Manipulation Following Total Knee Replacement Surgery
Knee replacement surgery is generally very safe and effective, but it is a major operation. For unknown reasons, scar tissue formation within the knee joint may be excessive in some patients (a condition known as athrofibrosis). This can result in joint pain and stiffness and reduced range of motion (ROM).
This stiffness is sometimes addressed by a forcible, closed manipulation of the knee joint by an orthopedic surgeon. In a recent study in the journal Orthopedics, the authors looked at the effectiveness of manipulation and sought to determine if any patient factors could be used to predict range of motion improvements following this procedure.
In this study the authors describe how manipulation following knee replacement is performed. Patients are given either epidural or general anesthesia. An assistant holds the heel while the surgeon gently extends or straightens the leg.
While straitening the leg, the surgeon applies pressure to the anterior (front) of the knee joint. The knee is then flexed or bent with the assistant holding the thigh while the surgeon applies pressure with his chest on the anterior of the tibial (shin) area to, as they say “allow slow, steady stretching and tearing of the intra-articular scar tissue” (“intra-articular” means within the joint).
This process is repeated until full Range of motion is achieved or until the surgeon “no longer feels creptiation” (crepitation is the dry, crackling sound or sensation resulting from rubbing bones or irregular cartilage surfaces together as in arthritis).
Some interesting findings and observations from this study:
- The surgeons looked at a consecutive series of 767 patients. Forty-six required manipulation. So this condition was observed in 6% of patients.
- On average, patient’s ROM increased significantly after manipulation. Patients were able to bend or flex their knee 22 degrees further, and extend or straighten their knee 4 degrees more.
- The flexion achieved after manipulation was similar to that which the patient had before having knee replacement. (Pre-operative ROM is often a predictor of post-op ROM).
- Several patient factors were not associated with the effectiveness of manipulation. These included patient sex, BMI and alignment of the knee joint before surgery (i.e. the amount of knock-kneed (valgus) or bow-legged (varus) deformity).
- The authors used several different types of implants. Implant design or type did not influence the effectiveness of manipulation.
- Patients manipulated less that 8 weeks after surgery gained more flexion than those manipulated after 8 weeks following their knee replacement.
- The patients were followed for 1 year, and those whom had full extension before manipulation wound up with more flexion at 1 year post-op.
- To avoid the need for manipulation (and presumably the formation of excessive, debilitating scar tissue), the authors suggest aggressive pain management for the first few days after surgery followed by ambulation and some exercise.
This study can be found in the June 2009 issue of Orthopedics.
References
1.Cates HE, Schmidt, JM. Closed Manipulation after Total Knee Arthroplasty: Outcome and Affecting Variables. Orthopedics. 2009; 32:398.
2.Arthritis of the Knee Joint. Complications of Knee Replacement Surgery. http://www.hipsandknees.com/knee/kneesurgerycomplications.htm#scar. 28-Feb-10
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Introductory Topics
Introduction - Home Normal Knee Anatomy The Diseased Knee: Osteoarthritis The Knee Replacement Procedure
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On july 23 2009 I had knee replacement my doctor manipulation three times, on march 09,2010 my doctor went back in took out all the scar tissues. I been in physical therapy for about eight weeks, I’m still not able to bend my knee, therapy is able to bend at 84-90 degree. my doctor want to manipulation again,I dont if that would help, I some help if anyone out there can help please do.
I had a tkr on 8-24-10, my knee won’t bend after 9 weeks of therapy at 3 x a week. They make me scream trying to bend it but not working. I go to Dr. tomorrow and am supposed to go back Fri. to get manipulated OUCH !!!! They say its scar tissue. I hope this works so i can get back to normal. I had a hip replacement Feb. and made out fine from that no problems. What do i have to look forward to after manipulation? How much pain will it be ?
I had TKR 7/12/10 and had problem bending past 90 on my own and 105 at PT with 2 people holding me down and Therapist trying to bend me. I had manipulation done 9/20/10 in morning and went to pt that following afteroon. knee bent to 120 every day that week. 2nd week knee swelled up and I treated with ice and alleve. Following week bent to 120 again and has progressed from there. Today at PT 11/1 I bent knee on my own to 118 and my therapist got me to 130 by himself without me screaming in pain. I also go to the pool at my gym every day and walk in the pool for an hour and do about 10 minutes of bending excercises which I think has helped a lot. But without the manipulation I don’t think my results would have been as successful.
Hello Steve,
Sounds like some hard work and persistence on your part is paying off with slow, but steady progress. Thanks so much for sharing your encouraging story!
Hi
Had tkr on 10/1/10 can’t bend knee much at all 40-60 degrees. I’m not sure about manipulation has anyone gone through this. How painful is it……is it worse than the tkr surgery itslef?
Had TKR on 9/29/2010. Can’t seem to bend knee more than 95 degrees. Dr. is suggesting manipulation after 12/28/2010. Any suggestions. I do therapy 3 x a week. I am 63 yrs. old and have put off TKR for 10 yrs, maybe that is why my range of motion is poor, just a guess.
I had tkr on 10-13-10. I can only bend my knee on my own to 94 and with pt 105 and hurts like hell makes me cry every day of therapy this will be my 4th week of therapy. The doctor wants me to come in and let him bend it.
Does this work after he does it and is the pain as bad as the dayhe did the replacement.
I need some good advice, please.
Keep working hard with your pt. I am 8 weeks post op now and can bend knee at 122 degrees. It took alot of work on my part and and with pt. I was stuck on 95 degrees but one day it just started to bend more and now I am happy to say I should not have to have a manipulation. Just work hard , it will come. TKR on 9/29/2010 and 20 visits to PT.
Hubby had his third knee surgery in June. First was 35 years ago, second was arthrosopic in 2005, then the TKR in June.
His range of motion has decreased to the point I must help him put on his shoes and socks and he struggles to put his pants on. His knee is often palpably warmer than the other, though he does not have fever otherwise. He had a very high fever immediately after TKR that they had a great deal of trouble getting down. Then he had a low grade fever for about 2 weeks after discharge from the hospital.
He was VERY compliant after surgery, so not following instructions is absolutely not the issue. He is scheduled for a knee manipulation in about a week.
1. What should we expect as far as recovery goes?
2. How much discomfort will he experience?
3. Christmas is in two weeks. Would it be wise to cancel our annual Christmas trip 900 miles away?
Thanks for your advice.
I am only 39 and had a TKR on 10-14-09 i absolutely hate it! I cant bend my knee to the point that i feel helpless! I have gone to my otho ddocs. And they dont seem to want to help me with my situaton they basically they have thrown their hands up n refuse to help! I went from pain to being crippled….if anyone knows of a specialist that wud b willing to manipulate my knee i wud appreciate it!
Just came home from Ortho visit/Therapy. I had a left TKR on October 5th 2010. Have been in PT 3 x week for 2-21/2 hour each session. I am now being scheduled for a manipulation sometime next week
My therapist has been working on my flexion aggressively for the last month and I am only at 76 degrees. I am scared to death to have this done.
I would like to hear from anyone who has had this procedure done. Thanks!!!!!
I had tkr on Nov 30th 2010 and have been doing PT since then 3x a week except the week of Christmas when I went 2x. I have gotten to 90% on my own and 100% with the therapist helping and my surgeon would like it to be better. He said my thigh muscles are tightening up and I need to relax them how do I do this when I know its going to hurt like hell. Any suggestions if I can’t get the knee better he is going to want to do that manipulation thing and I do not really want to go thru another surgery.
Cindy, please do not give up hope. I had very good phys. therapist help me in bending my knee. I did 2 exercises faithfully every day at home to help bend the knee. One was the wall climber. Laying on my back in bed or floor and walking my feet down the wall, crossed my good knee over my ankle of the new knee to help push the knee down as far as I could ben the knee. You can feel the bend and stretching of the the new knee, and every day I pushed myself to bend it further, I had my husband pencil every day so the next day I could go further, the other exercise I did was laying on floor or bed with a dog leash around my ankle of new knee on my stomach and and bending the knee as far back as I could, I also found that strecth felt good, because if you don’t do it I could feel the muscles tightening up. I hope I have helped you , and Good Luck. I was determined not to go in for manipulation. Barb
Hi, had knee replacement twenty two months ago, did all that was ask of me. now having problems bending my knee ,without lots of pain. have more scare tissue, than last year .my bend was at 90, so i made appointment . need to be manipulate, i never felt pain like this.if i hit the tip, of a anything, that causes me to stop quick .oh my goodness, the pain, the pain, stops me dead in my tracks. my knee reminds me of a bolt, that when its struck you cant get it loose.
I had TKR on the left knee on 12-20-10. It is the fifth surgery since breaking the tibia in October of ‘76. Artritis has plagued me for the past five years. I have lost muscle and tendon due to allowing the right leg to favor. Seven weeks post op and the swelling in the knee is still a factor. The skin is very warm to touch. Ice is my friend. The early stages of pain was mostly muscles that have not been used in years. Now the pain is the scar tissue creating a “Velcro” effect. The longer I sit and don’t move it the more the leg pains me. I just had a break through at PT on week 6. I was able to reach over the 90 degree point. It goes away after the next day however. I can go up stairs with ease but, down is not going well. My leg strength does not carry my 200 pounds. I am seriously considering manipulation due to the pain that exibits when I try to straighten my leg after a night of restless sleep. Sleep is not part of my life anymore. I get 1 to 2 hour naps at best. I was told that I could have my life back…….?
I ha a TKR on 12-21-10 and i am still in severe pain,can’t walk very well. I can’t sleep and i am in severe pain with throbbing and aching in my calf and shin 24/7. i am so upset with the pain and cry daily for hours. my surgeon thinks i am not trying hard enough and I am doing all i can to the poiint i get nausea and shakes when the pain is so bad. i go to PT 2-3 days a week and it is still difficult. does anyone have any word of encouragement for me? i am so sad. the pain i traded for is now to the point i could die.thanks to anyone with any help.
Don’t be discouraged. I had mine on 12-20. You need to treat it as muscles gone bad. Heat and Ice and stay medicated. I’m lucky to sleep two hours at a time. I work a 6/10 night shift at a desk and the muscles cramp continuously. I try to walk every half hour or better. No one understands or has advice. Work the muscle slow and easy. Soak it, stroke it, drug it. But don’t stop now. Good luck.
I have been fascinated reading about all the problems having TKR can cause. I had TKR back in 2009 and just recently began to have pain and problems bending knee.Saw MD who did the job, and he says it’s probably scar tissue. I don’t want a cutting operation yet again. I don’t think I can take it. But manipulation appeals to me as a substitute. Thanks to all who have written to this very informative website. Good health to all my new “friends” and thanks for your great comments!
I just had MUA on my knee yesterday. I am quite pleased with the results. I have very tight quad at the moment. But no pain in the knee it ought to be part of the procedure.
Why in God’s name would a surgeon not apply a dynamic splint for knee extension and or flexion in the patient’s therapy when they first notice the patient is having difficulty…?? These devices have been shown to reduce the risk of a patient having a manipulation by over 80% if applied early on in therapy. Why is it that a doctor would do something so archaic over trying something as simple as a Dynasplint early on?? I think its time that we start questioning doctors and forcing them to become more proactive in their approach to protocol.. Wake up MDs and use the technology!!!
Is there a “window” to manipulate bend after a total knee replacement. In December my doctor “gave” me 3 months to see what I could on my own to regain extension and flexion, that while we had passed the window for extension manipulation I still had up to 6 more months to decide if I wanted flexion manipulation. Returned today (I am now 6 months post-op) fully expecting him to set up an appt for manipulation under anesthesia, but he said there is only a 3 month window for any manipulation and I am well past that…… I am terribly confused. PT has been making progress, can actually get the knee to hyperextend, but I can’t get into single digits on my own, 10 at best. Any suggestions??????
Hi Joe, I cannot agree with you more!! I have had nothing but difficulty from my surgery on 120110. I had MUA on 021611, which seemed to help for about 3-4 days, but the pain was so bad after the procedure that I could barely move or walk. My therapist finally got me a splint from Dynasplint and I have been wearing it for the 3 days that I have had it. It seems to have helped me more in the 3 days than anything else that I have tried. I should have had this thing from the minute I woke up from my MUA. A CPM machine is great too, however it only works if you can bend your knee, which in my case I can’t get passed 40-45. I’m only 45 years old and led an active lifestyle before my knee procedure. I have a career as a Deputy, however if I can’t get my knee to bend my career and lifestyle are soon to be over. My doctor just shakes his head in discust as if I’m to blame for my condition, I’m beginning to think it’s time for a second opinion. I am so glad I stumbled on to this website. Reading all these posts helps me know that I am not alone in my misery.
I had a TKR 06/10/2008. I had two Manipulations,in July and September of the same year. MD said that he was able to fully bend and straighten knee during both manipulations. I basically have “0″ recovery. I have had so much PT and no progress. the more PT I have the stiffer the knee gets. I cannot bend my knee. I am unable to kneel on the floor and cannot climb stairs more than one step at a time. I cannot walk very far. Cannot bicycle, no alyptical, tread mills or nue step macines. My MD and several other MD opinions say that I have two much scar tissue and it grows real fast and will not allow knee to work proprely. My knee is worse than before I had it replaced. I need help! Can I have the scar tissue removed? will it come right back? My other knee needs to be replaced. Will I have scar tissue in that knee also?
The brand of TKR that I have is from Howmedica Osteonics. Have their been any problems with that brand?
Hello Everyone,
I just had my manipulation done yesterday before that I could only bend my knee at 40 to maybe 55 degrees with the help of my therapist. I was so upset about the manipulation that I started having more anxiety attacks and just feeling totally depressed I was scared out of my mind to have the manipulation done well I did it yesterday they gave me somthing to calm my nerves and took me back to the operating room, there I was put to sleep and and hour later in recovery, my knee has bent more my ortho surgeon said he got it at 110 its very sore not as painful as I thought, I can’t straighten it out all the way but just being able to bend as let me get some sleep. I will keep everyone posted as time goes by good luck to you all.
