Soreness and stiffness 10 months post TKR

I bet to differ, if you have had success with your surgery wonderful. There is that small percentage that wont and no amount of physical therapy will change that. I had both knees replaced in 2018, within weeks my knees started getting stiff and I had the most debilitating pain. My knees felt like they were on fire and I constantly felt like I was being electrocuted. I was going to PT 3 days a week. 2 months after surgery I landed in the ER, my doctor had no clue why this was happening he couldn’t help. I went to another doctor, he was baffled and I went to a third. By 8 months I could straighten my right knee but only bend 60% and my left knee was stuck at about 45 degrees. He decided to redo my left at the 1 year mark, I came out of surgery and within weeks my knee was again getting stiff and the pain was unbearable. Within 3 months I had a manipulation and nothing changed. My doctor couldn’t figure out why my knee was not improving and got to the point where I was told I was making it all up to get opioids and I was dismissed as a patient. All of this while I’m still going to PT. One day my therapist told me I had really bad Arthrofibrosis and recommended me to a surgeon she knew. My first visit he told me I had CRPS and sent me off to pain management to get my pain under control before he could do anything about my knee. I ended up with a spinal chord stimulator, monthly visits to pain management, I was doing Ketamine infusions to combat the pain. After a few months he again revised my knee. I had so much scar tissue, in his words “ he gutted my knees” After surgery I felt some relief from the pain in my left knee but the pain in my right knee was almost unbearable. I was on a mission after this second revision to keep my knee straight, and have as much motion as possible. I kept my knee straight but I was never able to get more than 60 degrees flexion. Within 4 months I only had 25 degree flexion and 3 years later that’s where it’s at. During this time I started loosing motion in my right knee and it became worse than the left. The pain was so bad I was getting nerve blocks every 3 months. It got to the point where my knee was stuck at 40 degrees flexion and I couldn’t move it at all. No amount of PT was going to change that. I ended up with a mobility scooter. I went back to my surgeon who had done my last surgery and he was honest, he told me he would not do another surgery because he did not know how to stop the growth of the scar tissue in my knee which was the culprit. He referred me to another doctor and I knew they were going to do the same thing and within months I would be back in the same position I decided to start looking for better solutions and I ended up at the Mayo Clinic. This was a game changer. They have an ongoing research study to try to understand why scar tissue forms so rapidly in some patients and a protocol to treat said patients. I am a part of the research study, I had my surgery 5 weeks ago and my debilitating pain is gone, I can get out of a chair by myself, I have full extension in my knee and about 95 degree flexion. I’m working on it every day. This is the best I have felt in 5 years. Scar tissue is your worse enemy after TKR, for sone of us no amount of PT is going to stop it, I’m heading back next summer to get my left knee revised for the third time and hopefully I will have my life completely back. It’s been quite the journey. The last 5 years have been rough but finally I’m on the path to recovery.

Thank you for sharing such detail. I also still struggle with my rehab (Left TKR Jan 2023) and have have some people insert their opinion to just do the work. I was a college athlete and active until the TKR although modified activity for some things. I had pain before and pain now. I did three months of extensive prehab and have been doing at home exercises seven days a week (missed 2 days in 7 months because of family emergency) as well as going to PT three times a week. So many people look from outside and determine what your 'issue' is without knowing. Good for you that you finally have some relief and perhaps others in your position will be able to draw from your post to push to visit Mayo for scar tissue resolution. Good luck in your future rehab and carry on with the journey.

For all the people on here complaining about pain and stiffness, how much work did you put into your recovery (not to mention exercises prior to surgery - and yes, you can do exercises that avoid all or most pain prior to surgery)?

My surgeon told me a successful recovery from TKR is 10% the work/skill of the surgeon and 90% the work/commitment of the patient.

There is no silver bullet here, no magic pill. If you want a happy TKR recovery you have to work for it.

