Limited ROM 5 years after TKR

Posted by roknrol101 @roknrol101, Fri, Sep 27 8:26pm

Can someone please help me! Had TKR 5 years ago, both knees! Went to PT on the first one bit it hard and it’s great, no pain excellent ROM, not so on second, went to different PT and not as aggressive on Theropy, now have limited ROM on second knee, and swelling and stiffness, is it possible to regain ROM after that long without surgery

Hi @roknrol101 – First, welcome to Connect! I'm glad you found this group. Great people here with plenty of TKR experience. I have had both knees replaced – two years apart. My most recent one was January of this year. I definitely think physical therapy could help you regain ROM. Anytime we exercise and work out our joints and muscles, it helps increase flexibility and doing it under the direction of a knowledgeable therapist should just add to the benefit. At the same time, I'm thinking that after 5 years, you might want to schedule a re-check with you orthopedic surgeon just to ensure that there aren't other contributing factors like scar tissue, etc. When you say limited ROM and swelling, can you share some specifics… how much ROM? a little swelling occasionally or lots of swelling every day? Also, what do you think about having the OS do a re-check?

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@debbraw

Hi @roknrol101 – First, welcome to Connect! I'm glad you found this group. Great people here with plenty of TKR experience. I have had both knees replaced – two years apart. My most recent one was January of this year. I definitely think physical therapy could help you regain ROM. Anytime we exercise and work out our joints and muscles, it helps increase flexibility and doing it under the direction of a knowledgeable therapist should just add to the benefit. At the same time, I'm thinking that after 5 years, you might want to schedule a re-check with you orthopedic surgeon just to ensure that there aren't other contributing factors like scar tissue, etc. When you say limited ROM and swelling, can you share some specifics… how much ROM? a little swelling occasionally or lots of swelling every day? Also, what do you think about having the OS do a re-check?

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Hi Debbra, thank you for responding, I had both done 4 months apart, ROM is at about 95-100 degrees, moderate swelling is everyday after standing more than 30 minutes. Went back to my OS surgeon last week, and he says there is no scar tissue, and knee looks great structurally and says that my hip may be causing the swelling, so he X-rayed the hip and it is in need of replacement and I have had some discomfort in the hip area. He also said that a manipulation surgery is out because of the time frame since my surgery. With that Your right about exercising because that is what he told me to continue with, so I am going to start exercising and working hard to get my leg stronger and increase ROM in my knee and start to prepare for a hip replacement.

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@roknrol101

Hi Debbra, thank you for responding, I had both done 4 months apart, ROM is at about 95-100 degrees, moderate swelling is everyday after standing more than 30 minutes. Went back to my OS surgeon last week, and he says there is no scar tissue, and knee looks great structurally and says that my hip may be causing the swelling, so he X-rayed the hip and it is in need of replacement and I have had some discomfort in the hip area. He also said that a manipulation surgery is out because of the time frame since my surgery. With that Your right about exercising because that is what he told me to continue with, so I am going to start exercising and working hard to get my leg stronger and increase ROM in my knee and start to prepare for a hip replacement.

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@roknrol101 – I'm glad to hear that your doctor feels good about what's going on with your knees. No scar tissue is GREAT! I haven't had a hip replacement, but I know that on my two knee replacements strengthening the muscles was a huge help. I can't say enough good things about doing "pre-hab" prior to joint replacement. You will go into it strong! And my friends who have had hip replacement surgery tell me its easier than TKR's. Wishing you the best. Have you scheduled the surgery yet?

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@roknrol101 HI, and welcome to Connect. I too have had TKRs on both knees, the R about 6 years ago and the L two years ago.

I think they say that not much can be gained in ROM after two years but I definitely did gain some on my R knee beyond that. I just think you cannot expect huge gains. ROM of 100 is not the best but it is manageable. I hope with exercise though that you will be able to get rid of the swelling and stiffness. That's a long time to still be experiencing that. My swelling did not last long at all, nor did my stiffness until recently because my activity has been limited due to an unrelated fracture. With so little exercise I am definitely feeling stiff.
If you don't get exercise pretty much daily, I would advise you to try to do that unless for some reason your doctor does not advise it. I use the elliptical at my health club and my recumbent bike at home. My orthopedic doctor told me after my TKR to ride my recumbent bike for 30 minutes a day, 5 consecutive days a week, and then two days of rest for recovery. Now I do more elliptical than bike simply because the elliptical gives me more cardio.
It's great to work with a good physical therapist, that can get you started on the right path of exercises you can do on your own. Since you know that the knee is good structurally, and there is no scar tissue, the exercise should help.
I am not sure how your hip could cause swelling in your knee but of course everything is connected. The exercise will definitely help with recovery if you do go for a hip replacement. On the bright side, from what I have heard, it is an easier recovery from a hip replacement than it is from a knee replacement.
JK