Glad I read your comment Rachel. I am having knee manipulation done after my total knee replacement that was done on Feb. 9, 2011. My knee will not bend more than 53 degrees and it is driving me crazy. I am a little worried about the pain of the knee manipulation, but I just want my knee to bend. I am having panic attacks and cannot sleep. I just hope this works for me. My ortho said I do have alot of scar tissue since I have had 3 scope surgeries prior. I am definitely going to ask about the dynamic splint though.
Good morning,
Well it has been 4 days since the manipulation and I have been in therapy none stop except Sunday I told my therapist I was taking it off and did my own therapy at home. My knee is still sore and swollen it has been painful I guess the first day was not bad cause I was still gooped up with the meds they gave me and the injection in my knee but once that started wearing off the pain kick in I was given a stronger pain med to take and that does help but of course your never pain free. My leg is bending more I’m at maybe 75 to 80 but I can’t straighten my leg out all the way so that worries me we have been placing weights on top of my knee to try and flaten it out. I will give another update later. Good luck to everyone.
I had my TKR just before Christmas 2010 and had manipulation in february. It doesn’t bend all the way back yet but I think the secret to success is the bike. Do it everyday for ROM and stairs for strength. The pain is getting better. I too was ready to give up. Hang in there for your sanity. It’s all that keeps you going.
Hello, I had my TKR on 2/28/11. all 3 parts to the Knee were bad the bone was bent and 2 cycse around the bone, so i was a mess, after getting home I had Home Heath come MISTAKE, the PT wanted to been my knee get her range # and leave maybe stayed 10 min. leg only bending 75, did this for 2 weeks, had a DR. App. told them i wanted off home heath started going for PT at Hospital did that for week and 1/2 increased my range to 82, another DR app. The Dr was NOT happy with #’s i could get my leg straignt that was the good part, he told me he wasnted to manipulat me in 3 days he wanted the #’s higher, I did it yesterday, he bend it to 130 come out of surgery and a PT was righ there to work with me I got it to 110 myself, come home that afternoon meds wore off and leg felt like a truck had ran over it but i had much more movement in it and that was awsome i selp better last night than i had in over 9 months, this morning still sore but nothing i can’t live with i was sent home with a machaine to help bend your leg and i Love it it helps So much i go for PT today and am excited on how well i do, I hope this helps anybody that is going thr this ordeal I will keep you posted, I am 50 years old and want my life back. Good luck to you all…
Thank you for your comments Shelly. I see your Ortho told you that you had a lot of scar tissue. Did he say that it grows real fast and attaches to everything and limits mobility? Did he say that the scar tissue could be removed successfully? I am not getting any encouraging news on mine. He says that my scar tissue is aggressive and grows fast. He, and other Ortho’s cannot promise me any positive recovery with any knd of surgery. I have already had two manipulations to no avail. My knee will not bend and I am in constant pain.
I had total knee replacement on 02/08/11. Three days after being released from hospital, I developed pneumonia and a blood clot that went from leg to right lung. With this sickness I was unable to do regular PT resulting in my being behind with therapy. My ortho doctor suggested knee manipulation. This procedure was performed on 03/25/11. I honestly believe this is one of the biggest mistakes I have ever made as my knee/thigh is swollen, using a walker once more, and running fever every afternoon. I feel so bad and even though I go for PT everyday, so far I feel no relief. I was bending 90 degrees before manipulation and only 70 degrees now.
Dennis, when I had my TKR in June of 2008 I bought a $600 recumbant bike and tried to use it. I could not bend my knee enough to pedal in a full circle. I used it for quite a while just going back and forth with no positive results. I traded the exercise bike for a $1000 elyptical machine. Same problem! I cannot get a full range of motion on the machine to walk on the lowest setting. So I had to put it away. If anyone is interested I do have it for sale. I do not understand why the more I exercise the more stiff my knee becomes. I have about 8-10 PT personnel that are puzzeled as well. I am at a loss as to what to do?
Dan, yes he says that my scar tissue seems to grow real fast and attaches to everything and limits mobility. He seems to think the manipulation will be my cure, but I’m not convinced. After I had my TKR, they came in the the CPM the day after my surgery, I only was able to get to about 74% ROM and I was on morphine and my pain meds. He did not send me home with the CPM, so I asked if I could have it to use after my manipulation, but he said “no”, I will have aggressive physical therapy. I did bring up some of the comments I have read from other people about having more than 1 knee manipulation and even the possibility of having the scar tissue removed. He is adament that I will only need this one manipulation. I am very frustrated. I need to get back to work as soon as possible as I have had no income since 3/16/11. I also have not been able to sleep; I get maybe 2-3 hours sleep a day. I am so tired and sore. I sure hope this manipulation works. As of today, my ROM is only about 50%. I will update after my manipulation.
Good morning,
Well so far I have impoved my range of motion to 93 degrees. I am still sore and some swelling but the pain is still there. I can’t fully straighten my leg out but I am working on it. My therapist was very happy with the improvment, because before there was nothing. If anyone needs a manipulation I say go for it you need to give it a chance to see if it will help. Its nerve wrecking but it has help me get more ROM. Good luck everyone I will keep you all posted.
Dan, don’t ride until your knee is sore. Just use it to achieve ROM. My knee swells and gets stiff from a lot of walking, I use the bike to get back ROM. I was thinking of muscle building, but that is not in the picture yet. The stairs I climb at work has helped with that part.
Shelly, When I had my TKR I went home with a CPM also. I used it for a couple of weeks. I increased the CPM to where I was up to 90 ROM with it. Of course I was grabbing a hold of the head board on the bed and in excruciating pain. The more I used the machine the worse my knee got. I hope your manipulation goes better and helps. I too, do not sleep very well, especially in a bed. I sleep longer and better in a chair in the living room.
Dennis, I was not riding the bike until my knee got sore. In fact my knee was sore even before I got on the bike. The more I try to stretch and exercise the stiffer it gets. I am not trying to keep saying the same thing but I am at a total loss of what I can do. I can exercise every other part of my body with no problem, but not the left knee or leg. I just spent about 10 to 12 weeks in PT (3X a week) for more cardiovascular to try and lose some weight to see if that helps. I also spent some of that time working the left leg. Nothing! My right knee is close to needing a TKR and I am afraid to because of maybe having the same trouble. Would I have the same scar tissue problem? Prior to my TKR on my left knee in June 2008 I had had it scoped three times from 1981 to 2003. My right knee has been scoped twice. Once in 96 and once in 2007. Getting older is not fun physically!
Hi Dan,
I was reading your comment about you sleeping in a chair in your living room and I too have had to do the same thing except I’m on the couch. I have not been able to sleep in my bed since the TKR in Dec. I even thought about buying a chaise lounge to put in my room but I barely have any space now. I’m so glad to have found this site because I thought I was all alone in going through this. Thankyou everyone for sharing your stories it sure helps me get by and gives me motivation not give up thankyou.
Had my knee manipulation this morning; very painful at first, not too bad now. Went to therapy right after my manipulation, got to 70 degrees, so I am hopeful this worked. I am able to bend my leg much more and it actually feels better bent and sitting up rather than lying down even though I am so tired and just want to sleep. My doctor finally authorized for me the use of a CPM so I am excited to push myself to get better each day. All my strength building of my thigh muscle and hamstring is back to nothing, so I have to work extra hard to get that back. I will update my progress again at the end of the week.
Hi guys!!! Been reading since Oct. of 2010. Had TKR on Oct. 19th 2010, was put on the bending machine in hospital, got to the 90*, went through PT and could not get to 97* after that. Had Manipulation on Dec. 14th 2010, he said he got it bent to 125*(also (120* during surgery) I was released at 105* but I can not bend down to garden, or really do anything on the ground. I can do steps, but one at a time with help, I can ride a bike, and I do like that, but my knee (around cap area) always hurts or has some small pain. I can only sleep in certain positions for so long and then I wake up in pain. I have run out of insurance for PT so do bands at home. I need the other knee done, but will not because of the scar tissue that I seem to make real fast. Thanks for all your posts, go back to Dr in a week for 6 mon check up …. will let you know how it goes.
Well it’s been 8 days since my manipulation i sleep with my CPM and use in 5 hours while i sleep, i go to PT 5 times a week i got my RPM to 97 by myself and 105 them pushing, go to the DR tomorrow very scared of what he may do… only can sleep the most 5 house at a time and pain or stiffness wakes me up, the pain is only in the part of leg above the knee, still very swollen, hoping for a good report from my Dr.
I came upon this website tonight as I was searching for some kind of answers or information on manipulation surgery. I had TKR on January 31st 2011 and have felt that my progress has been extremely slow. I went to PT today and my ROM on my bend is about 100-105 without assistance and I got up to 115 with them pushing on my leg while I scream. My problem is getting my leg straight. My doctor appt followed the PT session and he now has scheduled me for manipulation on Monday. He says he was not as concerned with my bend as he was with me getting the leg straight. He says that if I don’t get the leg completely “straight” within the certain window (3 month period), I will walk with a limp and not be able to lead a normal life as I have been used to. I am 50 years old, active, with a physically demanding job and have alot of living to do. I am so tired of the pain and cannot sleep just as everyone else. I sleep on the sofa and can’t sleep more than 1 hr at a time. I was led to believe that the manipulation would give me my ROM and PT would therefore be easier than it was after the TKR. After reading the comments, I am convinced that the PT will be every bit as tough as before. Everyone on here seems to have problems with the bend but very few have mentioned having trouble getting that “straight” ROM. Has anyone had this problem? I am so nervous and trying to decide if I should back out and take my chances that I can get it on my own somehow. Any suggestions or opinions would be appreciated! I have been so depressed because everyone I have talked to that has had knee surgery had no problems at all. I felt so alone and abnormal! Thanks for the ear…….so great to know I am not alone!!!!!
Ok everyone….DOES ANYBODY have a answer for this one? Short version: I had TKR April 2010. (oh…Im athletic…petite 5′3″ 115 pounds…49 years old..) Anyway….PT/recovery went fine etc. etc. but I noticed a “sandy sound” approx. 5 months after surgery…I lod the doctor…over the months following…sandy turned to gritty…..to crunchy …to almost like a cracking…BUT ONLY when I STRAIGHTEN the leg. (ouch ouch too…) . But my flexion is 130!!?? I can walk etc….its ONLY when I straighten my leg that I feel a cracking grinding thing.Sooo….I told my dr. about it and he said “lets wait a bit before addressing it, but it could be a ‘cyclops lesion’. Just continue your exercises” (cyclops lesion is a fancy word for a heck of alot of scar tissue..??) Ok…fast forward. to to January 19 2011. this thing got worse so I had “scar tissue” removed. (a scoping) Today is April 7 (only a little after two months!!) and here we go again with this repeat: grinding crunchy pain (and I mean its LOUD…) ….BUT ONLY when I straighten or uncross my leg . Sooo….is it scar tissue? And if it is/was..why again a little after two months after getting scoped? Is it a tendon? Is it god forbid a bad knee? It hurts only on top of the knee (near the inside bottom if that makes sense…) ..almost as if it were under the knee cap (or known as a “button” now…) Im afraid to ride my bike or do anything because I dont know if Im making this “thing” worse or what. I dont know what to do any more…or what this even really is. …or why it is even happening AGAIN!!??. I am seeing a different doctor on the 19th in hopes of an answer/ different perspective/approach/diagnosis on this. I am so done.(tears…sigh…)….anybody have an possible answer or experience like mine? PLEASE??? Its rather a situation like having a broken foot and it is “fixed” only to replace it with a painful thorn. Not a great trade off so to speak….Anyway…thank you to my fellow knee sufferers out there and anything somebody out there can offer that has had THIS particular situation and expereince. Everybody I have talked to over the past year that has had a TKR, is cringing when they hear my knee straighten and just shake their heads saying,” Man, I have NEVER heard anything like that before!!….I have NO idea what that is!!”. So there you have it.
I had a total TKR on March 4th of 2011. Lots of pain and
antyime in therapy or at home when pushed hard lots of
swelling. At the three month mark I never thought I would never
hunt or play tennis again. Had manipulation at ten weeks,
helped a little. Slowly over the months gained a percent here
and a percent there. Now at 111, flexion 0-1 Stopped
therapy in Jan 1 2011, money issue. I do it all myself now.
twice a week at gym and twice at home. Over a year later
and still making small strides. I did go hunting in the fall
and am playing old guy doubles tennis. If a lob is hit
I just look up and go nice shot. For years before the surgery
I had terrible ROM in that leg. It could be that no matter how
long and how hard I work it, 111 might be the best I’ll see.
I read an article the other day saying a TKR is harder to come
back from then open heart surgery. Also weight is a huge
issue that is not talked about enough. Every extra pound of
weight is 4 pounds on the knee. I lost some after the surgery,
in hindsight I wish I had lost more prior to surgery. Good luck
to all.
Went to the Dr. Today got to 97 ROM on my own Dr. Was Happy with this # after Manipulation, wants me to still do PT 4 days a week and Use the CPM 2 hours a day, wants me at 105 in 2 weeks when i see him again, Leg is still swollen and hurt some when i walk not using the cane as much, I am feeling more like myself, sleeping at night is still hard to sleep more than 5 hours at a time due to stiffness.
Hi everyone. I just found this site while doing research on complications from tkr. I had a tkr on right knee on Oct 3, 2010. It is now april 10, 2011, so I am 6 months out. Here is my story maybe some info will help someone. I suffer from fibromyalgia a pain condition, which I am sure you have all seen commercials for new medications to treat it. I also needed the replacement for several years and lost some ROM. I was in so much pain after the tkr that I was crying alot from the pain. I received poor pain management, which I feel hurt my recovery. I went to a rehab hospital to have PT 3 hours a day for 14 days. Then I did outpatient PT since then. I was able to get my knee to strenghen out after a couple months but once that happened my flexion decreased. It was 103 with pts holding me down while another pt bent it while I was screaming and crying. ( my doctor says I am not working aggressively enough on it). I lost degrees and have been about 93. It was past 3 months so my surgeon did an orthoscopy to remove scare tissue, and was told I had alot of it. Dr said he got my knee to bend after scar removed to about 120 degrees. I had that done on Feb 18, 2011. I didnt gain anything after scar removed. After a month dr said to wear a dynasplint at night to help f
Hello Everyone,
Well I am at 90 degrees bend but a new problem has arrived I can’t get my leg to straighten out. My pt has been putting 2 five pound weights on top of my knee and I must say its very painful,before I couldn’t bend my knee now I can’t get it to straighten out. I had the manipulation and everyone is happy about me bending it but they seem to be overlooking the new problem. Any suggestions?
