked and i didnt have an infection, but he at least listened to me. It sounds like they think your just a winer when even i know your not. Go see someone who really cares about you . Your back can have probems if your leg is not straight exercises and pt can assist your walking alot also if your knee doesnt bend mines only around 90 degrees but with pt can get it to 116 but it seems to go back to 90 scar tissue. its really hard and its not a perfect fix for me but the really sever pain i do not have if it causes not to sleep i take a hydrocone 5-500 and it helps. so sorry your having problems but seek someone who cares darlene
I also wanted to say that your knee surgery is rather recent they say it can take up to 1 year everyone is different., maybe you just need alittle time. I would sure recommend another ortho dr and yours to talk to,one can feel so alone and depressed.talk to someone else darlene
My husband had TKR 6 weeks ago and is struggling with the bottom of his foot being tingling and a little numb. Surgeon said it could be from the swelling on a nerve but not sure. He also has a foul taste in his mouth and when he eats or drinks it is activated more and can’t eat much. Everything tastes horrible and has lost 20 lbs. Not sure if it has been from hydrocodone, tramadol, advil, tylenol or could it be from what is inside this new knee. He’s gone off pain meds and just taking advil now but still has foul taste and also weird smell in his nose. Anybody had this before and if so, does any of this go away and how long does it take?
Hey Ladies,
It seems that these ROM & stiffness issues are more of a problem for us than they are for men which is possibly due to the fact that the artificial knee was actually made for the male species and they have not yet perfected the female knee yet…….., just a theory. My TKR was done 11-09-10 and I still have issues, however my husband had both knees done and never had any issues, makes me wonder…….
I have however noticed just in the last month or so the stiffness has definitely decreased unless I wear heels or am on concrete for extended amount of time re:shopping, but now I have more pain in my shin and foot , so I try to avoid heesl and long shopping adventures.
There are different therapies one can try to lessen the pain and stiffness issues. In the beginning I used a PT, one that did massage to breakup the scar tissue as well as exercise the knee, then I did Thai massage to help with the IT band issue I was having and recently I have had Myofascial massage which treats the fascia in the body. re: look up the definition to fascia. All of these have helped me a great deal.
I feel we, and the Dr.s tend to forget that the knee is only one part of our body and that in order for it work properly your whole foundation has to work properly and I know for myself this was and is still not the case so I try to work on my (whole) foundation and NOT just the knee. Good luck ladies:)
Kathy,
Check out:
http://www.totalkneeweb.com/new-total-knee-replacements-specially-designed-for-female-anatomy
Also look in the article index for more stories you might find interesting.
Good Luck,
admin@totalkneeweb.com
There is a lot of different pains due to this surgery. I thought at first I would have to deal with the incision, the staples, some swelling and hospital food for too many meals. Confusion set in due to alien pains from that which was expected. I went to the all knowing web and Googled TKR proceedures video. They put our legs through so much trauma, for those that say they had no problems don’t know how lucky they are.
I learned on my own that one reason I couldn’t gain the expected flex in either knee was that I went so long pampering my damaged knees that my thigh muscles were totally weak and useless. I have since added moderate strength building workouts. Too strenuous and I discovered even more pains and intense cramping that only complicated matters.
Massage therapy is good, along with stretching the knees’ tendons to allow for more bend. Fight swelling, and find a doctor that you can trust that he/she will believe you instead of belittle you.
There is a ham-string running down the back of my thigh (probably yours’ too) that was causing a lot of resistance to bending at the joint with a lot of pain, at level 10, when trying to bend. Regardless, I continued trying to gain more flex because that is what I was told to do.
The resistance and pain were ever present, until one night after about 4 hours of good sleep with my legs elevated pretty high and comfortable, I swung them over to the floor, carefully stood up and distributed my weight evenly on straight knees. I heard and felt a relatively loud pop in my left knee which was so pronounced that at first I thought the piece attached to my femur had somehow came partially detached from the bone and had snapped back in place. But knowing enough about how this thing works, I quickly rejected that as the cause.
I soon discovered, in the morning, that as I tried flexing the same leg I still had about the same degree allowed without pain and when I pushed it to try to make more bend the resistance came from the quads and the tendons across the knee cap. The ham-string was sore but was not the focal point of resistance or pain any longer.
I’m not qualified to say what had happened, really all I can attest to is I think there was one of those infamous adhesions that finally let go.
I’m going forward in my rehab now with the idea that I do have the ability to get through such a major set back and that going through the pain to try to gain more flex is worth it. I do try to lessen my pain meds’ intake as much as I can, but when it comes to it helping to get through a physical therapy session, or self inflicted painful gains for healing properly…I rely on the meds for the help. I know that after the strain and pain is over, before the new swelling sets in, both knees feel pretty good and are more flexible.
I had tkr surgery about 8 weeks ago, and about a week later I began having severe muscle spasms and cramps in my quads, hamstrings and calf muscles in the implant leg only. These have been excruciating, as well as exhausting, continuing around the clock since that time. Needless-to-say, this has greatly constrained my progress in physical therapy, and to-date my range of motion is 65 degrees (despite having had a manipulation 2 weeks ago). On top of the cramping, if my therapist pushes me very hard at all, I seem to have a delayed reaction that starts several hours after I get home. With my entire leg as hard as a board, I will have severe and deep gnawing pain in my muscles that does not let up for 2 or 3 days, keeping me awake at night. Of course, I have to be back in therapy before the muscles have recovered. These sessions feel like torture, and to make matters worse, my therapist is tired of hearing about my muscles and has become very exasperated with my lack of results.
My orthopedic surgeon has also been more or less disinterested in the muscle involvement. At my last visit, he said that if I didn’t quit “protecting my knee” I would have to have a 2d manipulation. To help with that, he doubled the amount of narcotics I’m on (Oxycodone and Vicodin), despite the fact that I’ve told him the muscle pain accounts for at least 90% of my discomfort and that the narcotics do nothing to help with this. He basically said good luck and to come see him in a month. I ended up going to see my internist who took the muscle cramping very seriously. He prescribed Robaxin (a muscle relaxant), which has helped enormously but not enough to relieve the severe delayed muscle pain that frequently follows physical therapy.
I have scheduled an app’t with a different surgeon to get a 2d opinion and to rule out the possibility of an alignment or implant-size problem, which I’ve read can cause this type of problem. Unfortunately, his first opening is 2 mos. from now. In the meantime, I have not seen any online tkr discussions of this kind of situation. Any suggestions or encouragement would be greatly appreciated.
Sue,
Maybe you can find someone who Thai massage, it certainly work wonders for me.
Sue C., I’m assuming you are refering to one week after the surgery you began having the muscle cramps. I have to tell you that I did experience a lot of muscle cramps and pain related to my thighs and calves over the first couple of weeks. I’m not going to recommend that you view the surgery video…it’s very graphic, but I will say that your entire leg went through quite a lot of trauma. This causes more brusing than you can imagine. I was fortunate enough to have a Physical Therapist, while in the hospital, that was an absolute treasure. While he worked with me to understand what I had to accomplish to rehabilitate, he explained what had occurred under my flesh and what was causing much of the pain and restiction of movement. While he explained these matters in detail, he skillfully massaged the areas that he refered to at the time. The reason he did that was to be sure my mind was paying attention to the area he was describing, and he explained that these areas had been so traumatized that the nerve receptors didn’t really exist as before any more and the nerves and muscles needed to learn everything all over again.
The brusing needs to be massaged out, the swelling needs to be iced down and you need to learn which muscles need to perform which functions to accomplish normal and pain free use of the knee AND LEG. Right now, you need to learn to communicate with your leg’s parts in a way to make them do only what you want to do, and realize how to make them do it. This includes how to relax the muscles.
Unfortunately he was not available enough to learn all I needed from him and I have been under the P.T. sessions of much lesser educating perveyors of pain. But I have developed my independence because I understand what I have to expect from myself. I have not mastered the art of total relaxation, if I had I would have added another 25 degrees to my flex by now, but I know I will get there.
