Knee Replacement Stuck at 110 ROM

Posted by dkapustin @dkapustin, Apr 2, 2019

Hi everyone, I had a RTKR 9 weeks ago and seem to be stuck at 110/0 for the last few weeks. My OS saw me a couple of weeks and scheduled my next appointment for 3 months out. My PT said that I can gain ROM for months and that a person can live a full like at 110 and not worry about it. Well, I am worried about because I do ALL of my exercises religiously, push myself, am still swollen and in pain, and walk like I have a wooden leg using my cane. At 9 weeks, I feel as if I should be doing so much better and I'm becoming scared and depressed. Has anyone else had a slow and frustrating recovery like this? Anyone at 110 Rom at 9 weeks and then improved at a later time? Thanks in advance.

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@dkapustin

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.

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@dkapustin -- I am sorry about the amount of pain you are in! I don't have any experience regarding pain with Total Knee Replacement; however, I do know pain! So, if it were me, I would make an appointment with the surgeon. We all feel we are being "silly" for going "ahead of schedule", BUT we are all different, not to mention that there could be other reasons for your pain. Let the surgeon tell you if everything is OK. And if it is, maybe he can give you advice on how to handle the pain, or medication suitable for your level of pain. Stay well!
-- Dee

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@dkapustin

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.

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Time, I think, will be eventually easing the pain. Hope that you can get help from your OS for now. I did not have a turning point either, it just got less as time went on. Sure, I could have taken OTC medicines like Aleve - the only thing that seems to work for me - , but I prefer not to stress my system with too much stuff. Also, as far as I was concerned, what’s the ultimate point of having had the TKR if I still needed daily pain medication? If I wanted to dose myself up to the limit, I could perhaps have waited another year or so. Summary: it will certainly get less painful, and I hope this happens soon for you. It did not, however, totally eliminate temporary pain at a medium to low level, at certain times (like weather changes, or intense activities like yard work), but I did not expect it to. Hoping, yes. But alas, no.

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@dkapustin I went to a PT for hip bursitis this week and while there had him measure the flex in my knees. The one done in October 2017 is stuck at 115, the one done about five years earlier is at 125, and it was only at about 120 a year and a half ago, so it can improve apparently.
The therapist said it is more important to be able to get to 0 degrees than to get to 120 or more, because if you can't make your leg totally straight your knees can buckle. How is that number for you?
I just did some googling and found this. I do not know how reliable the site it is from is though. You can function fairly well with 115, I am proof of that.

"Range of Motion Basics After Knee Replacement Surgery. ... A fully bent knee will max out at about a full range of motion of 135° degrees of flexion. As a general rule, a knee flexion of about 125° will allow you to carry out most normal activities. For daily living, a minimum flexion of around 105°-110° is required. Jul 5, 2017"
JK

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@contentandwell

@dkapustin I went to a PT for hip bursitis this week and while there had him measure the flex in my knees. The one done in October 2017 is stuck at 115, the one done about five years earlier is at 125, and it was only at about 120 a year and a half ago, so it can improve apparently.
The therapist said it is more important to be able to get to 0 degrees than to get to 120 or more, because if you can't make your leg totally straight your knees can buckle. How is that number for you?
I just did some googling and found this. I do not know how reliable the site it is from is though. You can function fairly well with 115, I am proof of that.

"Range of Motion Basics After Knee Replacement Surgery. ... A fully bent knee will max out at about a full range of motion of 135° degrees of flexion. As a general rule, a knee flexion of about 125° will allow you to carry out most normal activities. For daily living, a minimum flexion of around 105°-110° is required. Jul 5, 2017"
JK

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Sounds like your exercise regimen has paid off, since your ROM is still improving. Mine was measured at 132 a few weeks ago when I had PT for a hip issue, so that part is good. But I am still working every single day on keeping full extension - and yes, 0 extension really is more important for stabiiity and normal gait, as I found out. You are a very determined, and well-execised lady!

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@ellerbracke

Sounds like your exercise regimen has paid off, since your ROM is still improving. Mine was measured at 132 a few weeks ago when I had PT for a hip issue, so that part is good. But I am still working every single day on keeping full extension - and yes, 0 extension really is more important for stabiiity and normal gait, as I found out. You are a very determined, and well-execised lady!

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@ellerbracke I will never hit 132, that’s phenomenal, but I would be thrilled to get to 120 on my L knee.
JK

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I am 3 weeks post Op and as of the day of surgery I was measured at 95 degrees. Once the pain and swelling hit during PT is was measured at 70 degrees. My knee is stiff and hurts kinda bad. My PT says I am behind where I need to be. I am busting my ass at PT and home so I don’t know what more I can do. So after 3 weeks I was just measured at 80 degrees. How abnormal is this?

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I hear you very loud. Tormented myself also had the Surgeron continuely say you should have better range @ each appointment. Doing physio 3x wkly, Pt x2 wkly, pool exercise x4-5 wkly. Daily home exercises. Post opp 11wks 90% range of movement. Last 3.5 wks, gave up on torment push on knee bending, but still doing all these exercises, but with my home exercises l shifted to strength rather than pushing the bend. Need the ability to stand & have strong legs plus had a L THP 12mths ago. Goal now is next knee in 4mths & return to ward Nursing so l need strong legs. Everyone is different, please don't waste mind torment got to feel mentally ok (important) lf your doing everything time is what is needed. 6wk window is only a goodbye to Surgeron & everything is ok, that's why they push for range within that time. Takecare & keep ok.

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@captjamesh

I am 3 weeks post Op and as of the day of surgery I was measured at 95 degrees. Once the pain and swelling hit during PT is was measured at 70 degrees. My knee is stiff and hurts kinda bad. My PT says I am behind where I need to be. I am busting my ass at PT and home so I don’t know what more I can do. So after 3 weeks I was just measured at 80 degrees. How abnormal is this?

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Hello @captjamesh, You will notice we merged your discussion with a similar existing discussion on Knee replacement and range of motion problems. @dkapustin @klarnold and other members may have some suggestions for you.

Icing and elevating was a problem for me. I wasn't doing enough of it according to my care team. Are you still icing and elevating the knee during the day when you are not exercising and doing PT?

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@johnbishop

Hello @captjamesh, You will notice we merged your discussion with a similar existing discussion on Knee replacement and range of motion problems. @dkapustin @klarnold and other members may have some suggestions for you.

Icing and elevating was a problem for me. I wasn't doing enough of it according to my care team. Are you still icing and elevating the knee during the day when you are not exercising and doing PT?

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I have a icing regiment of 6 times a day for 30 mins each. I use a compression sock for at least 2-3 hours as well

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@captjamesh

I have a icing regiment of 6 times a day for 30 mins each. I use a compression sock for at least 2-3 hours as well

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@captjamesh, My surgeon prescribed oxycodone to help if I had pain for the first few weeks. I didn't have to use any of the prescribed pain pills but I did use some Tylenol the first couple of weeks when I had some pain. Did they prescribe anything to help you with the pain or have you talked to your surgeon or care team about how you are doing?

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