I have been reading all the comments since I have shared my story on a few e-mails. I am finding that with all these stories their is no answer to these problems. I am not trying to be negative but I have suffered with this knee problem just sbout 11/2 months shy of 3 years. I do not hear or see in solutions for the scar tissue or for any improvement with the manipulations. I do not even hear any answers from my Doctor or any other Doctors. Just like your Doctors do not seem to have an answer either. My physical therapists are simpethetic but just shake their heads not knowing what to do. As I have stated before the more PT I do the stiffer my knee gets. My knee is close to being straight but will not bend at all. I am at a total loss of what to do. Somebody tell me if i am wrong.
HAD LEFT TKR 1/25/11, WENT HOME WITH A CPM MACHINE, USED IT FOR A MONTH. HAD PT AT HOME FOR A WEEK,THEN OUTPATIENT PT 3XWEEK FOR 6 WEEKS, TILL INSURANCE RAN OUT. WAS ABLE TO GET TO 83 ON MY OWN, 87 WITH PT PUSHING. MY PT ALWAYS WOULD PUSH FIRST, THEN HAVE ME PUSH BACK FOR A FEW SECONDS, THEN RELAX WHILE SHE PUSHED EVEN HARDER FOR ANOTHER 10-15 SECONDS, 5 TIMES EACH SESSION. WORKED MUCH BETTER FOR US BOTH WITH ME LYING FACE DOWN. SINCE THEN I SIT IN A CHAIR WITH FOOT PLANTED ON FLOOR AND SCOOT FORWARD TILL I CAN’T STAND IT ANY LONGER, THEN HOLD THERE AS LONG AS I CAN STAND IT, USUALLY 20-25 MINUTES AT A TIME. THEN ICE IT. HAVE GAINED ROM STEADILY. DR. HAS ME LIFTING WEIGHTS TO GET EXTENSION BACK, BUILDING UP MY QUADS AND STRENGTHENING THE QUAD LIGAMENTS AND TENDONS. IT’S ALL VERY PAINFUL, BUT I AM DETERMINED TO AVOID THE MANIPULATION. ALSO, I HAVE FOUND THAT I SLEEP PRETTY WELL WHEN I BEND MY KNEE AS MUCH AS I CAN JUST AFTER LYING DOWN, ON MY SIDE WITH IT ON A LARGE BODY PILLOW, THEN WHEN IT STARTS TO ACHE, RELAX IT AND THE REST OF MY BODY, AND DRIFT OFF. HOPE THIS HELPS ANYONE WHO NEEDS TO TRY SOMETHING ELSE TO GET SOME RELIEF.
Comment for Dan on April 14th:
I am in the same exact situation you are. I have full extension, I too cannot bend my knee, I had manipulation surgery under anesthesia by my Dr. last Thursday. He is a big guy and he could barely get 70 degrees. I was told it was becuase of scar tissue. I am trying to find out what is next for me? I would like to have arthoscopic scar tissue removal surgery and then immediately after have him try to manipulate it. I just don’t know what to do? Has anyone responded to you about the scar tissue issue?
Eddie, no one has really answered my questions on the scar tissue. I did have my first manipulation about 6 weeks after surgery. They did put me completely under and even gave me an epiderral and I stayed in the hospital 3 more nights. He said he did get my knee to bend and straighten all the way. Before I left the hospital a physical therapist was able to bend my knee past 90 degrees. He had to be pushing on it to get to that point. I went home and tried PT again to no avail. Six weeks later I went back in and had a second manipulation as an out patient. Went home, same ordeal with PT and no improvement. I am going back in to see my Doctor in three days. I am going to ask about the scar tissue removal. I had a friend that two TKR and one had a lot of scar tissue and so he went back and had the scar tissue removed within six months of his replacement. He was doing better after having the scar tissue removed. So I will let you know what I find out from my Doctor this Tuesday.
I had my surgery December 21, 2010..
It is now May lst. 2011, I have had manipulation one month ago because I couldnt get range of motion past 80 and flex under 10.
After manipultation I can get to 109 on my own, 116 with pt help..this is okay with me, what is not happening, my flex is still at 10 or above without pt help, and 6 with thier help..this has not improved even after manipulation.
The surgeons keeps telling me, relax, its going to get better in time, sometimes it just takes people longer. I asked him if there was any chance he made a mistake because I knee is so tight, all the time, its very difficult to walk because it takes so much to move the knee, I am off balance and just after sitting for a few minutes my knee stiffens up so quickly..so my problems are continuious stiffness, it almost feels like thier is no fluid in my knee, like its dry and gets stuck..there is no pain involved, just stiffness..is the stiffness causing me not to be able to extend below 10 on my own.
Any help out there?
I had a knee replacement done on March , 2011 it still hurts like hell got test done they said everything is ok. bending only 80 degrees im so scrared i wish i had kept the arthiritis
Eddie, I had to postpone my doctor appointment today for two weeks because of an emergency that came up in my family. So I will have to put you on hold until the 17th of May. I am sorry! I will contact you then.
I went to my 6 month check up, and just with what I am doing at home I have progressed another 5*s so I am now bending at 110* I can feel that I am a little better. I am doing more and more things without thinking about it or feeling it. I am though still having pain or aching at night to the point where I have taken Tylenol and ibuprofen just to sleep. I have not felt bad enough for anything stronger. I know that there is still scar tissue in my way, but I ca not afford an more therapy or surgery or manipulations. I am believing it will get better and better. I pray for all of you who are and have gone through all of this. Just keep working …..
Sherry …. keep our pain under control…… it will help.
Take the pain meds faithfully. Get used to little sleep. It’s best in a recliner. It’s best to use an immobilizer. Expect the pain, but expect it to go away. Use the bikes and stairs when possible. Only go up at first. I had my surgery around Christmas 2010 and manipulation in february. I now am at about eighty percent better. Very little pain, just minimal swelling. Good luck
I had my TKR on 2/7/11. I was very lucky with my straight ROM as I was able to do that on the third or fourth week after surgery. My problem has been bending my knee to the ROM that I need to be. For about a month I was stuck at 90. With the help of pt I could get more ROM and I have a high pain tolerance and when pt helps push my knee I am about to come off the table. I was re-evaluated on 5/6/11and I could do 110 by myself. With help by pt he could get my ROM to 118. I was excited to go to pt yesterday with the hope of being able to do maybe at least 115 on my own, but now I seem to be stuck at the 110 to 112 ROM with help I could only do 115 not even the 118 that pt got me to on 5/6/11. My pt says my doctor will not do the manipulation. Before my last pt ended 5/9/11 pt did an ultrasound for 15 minutes to help break up my scar tissue. She told me to elevate my leg and knee all night and to make sure my knee was above my head and to have my ice machine on it all night. This morning I thought that I would be real sore and uncomfortable. Luckily I am not sore. I am going to start stretching my knee soon so I can help to get more ROM. I would like to be able to do more ROM on my own when I go to pt on 5/11/11. I go to pt 3 times a week.. My insurance will only allow me to go to pt for 35 times. My pt will end the last of May sometime. Then I plan to continue the exercises at home and to continue using the colored elastic bands and to join YMCA to use exercise equipment to help keep the ROM in my left knee. I have been lucky that my TKR has not hurt that much after surgery except if I hit it or turn my foot wrong or do certain exercises or pt is pushing my knee to get more ROM. I even went back to work 6 weeks after my surgery, but I work in an office atmosphere and the owner of my company will only let me work 8 hour days and not 11 hours a day as worked before surgery. My pt says that everyone that has a TKR is different. One may scar more than another person. Hopefully my right TKR will be easier than my left one and the recovery time is faster and my ROM is better. I am not a good patient to wait to get better. I want the ROM of mobility to be the most it can be and be now.
hello i just had my tkr done mar 24th 2011.im doing everything my therapist says and it seems i still cant get my knee to get straight. even with the brace the dr gave me and im limping around and in alot of pain,when doing the exercises all my knee does is tighten up so much that i can barely do the exercises can anyone tell me they have been there and done that and what they did to make it better i go back to the drs may 20th,2011.im so upset and deeply depressed all i do is cry and my poor family is taking the blunt of it all.just at wits end i want my knee back normal whatever that is for me .i told my dr 5 weeks post -op i was so ready for the manipulation but who knows i feel i know my body and its telling my my knee isnt right. hope to hear from somebody in the same boat
Linda, my TKR will have been 2 years ago this June. The best thing I can say is do not give up! There are no guarantees. You can read about my struggles in this web site. Just look for the name Dan. I have not had a lot of success as you will see when you read the messages. I am not one to give up. Keep up on the exercises and stretches. Lay on a couch with your heel on the arm of the couch and hang some ankle weights over your knee. Relax your knee as much as possible and see if your knee will gradually straighten. You may only be able to do that for a few minutes at first. Try and increase gradually to where you are stretching it for 15 to 20 minutes. It will hurt but try and work through it. The other thing to do is try and work out in a swimming pool. In the shallow end you can walk or do squats. You can also put your back against the side of the pool and slide down to a seated position slowly bending your knee. Another good exercise is a recumbant bike. Hopefully you can pedal in a full circle. I never have been able to. But, you can still pedal as far as you can one way and then go back the other way. Do that back and forth. Do a lot of icing. Before you do any of these run them by your PT. Try and find a friend or family member that is positive and encouraging that will help you exercise and keep your spirits up. Even with all the trouble I have had I still believe in TKR and know they have helped a lot of people. Keep at it! Keep your head up! Blesings to you.
Dan
I had left tkr in May ‘09 and at the time, both knees needed to be replaced, so I wanted to have both done at the same time. My doctor strongly advised against it and opted to have the left done first as it was causing the most pain — cortezone shots bought me some time for the right knee. I’m glad I took his advise. For those facing this same decision, this was his reasoning – the body has to work hard to heal one part of the body successfully/ideally. If it has to heal to parts at the same time, it is highlyt likely that one part will heal ok, the other not so much. My husband proved that point the first of March when he had his second knee replaced.
Because he had the good new knee on the left, his PT success progressed much more quickly for the right tkr than he did with the first tkr where the right knee was deteriorating and could not adequately support his PT efforts and he still has problems with that knee. Also, this time around he requested more agressive pain management and that also made it easier for me to help him because he didn’t wince in pain every time I had to help him with some activity or another. With all that said, now its my turn to have the right knee replaced (we’re taking turns) and I’m faced with a new decision. In the time since my first tkr, I became complacent in continuing ROM exercises and I now have less than ideal ROM in that knee. The doctor proposed my having MUA when he replaces right knee on May 23rd and I agreed. Then I recalled his advice against having double tkr and wonder if tkr on one and MUA on the other at the same time will hinder total healing and ROM recovery. I don’t expect the pain in the manipulated knee will be as bad as in the tkr knee, but it will be a challenge just the same. So . . . . . is there anyone out there who has had this done that could advise me of the pros and cons? Fortunately, my hospital holds tkr classes once a week and I plan to attend one this coming week, but would like input on first-hand experiences. Any comments will be appreciated.
Not sure what “awaiting moderation” means in this context.
See previous comment. Before that comment I input a dissertation on my recent tkr experience and ask for comment and . . . . the comment appeared on screen with “comment awaiting moderation” and a count-down clock. Then the comment disappeared. Is there a word limit or additional input required?
Joyce
ok, one more try at this – I had my left knee replaced (total) in May ‘09 and am now scheduled for tkr of the right knee on May 23rd. Unfortionately, since the first tkr, my ROM has decreased and upon examination, my doctor suggested MUA of the left knee during tkr of the right knee. This will require caring for both at the same time and I’m concerned that one or the other will be shortchanged in the PT effort. My right knee needed replacing when I had the left one done and I wanted to have both done at the same time, but my doctor strongly advised against it. He explained that when the body is working hard to heal two knees, the tendency is to favor one or the other and thus recover with unequal success. I know I’ll be challenged so I’m hesitant. Has anyone commenting on this website had this experience? If so, please share your experience – pro and con.
I had double TKR on 2-25-11, and of course the first thing that I faced was “you will have to use two CPM machines, simultaniously to be sure you progress your flex and extension equally.” That was the first act of lunacy involved in my recovery/ rehabilitation. None of the Aids on the Rehab floor knew how to set up two machines at once, but that didn’t stop them from throwing them up on my bed and acting like they knew how. Then I was informed that they had their orders to be sure I was strapped onto these things at least 8 hours a day at the settings they were instructed to apply, and store the control boxes where I couldn’t get to them.
My first act of defiance was to insist that I was removed from the narcotic pain killers because I could not sleep, it was driving me crazy. Second act of defiance, I said “We will set these machines up the way I say, or not at all…and the control boxes will be under my control.
A word of warning. Don’t take over your medical care decisions unless you have the proper alternative measures ready to demand. I didn’t know what pain killer would suffice, and it took three days to get a staff doctor to prescribe one that my wife researched and finally suggested , because there was no other effort from anyone else to make that determination. How much flex and extension you gain in the first few days relys on how much pain is involved. Yes, I fell behind a bit, but honestly I feel my knees benefited more from the added rest and healing that resulted from not allowing what I am convinced would have been damaging abuse to already badly damaged and weak muscles and tendons.
Now, two and a half months into rehab, I’m doing okay, now that I’m NOT going to PT sessions where their goal is to amaze the medical world with the amount of flex they can force out of a set of artificial knee joints with still stressed, stretched, bruised and swollen muscles and tendons with the strength equal to that of a tall toddler.
I have stressed and knotted up front and rear thigh muscles, calves, hamstrings, vertical petella tendons and ACLs. I’m going to my doctor tomorrow to see what he thinks about me going to a message therapist to learn how to relax my legs because I know that is why the knees seem stiff and flex improvement is sparce. I know after reading this comment list by all of you folks that I totally empathise with, I will not get them manipulated…ever.