People who don’t understand your complaints have never felt your pains, and also don’t want to hear how it is they have failed you by not being able to make your case go as well as the text book cases go. Communicate with your leg, listen to it’s complaints, and expect yourself to realize what you need to do to make it right.
I still have these problems and my next step is to employ a good massage threrapist to help me learn to relax because that is presently my highest hurdle I need to overcome.
Seeing that the last couple of entries here are dated 5-6-11, I’m lead to believe everyone is doing great now. I’m not…I’m doing okay, but I would sure appreciate hearing about why everyone is doing so well so I may be able to apply your successes to my recovery of double TKR.
Stiffness and poor flex/extension seem to be the common complications with most TKR patients. This TKR complications’ sight has a comment collection of persons that have been through knee joint, anestitized manipulation, last count was 62 comments. PRETTY SCARY STUFF. I suggest everyone read them totally before allowing this to be done with the promise of “may increase your flex and/or extension”.
Update: Surgery 10/28/2010..Manipulation 2/22/2011. Still stiff and lack of ROM maybe 95 .Steps: one step at a time up and down…Now I have IT band pain. I limp……
Oh! yes my original pain before surgery went away but I traded it for another pain…Will I ever be pain free….
Had TKR 4/6/11. Part of thigh is numb, as well as knee, part of lower leg, ankle and foot. Little range of motion, so had manipulation on 5/24/11, but numbness and heaviness (leg feels like it if full of wet clay) and pain has not improved. After the manipulation, I went back to using the CPM, am going to PT every day for a week, went to the chirpractor Friday, but see no change. Surgeon claims he doesn’t know why leg is numb and told me go go off pain meds the day after the manipulation, even though I am in constant pain. Am going for my two month checkup next week with the surgeon. Would love to hear from anyone who has had numbness in leg/foot..
Carol
Tomm, sorry not to post sooner. I’ve been wanting to thank you for your thoughtful reply. The info. was helpful, and your encouragement meant a lot to me. I’m sorry to hear you’re not doing well, and like you, I wish I could say I was one of those who had “moved on.” The truth is that it’s kind of been one thing after another and at this point I’m frankly feeling a little depressed. In the way of an update, I’m still at about 50 degrees flexion at almost 3 mos. post TKR. The muscle cramps were still very bad up until a few weeks ago. I went to the ER for something unrelated, but also ended up pouring out my TKR woes to the ER doc. He decided to do a doppler ultrasound on my leg to rule out a blood clot. Lo and behold, there was one, and now that I’ve been on blood thinners for a few weeks, my muscle spasms are almost gone. I’m so grateful that the DVT was discovered and is being treated, but it’s disturbing to think my surgeon’s only response to the muscle problems was that I needed to be patient and have a more positive attitude. So after turning that corner, a week ago I had some kind of injury in PT when the therapist was “torquing” my leg while bending it. Now I have swelling and severe pain in and behind my knee when I’m on my feet after only a few minutes. I tried to get in to see my surgeon, but could only see his physician’s assistant who told me there were no tests for soft-tissue injuries and that I’d be a lot better off if I’d focus on decreasing my anxiety. I managed to assert myself a bit and insisted that I wanted a consult with the surgeon, which is scheduled for next week. So I’m working at hanging in there and looking forward to the day I can post something a little more uplifting on this site. In the meantime, my best to everyone here.
i had total tkr 6-14-2010 its been almost a year i went back to work 8-28-2010 im a grocery stocker.my knee is still stiff i have some pain i also have loud hard knee popping.all the time i can walk with know problems, im going to invest in a good excerise bike & hope it works. i still have know feeling in my knee still can’t be on both knees but the pain isn’t what it was befor i had the surgery!
I feel that the doctors DO NO listen they think we are a bunch of cry babies. Dont tell me my knee doesnt hurt until you walked
( limped) in my shoes. I stil have pain behind my knee before and after surgery. IT Band hurts on left side of (left) knee. Original surgery 10/28/2010. Manipulation 2/22. All the doctors are concerned about is their reputation and that all surgeries are “wonderful” well they are not. Thanks everyone for letting me “b—-h.” I feel better now..HA
I am a 60 year old male, good health and very active. I had my TKR x 1 on 12/13/10. I have had just about every problem mentioned in these posts to included falling on it the same day of the operation. I was on a pick line for 6 weeks for an infection I never had, I have had it scoped, been to PT at least 2 time a week for ever and had it manitulated. I have been to a massage therapist and 2 acupuncturists. After all this I feel somewhat fortunate in that I am able to finally get my leg straight, thanks to the “Jaz splint” that I had for 3 months, and I have 115 flex. My biggest problem is that my muscles in and around the knee joint are tight, very tight. It hurts to walk and go down stairs. I am tired of having to take a pain pill to get through the day. From what I am seeing here, there is a difference between stiffness and being tight. Since I can get my leg straight and have reasonably good flex, I do not feel my leg is considered “stiff”. If anyone has any hints or magic bullets about how to rid of this tightness please let me know.
Roger,
Time! It was a year and a half almost to the day that the tightness finally eased up. The more strength I gain in the muscles the less tightness I have. Good luck!
Yes , Kathy. I could not agree more. Muscle strength is easily the key component to succeed in rehabilitation. I have not had a conversation with anyone in the medical field that has even brought the subject up with any real suggestions of how to do it or recognize improvement when you accomplish it. Problems I have encountered in strength building is the tendons and smaller muscle tissues are the ones that have to stretch and gain strength to increase range of motion. While therapists were forcing 10 more degrees rom the additional damage to these weaker tissues increased, they just swell and hurt more, and I would take two steps back in rehabilitation because I couldn’t do my PT homework.
I do my own PT now, and I have hired a message therapist to help condition the muscles so I can do reasonable strength and flexation exercises. I am gaining in both goals because I don’t have to recover from the workouts for two days anymore.
Roger: I too had to deal with a picc line for over a month after my hopital stay. It sucked. I had both knees done at the same time and they are not recovering the same due to my left knee required more prep and repair. I benefit more from deep tissue leg message and really concentrating on the knees than about anything else. My left has been about 10 degrees behind the right, but I have been fortunate in always being able to get full extention in both legs. The only time I have problems straightening either knee is if I have them flexed fully for any extended period of time.
We have to keep moving, and communicate with our bodies. Please forward your experiences and lessons learned to the rest of us because if I have learned one thing…it is that we have the experience and abilities to help each other more than anyone else.
Thanks so much for your input. I wouldn’t wish this on anyone, but having said that, I am so glad there are people like you who have experienced the same pains and are willing to share your different methods of dealing with them. I canceled my appointment yesterday with the massage therapist / acupuncture person. I really wasn’t seeing any improvement. We have a nice gym where I work and knowing what I was taught during the first 4 months after the surgery, I am doing on my own now. Not trying to push too hard, but getting a good workout every other day. I find myself taking a pain pill the day after. Never been a pill person, but as you know the pain gets to you. If you guys know of or have done some different exercises that have worked for you please let me know.
Take care!
I have been erading all these posts and am very happy to have found this site. I had a TLKR on Nov. 2007. I had been on a cane and leg brace for a year before I had the surgery. Yes I still do get some stiffness, but not always. Getting more active hurts more at first, but if I keep it up, I see improvement. I certainly can’t wear heels, however, and after an hour of walking and I’m ready for a rest. I find that fish oil helps with the inflammation and swelling. The swelling does create stiffness for me.
I have gained weight and that has made my knees and back hurt much more. Being arthritic, swelling and pain is always a issue, but the weight gain has impacted my knees the most. I bought a folding bike with a low “leg through” threshold to get exercise and build muscle. It’s easier for me than walking. Hope some of this may be helpful…this idea of a six month recovery is crazy. It takes a long time. I had lots of scar tissue…couldn’t straighten my knee and it would get STUCK. that workrd itself out over time. Now sometimes my knee kind of pops out if joint…this may be to ligament loosening doc says, I think it could also be from too weak muscles. Stairs have always been an issue, but gradual increase of stairs over time has enabled me to be more proficient at them. As far as pain, I had alot of pain. I did have to learn to endure more pain than I wanted to. I did get pain meds when I needed them…but be careful some can be highly addictive. When the Utracet took away all my pain, I surely did NOT want to give it up. Now I just take Celebrex and use ice pks, hot pads and soaking hot baths as needed. Best wishes to all of you, try to be patient it takes longer than the Doctors say to get your leg back.
