Poor range of motion after TKR and manipulation: What to do?

Four years ago I had a TKR followed by MUA six weeks later. Doctor said “it bends” after manipulation and showed me video. Had PT for 16 weeks. Knee stayed swollen, scar tissue took over, ROM went from 35 to 20 over 4 years. Fast forward - New surgeon discovered original implant was defective & ill fitting. He performed Revision TKR Nov 22’. It took an hour just to remove scar tissue! Had MUA 4 weeks later with ROM at about 60 (to get ahead of repeating scar tissue build up again). No nerve block with manipulation- whew worst pain ever - all in quad. PT daily for 3 weeks following MUA…then 3 x week. Then 2 x week. Now finished 15 weeks total of PT. Used pain meds during PT for several weeks, eventually just needed muscle relaxer and not even that the final 2 weeks. Knee swelling subsided gradually with elevating & icing several times a day. Biggest challenge in PT besides learning to walk normally was getting quad to fire up and then stretching it out after years of not using. Putting heat on thigh - then letting it dangle from side of massage table while letting gravity do its job and massaging thigh helped in PT. I started out using a rolling pin at home to massage thigh area, now using a tennis ball to massage which has helped immensely. I have massage table at home so still using it to dangle/stretch quad. My ROM is 80 and getting better (my new surgeons goal was getting me to 90 degrees). I know 80 not optimum but I feel so much better. I walk normally and can go up/down stairs (with bannister or handrail) normally. I’ll take it - while continuing to do the exercises & massaging. It takes a while to get through the healing, but perseverance and determination not to go back to where I had been helped. My PT’ s were great and bounced ideas off each other, along with my input on what I needed all helped get me where I am. Seems no two stories found on this forum are same but hope you get some useful info, some answers & mainly relief.

I have had so much trouble since my TKR. PT essentially said they couldn't help, I needed to go home and "heal." My entire leg vibrates. It is maddening. It has been 5 1/2 months and I am so 😞 discouraged. I had a genicular ablation and not seeing much benefit. HELP?

I admire your patience and perseverance. I am on your same road, and praying I can stay the course as you did. Had trauma from the MUA and am 6 weeks in recovery from that. Bleeding and quadriceps hematoma resulted, excruciating tenderness and Pain, no weight on operated leg for at least 3. 1/2 weeks, now about 80% weight bearing. Next step mentioned is the surgery to remove scar tissue. Leg still swollen, so I hope it can wait to let it heal more from the MUA. It seems that once you’re on the difficult recovery road, you dont get off for years! Choices are difficult.

Sorry for your grief. I found the following article that contained some ideas.
https://orthoinfo.aaos.org/en/treatment/revision-total-knee-replacement
I'm not a doc, but I'd want to be damn sure the prosthesis is installed properly and nothing has deteriorated or infected. The article emphasized weight loss which I found to be very helpful. If my weight exceeds 170, pain increases. Get back down to 170 or below, pain decreases (I'm 5'10"). The second, very helpful idea reqd building up the muscles that allow me to stand on my toes and my heels thereby relieving the knee of some of the workload walking up stairs. My third advance took place after I switched docs. The second doc treated the issues differently, she was much more patient & thorough. Fourth, I just got the results of my MRI which the second doc used to determine damage to a tendon the first doc cut thru during my TKR. I am scheduling "tenex" to see if that will mitigate the damage done to the tendon. Fifth, I use knee muscle building machines at the gym but I don't expect the TKR knee to bend as far as the non TKR knee. Suffice to say, I use the machine to build muscle but both docs told me to AVOID the machine in the photo I attached. Last, instead of ibuprofen, the sec doc prescribed Nabumetone which is easier on my stomach.
I wish I could offer more.

Hi all I am where everyone is had tkr was too big year later had revision went amazing felt awesome only was able to get to 105 flexion but workable……never was totally out of pain I just thought going to take time and dr told me would always have some pain because of being revision …. I am at lab now gettin Ltt test checking for my body having issues with metals used…. I don’t know I was exercising 5 days a week had to slow down was affecting my other knee which is bone on bone and. Am not getting done …. So I have to not be so hard on it …. I recently started organic caster oil it is said to get into the deep tissue break down scar tissue so heck I will try… I wear pad all the time I will let you know in few months if it works…..my knee is tight pain in back of knee ….so I will see what test say go from there …..good luck to all …. Hope you find relief

Four years ago I had a TKR followed by MUA six weeks later. Doctor said “it bends” after manipulation and showed me video. Had PT for 16 weeks. Knee stayed swollen, scar tissue took over, ROM went from 35 to 20 over 4 years. Fast forward - New surgeon discovered original implant was defective & ill fitting. He performed Revision TKR Nov 22’. It took an hour just to remove scar tissue! Had MUA 4 weeks later with ROM at about 60 (to get ahead of repeating scar tissue build up again). No nerve block with manipulation- whew worst pain ever - all in quad. PT daily for 3 weeks following MUA…then 3 x week. Then 2 x week. Now finished 15 weeks total of PT. Used pain meds during PT for several weeks, eventually just needed muscle relaxer and not even that the final 2 weeks. Knee swelling subsided gradually with elevating & icing several times a day. Biggest challenge in PT besides learning to walk normally was getting quad to fire up and then stretching it out after years of not using. Putting heat on thigh - then letting it dangle from side of massage table while letting gravity do its job and massaging thigh helped in PT. I started out using a rolling pin at home to massage thigh area, now using a tennis ball to massage which has helped immensely. I have massage table at home so still using it to dangle/stretch quad. My ROM is 80 and getting better (my new surgeons goal was getting me to 90 degrees). I know 80 not optimum but I feel so much better. I walk normally and can go up/down stairs (with bannister or handrail) normally. I’ll take it - while continuing to do the exercises & massaging. It takes a while to get through the healing, but perseverance and determination not to go back to where I had been helped. My PT’ s were great and bounced ideas off each other, along with my input on what I needed all helped get me where I am. Seems no two stories found on this forum are same but hope you get some useful info, some answers & mainly relief.