Eddy and anyone else, I went back to my Doctor today. If you recall from my earlier postings my left knee is at “O” recovery. My knee is stiff and will not bend. I had TKR in my left knee in June of 2008. with two manipulations about 6 weeks after surgery and 6 weeks after that. Today my Doctor took some xrays to see if maybe my bone rejected the metal in my knee. He is going to do a bone scan in a few days. It is possible that he might have to open my knee up to remove all the scar tissue. He said my knee has gone to far to remove the scar tissue by a scope surgery. He wants to make sure the bone has not rejected the metal first and then procede from there.
Joyce, when you click on send you have an option to edit your message. You have about 4 minutes to edit and save your message, then send it. Hope that helps.
Dan
Joyce…total recovery relies on setting your mind to doing what it takes to heal properly. My double knee replacement has been tough but I have made good progress. How well you prepare your body for the surgery is a key factor. Muscle tone and strength are extremely important in the legs and upper body. One reason I was allowed to have both legs worked on at the same time was that I could toss myself around pretty well with good upper body strength.
Eat right because that is the beginning to proper healing. Protein heals muscles; calcium heals bones; chocolate will only keep you awake at night.
One last observation…I have never gained permanent flex or broken loose adhesions by having a physical therapist forcing my legs beyond what flex I accomplish on my own.
I am grateful that i found this site i had tkr on march 15,2011.. i’m currently going to pt. I prepared prior for my surgery in the pool strengthening my quads. i am at a 100 degree bend and i can straighten out my leg, although i cant sleep at nite it does get better. ICE AND VICODIN ARE MY BST FRIENDS.. I cut back on taking the painkillers i dont want to get addicted… i got to pt at least 2x a week but i feel the main thing is DETERMINATION.. AND FAITH. no pain no gain so u must push yourself beyond ur expectations.Keep telling urself I CAN DO THIS I MUST DO THIS.. my doctor wants to do manipulation… he wants me to be at 120 but after reading these post i dont think that i am a good candidate for it.. because I HAVE THE POWER AND DETERMINATION TO MANIPULATE MY KNEE MYSELF.. I GOT 1 WK AND A HALF TO GET IT TO AT LEAST 110 AND I AM GONNA DO IT.. I PRAY ALOT.. I am glad i read ur comments. i will stand in the gap for u guys.. its gonna hurt but just think to urself its gonna get better. Every day may not be a good one, but know that a brighter day will come keep up the good work, go to the pool as others have suggested, do squats, march high knees, ride an indoor bike, pray, I CAN DO ALL THINGS THROUGH CHRIST WHO STRENGTHENS ME….
I’m trying to post my comment but im getting awaiting moderation… what does that mean?
one more try.. awaiting moderation….
Hello Rosemarie,
Comments are reviewed for “appropriateness” prior to posting. Sorry for the delay. Perhaps folks can move this conversation to our Forum?
Admin.
Ok….so…..short version: does anyone have an answer to this one:
Why I have a great flexion (130!!)… BUT….have pain and “crunchy sound” ONLY when straightening…NOT the bending. Im the OPPOSITE of everything I have read so far in this website. Anyone out there that has this situation? Help!!. Thanks
(if you want more details….read my other posting of April 7.)
I had my tkr on 2/24/11. I am having a lot of problems with flex. I have done all the PT asked of me and more. The doctor and I discussed manipulation in April, but I was heading out of the country for 3 weeks and we decided to wait and see how I felt when I came home ( I even had pt while away). Friday I went to see the doctor and was informed that he wont do a manipulation now. He says too much time has passed since surgery (12 weeks). I was advised by PT to wait till my return for the manipulation so that I can aggressively work on it and achieve more bend. Now I’m at my wits end. I’ve read the optimum time for manipulation is 8-12 weeks, would one more week hurt that bad? Doctor says there’s chance of tibia breakage if he does it now.Has anyone had this happen to them? Is it rare or fairly commons. I may want to try it and take a risk if it is not a huge rish. I am 55 years old and have no osteoporosis or rheumatoid arthritis. I only can flex to about 90 and the knee hurts. I really wanted this surgery done and now it feels like the biggest mistake of my life. I agree with the person who wanted their arthritic knee back. I am reading about manipulations done up to a year after surgery. Has anyone had it done a few months later? Did you feel like it was helpful?
Melinda, I would seek an ultrasound diagnosis. In fact I will seek one to find the origin of my complications. I think my parts are all good, but I believe an ultrasound will find out why my ACLs and PCLs are not taking their responsibilities well to these new knee parts. Your problems could stem from scar tissue or bruising from such a high ROM. 130 degrees is a lot of stretch for those soft tissues to not be bleeding and swelling a lot.
Thanks SO much Tom for your response. Here’s the thing: my understanding , and I was told, that when you have a TKR, that the ACL’s etc. are gone now,So if anything, perhaps it is crazy inflammation along with this scar tissue….. but
I think its excessive scar tissue that I have ….WHICH APPARENTLY MY BODY PRODUCES AGGRESSIVELY!!!! And now I may need to go in for round 2 in August to have scar tissue removed….oh brother!!!…..( one small bright light of this dlillema: the doctor DID say that sometimes the scar tissue can go away on its own either somewhat or completely!! But how long do you wait to know?? Does it get worse or stay the same if you do nothing?) And how the heck do you avoid scar tissue from coming back to begin with?? And to avoid surgery for THAT??? Anyone know?? Its like the TKR went great….and here I have this stupid scar tissue snag thats an on going thing!!!????? Painful to straighten but not to bend. You can hear it crunching when I straighten only and it hurts. Now how crazy is that compared to the other things submitted in this website!!??.
I feel for all of my my TKR friends out there. Hang in there all of you…I get it. Sigh…..
Melinda, I originally injured my knee in January of 1977. I should have went right to the hospital and had surgery. But, no not me, I did not wnt my brother to feel bad so I just went on and let it heal. Well, scar tissue took over and started pulling my knee cap over. In 1981 I had two scopes to fix my knee about 6 months apart. I was told that I waited too long and the scar tissue had set in. The damage was done. My knee was ok until 2003. I kept playing softball and basketball and being very active until 1997 when I had to have my other knee scoped. After that I was not able to go back to basketball even though I did do a little bit of softball. In 2003 I had to have my left knee scoped a third time (the one I originally injured). In 2007 I had my right knee scoped for the second time and it was slow coming back but it did to where I can bend it and walk fairly normal. In 2008 I had my left one TKR. That is the one I had injured in 1977 and had the scar tissue in. I had two manipulations. They have not helped. The mechanics of my knee are fine. Supposedly it is scar tissue. I just had a bone scan last week. I am waiting for the result. They want to see if my bone has rejected the metal. That happens in a few cases. The doctor might be looking at opening my knee back up and removing the scar tissue. I have no idea what the percentage is for recovery for this type of sugery. My TKR was three years ago this June.
Melinda, you are right…the ACLs are gone, but the PCLs are intact. I was told that the knees are more stable due to the way the joint components work together. I can accept that, but I know the PCLS are having a hard time adjusting and I have benefited quite a bit with the message therapy. My therapist has been in the business about 25 years and has worked with a good number of TKRs and explains what she is doing, why she is doing it…and tells me what to expect during the procedure, and the results to expect. I also elaborate on anything else I experience during and after the sessions so she can explain what I may not understand. I am very happy with the results, and understand better the problems that used to scare the hell out of me.
Hello Tomm, Melinda
Regarding the ligaments and knee replacement, you can visit our article:
http://www.totalkneeweb.com/how-are-the-ligaments-affected-in-total-knee-replacement
There are also additional related articles at the bottom of the page.
Admin@ http://www.totalkneeweb.com
I was sent to Kosovo in 09, and as I was in my room I received a call asking me to go into the office ASAP. As I was on the road going in to work (People have told me what happened as I don’t remember anything from that day as I was in a coma for all of 2010). My car was rip in to two parts and I really didn’t make it from the records I died 4-time (first-9min, second-4min, third-3min, last-15min) there are other thing that are being worked on but my Right knee was done rip open on that day and they are going in to Manipulate it next month for the first time. I have read some of your comments in this report and see that after 1-yr it can’t be done and some have had it over a year later. my question is:
1- how painful is it (manipulation) after you come out of surgery??
2- how long do you need to wait to get up and PT your leg??
and I mean walk and not that nonsense of “it’s up to you and your inner strength” crap
3- I can’t sleep very well at night as well so will this part get worst
I don’t know how this will go but I have no choice
Victor, I know there is really nothing I can tell you about pain. I can tell you that the medical persons always ask you to rate your present pain on a scale from 1 to 10. My scale consists of three numbers…1; 6; & 10… #1 is normal everyday before stepping wrong or twisting the knee or bending it too far or too fast… #6 is for after doing one of the above… #10 is for when a doctor or physical therapist is working on me. They say pain management is very important in rehabilitating. That is done with drugs that practically drove me mad. I refused them after about four days, they couldn’t seem to come up with a non-narcotic drug that really killed any pain afterward. If you can handle opiates, they can make it easy on you. BUT, I have heard from a couple of sources that a tibia or fibula can be broken during a minipulation.
I think you should ask about alternative methods, like an ultrasound scan and scar tissue being removed orthoscopically, or deep tissue massage. I think there is less chance of bone breakage that way. I think bone breakage pretty much scraps the whole idea of fixing your leg.
They always want you to get up almost immediately, and do what they say you should be able to do, no matter what the procedure is you just endured.
With me…sleep is something that I earn every night by experimenting with different positions, pillow placements. And asking myself how a position is going to feel in about three hours or how are my knees going to react when I try to walk away from the bed? Knee stability relies on what parts have had pressure or tension or slight twist during the sleep.
The stronger my leg muscles get, they were very weak in the beginning, the better the repairs feel in stability, flex and endurance.
Good luck Victor. You have been through a lot already, I hope they have your best interests at heart in whatever they do.
I am so scared about my knee manipulation scheduled only hours away from now. Reading each story and having greater details has been insightful. It sounds horrific that the doctor actually does the procedure by my knee then applying his physical strength to crack the scar tissue. Did I really read that correctly?That is modern technology? My knee/leg is straight but will not bend the last 10 degrees according to my doctor, making it a quality of life issue and procedure. I was wanting be reassured that everything would turn out just fine. Now, I am not at all convinced that I want to do this. It is too late to turn back . I do appreciate the experiences and information that doctors don’t always share.
Janice
I too will be going for the manipulation at 10am today. Good luck to you = and to me. I was terrified about femur breakage,but the Doctor assures me that my chances of that happening are slim – he said 1/2 of 1 percent for me. Post your progress, as I will. I got to PT this very afternoon!
Update from yesterday. I had the manipulation done – 14 weeks after surgery. The doctor said my knee bent pretty easily. I could not bend past 90 without pain. He had it to 130. I went to PT in the afternoon and we were bending it (with a little pain – but not too much) to 110. I have spent time last evening and this am on a CPM to continue getting the knee to bend. It’s the first time in a very long time that I am feelng encouraged instead of frustrated and discouraged.
Janice, I hope you are having similar good vibes. Please let me know.
hi all , i had my TKR may 6/11 felt very tight from day 1, now at 6 weeks i have 70 bend and cannot straighten. My doc says manipulation next week my PT thinks we can gain some not sure how much,quite mixed on it all any suggestions ?
hi all , i had my TKR may 6/11 felt very tight from day 1, now at 6 weeks i have 70 bend and cannot straighten. My doc says manipulation next week my PT thinks we can gain some not sure how much,quite mixed on it all any suggestions ? I have had 3 prior surgeries on same knee!
When I force more flex in either of my knees the tendons that have to stretch over the knee cap and the sides of the knee swell because they have to stretch and pull the membranes apart and bleed into bruising. After icing and massage I feel I have gained some perminant improvements. It also seems to help if I ice again after the massage. Be sure to have a towel or other barrier between the ice bag and your skin because the ice will cause damage.
I am trying heat compresses where I have debilitating pain because I have had a lot of success healing other injuries with heat. I’ll be posting more later on if it seems to be helping or not. I really think it will.
Is anyone having progress-hampering pain behind the knee when trying to bend/flex, sort of like the tendons don’t seem to be in place right to easily bend?
Hello! I am back. Fir those who have followed my earlier postings, I saw another doctor today for a second opinion on having my existing TKR which I had done in June of 2008 taken out and a new different type put in. This Doctor said that the decision will be up to me.My knee is completely stiff, almost completely straight. It will not bend at all. My goal for having a new TKR would be to gain enough movement to walk and bend past 90 degrees so I can peddle a bicycle. The doctor said that there would be a chance that my knee would come out worse. He asked if I was willing to live with it the way it is. He felt that my chances of having it improve would be better than 10% but no greater than maybe 70%. It could be anywhere in between. He said if I was to be able to walk somewhat normal and be able to ride a bicycle would be considered a homerun. The rehab would be very strenuous. I would be using a lot of pain pills and would have to work way more than I have at anything before. I would have to wlork hard to beat the scar tissue that would come back. I have a lot of scar tissue and it grows fast. The decision comes back to how big the risk is and if the risk is worth it? I have to make that decision. So, that is where I am at. I will let you know what I decide…That’s all for now!
Dan
Dan, I think your TKR results are some of the worst that I have ever heard of. Going for a second opinion was definately on the mark. What is expected of you after surgery is indeed a major, major task. What I expected from my surgeon was that he be the best engineering mechanic that he could be, because of the task at hand calls for that qualification to be successful. Personally, before I continued with trying to gain a better outcome in your circumstances, I would seek another opinion of a more successful mechanic, that could stand behind better numbers than you have been offered. If they can’t tell you exactly why your knee presently doesn’t bend, a better surgeon probably could. They are dealing with physical conditions that should yield to accurate trouble shooting and repair. I don’t understand why you haven’t been offered the removal of excess scar tissue to see if you can gain the flex you desire. Do they stand behind the product they installed? Could that really be your problem? Third opinions are not against the law. I hope they can fix you, because you have been through too much for them to fail you to such a degree.