Anne Marie
Maybe someone here can shed some light on my flex problem. I am 6 months out from my TKR and having problems getting a flex beyond 110 deg. Are there any exercises that you have discovered that will help break through this barrier.
I am scheduled to have surgery by dr steve nguyen in orlando.He does quad sparring knee replacement.He does it from a lateral incison on the outside of the knee.One day in hospital walking in a week is what other patients hve experienced with yhis surgery.Has any body heard of cutting the outside of the leg for knee replacement.Why is he the only doctor to do this procedure?
please email me follow ups
I’ve been experiencing something that I can only evaluate as large finger-type scar tissue breakage. In only one knee so far. It has happened a couple of times and is a bit alarming at first. It is not real painful but is very uncomfortable. As I try to walk as I have been, I can feel the broken segments fighting each other for passage as I bend the knee (again, this is based on my own assumptions) and I can feel them actually causing miss alignment of the joint’s components which actually feels like it is being forced apart a fraction of an inch.
Last night I sat in a low chair too abruptly, flexed the knee too quickly and felt a resounding pop and sharp pain in the same knee…it happened again. This time the same complications are happening, but magnified at least twice the amount as before and it is causing swelling, which of course enhances everything too.
I’m going to the gym, message and water therapy today and see what effects and results that brings….I’ll be back afterward to relate.
As I mentioned in my last entry, I believe what is a scar tissue adhesion break that seemed to be interfering with my knee movement is best tolerated by an ace bandage moderately wrapped around the joint to pretty much hold things in place. The joint bends smoothly but the bandage restricts the degree of bend, and it takes more effort to straighten it fully also. So removing the bandage and massage seems to be a necessity for the best results. I think the scar tissue has to wear away to be less intrusive to motion so I am working out on different leg machines, light weights, while still wrapped with the bandage.
There are two machines at my “Y” that help in a few ways. One is called a “seated leg curl machine” (by CYBEX) that I use enough weight to know I am waking the muscles up, so to speak. And the other is a “seated leg extension machine”, that I use ten pounds to help bend the knee. Between these and walking a treadmill with average 10% incline and deep tissue messages every day seems to be the program that is giving me the best results with the least amount of harsh pain.
I had TKR on 6/6/2011, left knee and I am experiencing a great deal of pain, stiffness and tightness, especially in the morning. The severe internal tightness is very concerning. I have not been successful in obtaining 90 degree bend, but very close. There continues to be swelling and a very stiff hard area on the outside of the knee. Also concerning is the swelling I experience in my foot after exercising the knee. I am pushing and pushing and I can not get the knee to a 90 degree bend, I just finished in home therapy and moving to outpatient. Could it be that I have developed scar tissue and need manipulation? I am doing all of the exercises and going to the pool daily to stretch the knee. I am only 46 years old and thought I would do much better with the recovery. Any suggestions or help you can give me is much appreciated. I am very happy I found this site. Reading other stories and knowing there are people going through some of the same issues really helps. Thanks in advance for your feedback.
I really must enter here that I think one of the best treatments that I get the best and most immediate results to is …………………………(drum roll)..Self performed deep tissue message with baby lotion.
I have to massage both knees, so of course it takes longer and I have particular areas that require more attention. But I have found that I am more aware of where the stiffness, pains, swelling, sore and bruised are and can be more effective that someone else working on me.
Really–invest some time and effort into this. It increases blood flow, enhances healing and lessens pain.
The lotion can be of your choice of course, I just prefer the smell of baby lotion, and it’s cheaper than others.
Elizabeth, aside from the swelled foot, I would tend to say you were coming along the healing process pretty well. You may, after a month of healing, have developed some scar tissue tagging onto where it doesn’t belong but if you keep working at flexing and icing afterward you can get it to stretch and/or let go.
I found that that very stiff problem stems from having to force a lot of sliced & stitched tendon tissue to stretch quite a distance for good flex. Stretch doesn’t come easily and is probably requiring more muscle strength to do than you have on hand. Do your strength building exercises faithfully and the stiffness can be overcome.
Just another thing to keep in mind while you progress, even when it has healed to where it is well functional, it is never going to feel like what you are used to. It will probably be okay, but not absolutely natural.
I have had two complete knee replacements. One twelve years ago and one six years ago.
After this period of time I am feeling stiffness and burning in my knees now, which is very uncomfortable and would like to know if anyone has any ideas in easing the pain and stiffness. I have already had about thrirty sessions of actuputure but still no easier.
Regards.
I HAVE NOT YET HAD TKR SURGERY WHICH IS SCHEDULED FOR SEPT. 2011.. I HAVE JUST READ THESE BLOGS AND AM NOW SUPER NERVOUS…MY LEG IS SO BOWED OUT IT IS IMPOSSIBLE NOT TO HAVE SURGERY..I CAN BARELY WALK NOW..BUT I DO NOT HAVE ANY SIGNIFICANT PAIN. I AM SHOCKED BY THE LEVEL, THE INTENSITY AND THE DURATION OF THE PAIN THOSE WHO HAVE HAD TKR SURGERY ARE EXPERIENCING. DOES ANYONE HAVE A GOOD RESULT….ARE THERE NO FAIRY TALE ENDINGS OR ONLY NIGHTMARES. MORE THAN 10 PEOPLE WOULD HAVE RATHER STAYED IN ARTHRITIC PAIN THAN EXPERIENCE THE DELIBILTATION AND PAIN AFTER SURGERY WHICH WAS SUPPOSED TO ALLEVIATE THEIR KNEE PROBLEMS. I SIMPLY DONT’ KNOW WHAT TO DO.
Tomm, thank you so very much for the feedback. I have finally reached a 90 degree bend. However, there is still a great deal if tightness, stiffness and swelling in the knee. Here is the good news, I took your advise and have had a massage therapist give me a deep massage and stretching the knee. I have gone twice and I have seen major improvement.
I recently had a visit with my surgeon and unfortunately he would like to manipulate the knee on the 10th of August. After six weeks he is not pleased with the range of motion. I am going to continue to push this knee and hopefully I will get the range of motion expected. I am having massage therapy twice a week opposite my outpatient therapy days. In addition, I just ordered a recumbent bike which I hope will also be helpful if I ride daily for 30 minutes. along with all the strengthen exercises
Just wondering when I will get some relief. About when will I wake up and not feel like I am not starting from ground zero.
Thanks again Tomm !!
Hello.I had my first (left) TKR January 27 of this year and the next one (right) at the end of April. At first I worked hard at PT but became kind of lax. At this point, I have reached a 115 degree range of motion on both. I have a perfectly straight (flex?) left knee but not so perfect on the right one. It is kind of painful once I’m sitting down for awhile to get up, but aside from a little stiffness, it’s
okay. nights are tough. Is it too late to get a better range of motion? It is SOO painful to do the knee bend exercises! The humid weather isn’t helping me. Any
hints? By the way, thanks for everyone’s comments on this board. They have really helped me through these surgeries! Thanks!
Mrs A:
Yes, I know a man with very bowed legs who had a TKR around 11 years ago, when he was in his 60’s, then had the other one done a year later. A year from then he had to have sciatica surgery. But he is fine, his legs are pretty straight, he golfs, and is so pleased he had his knees done. Good luck with yours.
P. S. I have had the knee surgery from hell – pinched nerve in the back between L4-5 which I am hoping to soon have treated, numb and painful leg and foot, swollen and painful knee, and it’s been almost 4 months. Has anyone encountered back problems from the surgery?
My latest best move for improvement was going to my personal physician. Physical and blood work indicated I was vitamin deficient in B and D. I have been noticing daily improvement in motion, less pain and my stamina is through the roof. Gotta run…more later.
