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

Posted by ffpm1381 @ffpm1381, Mar 25, 2023

I had a TKR 3months ago and had manual manipulation 4 days ago. My ROM was great while on the nerve block but as soon as that wore off my ROM went from 110 to 70 degrees. I do have a lot of pain in the quadricep and the muscle are very tight. I am taking a muscle relaxer with no relief. I am thinking of going for a second opinion. I had a comformis knee replacement and I am going to PT 5 days a week without much success . Does anyone have any recommendations or have had the same problem.

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Profile picture for cathymw @cathymw

My surgeon mentioned at my 6 week postoperative that he’d go down a size for my other knee there was debate about it being too large. How the hell does that happen? Don’t they have a plan and parts ready? That may be what contributes to my issues. Who knows?

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When I had my knees done in 2015 (june and Sept) , the surgeon ordered a standing xray of my lower body. These xrays were sent to the engineers at DePuy and they came up with the “parts” my surgeon should use. While I had some initial pain, I was walking quickly. Both knees felt like my normal knees - actually better. So far, so good. I urge patients to pick their surgeons carefully!

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I have to laugh at this as I bought I had. Top of the line in one review after another. “Center for Excellence”.19th Best hospital in country for knee replacement… I actually drove 4 hours for this!

I’m still trying to figure out where the disconnect was. I give my new knee a “C-“. It is what it is and I really should get the second one done but don’t know if I can now.

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I had total knee replacement, manual manipulation and revision surgery within 10 months. I can bend my knee 95. But it swells up after physical therapy and/or exercise. I can only walk 1/2 mile. Started electro magnetic therapy and it is helping with the scar tissue build up but still having swelling. I even rented a flexinator for home. No pain unless I bend my knee to far. I'm also seeing a functional doctor helping me with walking/sitting. She even prescribed Epsom salts for feet and knee. And magnesium for pain/stiffness. It's hard not to be depressed. It doesn't make sense to exercise with my knee swollen. Did I mention I was also given steroids? Any more suggestions? I was wondering if anyone has tried stemwave Therapy. It's costly, does it work? Will nano knee help? Go through the process again? Any suggestions?

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Profile picture for burdie @burdie

I had total knee replacement, manual manipulation and revision surgery within 10 months. I can bend my knee 95. But it swells up after physical therapy and/or exercise. I can only walk 1/2 mile. Started electro magnetic therapy and it is helping with the scar tissue build up but still having swelling. I even rented a flexinator for home. No pain unless I bend my knee to far. I'm also seeing a functional doctor helping me with walking/sitting. She even prescribed Epsom salts for feet and knee. And magnesium for pain/stiffness. It's hard not to be depressed. It doesn't make sense to exercise with my knee swollen. Did I mention I was also given steroids? Any more suggestions? I was wondering if anyone has tried stemwave Therapy. It's costly, does it work? Will nano knee help? Go through the process again? Any suggestions?

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@burdie
Have you been to another orthopedic specialist for a second opinion?

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Profile picture for steveinarizona @steveinarizona

@burdie
Have you been to another orthopedic specialist for a second opinion?

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@steveinarizona
Next on my to do list. He did my left hip with wonderful results! I had the nano hip replacement. He's well respected.
Thanks for the suggestion. The Dr. Modified the knee replacement and still having trouble bending.

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Im in the same boat TKR early June 7 weeks later I had a Manupilation bend was good after Manupilation but after 7 days of Physical therapy im back to feeling the tightness of scar tissue.
I getting really depressed and don't know what steps to take next, another Manupilation or scar tissue removal?
I wish I had never had the surgery

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I have same problem. Tkr, manual manipulation, knee revision, 8 months of therapy. I am now getting electro magnetic therapy which has helped alot. I've been looking into ozone therapy but I'm going to try cold laser therapy next. No pain just stiffness. I also went to a functional doctor. She has helped me alot! Good luck and keep looking for answers

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You might consider trying shockwave treatments. I found them SO helpful when my TKR leg wouldn't heal. They aren't paid for ny most insurance plans, though.

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Profile picture for mrnomad @mrnomad

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.

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Profile picture for mrnomad @mrnomad

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.

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@mrnomad Did the doctors tell you why you shouldn't use this machine? My PT person has me using it and I don't want to do something wrong and reduce the progress it has taken me 16 months to acheive. Thank you.

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