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Limited ROM after total knee replacement.
Hi, I seem to be stuck around 90 degree ROM following tkr surgery 20 weeks ago. I went to PT for two months and have been doing post op stretches and exercises daily. I've had constant swelling ever since the surgery and recovery has been very slow because of it. I've also had several prior surgeries on the same knee so figure scar tissue is at least a big part of the problem. I was wondering what options are available to me without doing a MUA? Any thoughts or suggestions?
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The Mayo Clinic, Rochester.
My BMI was 41
yeah my PCP threatened me with that. told me i had better do my exercises. OUCH
So it was because of your BMI,just to be clear?
Yes, why?
There are risks that go with medically complicated morbid obesity. Some physicians won't do over BMI 40. Some do 40-45
and some 45-50. Comes with the territory. The following paragraph explains why physicians decline to do the surgery on morbidly obese people.
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Because of the increased risks of complications, it is common practice for some surgeons to restrict the use of TKA in patients with a BMI of 40 or higher. Based on the current available data, many surgeons and surgeon groups across the country withhold surgical intervention in morbidly obese patients until body weight is optimized and associated medical comorbidities are better controlled.3 There may always be exceptions to this type of policy, and opponents to this position do exist. Nevertheless, the medical and societal implications of withholding TKA in morbidly obese patients are unknown.
The left knee was in bad shape in 2012. I tried PT, cortisone shots, pills, ice, etc. Nothing worked. They sold me a cane. I do not qualify for bariatric surgery, i lost 28 lbs on my own with diet changes and treadmill desk walks, The knee did not improve.
In 2016 i tried to get pictures of a grandchild in the marching band and took off walking very fast following the band. Then the popliteal cysts ruptured and the pain was like in the left knee but here they did an MRI and fixed (right knee) in January. I'm pretty certain that the same things are broken in the unfixed knee. I have been walking with a cane since 2012. The TKA leg is now doing better than the unfixed leg per PT. So....i am trying to get back to my two hour a day treadmill desk walks and try to take off more weight before knee #1 gets repaired if they will do it.
I have pain in the left knee just driving the car. I'm doing steps backwards with the left leg down first to strengthen the surgical knee, but also because the left knee hurts and does that give out thing. It has a knee effusion, popliteal cyst, bone on bone lack of cartilage etc.
Morbid obesity plus age plus osteoarthritis plus injury = knee problems. It is what it is i guess.
Hope that helps you understand why they declined the surgery. Pretty common occurrence.
Blessings.
n
Thank you for the detail explanation.I'm glad you did so because your initial statement that Mayo refused to do the operation (without explanation of obesity factor) candidly,seems a negative assessment of Mayo.I wish you the best.
Where or how do I find the Mayo Clinic videos on rehab stretches?
Just to clarify, i was in no way was i making a negative assessment of the Mayo. Sometimes the continuity of a discussion gets lost. I think i remember mentioning about my morbid obesity in a previous post. However, just to clarify so that no one gets confused here is some information about medically complicated morbid obesity and TKAs.
There are risks that go with medically complicated morbid obesity. Some physicians won’t do over BMI 40. Some do 40-45
and some 45-50. Comes with the territory. The following paragraph explains why physicians decline to do the surgery on morbidly obese people.
Restricted access
Because of the increased risks of complications, it is common practice for some surgeons to restrict the use of TKA in patients with a BMI of 40 or higher. Based on the current available data, many surgeons and surgeon groups across the country withhold surgical intervention in morbidly obese patients until body weight is optimized and associated medical comorbidities are better controlled.3 There may always be exceptions to this type of policy, and opponents to this position do exist. Nevertheless, the medical and societal implications of withholding TKA in morbidly obese patients are unknown.
Hi, @niazumbanut. I'm wondering if you would mind posting the link to the particular video you saw and liked on post-knee replacement exercises? I think it might be of interest to various members who've been talking about knee replacement, and it would be great to be sure of finding the right one.
I'm sorry if I'm not writing in the proper place here. I'm a newbie ;o) Did you have the MUA? If so did help? I'm facing the same thing and scared to death!
Hello @barefoottwin, and welcome to Connect. You did post in the right place. We have multiple discussions on knee replacements here on Connect. Here is another one that is quite active, https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/. That discussion has been a bit more active more recently, so you may be interested in clicking on the link and reading through some of the things the members have shared.
I had my right knee replaced in in 2006. I had aggressive scar tissue formation and had to have two manipulations to try and break up the scar tissue. Eventually, after a year plus, I achieved 0-110 ROM. It was not an easy road, but it has been worth it in the end. I was fighting years of bone damage, so my right knee had not been straightened to 0 for well over a decade. When I woke up for my manipulation they had my leg in a brace straightened to 0 degrees. As you can imagine, all of those muscles and tendons were screaming because they were being stretched in a way they had not been stretched in a decade. I can understand your fears, especially since we are all so different and our bodies react differently.
@barefoottwin, if you don't mind me asking, how is your range of motion right now?