Mrs. A
Unfortunately the people who have taken the time to find this site and talk about their TKR are the unlucky ones who have had problems after the surgery. I am one of them. I had my TKR on 12/13/10, going on 8 months ago. After alot of work and the use of what is called a Jaz splint, I am finally able to straighten my leg completly, something I didn’t know if I would ever be able to do again. I am now working hard on the range of motion. I am able to get 120 degrees of flex out of it and still see the PT people once a week. The tight feeling is persistent and apparently something that others have experienced for up to a year and a half later. The surgon and PT people tell me it will go away in due time. It is a very uncomfortable feeling. My knee is still sore and it continues to hurt most days. I have set a goal of being able to get 130 degrees of flex by this December and hopefully the tightness will subside by then and the sorness will leave.
Take it for what it is, but my personal advise would be to get a second or even a third opinion from differend doctors. There are several different ways of fixing knees and it is worth the time to check them all out. I did not, and I have yet to see the day were I can say, wow, I am really glad I had my knee replaced.
Good luck and I hope things turn out well for you.
Roger
Roger
MRS A:
The recovery from TKR is truly a process and a journey. What I have learned is everyone’s recovery is different and there are so many factors that hinges on recovery including your lifestyle before surgery, family history and your personal dedication to a successful recovery.
Recovery is tough to say the least and requires a great deal of effort on your part every day. There will be very painful days, many of them; however, you have to stay the course and do what is required of you. Your knee(s) will never be the same again. Many people that have had TKR says it is the best thing ever did.
I am no expert on getting through this process successfully, but I can share some things that have helped me and what continues to keep me in a positive space while I look forward to a great outcome soon.
Do not measure you progress against others, everyone is different and progress differently. I recently read a blog about a man who was on the elliptical at week 4 and sleeping pain free by week six. I thought what the heck was wrong with me. I soon learned he was a previous runner and he had PT and home care daily for the first three weeks.
Do your exercises!!! It is important to start immediately doing your exercises and complying with your Thearpy. The core strengthen exercise are critical to the range of motion and the straighten of your knee.
Review a TKR on YouTube. Truly understand what happens during surgery. Get prepared. Get all questions answered and dont be afraid to ask questions. Learn the strengthening exercises now and do them if you can.
Use the KPM machine as much as you can. It helps with the range of motion. I wish I used it more than I did.
Ice is your best friend. I love the Cryo cuff machine. You want to reduce the swelling and ice, ice and more ice. Not right away but massage therapy worked well for me.
Pain Management is important and know that you will have some bad days. Have a good support system, eat healthy, drinks lots of water, stock up on pj’s and around the house wear and magazines,
books, music, movies, crossword puzzles, any fun things you can do to keep your mind occupied have it ready before surgery.
Try to find others who have had surgery with the same doctor and see what they are saying. I agree with the previous blogger, get a
second and third opinion. There may be other options.
Stay the course, It’s a process and takes time and Stay Positive you will get through it! I wish you much luck with your surgery and keep us abreast of your progress.
I just had TKR a month ago 6/27/11, still have minor pain but a lot of stiffiness . Still only have about 90 rom go back to the Dr’s tomorrow he may want to do a manipulation on me also. Still going to Pt 2 times a week getting better but wish I knew you really have to keep it moving most of the time . How do you keep it moving when my leg still swells up most of the time . To keep the swelling down they tell me to stay off from it but then the more im off the stiffer it gets can’t win keep putting ice on it several times a day which helps some .The swelling goes all the way to my foot even my ankle swells a lot. Hopefully this will get moving soon have to go back to work in 3 weeks ,I work in Pre K so I have to be moving a lot. Any sugestions ?. I used the CMp and had Pt at my house the first 2 weeks at home helped some but not a lot. need to be moving more.
Cathy,
The bike and ice are your two BFF’s right now and for some time to come. USE them!
I thought this was worth passing on to all who have had a TKR and are having sorness problems. I have been receiving PT treatments for the past 7 months with little improvement other than getting my leg straight and getting 120 flex. Both have been big steps for me. The last two visits, I have received what is called “Instrument-assisted soft-tissue mobilization”. The soreness is almost completly gong the day after the treatment. It comes back a little as the week goes on, but not near as much as before. This is something I wish they had done months earlier. Check it out on the internet. There are some very good articles about this treatment.
The swelling persisted in both of my knees until a nurse unrelated to the surgery or P.T. asked if I was elevating my legs at rest. I was not. She suggested that I make it part of my anti-inflammation treatment, and it eliminated the swelling immensely.
Seven weeks post op and still a great deal of tightness and stiffness. There has been some improvement with ROM and straightening of the knee with massage therapy and going to the pool. I have been going to PT 3x week and diligently doing the exercises at home. The inside of the knee is excellent and feels great. The outside of the knee has a large dark spot which is very tight and hard. It prevents the knee from bending beyond 96 degree. Therefore, I will get a manipulation next week. I am praying for the very best and hope that scar tissue is the issue I am experiencing and the manipulation and intense PT following will address the tightness and limited ROM I am experiencing. Please share any experience you have had with manipulation.
I am one of the 6% that are plagued with scar tissue problems after TKR. Six years ago I had bilateral TKR. My right knee did great but my left has been a problem. I had manipulation a year after my surgery which did not help. Two years later I had a revision with manipulation and surgical removal of scar tissue. This helped some but I still can barely get 90 degrees out of it. I am 63 but in very good physical shape, exercise regularly and have been through PT four times with this. I have about given up but decided to try deep tissue massage which I have just started. PT has not worked. It may be too late for me to see any improvement. I probably waited too long to have surgery in the first place (according to my doctor). Any suggestions would be appreciated.
I had total knee replacement 3 years ago in May 2008. I am 59. I was on crutches for a year before I had my surgery. I had both knees done at the same time. I’m not sure if everyone has both done at the same time.
Hi everyone,
My mom had TKR in early July 2011. Her recovery has not been anything like she (we) had expected…extreme pain, chronic swelling, infectionsX2. She had the CM machine for 2 weeks post op, and has been going to PT 2X per week since….8 weeks post op to date. Still icing and elevating and MOVING as much as she can stand it! ROM is about 90, but she can not stand on it very long.
Right now, she feels she made a “BIG MISTAKE” because she is able to do less now than before the surgery. Hopefully, this will change!
One thing she is experiencing that I haven’t heard anybody mention is SEVERE knee tremors/spasms. They are EXTREMELY painful, and last anywhere from 30 seconds to 1 minute, and come repeatedly within a block of time or if she is lucky, a few hours apart.
Has anyone had the same experience? If so, any suggestions for how to eliminate these spasms?
I will speak from past and present experience. In 2003 I was in a car accident that resulted in a full knee replacement. I had no expectation and eventually (5 months plus later) I returned to full range of motion with no manipulation or additional surgeries. This acheivement I give to my PT doc for aggresive pt and support and then to myself for not giving up. that knee lasted until recently when I had some problems. revisional knee replacement done on 18 AUG 2011. From PT standpoint the goal was from 0-110 degress in four weeks. I am barely at 75 with active motion, 80 maybe with passive. I have had more pain, and more swelling than what I remember the first time. I am only 32 now and need full range of motion to enjoy my kids and life. But I say, do not fret, I did not meet my PT goal, and I know that I was discouraged. But when I compare where I am at now to where I was 8 years ago, I say I think I am doing a heck of a job. I am going to focus on PT and my goal… One day I will be painfree and have a great range of motion…. i don’t care if it takes 5 months… i will get there.