Hello, just a comment to Dan. I’m in the same boat. My knee is completely stiff with limited to no movement so I sought a second opinion too . The first surgeon wanted to do another TKR to replace the knee with a new one, which I did not want to do. The whole experience was a disaster. The second surgeon said there was nothing wrong with the knee itself and there was no need to replace it. The second surgeon is going to go in a remove all scar tissue and manipulate but keep me in the hospital with constant pain relief from waste down (cath in leg or epidural) for 4-5 days and constantly manipulate the knee to keep the ROM going. Sure beats another TKR. You may want to ask your second surgeon about this option and the chances for you of getting better ROM so you can ride a bike or walk comfortably. Also reduces the scar tissue building issue.
I had a TKR on 4/28/11/ The pain isn’t as bad now but worse on the days of PT and I still have a hard time sleeping. I cannot sit very long without getting stiff. I see this is happening to many people. I am at a range of 98 and now the doc is telling me I will need manipulation because of the scar tissue. I am so scared because I have a low tolerance for pain and cannot bear that kind of pain again. Is the pain that bad after a manipulation and how long does it last???
Sue – you have pain after the manipulation, but not as bad as after the surgery. You have to work very hard at PT to keep the knee bending. I had the MUA on June 14 and have been to PT every day. in the OR he bent my leg to 130, but I can only do 110-115 on my own at PT – with pain. I am giving up on the painkillers – percoset and vicodin. I hate the pills. I am going to try acupuncture this week to see it it helps with the pain and stiffness. Good luck to you – I hope it works .
I had TKR June 6, 2011 and startet PT day after the staples have been removed, 4 weeks later and absolutely no improvement with bending. When I left the hospital I had a 45 degree bent . With PT help I was only able to get to 55. I got so stressed out and tensed up that PT did not help at all. The knee just stiffened and swelled up. I stopped going to PT and trying to bent my leg in warm water in the tub. This helped with previous knee surgeries. I take Magnesium to relax the muscles, and warm milk with a bit of honey to try to sleep. I know it takes time to heal and I agree with a previous comment that in some cases scar tissue will heal and go away on it’s own. This would be my 3rd knee surgery on the same knee and previously, meniskus removal and ACL, I have not been to PT, and within a reasonable time frame, the knee heals and regular movement was returned, with no added stress . Trust your gut feeling and listen to your body.
I had TKR in 11/10 and had extreme difficulty with flexion. My extension was great. I was religiously doing my PT and my husband is also a PT, so had my own in-house. My flexion would never go past 70. Finally, after my persausion I agreed to manipulation which I had in 2/11. Went immediatly from the manipulation to PT for 7 straight days and WOW what a difference. I am now at 120 degrees flexion and 4 degrees extension, can ride a bike for 2-5 miles and am back at my job which is as a nurse. My pain is very rare, but swelling does continue. But, after 6 years of not being able to walk for more than 5 minutes without pain I am so happy. The manipulation wasn’t all that painful. Go for it!
I had a TKR April 13, 2011 which went fine. I did get a rash that I now think was cellulitis or an infection. I am 32 and have been very athletic my whole life. I played soccer for 15 yrs, even collegiate level, amid other sports. After 4 surgeries on my left knee (ACL reconstruction, revision and multiple scopes) and 3 on my right (ACL reconstruction, scope and meniscus tears), I had to have a replacement. Too much degenerative OA in the joint, which also runs in my genes.
Everything went well and I have great extension to 0 degrees (better than Pre Op) but felxion is only around 110-115 (10 degrees short of flexion Pre Op). My surgeon convinced me to try manipulation based on where he feels a pull on the interior/medial side of my knee. He thinks it is scar tissue impeding my ROM. I have been hard core about my PT, 2x a week and very aggressive. Also stretch, ride my recumbent bike and eliptical daily. I am scared to death of this manipulation and I am not sure what to expect!?!? I hope I am making the right decision, as I am not sure that my surgeon’s goal to get my flexion to 130 degrees after 14 weeks is achievable. Anyone have any thoughts? Words of wisdom or what to expect after manipulation? I am done with the daily pain and stiffness….especially after 17 years of this.
I had TKR on 6/6/11 and I am having a great deal of swelling, pain and stiffness. I go to PT 3x a week, work very hard at PT and very dedicated to my strengthen exercises at home. My flexion is only 94 and my doctor feels I have scar tissue that is preventing me from further ROM. My surgeon has recommended manipulation on August 10th. I am also very nervous and don’t know if it’s the right thing to do. I really feel if I get the swelling to go away, I could push the knee a bit more and get more ROM.
I would love to hear feedback and pros and cons of manipulation.
I had my TKR on 4/28…did PT 3x a week and had the manipulation done on 7/25 and only gained 10 degrees and now am up to 100 degrees and only doing PT 3x a week still. Does this sound right?? I am very disappointed and upset with my progress. The doctors office said patience and time…and PT. I don’t feel like PT is pushing me hard enough….any suggestions or comments?? Thanks : )
My tkr was on Feb 24. I had a manipulation on June 14 and have been to PT almost every weekday since. It was cut to 3x per week toward the end of July and now 2x per week. I work it at home also. FINALLY after almost 6 months I am starting to feel much better. I was stuck about 90-93 before the manipulation. Right afterward, I was about 110. I plateaued at 115 for a few weeks. My doctor ordered a few more weeks of PT for me at the end of July adn it has paid off. I can now bend it to about 118. My goal is 120. The manipulation was a godsend for me. You have to work and it has to hurt, but it does pay off. I can even walk down steps like a normal person now. My advice is to have the manipulation, work with a good dedicated Physical Therapist (mine have been GREAT) and a doctor who wont give up on you. I am glad I did
and so happy that I am finally feeling like a human being again.
Keep working and dont give up. Give it all you’ve got and stick with it.
I have finally reached 105 and got to 108 with pain. I am still doing PT only 3x a week and have never done 5 days. They just put me on Lyrica today for the nerves in my leg so I am curious to see if there are any changes and if anybody else has had this prescribed to them. My leg still gets really stiff if I sit for more than 1 hour. I am now doing pool therapy and the therapist thinks she will get me to where I need to be at 120. It has been a long painful road and I really want my life back!! I for one would never do this again unless I was going to wind up in a wheel chair!! Wish me luck and good luck to everyone!! : )
Sue, I haven’t taken Lyrica. I too want my life back. I would’nt do this again eather. It’s been 10 months, I have more pain and stiffness than before surgery. I just found out about Manipulation through this website. I have that crackling sound to the point where people ask me “whats that noise”. I want to find out why my doctor didn’t tell me about this sooner. He x-rayed it 5 months ago and told me I had scar tissue but if I worked real hard it might go away. I have worked very hard and it’s worse. So it’s back to the doctor, I hope theres something that can be done. I can’t stand not doing what I love to do any longer.
I just found this website & i have been reading thru the chats..i had a tkr on June 2/11 and have been doing phsyio for the last 2 mo. This is my 3rd major surgery on my leg and they are telling me that because of that there is a lot of scar tissue, i am only at 80 on the bending but the one thing no one is talking about is the straightning, i can not straighten my leg at all the most i get from the straightening is 23. Does anyone else have the problem with straightening the leg?? because the doc and the therapist both take 2 measurements.. could some one let me know on this. they are talking about manipulation and there are not to many good things written regarding this, keeps it real scary. thanks for listening
I sympathize w all as i know the full pain of this TKR may 6 /11and secondly manipulation july 14 /11, then after manipulation my back went out for about 8 days which totally dismissed my knee pain ,but through all that i am starting to work my knee steady and increasingly harder almost can do stairs up sill easier than down and continue w p.t. My question is after 14 weeks is it a good idea to start pool exercises ? etc. swimming ??
Had a total knee replacement in April of 2011. Multiple complications, but after having a physical therapist with a brain, I am starting to see a light at the end of the tunnel. And it’s no longer an oncoming freight train!
Stay positive, for better ROM and built up scar tissue problems, ask your therapist about a Joint Assist System. The JAS was recommended to me by a therapist who said it’s painless. She wasn’t lying, it takes time, but you do it yourself and you make the adjustments according to your comfort levels! It works, and after what I thought was going to be a career ending injury, I will soon be able to have my life back.
Take any additional weight off that you can as well.
I hope this helps.
Thanks guys but i also have another question, i am still on crutches, i cannot walk unassisted, is this normal, again my tkr was June 2/11 and if so how long before this all gets normal again?! My PT is starting me on pool therapy this week and it isn’t 14 weeks for me yet, i don’t know whats to soon for each individual..i was reading about this manipulation that it should be done before 8 wks i am over 8 wks and my doc won’t be back from holidays until Sept.!! anyone had this done after this 8 wk mark and did it still do some good?? What is a Joint Assit System?? Lots of question sorry about that but i feel so uninformed regarding all of this..and usually i am quite informed about everything i do, but somehow in all that i read before my surgery i never read anything about this scar tissue being a problem!! Thanks Guys
Hi Bud and Debbie…I do believe the manipulation is helping now and I just reached 111 today with pain but that is a milestone for me! The pain after manipulation isn’t too bad….go for it!! I finally lost my cane…and can do steps slowly but without it!
Hi Tony…thanks for the advice on the JAS…..I will mention it to my therapist. Thanks!!
Hi John….I have done 3 sessions of pool therapy and find it easier and feel it has helped me alot!! Go for it!!
Hopefully in a couple of weeks I can go back to work and will have my life back………good luck to everyone and hang in there!! I was and have been discouraged and am finally feeling better about all of this….have a great weekend! : )
Debbie
I had my manipulation at 14 weeks. It was a godsend for me. I was at 90 with pain before and will be released from PT tomorrow at 120. I’m almost back to normal.
If you have no conditions like osteoarthritis and your bones are strong, you should be fine.
I was warned about the possibility of femur breakage and it terrified me, but I had no other risk factors, I am relatively young (55) and Dr said the chances of femur breakage for me was about one half of one percent. I am VERY happy I had it done. Talk with your Doctor, and GOOD LUCK.
Thanks Sue for the encouragment, I have read your posts and it seems like i am right on schedule for feeling discouragment!!, i am just about at my 3 month mark and i am feeling very discouraged by this whole process..but reading your posts gives me some hope, thanks for that!! I am doing pt 2x a wk right now (well actually one of them if pool therapy) and exercises at home and lots of walking with crutches but its walking, good for you sue off of the cane! I can hardly wait for that day. Can you let me know what your extension was because mine is just not moving at all nor my leg bending when i am laying down if i am sitting i can get quite a good bend in it, but not on the extension. Thanks for the help.
Hi Debbie….as of last Friday I am at 111 with pain and 108 without….still have a way to go to hit 120….but you should be doing PT 3x a week. I do 2 pool and one land…..good luck!!! I would encourage the manipulation even though at first it feels like your leg is worse than before the manipulation.
I had a tkr 7/25/11. Brief hx: I had prior surgery 1970 and 1972. Shattered knee cap in ‘72, had it removed, with no knee cap replacement. Last 12 months lost ROM, and could only walk with crutches. Too much pain to sleep.
Immediately after surgery, pain was gone. Only have healing pain. Cannot get ROM past 65, was only 85 prior to surgery.
Now doc wants to do manipulation. I have only had the Dynasplint one week, which has been very helpful. I do therapy 3x week, plus daily at home. Water therapy starts today.
Question: has anyone had tkr without having a knee cap? I want to postpone manipulation at least one more week and give the dynasplint another week to work.
I am 55, and scared to death of going back in hospital for two days.
Hi Maureen…..I feel the pool therapy made me progress more than the land PT. Good look with it and I do have a knee cap and didn’t know they did surgery without replacing it!! I had my TKR on 4/28/11 and am still at 114 bend….hoping to reach a 120 soon!!!
I am so relieved to have found your comments. I felt alone in a desert. I have had two TKRs on my left knee since last November, plus three manipulations. I also had three previous “clean out” scopes. I cannot get back a decent rain of motion. My last manipulation was last Tuesday. I had to lose my mind with pain to get two shots after the procedure, unlike an earlier manipulation with the same doctors in late March. At that time he got me to 108, but scar tissue took it away. Last week, I was sent immediately to rehab the next two days. The PTs bruised my knee and made with cry out with pain. At home PTs have pushed me very hard and with far less pain. My doctor doesn’t really belive in fibromyalgia and its effect on pain and attacking muscles, etc. After a year of my life destroyed and me worse now than after last week’s manipulation, I am going it on my own with the exercises I have learned. The common theme I believe, is revision is a new revenue stream for docs and they don’t know half what the implications are afterward and how to fix us. Multiples manipulations I think bring more risk of scar tissue and more pain. Our knees are not being allowed to heal properly at TKR time, we are dumped from hospitals, sent to rehabs with poorly trained PTs and told too often we are not working hard enough. This is a major medical issue, thank goodness for the study, but my knee is swollen, bruised and worn out. I will not risk anybody touching it again. Orthos also have huge ego issues and often times are poor listeners. I have gone through this nightmare with three different doctors. I have a better knee with my second TKR, but the same poor outcomes in terms of motion and pain.
