Limited ROM after total knee replacement.

@ellerbracke My ortho doctor has quite different ideas than most, and his success rate is huge. He advises "gentle PT". The in-home physical therapist had worked with his patients before and seen the successes so was happy to abide by that. The outpatient PT had no idea what to do with me, he was pretty much useless.
JK

Well, retroactively (in case there’s knee # 2 in the future), that is basically what I was asking regarding PT. My therapist instructed - meaning showed me exactly what to do, so I would do it correctly, - and then left it up to me how hard and how often I can/want to do it. Sounds close to “gentle” PT?

@ellerbracke - My doctor ordered in-home PT 3 times a week until I was able to drive, then outpatient twice a week for 6 to 8 weeks. I'm doing this with my left TKR now (surgery 1/29) and I did it with my right TKR (done in April 2017). I thought that the PT was one of the key factors in my successful recovery. My therapists give me the exercises, watch me do them, correct my form when needed, and walk with me when we do outside walks. It's kind of like having a personal trainer. I definitely push myself harder when I'm with the therapist vs. the days I'm on my own. I may be especially fortunate to have GREAT therapists, but both of them have anticipated when I could do more, encouraged me to try harder AND reigned me in when I tried to do too much. Last week, I was at 3 weeks post-surgery and I had full knee extension and 128 degrees flexion. My outpatient physical therapist says we are going to work on balance and functional skills along with maintaining the ROM - and getting up to 130 degrees where I was before the surgery. Bottom line is that I would not have been where I am without these caring and skilled physical therapists.

Congratulations! I'm sure a lot of your positive outcome was due to your perseverance as well!

@ellerbracke If you want to progress you need to exercise the knee frequently, preferably daily. I think what my ortho had in mind was to not push it to the point of excruciating pain. When I had my first TKR, the PT I went to would bend my knee until I very literally screamed. I ended up hurting so much the next day that I couldn't exercise my knee at all. From what I have heard, this is not uncommon. You definitely need to work the knee and to do it pretty much daily. My ortho is opposed to is doing it to the point of extreme pain. He actually thinks patients can do as well with recumbent bikes, moving the seat closer and closer as you increase the bend in your knee, and also water jogging! He is totally, completely opposed to the equipment where you put your feet on a platform and it pushes your legs toward your body -- I forget the name of it. He is also opposed to icing the knee! According to him, ice prevents the blood from circulating to the wounded area, and the blood is healing. I think it was six weeks at which he was OK with ice. I know he sounds unorthodox but he is very successful and there are literally people from all over the country who go to him.
JK

@debbraw WOW Debbra, that's wonderful. It sounds like you had a good surgery and great PT. You are very fortunate. I am sure you had a lot to do with having such a successful recovery too, so give yourself a pat on the back. My in-home PT was similar to what you describe. My outpatient one - not so much.
JK

Debbra: WOW! Sounds like you are doing super well, at this early stage. Even though I had 104 degree flex on day 2 after surgery, it took me about 6 weeks to get to 128, and almost 4 months to finally get full extension. I blame the latter on the fact that I had had a knee scope 11 months before the TKR that was not helpful at all, and I was in pretty much constant pain during those 11 months, and probably underused the knee. I wish you continued success, and it is nice to have someone show the positive result to balance all the negative side effects that people have reported. Way to go!

The FDA does not test most devices implanted in humans.
https://www.newscentermaine.com/mobile/article/news/fda-does-not-test-most-devices-implanted-in-humans-and-one-woman-is-paying-for-it/97-560e3fe1-c171-407d-b49e-c43a9b76ab84
Check your implant for medical safety history:
https://medicaldevices.icij.org/
Compare against with surgeon to see if they are receiving payments from the medical device company manufacturing the device they implanted in you:
https://openpaymentsdata.cms.gov/

I had knee replacement surgery in June last year.l had good movement at first. Then l started to be not able to bend my knee and struggle to go up and down stairs. I attended some physical therapy sessions and on the bike possibly extended to far,, causing severe pain. I was wondering if l could have damaged the replacement, or moved it. I have had a manipulation and also x Ray. Which shows no damage. Have constant swelling also. I did all the exercises daily. I will be seeing the surgeon next week. Do not really want to have any more surgery. Any suggestions on how l could improve this?.

Hi @donheads - Welcome to Connect! Glad you checked in here. I am also glad to hear that you will see your OS next week. I've had two knee replacements and I'm happy to say that I didn't experience the kind of setback you are describing. But everyone is different and I have read posts from people who did have this kind of difficulty. I'm going to tag a few others who have had TKR's and might be able to share some insight: @ellerbracke, @cobweb, and @gutthookd. Meantime, could you share some more information on when you had the manipulation? Did the surgeon talk about scar tissue being a possible factor in your losing ROM?
Here is a thread that might interest you:
https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/?pg=39#comment-272223
I'm wishing you the best and hoping we can get a conversation going that will address some of your concerns.