Hello, I am a 55 year old teacher who has had 12 operations on my left knee, the last was done on August 10, 2011. This particular surgery was done to address femur bone loss and a loose femur component. I had to have bone grafting and wedge parts from zimmer added to my smith and nephew parts. I’m usually a very active person on my feet constantly. Right now I am in so much pain I don’t know what to do with myself. My post operative instructions were to go home and stay off of the leg and knee for 8 weeks to allow the bone grafting to heal, oh and also there was to be no at home physical therapy, no outside physical therapy and I was given a brace that only allowed 60 degree knee bending capabilities. The other surgeries addressed chronic infection, bad Depuy parts, and my knee rejecting parts. I consider myself to be reasonably active in my life, I use to ride bikes, dance, ice skate, roller skate and everything in between. I’ve worked well with physical therapy in the past however, this last operation has stopped me cold. Pain 24/7 is not cool. I like what a lot of you had to say about massaging the incision with oils, that works to help smooth out the scar tissue under the incision, and ice is our best friend. From my bed I have achieved 90 degree bending of my left knee. I have performed all of the allowable exercises that I can do from my bed, I am 6 weeks from surgery and the pain is the same as day one. I was also told that there will be no manipulation of the knee. Patience is a virtue and even working with special needs children, I know that I am running out of mine. Will I really have to live with this pain for the rest of my life, does this mean no dancing, if so what a drag…
7 weeks from TKR on right leg. At 6 weeks to the day, I had 110 degrees and straight (zero). Got cocky and actually rode my bike to work several times (7 miles round trip – seat up high, non-surgical leg doing most of the work). PT twice that week, in the gym doing ’stuff’ other days, stairs, some water walking. On Sunday – yesterday, I felt like it was week 2 again. flex less than 90. Obviously I over did it. I am kinda caught in the middle – PT thinks ‘more is better’ – my surgeon is of the opinion guys like me (active 50 year old – ex jocks) always over do it.
HI, I had my tkr 2yrs ago and my rom has NEVER been more than 95. The pain in my leg is regularly not too bad, however, the mussle spasms are horendous! I wake screaming in pain and the muscles are locked up tight, in a knot! I have tried ever drug you can think of, have had by blood lvls checked (yes all of it!) and have tried every diet you can think of. The specialist keep telling me, to stretch and take mussle relaxers (they have no effect either). The amount of use and or lack of use does not flair it or stop it. Has anyone else experienced this locking mussle spasms and if so have you found any relief? Any help would be appreicated. I am at the point now where I fear sleep… (it seems to be much worse at night!!!!) Thanks so much. Peggy
Elizabeth – on Aug. 6th, you wrote of a manipulation ‘next week’. how did that go? I shouldn’t complain – at 7 weeks, I have 110 degrees. but I thought it would be better.
Hey guys, so sorry that so many of you have so many bad experiences with your TKR surgery. I am a 56 year old. Had my surgery on May 5, 2010 on right knee. I had a great surgeon and therapist. I can bend my knee about 120. This happened for me through much pain. My therapist pushed me hard. I did everything he asked of me and more. He encouraged me to and allowed my husband to participate in my recovery. I am about to go have my left knee done. Not looking forward to the pain, but am assured of my recovery if i do what my doctor say and therapist. Some people pain threshhold is lower than others. This will sometime keep us from pushing through the pain to a full recovery. Please know that the saying “no pain, no gain” is very true when it comes to tkr surgery. I also had a wonderful support group in my family. My husband stayed by my side. nurses did not have to do anything for me. He did it all. So I feel for the lady who the tech let fall. It is a serious surgery and you need much support afterward. But remember it takes a lot of hard and painful work to a full recovery. The scar tissue develops if it is not munipulated by a skilled physical therapist at least 3 times a week. The scar tissue causes a lot of pain. My insurance would’nt even allow me a machine at home to keep my knee bending. By the time, 2 wks., to be exact, I got to therapy I had much scar tissue. So munipulation is key. God Bless!
I had TKR on April 11 of this year. I just got released to return to work. However I still find it hard to sleep and several times a day I get this stabbing pain in my knee that hurts like he’ll. Like others Doctor says all is fine.but it still hurts.I just started walking without a cane,but I wobble not a normal gait. I can only bend it 85 degrees. No matter how hard I try. I swim,walk and bike on a stationary bike. But getting out of a chair or couch is hard. And if I sit too long it is stiff. Does anyone else “feel”their knee? I am aware if it all the time and it’s tight as heck. I would not be able to do a job that required me to stand.I wish I would not of had the surgery.it’s been a night mare.
I’m 63 & had right TKR on 4/4/2011. I had been going to a gym for the past 16 years and am quite active. My surgery went great & I went home after 3 days (was told rehab centers are old school unless if medically necessary). In addition to the usual home & outpatient P/T, I rode my bike every day in the house (I bought a “lifter” for the back wheels to make it stationary). I drove (standard trans) on day 11 & went back to my gym in 3 weeks although at a much slower pace, & if doing leg exercises, only doing the machines that were at the P/T office. I think I was blessed going into this surgery with good leg muscles and good upper body strength which we all need pushing ourselves up out of the chairs and tubs. Prior to surgery , I had bone on bone for years which made my leg deformed and quite painful. After TKR, I no longer had the horrible pain up and down the back of my leg. By month 3, I actually had bounce back in my step when wearing my sneakers. (I must say, however, ladies, I rarely get out of my sneakers as I’m able to walk my best in them.) Now for the bad news. We got hit pretty bad with Hurricane Irene & I was out of the gym for two weeks. We lost power for a while & I became much less active. Just before going back to the gym, I woke up one AM with a tremendous tightness on the front of my thigh and my knee felt like it had a metal plate across the front of it. I’ve been taking Celebrex AM & PM for 1 1/2 years which usually helps the swelling, but it didn’t help now. Went back to the surgeon one week later as it was getting worse. After x-rays, he said everything is healing great and he doesn’t see anything wrong despite warmness over the knee! I’m now one month with this new dilemma and am finding this web site, as well as others very helpful. Hopefully, this is just scar tissue that formed the two weeks I wasn’t moving. I was massaging the scar for three months after the surgery & it had practically faded. I then stopped. I’m now going to start again as well as massaging the thigh.I had hoped to be dancing at a wedding in Nov. in real shoes, but now I’m not too sure!!!!! Clearly, after this surgery, one size doesn’t fit all. We all recuperate at our own pace, and some, unfortunately, have some setbacks. These type of sites are great for the ones who are having problems & looking for answers, but a bit scary for the ones deciding if they should take the plunge and get the TKR. Good luck to all!!!
Besides having had bilateral knee surgery 3 years ago, I also have poor circulation in my legs. I used to prop my legs up on several pillows and that seemed to help some. But now I’m putting my legs up on the wall. I scoot my bottom up to the top of the bed and put my legs straight up. I think it’s helping. I’ve also had the tight cramps in my calves. Especially in my left leg which isn’t straight after the surgery. The femur of my left lef isn’t straight, so that might put more strain on it. But I think this helps. I’m going to keep doing it and see if I still have the cramps. I’ve found some medical patches that I put on the painful parts of my knees and it seems to help to have the medication right where the pain is. I seem to have the most pain on the inside part of my knees.
It’s been 3 years and I was bone on bone and on crutches for a full year before I had my surgery. I’m not a very physically active person, but I can safely say that I’ve had pain and discomfort every day for the last three years since the surgery. I feel better than before the surgery and I don’t regret it, but I feel handicapped now. When I ride the city bus, I always ask for a seat because standing up and moving back and forth is uncomfortable and painful.
I’ve had acupuncture on my knees and also my bunions that I had operated on about 5 years ago. That seems to help a lot. Also, I’ve had injections in my knees and that seems to help. I’ve taken anti-inflammation medicine but I had to stop because it gave me stomach pains.
I had TKR on 10/28/2010 and manipulation on 2/22/2011. Still cannot go up and down steps ” normallly” go one step at a time. Stiffness depends on weather. I was very mislead regarding this surgery by my physician. I cannot bend more than 95 and that is on a good day…..I can feel my knee all the time. Very very disappointed.
It’s now been 9 months since my tkr, I still haven’t reached the “Glad I did it day”. I still have the tight feeling around the knee and have only got it to 115. Atleast it is straight now, I thought I was going to walk around with a bent knee for the rest of my life. I have read that some folks go an entire year before things get better or atleast closer to normal. The first three steps after sitting always bring a grunt and going down stairs is still painfull. I work out 2-3 time a week on the bike, treadmill and knee pulls on the big rubber ball. I am very sore 2 days after I work-out and still take pain med to feel better in the afternoon. I guess I can be thankful that I can get a full nights sleep without waking up in pain. The tight feeling is getting hard do deal with. If any of you have any ideas on what to do to get rid of this band around my knee, please feel free to shoot me an email. December 13th of 2011 will be a year into this, sure would be nice to spend the holidays without the soreness.