Am 62yo very active male who enjoys playing golf(walking) and do a lot of upland bird hunting(walking also)….had tkr on Feb 2 2010…..severely damaged my knee when 20yrs old an had the old style meniscus removal done then with a 4 in scar and very little PT but was a HS coach at the time and did mostly quad building exercises at the HS weight room. Ten years later had to have the knee scoped to clean out the scar tissue from the first surgery. For the next 30 years I got by with fluid drains and numerous cortisone shots until I finally reached the enough is enough point. My surgeon was a golfing friend of mine and he explained all the finer points of what the surgery would entail…including the PT part !! The first day or two post op, the in house PTs put me in the CPM machine at which I was already @ 74 dgrs bent but not quite straight. I was released from the hospt two days later and was to have a home visit P T see me for a few sessions before the “real PT regime ” was to begin. The lady was very knowledgeable but very unsympathetic in the amount of pain that was to be administered in the next few visits. I was allowed to keep the CPM machine at home for the entire duration of my post op PT experience. I used a walker for about 2 weeks then proceeded to cane for the next 3 wks. I was somewhat amazed that I had to learn to walk all over again in a proper manner because I was “training myself to limp” according to the PT. My appetite was non existent and I was loosing weight but was severely irregular due to the Vicoden I was taking. The constipation was a very severe problem so I decided to stop taking the Vicoden. I was going to “tuff it out” !! The first few days at the PT facility was a REAL grueling experience.I was pushed through the usual knee rehab exercises and some I am sure no one has mentioned in these pages.Did anyone spend time in the LIDO ChAIR ??Did anyone kneel on the floor on two pads and then bend backwards ?? I am sure you all had your favorite “torture” exercise to look forward to each session but my point of mentioning these two was the PTs threat of avoiding the manipulation man. I constantly asked why the massive amounts of fluids on my knee could not be drained off (aspirated) as I felt this would help me a great deal in reaching my ROM goals because the fluid build up was blocking my motion in both directions. I was always met with the same answer….we can’t risk the infection….hell, the entire surgery was a risk of infection !!! I actually started to improve in attitude when I was able to walk up and down stairs w o grabbing the hand rails. The flexing and straightening were constant painful goals and I know what everyone went through. I went through 5 wks PTx M-F and then decided I would take it from there. The most important thing I learned was the PT would be a lifestyle component if I was going to maintain my activities. I am glad I had the surgery done but was not prepared for the “boot camp” that was to follow.I know I went through some mild depression dreading every day at therapy… But was able to see the light the day I conquered the flight of stairs!!! My flexion numbers aren’t fantastic (105) on the Lido Chair but my straight numbers are good.I wasn’t going to be a major league catcher anyway!! I will be 2yrspost op in Feb 2012 and and enjoy golf (walking)and hunting(walking) with very little pain or swelling. I also ride my bicycle and my main life saver is my Elyptical machine which I use 4 times per wk at 30 min on level 12. I also do some weight training with leg extensions and the hip sled. I feel the legs are the most important part of the body and keep both as strong as possible. The quads are extremely important to keep strong….the more I work them the less pain and stiffness I have. Your mobility is everything!! Good luck to all and God Bless !!
Hi everyone i finally have a date for the manipulation oct 4 and they are going to immediately put me on the Continuous Motion Theraphy machine. Has anyone been on one of these they look very painful??? Please let me know what or if it helped and has anyone had to use one after the manipulation, the are also going to put me on a JAS (joint assist machine) at home?? I understand about the PT seeming like torture but when i look at CPM machine they may as well lay us on atable and stretch us like they did in ancient times!!! looks scary but does it help?? I can’t find a whle lot about it on the computer especially about the degree of pain while you are doing it and yes i am leery about pain because the hospital sent me home without any pain meds when i had my kee done..i sat like that for about a week before i could not stand it any more!!! Any ways any feed back on these two devices would be greatly appreciated.
Add TKR March 2011. Have gone through all the PT insurance will provide and got to 110 with help, 95 on my own but now I am loosing motion and always in pain. Dr. wants to do munipulation but after 7mo I am worried he will break something. Second Dr. did not recommend munipulation bot a torture board. He said it is painfull but would increase my range. The JAS sounds even better. Has anyone had munipulation at 7mo?
Hi…just wanted to give you an update……after 5 months I have finally reached 118 range of motion. I am doing the steps much better and the pain is pretty much gone except on PT days. I am still not happy with my bend and plan on keeping up with my PT and then will continue at home once the insurance stops. I really don’t like the way my knee looks bigger than the other……is everyone elses knee bigger than the other after the swellen went down?? Also, Is there anybody that has their knee feel like it has a fever. Mine gets really hot at times…..what does that mean??? Have a great day everybody on my way to PT. : )
i had TKR 5/4/11 i’ve had home pt since day 5 after surgery till 3 weeks after. i’ve done outpatient pt rite up till 2day 9-29-11 i also work it at home. i’m 54 & work a very physical maintenance job & have been out of work since the surgery. it’s also a work related injury goin bak to july 09. i’ve made good progress thru pt but i only can bend my repaired knee to 111 on my own they can get it to 120 with tremendous pain as of 2day. i can see this is better than most of you that have posted on here. to do my job safely i need my knee to bend closer to 125 with my good leg. my surgeon has mentioned a manipulation to remove scar tissue which is causing my lack of motion in 4 weeks if i dont get the ROM from pt & more surgery scares me. work is pushing for me 2 return & i dont have any lite duty with my job. can any1 tell me how much improvement they have gotten thru a manipulation so i can decide if i should have it done or keep at it thru pt. the therapists have said 120 is the best they have seen & i’m at as good as they’ve seen or better. this has been quite frustrating to say the least
I am just over 7 weeks out from TKR on Aug 9th. I like to think that ‘fever’ – is a sign of healing. It is blood flow, and while surely related to inflammation, it can’t be all negative.
I currently have about 110 degrees flex, and straight extension. Been here for about a 10 days, kinda hit a plateau. I do PT 2-3 times per week, daily exercises 3 times, and the gym between PT. Stationary bike, stairs, pool walking, squats, long walks. and I have returned to my Tai Chi classes – which is quite good, no impact, but demands balance control which is good. and I have to listen to PTs tell me I am not working hard enough. I expect much more flexion – since my pre-op was 140. I had no flexion issued prior, and hope I can get at least 125 degrees. and yes – the new knee is bigger – still swollen some.
Wow! After reading all of the other comments I feel like a whiner. I had TKR in 2/11 and my ROM is -1 to 145. BUT! It’s very painful every morning to start walking again or any time I sit for that matter. I’ve tried walking a mile or so and that doesn’t help. I tried NOT walking a lot, and that didn’t help. I tried stairs but need to pull myself up and forget going down. I haven’t tried pool therapy yet but I don’t think bending is the stiffness issue. Could be scar tissue. I’m seeing the doctor on Monday and if he gives me the “it takes time and ice” again, I’m going for a 2nd opinion. Something isn’t right. Pain is just below the knee cap.
Had TKR on July 21, 2011. Have had sciatic complication since that time…lots of pain with that. I have a lot of pain in flexing the knee and after three months of physio cannot bend more that 75 degrees, extension is also very painful. Have been doing physio 2 x week, and also do at home. Can get around alright but the bending is extreely painfull. Am considering alternatives such as manipulation.
What is the Dynasplint ? Can the physio do this ?
I have arthritis throughout body, especially legs and feet. I can’t really exercise to lose weight because of these problems…I though TKR would help but now I am disabled, depressed and dependent on other people to help me .
What options do I have now 12 weeks post-surgery.
Had TKR on July 21, 2011. Very painful sciatic complications. Experienced painful flexion from first physio…2 x week for three months now. Have achieved 75 degrees flexion and with extreme pain. I do mainly flexion exercise at home because that seems to be the most difficult. Pain of varying kinds is my constant companion. No position is comfortable after a few minutes. Using pain Rx, but nothing helps with the sciatic much. Have dull pain in and around knee all the time. Can get around okay, but gait is not very good yet. Doctor is not very helpful and thinks I just have to work harder and suffer the pain in order to get better. Am considering alternatives such as manipulation. What is this “Dynasplint” ? Can a physio apply this, how does it work ?
After three months and still not able to drive I am disabled, depressed and dependent on other people to drive me and my granddaughter around. I am very disappointed and demoralized at this point !
I went through a TKR on July 18, 2011. I have been working very hard on my rehabilitation and physical therapy. I am at -2 % on my extension, but I’m still having problems with my bending. I have gooten to about 100. I have been extremely swollen, but have seen progress still. Is this something that is normal and will I be able to bend my knee further as the swelling goes away? I can come up stairs pretty well, but I am having difficulty coming down flights of stairs still. My operated knee just does not want to bend enough with this. Any and all comments are appreciated. Thank-you.
Kim
I had my tkr July 25, 2011, and could only reach 70 bending at the most. I do not have a knee cap through previous accident 37-years ago. I had a manipulation Sept. 12, was scared to death, hated the entire three days in the hospital, but can now bend 110 on my own. I have been at rehab 5-days a week, take off Saturday, and see a trainer at my gym on Sundays. I bike and walk, and work on hamstrings. Hardly any pain until I start falling asleep at night, then all hell breaks out, and I take a pain killer and go back to sleep for the night. Prior to the tkr I could no longer walk, was on crutches for 3-months. I keep a walking stick with me that I can use as a cane if needed (down steps) but otherwise walking on my own.
I am actually happy I had it done, and very blessed I had a great surgeon who would do the surgery with my history.
Good luck to everyone.
I had a tka on july12,2011 had awful home post op care, started going to out patient PT, on the first day I had 15 degrees extension and I believe 75 degrees extension, starting going 3 days a week. Went back to work 2 months after surgery with my extension at 4 degrees and flexion at 96. 3 weeks later,my flexion was 78 degrees and I had 5 cm swelling on the operative side, MD suggested Manipulipation then aggressive therapy(5 days a week) this had done wonders , I am now at 110 degrees and riding a bike at 12 miles an hour. If you are having problems oh please go for the MUA it makes a difference.
I have read with great interest other peoples’ comments about their TKR experience. My surgery was 8/22/11. Everything went fine. I started with in-home therapy 3X a week, doing everything I was supposed to do. Then I transitioned to outside PT and have faithfully gone 2X week for the grueling sessions. They also gave me a leg extender that I use at home twice a day. My knee is still stiff, achy, and won’t bend beyond 95 degrees. I have also been going to my gym and doing the exercises on the eliiptical, bike, and weight machines. I don’t know how much more I can do but somehow I’m made to feel that I’m not doing “enough.” This recovery has become a full-time job for me. I also haven’t slept through the night since 8/22 so I am sleep-deprived and worn down. I’d like to think I made the right decision with this surgery but I’m not convinced. Does anyone have any suggestions?
Hey Cindy,
Keep your chin up! It will get better. I had my tkr in April and am still in pt 3 times a week with 95 degrees of movement. It takes time. My dr actually was very honest with me rite up front and did say it would take 8 months to possibly a year. Other drs told me 4-6 months, which I knew wasn’t true from the beginning. Also, don’t OVER excercise! I did that, thinking it would help? And all it did was increase swelling, which made it harder to bend the knee.
Hope this helps. And you’re not alone!
To Cindy – your experience sounds a lot like what I went through this year. I had surgery 2/24/11 and, like you, did everything they told me and more. I could not bend past 90-95 either. I did have a manipulation done on 6/14/11. It was the best thing I did. I was at PT 5 days a week after the procedure for the first month. My doctor let me continue pt until the end of August because I was showing progress. I worked my knee until I hit an easy 120 bend. I am “almost” normal now – can walk normally, walk up and down steps without pain, I can turn over in bed at night without waking up screaming, and my life is almost back to normal. I’ll never have full bend, but can live quite well with the way it is now. Talk to your doctor about a manipulation = compared to the surgery, it’s a piece of cake! Mine took 3 minutes and I’ve reaped some great results. Don’t give up yet. And if your PT is not supportive and helpful, find one that is and will work with you.
Hi Cindy ,you are 2 months into your recovery,i would suggest give it some time to heal ,things should settle down ,i know i had similar issues my TKR was may 6/11 and its still improving
nancy i noticed u had a good experience with your maipulation surgery about 4 months after your TKR. that makes me feel somewhat better about going that route. i wrote a comment on 9/29/11 about my TKR it’s been another month of PT & the knee is stuck at 110 rom on the bend. my surgeon is going to seek approval for a manipulation now. he said i have alot of scar tissue thats the major cause of my lack of bend & a 15 scope to laser it out should fixx it to where i can bend it & get back to work..
Thanks John, Nancy, and Tony for your words of encouragement. I will keep plugging along with my PT and exercises. I do see my doctor this week so I will get a progress report from him. I also purchased, on the recommendation of my PT, a device called “The Stick.” I got it at a running store. You roll it across muscles and it really feels good. I use it when my leg muscles are achy and tight.
Cindy – you might be overdoing it. Take it easy, and use ice as often as you can. Tony – I am always overdoing it – but then, most PTs seem to think you cannot overdo it. but that may be from dealing with people who really have to be pushed to exercise. I have been a gym rat all my life, so I embraced the work. but the swelling – does prevent reaching that ‘end point’ on range. I am not sure what timeframe my doc told me for recovery. I think possibly I heard what I wanted to think – which was ‘a few months’. Heck, he may HAVE said ‘a year’, but I probably thought ‘no way, not with me’. Now that I am three months out, I realize it can take a year. Nothing I ever had happen to me (previous knee surgeries, shoulder, car wrecks) ever took longer to recover from than ‘a few months’ – but this sure is different. I am humbled.
Hi Ron
Due to unusual circumstances I did have the manipultation done in the 4th month after surgery. I was only at 90-95. The doctor did the manipulation because I was just outside the 12 week “suggested:” time, I am relatively young for this operation (55) my bones are very strong and I have no history of osteoporosis or osteoarthritis. I was happy to have had it done. I had PT for 2 1/2 more months though. The flexibility I gained in the last month of pt was worth ALL of the PT I had. I went from 110 top 120 and it made a huge difference. Good luck!
