PT for TKR - Pain from stretching & Other rehab questions

I had a Total knee replacement on my right knee and will need the left one done soon. I used to teach kindergarten and preschool. I now have a job where I am on my feet the entire time. My TKR was in May. I did not go to rehab, but have been in PT and hydrotherapy. I have good bend and flex, but my doctor has increased my time off of work because of the demands of my job. It sounds to me that you are not ready to return to work. To do the job you do you need more range of motion. Have you asked your doctor about extending your leave? @JustinMcClanahan do you have more information or know someone who has has a bilateral TKR?

@ssbionicknee, I am tagging @gailfaith and @10nsmom who have both discussed having a bilateral knee replacement and may be able to share their experience with it again in this discussion.

5 months ago had Right knee TKR, was stiff legging it for 6 to 7 years prior due to not having the right time or insurance available. This year (2018) I finally did it. IT was bad. The knee had NO menisus and it was bone on bone with pieces of bone floating around the knee. I had 3 prior ACLs done on the right knee, last one 8 years ago, so very familiar with knee recovery. 54 years of age now and got a TKR. After the first month, I was only getting a ROM 10 to 60 degrees, so we did a MUA (1st). Then I gotten 5 to 90. Physical Therapy (everyday) for 4 more weeks, and it was not getting any better nor retaining any new ROM. So a 2nd MUA in August, got 0 to 100, but not retaining it through PT (everyday). Thus another 5 weeks and another MUA (3rd), well no improvements still 0 to 102 and thru PT it is just awful painful to try to get beyond 102 ROM. Doctor and PT thinks that I will get it, but they are not sharing with me HOW? nor WHEN? I loss my job due to this and now Im not sure what to do next? Another MUA? let time tell? leave it be it will get better? I just cant continue with this everyday PT drill and the amount of knee pain I have to endured. Im done with the pill scene it just not right to keep taking pills (heck at one point I was taking up to 5-6 oxy per day) now I take only 1-2 alieve per day. ANY THOUGHTS/SUGGESTIONS on what someone else experience at this point as they were going through this, please share... One simple question to any professional - how is it that during a MUA I can get -10 to 120 ROM (normal knee ROM) but when I leave the MUA procedure directly over to the PT office (~15 mins later) I can only get 0 to 101ROM? how is the retention not there? Is there something else besides scar tissue buildup that can not allow ROM? should I look to be tested some other way? (reaching for straws here). THANKS for reading and if so replying.

Hello @kded4009, welcome to Connect. I moved your discussion and combined it with a discussion titled, "PT for TKR - Pain from stretching & Other rehab questions." I moved your discussion so that the members already discussing PT, and the difficulty that comes with it, after knee replacements would see your post.

Personally, I can relate to your situation. I had my knee replaced when I was 19 due to severe arthritis that had deformed my knee to the point of no return. My rehab was a nightmare. My initial ROM after surgery was only 15-60 degrees. I had a manipulation, and it remained the exact same, so I had a second manipulation, with no improvement. I was told I had aggressive scar tissue growth - which may have been due in part to my age and my bodies ability to heal more quickly (kind of a curse in this situation I guess). I had a full leg cast made that had hand cranks on the knee to force my leg to bend, that did not work. In the end, I was playing catch football with my friends, jumped for a catch, landed, heard a pop and the next day I was around 10-110. After that, I slowly gained improvement and am now happily at 0-120(ish) with no pain. From the day I had my surgery to the day I hit my final ROM was probably well over a year and closer to 18 months post-op. My biggest suggestion, is do not take PT off. I don't think I pushed myself hard enough in hind-sight. But, I think what is most important is that you allow yourself a mental break as well. It is tough, and it is hard to not get frustrated when you don't feel like you are getting anywhere. But, in my opinion, you are looking for improvement by a few degrees here and there, even if it is slower than what is expected. You never know when it may just "pop" for you.

Left Knee replaced 6/15/18, PT every day and no progress, 7/12/18 aspiration revealed staph infection, 7/13/18 debridement to wash out infection, 7/14/18 started two weeks of daily antibiotic IVs, 8/19/18 MUA since I could not get past 90' bend, no change after MUA, continued with PT until Medicare coverage expired, still no improvement in bending. Swelling, pain, and immobility continue. Fired my doctor. Trying to get well on my own, but still very little progress. Good Luck.

OMG, where r u? let people know so they don't go thru this hell? So Sorry for your pain.

@kded4009 sorry to hear of your pain with knee my Mother had infection after her knee surgery but first bout on antibiotics cleared it up do you feel you need more antibiotics? If you can get in the water and do knee exercises its easier water takes the pressure of our joints. As long as there no open areas. Best of luck

Dr Moor, Doctor’s Hospital, Sarasota FL

I had a knee replacement just over 6 months ago, at the age of 52. After 3 weeks I was not able to flex my knee more than 60 degrees. I started a course of twice weekly physio for 4 weeks. I ended up having a manipulation at the end of June , the diagnosis was made of arthrofibrosis. I underwent a further course of twice weekly physio, there was no improvement, just more pain and swelling. The surgeon then decided to perform more surgery , I had arthroscopic arthrolysis and debridment of the knee, I had extensive fibrosis in the knee. Following this surgery just over 2 weeks ago I was unable bend my knee initially , due to neuropathic pain, my GP increased my dose of amitriptyline. Within a day of starting this increased dose my knee flexion has improved to 90 degrees, the most it has been since the knee replacement. I am also taking baclofen three times a day , paracetamol, brufen and as required oramorph.
I have to get back to work as I will be in no pay next month, but not sure how long it will take for the knee flexion to improve fully, the surgeon suggested 8 weeks.

Hello,
I am in need of reaching out. I am at the end of week seven.
To first say; all clinicians say surgery was successful and PT is on average track. BUT.
For example; yesterday I finished a rather positive day of rehab and incorporated a couple new PT items.
But, all of today is a horrid mess of pain and can’ reach anywhere near yesterday’s success. I get so dejected and sad.
Do other people see this cycle?
Today is sad for me, and don’t see any blue sky????
Others?