Roger- Did you have the same tightness from the beginning? I got a tremendous tightness 5 months after across the front of the knee only. I’m wondering if this is due to the nerve endings that had been severed and reattached now coming back to life?? It feels like a metal plate inside the top of the knee. Could this also be scar tissue which I am now feeling due to nerve endings coming “alive”? See my 9/30/11 blog. Surgeon says it will take a year, but I seem to now be going backwards with my recovery!
I had my knee replacement surgery 3 years ago. I used to wear braces on both knees that I bought that are like what athletes wear. Now I wear an elastic “sleeve” that I put large paper clips at the tops to keep it from rolling. These feel good on my knees and keep them warm. I wear them everyday. I do my exercises at night to help me relax to sleep. The rain and cold seem to make my knees ache more. The elastic sleeves help and sometimes I wear another “sleeve” over them. I often wear tights or longjohns when the weather is really cold. This seems to help keep them warm, too. I took anti-inflammation medicine for 2 years and then I had stomach trouble. I took it again recently, but only for a few weeks. I am trying to use more natural anti-inflammation to protect my stomach.
what would be a acceptable Arc of Motion for total joint repacement patients?
what would be an acceptable Arc of Motion for total knee replacements? Please e-mail answer. Thanks
Marianne, yes the tightness started sometime after the operation, I don’t remember exactly when since there has been so much happen since. I have been through manipulation to help get my leg straight and to also help me bend it. After about 5 months I was finally able to get it straight. Now the two biggest problems are the tightness around the knee that you talked about and the range of motion. I am able to get 115-120 and that is about all. The Doc want to manipulate it again, I’m not sure I am really up for that. I have been told by people in the business to try swiming and then a hot tub afterwards to try and get it to bend more. I work out every other day and usually very sore form the exercise. The tightness just will not let up. It will be a year in Dec for me, the Doc said it takes some people a year to fully recover. I really hope he is right. Everyone says it is just scare tissue. I am trying my best on the stationary bike and other exercises to break it up.
Did you get to dance at the wedding?
Roger—I was able to swim every weekend this past summer in either a lake or ocean. It felt great and really loosened up the knee, although I do have full range of motion already. If I had more time, I would go to our local YMCA and swim every day. Whenever I go in our hot tub, the entire leg swells and gets very stiff. I then have to go on my bike to loosen up again. I’ve been massaging my knee and lower thigh twice a day for about 10 minutes. It seems to help temporarily. Once I’m up and about doing all my usual walking, by the end of the day, the metal plate feeling in the knee is as bad as ever. If I’m still like this after a year like you, I may pray for Armageddon! The wedding is the end of Nov., so I still have a chance to dance……
Marianne – The swiming sounds encouraging so I’m going to give it a try. The tightness or the metal plate feeling is really bothering me too. It is there 24 hrs a day. The only good thing about my knee right now is that I am able to sleep without pain, but walking is still a bother. I have found that wrapping an ace bandage around it seems to elleviate some of the pain while I am on it, enough that I can play 18 holes of golf from a cart. Have you heard of the Graston Technique? my PT girl used it on me several times and it really helped. I found several sites on you tube and have been able to do the same on myself at home with some plastic items I found around the house. You might want to check it out. There are also several sites on the internet about the Technique. It is for breaking up scar tissue. According to everyone, that is my problem.
just had the right knee replace about 10 weeks old. lots of swimming and phisio is a graet help. still swollen but what bugs me is when i walk ny knee cap clunks no pain but loud . i know that it will probably be 1 year os so to get right but this clunking is annoying. any advice ? cheers steve
Roger-you have totally convinced me that my problem is scar tissue also. I think it was only by sheer luck that I escaped the knee tightness for the 1st 5 months. As soon as the staples came out, I bought “SCAR ZONE” at the super market. It claimed to heal the scar faster & contained silicone and SPF of 30 which I needed for the sun all summer. At any rate, I religiously messaged this into the scar 10 minutes 2X a day which must have helped with the scarring. After 5 months, I thought the scar looked pretty good and I stopped. Five weeks later, I started having the tightness in the knee. Just above my knee cap, there appears to be a lump about 1 in. wide and 3 in. long.
Roger-checked out the Graston Technique. It’s really interesting. I met my 30 visits for P/T this year, so I may have to bite the bullet & pay for at least one procedure. I’ve found some small metal wrenches in the archives of our basement that I think may work. I just want to make sure I do it correctly and don’t make my knee worse. I’ll keep you posted after a month.
Steve–the “clunking” you hear is what the Drs. are calling clicking and I’m told I’ll have this forever! I can feel the clicking but I don’t hear it. I’m sure the severity is different with everyone. I had clicking for years prior to my surgery as there was bone on bone when walking, so this doesn’t bother me so much. I’m sure after time, we’ll all be use to it.
I been trying to take the pain but it hurts so bad i need to take care if the scar tissue but have diabetes and dont wont to be cut it takes a long time for me to heal
My knee was bone on bone, I had a TKR 12/17/11. I pushed thru the intense rehab with a bacterial infection in my intestines. Something was not right tho. I had strong tissue pinching and some sharp pains that seemed odd. At 10 weeks, I thought, my God, my leg stopped hurting. Then I lifted my leg, and it felt like the damn thing came apart. I couldn’t move it. Turns out a piece of cement came loose, my OS did a scope on 5/2/11. The following week, another piece came loose, I had a revision to replace the spacer done 8/8/11. The piece that came loose embedded in the tissue behind my knee, to this day, it still feels like it is being tugged. I have also had some really bad days dealing with pain, I sometimes work 16 hours shifts, on cement, and I walk very fast. My leg gives out a couple times a week, there is swelling under the kneecap left of center. Twice since 8/8, while sleeping, I have had shock like sensations that ran up my leg, it was so bad the second time, I stood up,( which stopped those horrible shocks), & watched TV til I went to work. As bad as the pain was prior to the TKR, I never walked blisters or callouses on my good foot, now I have both. Something still is off, one leg may be shorted than the other now. I should mention that for the 3rd surgery, I too had a femoral block, and fell hard on the leg on top of the CPM, and put a huge bruise on my butt. My point here is; surgeons make mistakes, sometimes well meaning therapists, don’t hear us when we tell them something is wrong. I am glad that I had this surgery, I had 2 weeks of mostly pain free stair climbing and walking. It took me a long time to get to that point, I hope it will happen again. I have had a bug since the second week of July, so that may be hindering my healing. Don’t give up, you are not alone.
I find that the ROM is heavily dependent on when or if i am ‘warmed up’. I will only have 90 deg when I am ‘cold’ but after some time ‘working’ it – I can get 110 degrees. I am 10 weeks out of the surgery, and had 110 degrees a month ago. Seem to be stuck. My therapist promises to ‘get me’ to 125 or more.
I am now 10 months out from my TKR. I am apparently one of the 5 percent that have experienced all the problems that I am going through. The two biggest issues are my ROM and the soreness that I experience on most days with walking. I have found two things that seem to help. First is the stationary bike. I start with the seat fairly high, where my legs are fully extended. Do five minutes there and drop the seat one to two inches at five minute intervals. End up with the seat as low as you can go to where your leg can not make a full reveloution. This part is important, after reaching that point, raise the seat back to where your legs are fully extended again and do a final 5 minutes. The other thing that has really helped is the “Graston Technique”. If your not familiar with this, look it up on the Net and check it out on Youtube or take the time to see your PT person and have them give you a treatment. I was able to find some small tools around the house that duplicated what the PT people used. It is rather easy to duplicate what they do. Two days after the treatment the soreness dissipates. This technique breakes up scare tissue, which according to my Dr. is my biggest problem. These are just two things that seem to be helping. I am hoping that with all the other excercises that by December, I will be close to pain free. My fingers are crossed.