Hi…just wanted to give everyone and update. Since having my TKR on 4/28/11 and returning to work in October I am pain free for the most part. I was stiff at work for the 1st couple weeks and had pain….not sure if it was the cooler weather or just being more active. I still have problems going up and down steps….but as long as the pain is gone….I will deal with the steps! I am not sure what my range of motion is but have a doctors appt on 11/30 and will keep you posted. All I can say is don’t give up……I was very discouraged and depressed that it took 5 months to get to this point. Hang in there everyone and have a great day!!! : )
I posted once before about my frustration at not being able to achieve flexibility despite doing everything I was told to do. A week ago, upon my doctor’s advice, my knee was manually manipulated. I am now BACK using my walker, after having been driving, going to the gym, etc., and only sleeping in two hour stretches. I do have better flexibility and my doctor considers it a success but I felt like I had been run over by a truck immediately after the procedure. I was in so much pain my doctor took xrays to make sure no bones were broken. I am still a little swollen and am basically starting over with the exercises, etc. I wish I had known how debilitating (although temporarily) this procedure can be to some patients. It was NOT a piece of cake for me. Please ask many questions before you have it done! I did not, and it really caught me by surprise.
hi cindy i had my TKR 5/4/11 now i’m having a manipulation dec 5th along with laser surgery to remove scar tissue i hope it isnt as bad as your experience. my dr said alot of scar tissue is preventing me from bendin my knee to what i need to b able to work safely. my job includes climbing, kneeling, squating, carryin heavy tool bags, & parts, working around trackbed on rail equipment. so i need it bending about the same as my good knee to work safe.
sue thx for your update i’m 6 months out & still cant return to work pain is gone just stiffness & lack of AROM
I feel so bad for some of you. I realize that everyone is different and not all surgeons do the exact same surgery either. I had a TKR on 09/26/2011 and I went home and had 3 visits with the nurses and 4 PT visits at my home. I saw the doctor on week three and I went back to work on week 4. I realize I am 52 yrs old, but my surgeon is a wonderful surgeon. He did my total hip replacement a yr. ago in August, 2010, and I was able to go back to work after 3 weeks. I will admit that the knee replacement was more painful than the hip, and I will also admit that the PT was painful. Fortunately, I did not have to go to any other PT other than the four times at my home. The doctor told me to use it and that’s what I do. I am very thankful that I did have the surgery as I was very scared but it was well worth it. Remember, everyone heals at a different rate and recovery time is always personal. Too bad the hospital bill wasn’t as easy to swallow! LOL!
I am at thirteen weeks post op – and have been stuck at less than 110 flex for 6-8 weeks. I got it straight, but no matter how hard I work, I can’t get the flex to progress. Actually – it is probably more in the 90-95 range – with some work, loosening and warm up, and some painful pushing – I get the 108. Most TKA would be happy with this, but it won’t work for me. I had full range prior to surgery. I have appt. tomorrow with surgeon to discuss possible manipulation. I hope I get the results Nancy got – our situations sound similar. Will let everyone know how it goes.
After reading about the Graston Technique on this site I decided to find a practitioner and giveit a try as an alternative to manipulation. This technique helps to promote the breakdown of scar tissue.
I had one session this past weekend and felt immediate improvement. I go back again and will give it a few sessions. The surgeon can’t do anything and it is a waste of my time to continue seeing him. In general the knee feels better, not so tight but I don’t know what degree of flexion I have. I will let the surgeon check that next week, then stop seeing him after that.
For Canadians, the write-ups are expectedly negative, but I say, give it a try. Physio’s can’t do everything, and generally will stick to their own techniques and probably not be interested in anything new or seemingly untried/unproven.
So for those of you suffering from “scar tissue” check out thie Graston Technique and find someone who canhelp you before trying any manipulation.
I am 38. I have been having knee surguries since i was 10. I beleive i have had 4 not including tkr and manipulation. I had tkr on 9-15-11. After 8 weeks of PT was only at 50 degrees flex. i had manual manipulation yesterday 11-15-11, I did require surgery to have scar tissue removed during this procedure. I think pain from this latest procedure is worse than the tkr. I did have morphine for 3 days after tkr and oxycodone after manipulation so than would explain the difference in pain level. I now have 54 degrees flex 1 day later, I have high hopes that the flex will increase as swelling goes down. I have been using cpm machine for 4 hrs on 2 off since I returned home yesterday. I think this is helping retain what little flex I have and will continue to use it for the next week. I think if I had this to do over I would have opted for a regular scope and waited to do a tkr in another ten or fifteen years. Good luck to everyone that decides to go through with this procedure.
Others have mentioned the Graston Technique and my physical therapist has been using it along with the traditional PT activities for awhile now. I do believe it helps- sometimes she digs pretty deep! She is also using it to try to stretch out my quad muscle, which has become weak since my surgery last August. I am now 2 weeks out from my manual manipulation, the swelling is just about gone, and I continue to attend PT 2 X a week along with 6-8 exercises I do at home. My leg was strong enough to drive prior to the manipulation but I’m not quite there yet. I alternate between using a cane and a walker. I’m taking each day at a time but would like to be up on my feet for the holidays (as would all of you, I’m sure!). Thanks for your comments and words of encouragement- they’re very, very helpful to me. People who have never gone through this procedure have no idea the time and pain involved in getting back to where we all want to be.
Hi….I had my TKR on 4/28 and the manipulation in July….I finally returned to work in October. I thought the pain would never end and I wasn’t ever going to bend past 115. Well the pain is gone for the most part and I am finally go up and down steps almost normal and really don’t care if I get any more bend….as long as the night mare is over. All I can say is hang in there….and my doctor said it would be almost a year until I would be completely recovered. Just do your therapy and I found that pool therapy gave me more range then the land therapy……Have a great day and hang in there…………it does get better…..and I never thought it would!! : )
This is to Steve R, WOW! I feel your pain and frustration. I am 44 and in the same situation as you. Hang in there!! MY TKR was almost a year ago and was the worst decision I ever made and I am doing anything and everything I can to help rectify the problem. I am due to go back to the surgeon and see if he can “fix” the problem so the knee can bend and I can walk again. Until then I live every day in terrible pain and discomfort hoping one day the stiffness will just loosen on its own and the scar tissue will free up. I’ve tried almost everything there is to try and NOTHING works. I hope things work out for you and you’re not as bad off as some of us are, especially at your young age. Make sure you check into the possibility of the manufacturer recall on the appliance. They are looking into that for me. Good luck and I hope all turns out well!!!
Before having manipulation, which can leave you in worse condition, try to find someone in your area ( chiropractor ? ) who is certified to do the GRASTON TECHNIQUE. I have had months of impaired flexion and painful extension after the initial TKR and with a sciatic nerve complication as well. This Graston Technique is definately helping to break down the excessive scar tissue and improve the range of motion. More surgeons and physios should be aware of this and willing to either learn it or refer people to practitioners of the technique. Surgeons are not gods and they are mainly interested in lining their own pockets…so you figure it out…if surgeon says you need another trip to surgery to fix the problem created by the TKR…question that and look for other alternatives. I don’t know if this Graston Technique will be the ultimate solution, I may never have perfect flexion or extension but I felt better after the first session and it continues to get better, so I have to think that there is some merit in it. At least now I can walk better and don’t have so much PAIN when I flex or extend the knee. But without nerve pain medication the sciatic is still a problem.. The sciatic nerve system runs right through those muscles the surgeon had to manipulate during the surgery and I think that this is responsible for all the pain I have had through thigh and low back.
I didn’t even go to my surgeons office today, for another 2 minute consultation, with reminders to keep working through the pain…I won’t go back until I can see some very real and lasting improvement.
Good luck people.
I wanted to post this on this manipulation site as a follow up to my story that I posted last night on the related site joint-stiffness-complications. I have been reading the postings on this site and wanted to give anyone that has been suffering for more than a year after their manipulation an option to find out about a possible alternative for the complications. After my TKR surgery I had the home PT come in, I had the Dynasplint for a few weeks and I was on Oxy and Vicodin for weeks. I was unable to work for 2 months. My PT was 5 days a week, 2 hours a day. My OS wanted me at 120, I was prob 75 after the manipulation. I started with electo on the joint to warm it up, then rode a bike for 10 mins to keep the knee loose. Then to the back room with the door closed, on a gurney with a rag in my mouth and tied down. I never got past 110. I can’t even start to describe the excruciating pain I went through during this procedure. Light headed, tears and one time blacking out.
After about 4 weeks of this therapy from hell I made an appointment with my OS and told him I couldn’t do this any more. He decided to try no therapy at all, give my leg a break from the therapy. I knew in my own mind something was not right with the surgery or the manipulation. Every time I called my OS for an appointment I ended up seeing his assistant, always being assured all was normal, hang in there and it will get better. About 9 months after the original surgery I had X-rays taken, again I was told everything looked great. In 5 or 6 visits to the OS office I never got to see my OS, always his assistant. Finally after 18 months of this hell, basically in constant pain, no flex with my knee, using a cane to walk I demanded a meeting with my OS. At the office visit he seemed shocked that I was in such a bad state and in so much pain. He said even though the X-rays showed everything normal he was going to refer me to the Nuclear medicine department at the hospital. It had taken 18 months of misery, losing my job, my marriage, constant unbelievable pain in my knee, almost total immobility before my problem was finally diagnosed. The nuclear medicine dept found that the insert had come loose and there was an excessive blood build up around the implant.
Unfortunately I could not have the surgery re-done that my OS had scheduled me for 5 days later because my Insurance had expired due to the loss of my job 4 months earlier. I am still in pain, unable to walk more than 50 to 100 yards without having to rest the leg.
The point of this post is for anyone out there that can relate to my symptoms have your OS schedule you for the bone scan with the Nuclear Medicine dept at your local hospital. This is NOT the same as an MRI. MRI will not show the loosening of the prosthesis. Read my post on the sister site I referred to earlier. I posted this because I related to so many of you that are still suffering, totally frustrated with everything that has transpired since the original surgery, still in pain and regretting having the surgery done in the first place. It could be the same diagnosis they found with me. I wish you all well and if this helps just one of you out there then I have given you hope for your future recovery.
I have been in excruciating pain for a few years. I has a severe case of osteoarthritis and it had progressed to the point that my menicus was gone and all of the cartilage. I was bone on bone in both knees. It kept me from doing thing with my kids 10 and 6 years old. The wife was on my tail because I wasn’t moving fast enough… I even waited a year longer because our insurance had a high deductable and copay.
19JAN2010 at 49 I had my left knee replaced (TKR). I was on the baseball field coaching little league at the end of March. My doctor may have objected had I told him but I was coaching. I wasn’t doing anything crazy because my other still hurt and was my strong leg for the time being. I am -1 and 132 in my range of motion on the left. I was comfortably pressing 150 lbs with just the left leg last week.
05OCT2010 still at 49 I had my right knee replaced (TKR). I went back to work after six weeks, just like I did with the left. Baseball season hasn’t started yet but this knee has taken a bit more effort so far. I struggled after two weeks to get past the 45-55 degree mark and that really concerned me. I had in home PT people come… I’m sorry but thy watch what you do and tell you what to do but they are hand off. I called my doctor. I said in home PT is not getting me where I need to be and I would like to go straight to out patient and have a more aggressive therapy. He agreed and out patient PT is where I went. If I had not had my left knee done, I wouldn’t have known any better and maybe I would have been content with 45-55 at two week and a couple days. Fortunately I had the previous experience with my left. No offense to anyone but I think I am on the young side for TKR so I was bound and determined to get moving asap! So my PT for the last five weeks has gotten me past the 45-55 stoppage, then past another at 85-90 and I am happy to say my best posting on this knee has been 116 and I think I am -2 or -3 for straightening. I am confident that 116 is just another stoppage to get by and I will at or near 130 by years end.
If you’re considering TKR, I think you find a surgeon who you feel comfortable with and someone you can and are willing to talk to. This is the person who is going to make you walk again! He or she will help straighten you leg if you’ve become bow legged, make sure the parts are the right size and your leg length remInd the same.
You on the otherhand need to get moving. Don’t tell me it hurts! Tell me how you got up on day #2 and took a spin around the orthopaedic ward of your hospital. I had a four day and three night stay. The worst part was having a nurse remove my cathater. It was embarrassing for me, plus that damn hose seemed to be a mile long. Thank goodness is was asleep when.it went in – whew! I walked on day #2, day #3 and cleared the stairs on day #4 then went home. I had a walker but I kept walking away from it. I don’t recommend walking away from your walker because you will aggravate the leg and then it blows up like a balloon. I hated the swelling so I would be back on the sofa elevating my leg and icing it down. They gave me a KREG ice machine each time. Ask for one!!! They have a better one at PT called Game Ready. That’s the ice machine to have if you have 3k lying around… The KREG was covered by insurance.
PT and your home exercises will get you up on your feet and moving again! Do your exercises!!! Don’t lie to your doctor, do your exercises!!! You will regain your ROM (range or motion) and forget about any discomfort you had and believe me, if the left had been a real nightmare, no way would have gone back. I did have an achy feeling behind my knee. They said the pain meds would not help so you have to deal with that but it’s worth it IMO.
Good Luck if you are having TKR!!! And remember do your exercises!!!
well i guess you lucked out rich. i did all my excersizes & 110 romm is all i have gotten since my TKR on 5/4/11 & thats w 5 months pt. goin in for a surgical manipulation on dec 5th to laser out scar tissue. it hasn’t broken with the pt & my exercisizes due to massive scar tissue. hopefully this will be it & i can back to work.
I’m sorry, I don’t understand why so many variations when it comes to a TKR. I mean I do understand tha people are different but are the surgeons doing surgeries that are that different or what? I’ve heard that some of the doctors cut up into the quad muscle or something and that makes it harder but if your surgeon does minimum evasive surgery and puts the right size knee in, I cannot understand how there are so many different problems. Alot of you seem to be my age or younger so you would think it would make it easier so I have to believe it’s the surgery itself! Am I wrong?
