Knee Replacement Stuck at 110 ROM

Hello @dkapustin. I had my right knee replaced in 2006 when I was 19 due to end-stage arthritis caused by a genetic bleeding disorder. My recovery was rough. I had to have two manipulation surgeries after the initial replacement because I had such aggressive scar tissue growth. My initial ROM was 15-60 degrees, it was awful. Eventually I got my knee to loosen (well over a year after the first surgery). My ending ROM that I am still at 13 years later is 0-110ish. That ROM does not inhibit anything I do, other than the occasional annoyance I can't comfortable cross my right knee up on to my left leg which is what I naturally did prior to surgery. It feels awkward to cross my left leg on to my right one, so this is just a cosmetic annoyance, not necessarily a functional one.

@dkapustin, do you know if it is scar tissue that is holding you back from gaining more? We all recover so differently from surgeries, some get full ROM right away and some like me have a real difficult time getting any. Personally, 0-110 is no issue for me. I still lift weights, do leg presses, golf, etc. with no issues. What ROM are your hoping to achieve?

I was hoping to get to 120 but I learned that I can live my life just fine with 110. I range anywhere from 105-115 depending on how swollen and sore I am but it average to about 110. I'm not sure what is going on but the leg is so stiff I am trying to learn to walk normally now while at least working towards not loosing any ROM. I walk like a pirate with a wooden leg and I don't understand why since I can certainly bend it to walk like with the other leg. It sounds like you had a very rough recovery and I am so sorry for that. This is my first TKR and I joined several Facebook groups and all I read about was ROM and MUA's. I am terrified of getting an MUA because I have Osteoporosis and have had a hip replacement on the TKR side so the fracture risk is higher for me than with other people. So I really tried to get the ROM right within the first 8 weeks but being stuck at 110 has me worried about what the surgeon will say if I don't improve. I suspect I may be worrying too much but, honestly, I've been diligent with my exercise, pushed myself hard, and am failing to understand why I haven't progressed more. It's very frustrating.

@dkapustin -- I wanted to mention to you that there is a possibility that PRP may help the ligaments in the TKR area. You should discuss this with the doctor at Regenexx. 🙂
--Dee

@dkapustin I understand your frustration. I really thought my second knee would hit 120 but it hasn't. I have PT next week for a different problem so I think I will ask the therapist to measure my ROM when I am there. I was going to have lysis but I think I will probably leave well enough alone, it's really not worth another surgery, no matter how small it is supposed to be. I can live with this, what the flex is, maybe 115.
JK

@contentandwell Actually, you are right. I can live a full life with s 110 ROM, I was just hoping to have better. Maybe we both will, ROM can be gained long after the surgery and PT. As long as I can do the things I did before surgery, it's fine. My goal now is to walk normally.

I had the opposite problem - great ROM, but in spite of diligent exercises only achieved full extension after 4 months. So I also walked sort of lopsided for a long time. It helped some that I kept telling myself / my brain, that my TKR knee is just a regular knee.... and to use it as such. Mental acrobatics, but even if it sounds weird, it did work to a certain extent.
Now - after almost 7 months post surgery, I still exercise the knee most days. Not sure if this is necessary, really, but I don’t want to regress.

@ellerbrack I am starting to use the "mental" approach to trying to walk normal too. MY PT got me to 118 ROM yesterday and told me that it tells them and my OS (they send him reports) that there is no problem or scar tissue preventing me from getting there, it's just pain. With reduction of pain and swelling, plus continued exercise, I'll gain ROM. I am at 2 for extension and continuing exercise but walk like a pirate. I'm going to try your approach.

Hating to sound like a broken record, or ad for a spa: get yourself into a pool membership, if you have access. Makes the exercises easiier, less painful, and at this point you would be right there participating either in classes, or doing your own thing. Big bragging: I just moved up to 70 10-Meter laps in an indoor pool... getting close to 1/2 mile. (TKR 09/13).
And yes, go ahead and just try whatever helps. Not sure how old your are, but when I was working age, there was a song called Quanta na Mera (Spelling), that I run in my mind when I walk.. No particular reason, but it works.

I’ve heard that water therapy is the way to go. That was my plan and I just wanted to ensure that my sutures were totally closed before getting into the “house of bacteria!” They are closed now so I’m reading to start! I really don’t know why I’m in so much pain 10 weeks out but my PT swears there’s no need to see my OS early. They say it’s normal. I really keep waiting for that big turning point regarding pain that everyone talks about.

@ellerbracke @dkapustin I resumed water exercises as soon as my incisions were healed, and continue to exercise in the pool at least three days a week. Generally, I do a class for 45 minutes to an hour and then continue with water jogging long enough to bring me to at least 90 minutes.

I am not sure what my ROM is now, I know my extension is fine, but I think my flex is a bit under 120. Along with that, I would recommend one thing that I started too late to really help. At the end of exercising, stand with your back to the pool wall and bend your leg putting your foot on the wall as high as you can and hold it there for 5 or 10 seconds. It is of course similar to the slides you do sitting but I think I can go further with it in the pool.

I am a huge advocate for pool exercise. It's low impact and can really be aerobic too. The other day in class I checked my watch and I was up to 140 BPM! If you have a pool at a Y or a health club you can use, go for it. That and my recumbent bike were the two things my ortho most highly recommended. He said the treadmill really does not help, but the elliptical is good too.
JK