I bet to differ, if you have had success with your surgery wonderful. There is that small percentage that wont and no amount of physical therapy will change that. I had both knees replaced in 2018, within weeks my knees started getting stiff and I had the most debilitating pain. My knees felt like they were on fire and I constantly felt like I was being electrocuted. I was going to PT 3 days a week. 2 months after surgery I landed in the ER, my doctor had no clue why this was happening he couldn’t help. I went to another doctor, he was baffled and I went to a third. By 8 months I could straighten my right knee but only bend 60% and my left knee was stuck at about 45 degrees. He decided to redo my left at the 1 year mark, I came out of surgery and within weeks my knee was again getting stiff and the pain was unbearable. Within 3 months I had a manipulation and nothing changed. My doctor couldn’t figure out why my knee was not improving and got to the point where I was told I was making it all up to get opioids and I was dismissed as a patient. All of this while I’m still going to PT. One day my therapist told me I had really bad Arthrofibrosis and recommended me to a surgeon she knew. My first visit he told me I had CRPS and sent me off to pain management to get my pain under control before he could do anything about my knee. I ended up with a spinal chord stimulator, monthly visits to pain management, I was doing Ketamine infusions to combat the pain. After a few months he again revised my knee. I had so much scar tissue, in his words “ he gutted my knees” After surgery I felt some relief from the pain in my left knee but the pain in my right knee was almost unbearable. I was on a mission after this second revision to keep my knee straight, and have as much motion as possible. I kept my knee straight but I was never able to get more than 60 degrees flexion. Within 4 months I only had 25 degree flexion and 3 years later that’s where it’s at. During this time I started loosing motion in my right knee and it became worse than the left. The pain was so bad I was getting nerve blocks every 3 months. It got to the point where my knee was stuck at 40 degrees flexion and I couldn’t move it at all. No amount of PT was going to change that. I ended up with a mobility scooter. I went back to my surgeon who had done my last surgery and he was honest, he told me he would not do another surgery because he did not know how to stop the growth of the scar tissue in my knee which was the culprit. He referred me to another doctor and I knew they were going to do the same thing and within months I would be back in the same position I decided to start looking for better solutions and I ended up at the Mayo Clinic. This was a game changer. They have an ongoing research study to try to understand why scar tissue forms so rapidly in some patients and a protocol to treat said patients. I am a part of the research study, I had my surgery 5 weeks ago and my debilitating pain is gone, I can get out of a chair by myself, I have full extension in my knee and about 95 degree flexion. I’m working on it every day. This is the best I have felt in 5 years. Scar tissue is your worse enemy after TKR, for sone of us no amount of PT is going to stop it, I’m heading back next summer to get my left knee revised for the third time and hopefully I will have my life completely back. It’s been quite the journey. The last 5 years have been rough but finally I’m on the path to recovery.

Yes you are one of the fortunate few. I had bilateral knee surgery in late Feb this year. I had so much swelling and bruising that it made it difficult to do my exercise. I persevered, but even with daily exercises, going to physio, both my knees were stuck.
My left was 75° and my right was 55°. The physio therapist was baffled that the joints just stopped at that. I had an MUA on July 5. It has improved ... my right is now pushing 77° with a -9° extension, and my left finally reached over 90° the other day, it was 98° and extension was -2°.
The cement feeling in my knees and the gridlock was due to scar tissue. I have osteoarthritis in both knees, and a bit in my wrists. Scar tissue is not pleasant, and some has returned, but I'm determined to kick its arse to the curb. I will say though, that what this 5 month journey has done for me, is that I don't want to go through knee surgery ever again, nor an MUA for that matter. I really feel for other patients who have scar tissue . It's debilitating. It makes us feel that there is no hope. I had the surgery because I was bone on bone, but at least I had a 118° left knee bend, and 123° right knee bend before my surgery in Feb. Hindsight is 50/50.
We don't all have that success story to tell. My surgeon kept pushing more and more pain meds , I said NO more after 4 mths of hell. They are very quick to prescribe the opiates, but it's not for me. I'm back to extra strength Tylenol 500 mg, only when i need it, especially at night. I take cbd oil occasionally to get me through the day. I'm getting my life back and it's not going to be on opiates, because they're not for me. Doctors need to quit thinking that every patient is cookie cut exactly the same way and that they should all recover the same. That's been my beef over this. Kudos to you and all others who have a happiest of success stories. My journey isn't over .. but I'll get there. Good luck to all other patients who are struggling with crappy ROM, I know how you feel. Praying 🙏 for all partial knee replacement and total knee replacement patients. I'm in your court. Cheers.

Thanks Scorpio. I admire your persistence. There is no reason that your ROM was better, much better, before surgery. Other than pushing opiates, which is concerning all by itself, how does your surgeon account for these results?

I admit I don't know much about how scar tissue forms. I strongly suspected it was activity based, that is, more activity, less scar tissue.

I'd try and get some answers from your surgeon. And then look into finding a new surgeon. All the best to you.

@heyjoe415
I worked very hard for 7 months pre-op and immediately started PT post-surgery at a facility 3 times a week and daily at home. I could not get ROM and had to have an MUA. I lived with horrible pain and swelling for months and lack of sleep. I know I worked harder than most and the end result was still not wonderful. There are no guarantees and each person is very different, no common thread of if you do this you are guaranteed that. I am now in my 21st month of PT and still working. I never stopped.