Hello. I am a 38 yr old woman who had a TKR of my left knee in February of this year. After 8 months of PT and a manipulation I can bend my knee well but CANNOT straighten it very well. I still limp VERY badly and have been unable to return to work. I was given the Dynasplint which hasn’t helped much. I still deal with LOTS swelling and pain. Sometimes I wish I never had this surgery. I walk worse now than I ever did before. So here’s the deal. My surgeon wants to go back in and remove the scar tissue and change out the plastic spacer in the implant. Has anyone had this done? Does it even have a chance of working? I’ve read a few websites that said typically, this procedure is not very helpful. Does anyone have a success story to share? I kinda feel like, if this is my only shot of walking normally again, maybe I should take it and pray for the best? The doctor is pressuring me to make a decision and I just don’t know what to do yet. Any suggestions or feedback would be appreciated.
I had a TKR on August 24. Was doing ok, flexion wasn’t where it should of been, but I knew going in that it was going to be a problem because of my lack of flexion pre-surgery. I had several procedure before deciding to do tkr and I didn’t do it because of stiffness I did it for pain control. Here I’m at 2 months in and started getting a sharp stabbing pain on the medial side of knee and going in for a manipulation in two days. If in fact the pain is from scar tissue I can put up with starting all over on pt but I have my doubts. This pain hurts worse then the coming off the nerve block from the tkr with not one Dr offering any pain medicine. This manipulation better work and of course I’m worried it won’t. My husband had one on his shoulder after his rotator cuff surgery went haywire. Best of luck to all of us and we are all different and you can research every tkr paper ever written but there is always a percent of us who don’t do well
Hello Fellow TKRs,
Oops, one year ago, I could not walk or straighten my leg. I can walk and straighten my leg now. I don’t know why I am experiencing intermittent electric shock sensations, those, like the tissue masses above my knee can cause seriously scary pain. However, most of the time I walk w/o pain. Sitting and standing cause a pinching pain that can last for days, the nerve/tissue pain is a flash burn then gone.
I would do it again, though I had to fight to be listened to that something was wrong, I do wish I did not have the spacer replaced. this one hurts and I think my TKR leg is a hair longer than my left leg.
someone recently commented on the use of lasar for the removal of scar tissue where scar tissue” is sited as major factor in post-op knee stiffness and limited ROM…
Can anyone tell me more about this use of lasar to remove scar tissue ? Where can I find someone to do this ?
Thanks
I have been reading these posts for over an hour and I wanted to share my story so that if it helps just one of you then I have accomplished what I intended.
My TKR was performed in July ‘05 after experiencing progressive pain over a two month period and going from healthy to crawling into my OS’s office and being diagnosed with bone on bone knee needing immediate surgery. I was operated on 5 days later.
I was the model patient. Surgery was performed on Tuesday morning and I was released at Thursday noon because of my miraculous recovery. My attitude was so positive at the time I was considered by my OS as the best patient he had ever performed TKR surgery on. To explain everything that transpired during the next 18 months I would have to write a short novel but space is at a premium.
Within 6wks of my initial surgery I had to have a manipulation done because of the massive scar tissue that had built up since the surgery. Following this procedure, during the prolonged PT and everything else I had to go through I just knew something wasn’t quite right with the knee. During the following 18 months I had to visit the OS’s office 5 or 6 times because I wanted to try and convince them something was drastically wrong with my knee. X-Rays were taken and reviewed and I was advised by the OS assistant that everything was normal and looked perfect. I never got to see my actual surgeon, only his office assistant. Finally after 18 months from the date of my original surgery in Jan’07 it came down to a showdown. I demanded to speak to my OS, one on one. He obliged and I told him I had been through 18 months of pure hell and he needed to do something to find out what the problem was still causing all the pain and suffering I was going through. I saw him on Jan 24 ‘06 and he told me because he couldn’t find a reason for my problems he wanted me to go to the Nuclear Medicine dept of the hospital as this would be the only way to look at “the bigger picture” concerning what was going on inside my knee. This procedure is NOT an MRI. It has to be done by the Nuclear Medicine dept. I had a 3 phase done scan done. Here is the report and I quote:
1. 3-phase bone scan of knee shows increased blood flow and blood pool activity surrounding the right knee prosthesis, with moderate intensity increased activity and delayed images surrounding the tibial as well as femoral component of the right knee prosthesis. There is somewhat more focal increased activity involving the articular surface near the intercondylar notch.
2. The findings would be consistent with loosening and/or infection.
3. The right patella is unremarkable in appearance.
My OS scheduled me for immediate surgery that day to replace the original TKR. My surgery was to be 4 days later on Jan 28 ‘07 but one day before surgery he called to tell me that because my insurance has expired 1 day earlier he couldn’t perform the replacement surgery (I had lost my job after 31 years with same company) and my wife filed for divorce in Oct ‘06. So here I was left high and dry. no follow up surgery after 18 months of total misery and my life falling apart due to the failing of the first surgery.
I’m not going to go into details since that time other than to say I am still experiencing the same pain, inability to do anything involving being on my feet for extended times. Can’t walk more than 50 to 100 yards at a time before resting up, etc. etc.
In closing trust your own instincts and your own body. You know it better than your OS. If you just know something doesn’t feel right or you are convinced there is definitely a problem ask your OS to refer you to the Nuclear Medicine dept for the scan that will reveal whether everything is “fine” as your OS has told you over and over again. I wish you good luck and hope my experience gives you another option to possibly find out the real reason your knee isn’t healing as expected. Trust your instincts.
In all the reports I read I hadn’t seen one reference to anyone being referred to the Nuclear Medicine dept. That’s the reason for this post.
I had tkr 7th may 2011 it was a very long and painfull recovery. went into hoapital last week and had manipulation it only bends to 95% so i only got an extra 15% as i only got a 80% bend before. but i know i have to work hard on doing xercise.
I had tkr on 7th may 21011 it was a very long and painfull recovery. i only got to 80% bend. last week i went back in and had manipulation, it was not painfull just more uncomfortable. Even now i only have a 95% bend. i am having more pt and just have to make sure i keep on moving and exercising
TKR April 2011. Only 85% ROM. Stiff knee when ever I sit for more than15minutes. Dr thinks its nothing, just one that its going to take a long recovery time. No matter how much I try I can’t bend it further. Wishing. I had never had it done.
When you write ‘80% or 95%, as in ‘percent’ – do you mean degrees?
Since I had 140 degree bend pre-op, and now have 100 degrees, I guess one could call that 70%. having 100 or 110 degrees, which I did achieve one day – is more than most, but for me, it isn’t enough. I seem stuck, after 3-1/2 months post op. Doc says he wants me at 5 months before considering a manipulation.
Hi. I had tnr for my right knee on 10/27/11. Today marks my 5th week. I have been going to therapy 3 x week and am almost at 90% but still unable to “peddle” a full circle. I saw my surgeon this past Tuesday and said he wasn’t happy with the results and is insisting on a manipulation. I’ve been reading other patient’s comments and there isn’t one that says the manipulation worked/lasted for longer than a few days. The surgeon also says he will send me home with a cpm machine and that I need to stay on it for at least 10 days. I wondered why he didn’t order it right away, after my surgery. He seemed frustrated with my hesitation and told me this is what he does for a living. Don’t get me wrong: I like him and I know he cares about his patients. But, when I look to see how the procedure is done, it seems barbaric. He can leave the hospital afterwards but what about me? What happens and what is the intensity of pain I will feel and for how long? Can anyone rate their pain from a scale of scale of 1 to 10 after the maniputation and how it lasted? I wish I knew what to do. He says he needs to know by Monday so he can schedule this procedure for Tue, 12/13/11.
I feel so bad for everyone who is having a rough time their TkR. It can be very difficult. I had my TkR on May 5,2010. It was very difficult for. My insurance wouldn’t pay for the machine. 10 days later I went to therapy it was most painful. My therapist felt sorry for me. I would cover my face and just cry. But I let him do what he had to. He promised me it would get better and it did. I let him munipulate the scar tissue away. It can be done. We could feel my scar tissue. But to munipulate it through therapy was quite painful, but well worth it. My range of motion is about 115. But I’ll take that to be free of the pain I suffered for 10 years. A good therapist can break up the scar tissue if they know what they are doin. He had me riding the bike I about 3 weeks. At first he helped me then one day I did by myself. Don’t give up. It’s important to get someone to constantly bend your knee as far as u can take it 3 times a week to gain ur range of motion. Please don’t give up. May God bless each & every one of you. TKR will never be like a normal knee.