Best of Luck Ron!!! I’m sorry the ROM has lagged for you but I would be encouraged by the laser. It sure sounds like it would do the trick. I push hard. The PT lady will say do 20 of these and after 40 or 50 I will ask, what next? Let us know how you make out and try to skip the in home do nothing PT and go straight to outpatient PT if possible.
denise all i can say is every1’s different when it comes to how they deal w pain & recoverying from a surgery. i have a hi pain tolerance some dont. i’m just hoping this surgical manipulation on monday does the trick but i’m also bummed i have to go thru all the rehab again. i’ll do what i have to tho to get it done. i know some on here managed to get back to there jobs within months of thier TKR but they dont mention what they do for work. if i had light a duty job i could of returned but i dont. i’ve been told by at least 3 PT therapists not many go back to what u do for work. most of their patients have non physical jobs or are retired. thats not what i want to hear.
thx rich & i will let every1 know how i make out
I had my hip replaced a yr ago and took 6 weeks off and I knew than that I had to have my knee replaced soon also. I also chose to have the hip done first as the doctor told me it was an easier recovery than the knee would be. Of course, that scared me and I put the knee off for an entire year. I wish every one of you that is having trouble and is having to have the extra surgery done all the luck in the world. I hope it all works out and you have a speedy recovery.
well just had my manipultion done yesterday morn i tell ya it doesnt feel bad. i took 2 perks at 1pm & 6pm then 1 at midnite & 1 around this morn at 9am. i used crutches leaving the outpatient surgical unit. they put me out at 7:05 & were done at 7:52 i woke up around 8:20 & left a little after 9am. by mid afternoon i was using my cane no crutches. only problem i have is the dreesing saturated with some blood under the ace bandage from the cpm machine. i am waiting on dr to c if i should change the dressingas they said change after 2 days. i had the machine at 85 degrees & could of gone more but didnt want to push it to much. i cant wait till i can get things goin to see if my rom is better i guess they got it to 130 during the manipulation after lasering out massive scar tissue. if i can get 125 that would b perfect for my return to work. i just thot i’d share this with you all that it wasn’t as bad as some have experienced but every1 is different. good luck to all going thru these very tough surgery’s.
Good luck to everyone. I am going to discuss manipulation with my surgeon tomorrow as he wants to do it on Tuesday. I just don’t know if I will go along with it though because I haven’t read anything positive about this procedure. It truly scares me. I’m leaning on continuing with outside therapy and inhome excercies.
I twisted my knee the other night on the stairs and if I could have caught my breath, I would have screamed but the shock was too much. I simply sat down on the step and cried. My knee swelled and turned red/hot within minutes. I iced it the rest of the night but the pain was so intense, I couldn’t sleep. Is manipulation really worth it and does it actually help? I’m torn between doing/not doing it.
I just thought I would write something positive about manipulation after TKR. I had a TKR at the beginning of June this year and was only able to get my knee to about 90 bend so was a bit disappointed that I was unable to use my pushbike and also a bit limited with stairs and certain things at work. I went for a 6 month post op check with my surgeon expecting that it may be too late to have a manipulation but was booked in for a few days ago. Went down to theatre, an hour later was in recovery, then back in my room with my leg on a CPM machine set to 110 bend. The surgeon was very pleased with results, he carried out an arthroscopy to remove some scar tissue before manipulation, he managed 130 bend getting my heel to my bum. I have suffered hardly any pain post surgery and can still manage 110 bend. I have a physio appointment in 2 days time but I am very pleased I’ve had the surgery as having read some post was very apprehensive before!
Awesome Beth!!! I am still around 117-118. the issue I have been dealing with the release of the rendon / ligament. I now better understand what took place and why the release was needed. because I have been so arthritic for so long, the leg had bowed. to rectify the bowing the bones were cut in such a way that the leg was lined back up. as a result, the knee cap was positioned incorrectly and needed to be shifted. a release of the tendon or ligament resolved the issue but made it rather tender. I’m not screaming bloody murder but it is quite a bit of discomfort if I tweak it wrong or twist it like Katherine has. I know it will get better. I am two months and few days now and I have improved greatly in that relatively short amount of time. I may have mentioned, I have little league to coach “again” this spring. I can’t be on the DL (disabled list for you non baseball fans) again! we’ve also purchased paintball equipment so I will need to be able to move!!!
it’s 1 weeks since my manipulation i can walk without a cane. the knee’s sore w still alotta swelling but i can bend it on my own about 95- 100 the swelling is preventing any more rite now. i can go up & down stairs normally rite now just enough bend to do it. he had me hold up on the CPM till i saw him this past friday. since then i’ve been using it at 120 max 2 hrs at a time. i will start with the PT excersizes 2day & prob outpatient PT after i see him this friday. it’s been sore like i said but tolerable as i’ve taken no pain meds since the day after the manipulation
I’ve read with interest the comments on the website. I have also added my two cents worth in the past. After having TKR in August and a manipulation in early November, I feel I am now on the road to recovery. I suffered from horrible insomnia coupled with anxiety surrounding my inability to sleep. After speaking with my ortho doctor multiple times, who told me he didn’t believe in prescribing sleep meds for this sort of thing, I went to my family doctor and received a prescription that now allows me to sleep for about 5 solid hours before I have to hit the couch. But five hours is so much better than 1-2. So, I would recommend trying this for a temporary relief to the horrible insomnia that many of us seem to suffer from.
Also regarding getting the leg to go straight: I was given a leg extention machine, many exercises to push down my leg, and warnings that if I didn’t get my leg straight, I was “screwed.” (my doctor’s words). So, my husband and I hit the floor- literally. He held my foot and pressed on my leg just above my knee. We did it twice a day for 4 one-minute sessions. Within two weeks my leg was flat and even had a tiny bit of hyperextension. My PT couldn’t believe it. We still continue to do it twice a day but hold it for only 2 minutes. It was the ONLY thing that got my leg flat! No gizmos or fancy machines!
Cindy, My doctor told me the same thing. Lay flat and have someone push the leg from just above the knee and force it flat. Do this a few times a day for as long as needed. It did work. I had surgery at the end of Sept, this year and the left outer part of my leg was numb until just a few days ago. Now that the numbness is gone I hurt a little,
Oct 5th was my last TKR. I am at 120-121 deg and -3 to be flat on the right leg. Left leg (Jan 19th) is 132-133 deg and -1 last time my PT lady checked. I will go to PT until the right leg gets to 132-133.
My ’straightening’ exercise – was to sit in a chair at the table, with my foot on a chair under the table. I squeezed a pillow, or wad of towels on top of the knee and the underside of the table. It pushed the knee down to straighten the leg. I would do that for 5-10 min – long as I could stand it, several times a day. It did the trick.
I had my TKR on July 26 11 and now 1-8-2012 I am have a manipulation I habe 110 rom but Dr want more. Leg straight but cannot bend . I am scraed sick about this. Have been told it is like have the TKR all over again. I hope not. Will seen.
I am having the manipulation done this week. I am 5 months out of TKA. I got it straight, but I only have 105-110 degrees flex. That won’t work for me. Hope to get 20 more.
I had a TNR on oct 3 2011 I had 3 major surgery’s before this and 3 scopes surgery went will but I’ve been stuck at 90 degrees since day one have PT 3 times a week but, I see the doctor tomorrow and was thinking the only way to get more range is manipulation, I would do right away if I can get the range well love to hear from any thoughts thank you
I had a total knee on Nov 2nd 2011. I had to have a manipulation doen on Dec 19th 2011. It is now January 17 and I have no more straightening or mobility . I am at a loss of what to do. I went to therapy the day after my manipulation and continued with it and within 4 days the knee was freezing up again and the bend is still there. I am not agood canidate for more surgery and I am afraid tha will be my only alternative. The doctor said that he instailed a thicker knee cap at surgery because my knee hyper exstended, now I wonder if that is what is holding my leg back frm straightening and bending more,??? Please if you can offer any solution I can do please contact me at the e-mail above, Thank you..
i had my manipulation on dec 5th. b4 that i got 105-110 degrees now i’m up to 117 & still have swelling preventing more flex. they lasered out a wall of scar tissue via scope with the manipulation. my TKR was done on 5/4/11 wish they had done this in sept i’d b back to work by now. the PT released me last friday i do home excersizes & have joined the Y so i do my leg work & use the pool for my therapy. i’m confident i’ll b returning to work by mar 5th which would b 10 months & 1 day out of work since the TKR. it’s been a long road for me but i can see that lite at the end of the tunnell. good luck to all of you hang in there & do your excersizes every1 is different but it can be done
I am now receiving additonal thearpy for my left TKR. I still have a bend that will not give. The manipulation did not work at all for me, other than to help me regress in the process of healing. Iam now 2 1/2 months out from surgery and still I am about where I was at 1 1/2 months. I go to therapy 3 x a week and do my exercises at home, but when I seem to progress any then I have 3 days between intense therapy, I start to regress~ Not even stay where I had gotten too!! This is VERY frustrating.. When will this get better??
sorry Rebecca… I wish yours was coming along easier! you definately have to keep moving & exercising, even on the off days from PT. I try to do squats in from of the sink to build strength. I am just now, at 3-1/2 mo, to lead with the right leg when climbing the stairs. It hurts but it will get better. I had my left knee TKR’d on Jan 19, 2011 and it feels great!!! the swelling / inflammation took a good 8-9 months to go away. I could always feel the heat in that knee when it was irritated. my right knee still has the heat… that also keeps you from getting the full range of motion. I like to ice it for 20-30 min and then flex it at home. tbe PT lady wants it all fired up and then wants me to bend it for a meassurement… I bend it easier on my own when it’s cooled off first.
btw… you mentioned your email. they don’t share that portion of your posting. that would need to be in the body of the posting to.be seen. good luck!
u have to work at it every day rebecca do your home PT to keep it loose. it’s a fine line tho to much & you get more swelling to little & you lose some flex. it could take up to a year before all the swelling goes down. did your dr tell you that. you just have to hang in there it’s tough & gets frustrating & every1 recovers different but it will get better in time
Had TKR surgery on Dec 6th, 7 weeks ago. I am 56, in good shape and pretty athletic. Straight flex is ok but frustrated that I can barely get to 90 degrees, maybe a 5 degree improvement after 3 weeks of PT. Doctor is recommending manipulation, I have an appt on Thursday, but after reading posts, maybe I should keep up PT for another week or 2 to see if improvement. FYI – full disclosure, I can play golf with just a little discomfort the next day. What do you who have had manipulation think? Thanks, Bob
Manipulation yesterday the 23rd. No pain afterwards, just sore. Can’t tell what I will retain, since it is swelling up, just doing ice and elevation. Doc says he bent it to about 125. but I can only get 90, less that before. I hope that is from swelling, if not, then it was a waste of time. Going in tomorrow for a ‘hivamat’ procedure – deep oscillation via electrostatics. Supposed to be good for healing and inflammation. Never seen it mentioned on this site. Hope it is real, and not some other black box of quackery.
Rebecca: I had the very same problem that you have now. My leg would not go straight despite all the PT and the manual manipulation. It still had a bend to it. Finally, out of desperation, I sat on the floor and my husband pushed down on my thigh and carefully lifted my foot. We did three one minute sessions, twice a day. I didn’t look forward to it but it did get easier. Within two weeks my leg was straight- and stayed straight with very little effort. My PT and doctor were impressed. This tactic worked better than anything else I tried. We were religious about doing this because I knew my leg could “backslide.” Today, five months after my TKR and two months after my manipulation, I was officially discharged from PT. Try this and see if it helps you!
Hi: At 76, got my TKR 11-17-2011 @ Presbyterian Hosp. Dallas — @ the Sports Care Rehab. consistent aggressive hard core PT works well .. after knock-out @ hosp. & 140 degree max. noisey stretch to break up the scar tissue .. after a few PT sessions, I went from 90 to 130 degrees ROM manipulation, necessary for faster healing; some lingering pain interrupts sleep @ bedtime even when taking Tramadol or Ibutrofen to ease pain .. laying down creates more pain as muscle stiffness returns; climbing stairs & self PT helps loosens the stiffness a few times/day .. seeing good improvement after 2 months past surgery .. lost about 20 lbs.
Thank you all for your very informative comments. This chat site has been more helpful than even my conversations with my doctor. I am 57 years old and received a Rotating implant, because of my age and to give me more mobility. I do have other health issues which, I feel is causing me more than needed aggrevation than wanted. I am slowly improving using water therapy heated pool.. I love the water and as it helps to keep swelling down is allowing me to have more flex and more mobiltiy. This, in oppinion is the best alternative for someone like me. I do have alot of issues still with scar tissue that is already forming back, I was able to break up some yesterday with exstreme exercise of motion. Keep up the good work TKR warriors!!!
Is there any one out their who has scare tissue even after 2yrs i cant bend my knee only at maybe 65. Before scare tissue i could been at 80 to 85 without pt. help, with pt 100. I talk to Dr. he said i was to far out to manipulate so i went back for more pt. hurt so bad they were force my knee to bend its the scare tissue that’s blocking my bend now i feel i have no one to help me why wont he clean out the scare tissue. my foot gets caught on side walk are a rug and i go forward and my knee locks because of the scare tissue you talking about pain oh my goodness Help!! please clean out my scare tissue.
Cindy, Thanks for that exercise tip. I am also trying a wide belt around my thigh and while buckled using my right foot to pull down while my left knee is on the ottaman. Sounds strange but it is working!! Whatever you have to do is my motto. And I can do this as much as I can stand too. Thank you again for all the helpful tips and now I feel we are connected to the world of fellow TKR’S and maybe bring some comfort to someone else today. God Bless you all..
TKE on Aug 9, 2011, Manipulation on Jan 23, 2012. I am past what I was at 90, to now maybe 110. Seems like a lot of trouble -the manipulation – to only gain 10 degrees. Doc said that he got a very loud pop, not the usual crack, snapple, but a loud POP. louder than he was comfortable with, but nothing broken. Amazingly, no pain, just mild soreness, and some swelling. My flexion range is still less than what I want, but my knee does feel different, something happened, I may have breached a wall. Swelling seems to persists. If I don’t do the exercises, I lose Flex, if I do them, I get swelling. Doc says give it time.
has anyone had a TKR with a manipulation 1 year after surgery?
Wonder if my recent 132 degree ROM causes lumbar region back ache or is it TRAMADOL related and does it create my new temporary hip pain too ?? .. I seem to have reached my ROM goal, as forced PT manipulation works .. will ROM stay if I quit my Physical Therapist & exercise @ home or do walking during the 6 months recovery time after TKR ?? .. after 2+ months, I still have some lingering come/go knee pain … RAY
ray… I am at four months and I have a lingering pain in my knee as well. I believe that when they are banging and applying the titanium part in place they irritate a lot of things. I get sciatica, from my.lumbar region down to my foot. If I can find that special position / twist while on my back I will actually hear a click or pop in my lower back and that knee pain is gone, until I roll over or twist. I had this during my first TKR recovery last spring and here I am a year a couple week later and that knee, hip, back feels great!!! I am just getting impatient with the second TKR… I know it will be be same in time.