← Return to Limited ROM after total knee replacement.

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Limited ROM after total knee replacement.

Joint Replacements | Last Active: May 26, 2019 | Replies (51)

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@billyro7

I am a 67 yr old male and had right TKR surgery on 10/18/18, with P/T 2x per week through mid January 2019 (with daily exercises at home which continue). My problem is that the knee remains stiff with limited ROM (90 degees) and unable to straighten my leg, (approx. 11-14 degrees from straight). Occasionally I have some discomfort, but it's mostly the result of the stiffness, so pain is not the primary issue...stiffness and limited ROM is the problem. The stiffness has been since surgery and the ROM seems to have plateaued at about 6 weeks post op. Since than it's like the movie Groundhog Day...every day the knee is the same stiffness (or a little more) as the day before no matter what I do. Because of this, I had MUA on 12/11/18, which really did not help at all, other than to have pain/soreness for a week or so afterwards, and followed this with 2 weeks of aggressive P/T. My surgeon said he was able to get full ROM of the knee under anesthesia. However, when I'm not under, there has been no change in ROM. About two weeks ago I saw the surgeon and he said it could be arthrofibrosis which may require additional surgery, but he wanted me to keep exercising and working the knee for a while and he didn't yet want to consider the additional surgery. I've kept up the exercises, in addition to using a stationary bike and treadmill at the gym several times per week. Nothing I do seems to lessen the stiffness. On the contrary, everything I do seems to result is stiffness, stiffness and more stiffness. Even icing the knee. I plan to keep on exercising the knee, but it sure does get angry at me after working it out. It feels like something is wrapped around my knee joint tightly so that I can only bend or straighten it so far. Reading the various posts here makes me realize there are many people with the same or similar problem. I've also read (and heard from some others) that they do something accidentally that makes the knee pop and get freed up. Any suggestions on attacking this problem? I really don't want more surgery on the same knee, but I also would like more, not necessarily 100% full, ROM. Also, surgery to remove scar tissue/fibroids can be arthroscopically or open the knee up. The latter really scares me, but I can't go on forever like this. In addition, my left knee is also bone on bone and needs to be replaced, but after this experience, I can't even think about that. I've read that because I had this experience with one knee does not necessarily mean that the other knee will have the same problems post op. Any helpful input would be appreciated.

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Replies to "I am a 67 yr old male and had right TKR surgery on 10/18/18, with P/T..."

@billyro7 Hi Billy. Your knee sounds painful. I had a TKR in October 2017, my second, and was in a lot of pain initially but the pain lifted at around 6 weeks.
The stationary bike is one of the two exercises my ortho recommends most highly. The other is water jogging - minimal impact. According to him, the treadmill does not help with knees, although it is good cardio.

My flex is not as good as I would like it so I may have a very surgery, lysis, to improve it. If that is what your doctor is suggesting it is not major, it is OP and pretty simple I believe. Most doctors say you can improve your ROM for up to at least a year so if you keep at it you do have plenty of time still. It is important to keep at it though.
Some physical therapists are much better than others. I had a great one for in-home PT while I was home-bound. Then I went to outpatient PT and had one I had used in the past for other problems but he did not do very well with PT for my knee. I only went to him for a short time. If one is not helping you should change, get some recommendations from other people who have had TKRs.

My doctor, like the doctors at Mayo and at probably all major medical centers, works for the hospital, he is not in private practice, so I don't think he would recommend it for personal monetary gain, although I am sure doctors are expected to bring in a certain amount of revenue no matter what hospital they are attached to. It simply is not ethical to do that, whether the doctor is in private practice or part of a hospital staff though.
The suggestion to find a hospital close to you that is highly rated for orthopedics is a good one. I live about 55 miles from Boston so I have a number of excellent hospitals to choose from.
Keep us up to date on your progress, I hope it will improve.
JK