Katherine, I understand your pain. I had a TKR one year ago tomorrow. I have been through hell since. I go in for another manipulation next Monday to try and get more ROM, currently I only have about 110 degrees flex and the knee is sore whenever I am on it. The Doc seems to think it is scar tissue causing the problem.
Hang in there and God Bless.
Canceled the manipulation, there is something more than scar tissue going on here. Going in for a bone scan tomorrow. Twelve and 1/2 months out. Not what I had hoped for.
I am a 64 year old female. I had tkr on right knee 07/09/2009. Had all the PT I could get and then move to another state before my one year checkup. I have experienced range of motion pain which has developed into full knee pain anytime I bend, flex, more over most any movement of the knee is painful. Visiting back in the city and state where I had surgery so I’m gonna setup an appointment with the surgeon and will report back his findings.
I am 8 weeks out from a minimally invasive right tkr. I just got off the percocet and am now on Ultram every 8 hours and Mobic. I am walking fine but after 9-10 hours of standing on concrete, my knee gets really sore. Is the pain normal? I also workout at least 5 days a week. I apply ice when I get home and elevate my knee. The swelling is still three but not as bad. Is that normal too? My ankle also hurts a lot at night and I’m still sleeping in the Laz Z Boy.
In August 2011 I had surgery to remove a bone tumor on the distal femur (knee-end) which involved not only removal of the tumor itself but some underlying bone in which the tumor affected. A graft using cadaver bone was used to replace that which was removed and it’s been a long wait for that to heal. As a result I have been in non-weight-bearing status up until now, January 2012. That’s about 5 months so far.
At the moment I am still at non-weight-bearing status but going through PT to increase range of motion up to and at least 90 degrees bend in the knee. Although PT has helped it has been an uphill battle and whatever ground is made up in flexion is then counteracted by tightness and somewhat of a return to its previous bending limit.
I’m told that if the knee cannot be bent to at least 90 to 110 degrees that I would have to go through manual manipulation under sedation thereby possibly causing tearing of muscle tissue and additional damage.
From what I’ve read online manual manipulation under sedation is something that should be done within 3 months of the surgery but since it’s been about 5 months for me because of the graft, does anyone have any idea what options I might have at this point? Arthroscopy perhaps?
I had my right TKR on June 27,2011 I am now almost 7 months out. still have swelling in my knee , I was told to expect it up to a year. Am doing most things ok still have some trouble going down stairs, and I live in a tri level house so some days it’s not easy. The one thing that bothers me if I stand in one spot for to long my knee gets stiff, I do stand all day working in a pre K class I keep me going all day. I still ride my excerise bike 6-7 days a week about 20-30 mins at a time , Helps keep it moving. Most of the pain is gone, Everyone has said time will help it improve and it has, So if your new just keep doing what they tell you to. Make sure you keep it moving as much as you can.
My right knee was injured when I was just 9. Over the years, I had a total of 11 surgeries on it as well as many, many injections. I finally got to where I was in extreme pain constantly especially when walking. This also caused my left knee to begin having problems also. After several years of talking with my ortho doc, I determined to have the left knee replaced as I knew what to expect of my right knee.. If all went well, I’d get the right one done.
My first surgery was on 8/3/11. I spent five days in the hospital, was walking the very next day with a walker. I came home with the walker and after 3 days, put it in the corner and didn’t use it again. I had home health therapy for 3 weeks, then went to outpatient therapy for 6 weeks. After 4 weeks, I could move my knee to 105 degrees, when I left it moved to 118 degrees. What pain I had was treated with percoset.
I had my right knee replaced on 11/9/11. Same treatment with home health and am now 2 weeks from being released from outpatient therapy. I am able to ride a bike for the first time since my twenties, walk up and down stairs with no indication of the old way I walked, and am currently at 106 degrees of movement in the right one.
Both are doing great and I am so happy that my quality of life is coming back after over 40 years of pain.
My recommendation to anyone thinking of this is to have honest talks with your doctor. Ask if you can talk to prior patients and if you can, go to an outpatient therapy clinic and talk to the therapists and other patients.
Good luck to all who are comtemplating this surgery.
I had Bilateral knee replacement in April 2010, I still have a some trouble going down steps, left knee still feels like there is band around it, but I don’t really have pain, just wondering how it is for someone else that has had a replacement for almost that long
Had TKR 12/6. Followed protocol of 4 days in hospital, 5 days in rehab, and PT 3 times a week. OS saw me after week 6 and I had 95 degrees ROM. He was unhappy and on 1/20 I had a manipulation where he got 140 full range. The next day my PT got it to 110 degrees with me screaming. Had horrific pain for three days after. Continued to bust my butt at PT and just started going into water therapy. Now I’m barely back to 95 degrees and seeing the OS on weds. 2/1. Wondering what he will say. I will suggest everything I gleaned from your comments about massage, Thai massage, instrument -assisted soft tissue mobilization, etc. Anything before a second manip.
P.S. If there was any treatment I missed or overlooked, please let me know.
I had a uni compartmental Knee replacement on 9/28/2012. I have full range (approx. 130) and am still having swelling and tightness on the muscles just above the knee. I am wondering how common is this and besides intermittent icing and damp heat, what can I do to re-hab the tear drop area of my quadriceps above the knee? I am walking and able to go up and down stairs but not without pain on the stairs. I periodically ride a bike and take short walks while being on my feet mostly all day at work. I injured my knee surfing ( torn meniscus) at age 20 which ultimately led me to my partial knee replacement. I am anxious to get back to being able to surf, anyone experience the same and have advice on my time line to recovery. I had a total hip on the same side as my knee 13 mos. prior to my knee surgery which is feeling outstanding. I am feeling a bit frustrated and impatient, thanks for any advice or encouragement.
I had a tkr at the Cleveland Clinic about six years ago. I am a jock and, yet, I found rehab extremely tuff to improve rom. Three months after replacement the same doc performed a “manip.” He bent the knee to about 130 rom; before the manipulation, it was a little less than 85. Each day I lost rom although I continued rehab. For years now, I have had to live with about 88 degrees of rom — not even enough to ride a bike normally. It may be very important to add, that I had my meniscus removed in 1970 and afterwards had about 110 degrees of rom — enough to continue being a jock, including running the Boston Marathon. In the end, the docs, and they are the Clinic’s best, told me I would just have to live with it. Additional surgery would be risky. Help!
I had my TKR in Dec. 2010 I have been through hell since. I have had every procedure one can have since then. The latest was a specialist that did a bone scan, drew fluid and told me everything looks normal. My knee is usually always sore, I have about 110 ROM at best. Still hurts going down stairs. Some days are better than others. The biggest complaint is the BAND feeling that is always around my knee. It feels as though the muscles just will not relax. I have seen others here that have the same complaint, but no where have I seen anyone that can tell me how to get rid of it. What is really sad is that we are the %5 of people who have problems, everyone else is up and about in a month or two and can’t wait to get the other one done.
Jack, from your post I think you and I have a good bit in common. I had meniscus removed from both of my knees in the mid sixties. Had bi-lateral TKR about six years ago, have had a manipulation done twice, the second time my doctor also removed scar tissue from my problem knee. My ROM is barely 90 degrees in my bad knee but great in my good knee. I am thinking of going to a new doctor and see what he thinks about replacing the replacement.. I walk stiff legged and it is easy to trip and fall. I have always been very active and continue to exercise regularly. I have been extremely disappointed with my results. If it is scar tissue causing the ROM problem how come my good knee isn’t affected?
I had mine on Aug 24,11 and Im still waiting for that bewitching month where there is no stiffness, pain, etc..I really think the prog. has to do with the stiffness going into the sugery. I have only 95 flexion and physical therapy cut me off when the tore my thigh muscle trying to get more. I also get tired of people telling me I didn’t rehab enough because I’m still paying that bill. The only good thing is I can walk further then ever before knowing my knee has a good deal of stability. Good Luck and walk walk walk and ride ride ride>