Can't extend leg past 10 degrees 8 weeks post tkr

Posted by tstansberry @tstansberry, Jan 24 5:13pm

My knee has been bad for up to 5 years now, had seen a supposedly top notch Dr back then and was told nothing was wrong with my knee. I was limping due to pain and couldn't go up or down stairs/inclines without pain. I finally got a second opinion and got a total knee replacement. I came out of anesthesia screaming from pain. I didn't find out why until almost 3 weeks later, I had developed piriformis syndrome due to the surgery. This has critically hindered my physical therapy. I'm 8 weeks post op and the piriformis syndrome has improved significantly but still not gone. I can only straighten my leg to 10 degrees. My knee isn't swollen and all the pain is on the back of my knee and radiates up to my butt and down my lower leg. No pain on front or around my knee. My physical therapist says to keep working on hamstring stretches, which I do, and I'm pretty faithful with all exercises. Can anyone give me any other ideas, and is it ever going to be possible to get my extension where it needs to be? I'm getting discouraged.

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cathymw | @cathymw | Jan 26 8:04am

May speak with surgeon as it’s critical to address possible scaring before it’s too late to fix it by an MUA. Recommended before 12 weeks to be most effective.

Your joint is not a functional joint at this point. I did PT 3x/wk, taking 5mg oxycodone before, as the therapists worked hard to get me to bend or flatten- to no avail. Had the manipulation under anesthesia and gained almost 30*, and now can flatten my leg.
Had to really make noise and be my own advocate. Your nerve issue slowed you down and you probably formed scar tissue around that joint ( I do not mean scars on the incision either). Arthrofibrotic bands of scarring tissue.

tstansberry | @tstansberry | Jan 26 9:55am

In reply to @cathymw "May speak with surgeon as it’s critical to address possible scaring before it’s too late to..." + (show)

The therapist can push my knee down flat, it's just very painful in my butt and behind my knee. I'm physically not able to put enough pressure to do that myself. I just started having my husband do the same since my pt is only 2x/wk. Hopefully this will help. Also, I know that from years of compensating and limping it probably wasn't straight for a long time. I will talk to my pt on Tuesday when I go to see what she thinks about your recommendation, thank you so much for your reply!

cathymw | @cathymw | Jan 26 12:17pm

I added weights as well, and bands, under the PT’s guidance. I too still have my spouse push my knee down every other day, as I never want to regress. When I didn’t do it over the holidays, I lost some progress and had to start all over again.
When reading, I extend my leg to a coffee table and put a 5# wt on my knee for 15 minute times.
I did use an ice machine during the night and after exercises for the first 4- 5 months. Really helpful for comfort.
Best wishes. Keep at it. Time is ticking for an MUA.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9957883/

tstansberry | @tstansberry | Jan 26 1:34pm

In reply to @cathymw "I added weights as well, and bands, under the PT’s guidance. I too still have my..." + (show)

Thank you so much for your reply, you've been very helpful ❤️

cathymw | @cathymw | Jan 26 2:41pm

Spouse is driving and I’m a passenger on a long trip 👍🏽

cbsculpt | @cbsculpt | Jan 26 2:55pm

It’s been 5 months since my hip replacement surgery and I am still limping and can’t raise my leg when lying on my side. I can’t put all my weight on my leg. I’ve done 6 weeks of physio and I exercise daily.