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If you don’t mind, how does he know you have no scar tissue ? I’m having same issue, TKR 5 years ago. Been to several docs, all say everything is alright ! Frustrating

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I had a knee replacement 8 years ago. Didn't know the importance of physical therapy. I had 2 weeks of home therapy that seemed too gentle. I then had 4 months of pt/ 3 and then 2 times a week, after leaving work. Usually 2 people would push and pull and force my leg to bend so much that there were finder print bruises over my leg. They would force it to get an ROM number to report to the surgeon. The best number was 93. Back to the Drs office, the P Asst had me step on the low stool to get on the couch. I stepped up with my TKR leg and she said that I the knee is fine. The Dr was busy, but came in and was reading the digital file and thought I was a different patient. He corrected himself, but I left without getting an answer to my poor ROM, which was considerable less than 93. Six 2nd opinions later, I finally found that my issue is SCAR TISSUE build-up. Two years ago, a different surgeon performed a Reconstruction and scrapped a lot of scaring. About five months of more intense therapy and now my knee is back to poor ROM. I decided to live with it, but now my other knee is bone on bone and I am afraid of SCAR TISSUE build-up again. I understand that some people are prone to haveng this issue and doctors do not really have a solution.

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@mclgracie

I had a knee replacement 8 years ago. Didn't know the importance of physical therapy. I had 2 weeks of home therapy that seemed too gentle. I then had 4 months of pt/ 3 and then 2 times a week, after leaving work. Usually 2 people would push and pull and force my leg to bend so much that there were finder print bruises over my leg. They would force it to get an ROM number to report to the surgeon. The best number was 93. Back to the Drs office, the P Asst had me step on the low stool to get on the couch. I stepped up with my TKR leg and she said that I the knee is fine. The Dr was busy, but came in and was reading the digital file and thought I was a different patient. He corrected himself, but I left without getting an answer to my poor ROM, which was considerable less than 93. Six 2nd opinions later, I finally found that my issue is SCAR TISSUE build-up. Two years ago, a different surgeon performed a Reconstruction and scrapped a lot of scaring. About five months of more intense therapy and now my knee is back to poor ROM. I decided to live with it, but now my other knee is bone on bone and I am afraid of SCAR TISSUE build-up again. I understand that some people are prone to haveng this issue and doctors do not really have a solution.

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Hi l had a full knee replacement over 1 year ago. I still have swelling. But what is really a problem got me is that l cannot bend my knee St all. So getting into a car or stairs is really tricky. I am waiting for a second opinion. Other knee is painful but there is no way l will risk another operation. Feel very down and it is affecting my job.

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@mclgracie

I had a knee replacement 8 years ago. Didn't know the importance of physical therapy. I had 2 weeks of home therapy that seemed too gentle. I then had 4 months of pt/ 3 and then 2 times a week, after leaving work. Usually 2 people would push and pull and force my leg to bend so much that there were finder print bruises over my leg. They would force it to get an ROM number to report to the surgeon. The best number was 93. Back to the Drs office, the P Asst had me step on the low stool to get on the couch. I stepped up with my TKR leg and she said that I the knee is fine. The Dr was busy, but came in and was reading the digital file and thought I was a different patient. He corrected himself, but I left without getting an answer to my poor ROM, which was considerable less than 93. Six 2nd opinions later, I finally found that my issue is SCAR TISSUE build-up. Two years ago, a different surgeon performed a Reconstruction and scrapped a lot of scaring. About five months of more intense therapy and now my knee is back to poor ROM. I decided to live with it, but now my other knee is bone on bone and I am afraid of SCAR TISSUE build-up again. I understand that some people are prone to haveng this issue and doctors do not really have a solution.

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@mclgracie I can understand why you would not want a second TKR under those circumstances. It is just the scar tissued that is standing in your way? How was your ROM after the reconstruction? Did it improve and then get worse again?
I know little about this, I have had two TKRs but if I have scar tissue it's not severe. My ROM never got beyond around 118 in one knee and 120 in the other — depending on who does the measuring.

@donheads When we are in pain or have a medical problem it really does affect us. I have had other issues and am feeling somewhat down about them. I am retired, but they have made me rather cantankerous at home and with friends. What does the doctor say about your lack of any flex? Is that from scar tissue also?
JK

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@contentandwell

@mclgracie I can understand why you would not want a second TKR under those circumstances. It is just the scar tissued that is standing in your way? How was your ROM after the reconstruction? Did it improve and then get worse again?
I know little about this, I have had two TKRs but if I have scar tissue it's not severe. My ROM never got beyond around 118 in one knee and 120 in the other — depending on who does the measuring.

@donheads When we are in pain or have a medical problem it really does affect us. I have had other issues and am feeling somewhat down about them. I am retired, but they have made me rather cantankerous at home and with friends. What does the doctor say about your lack of any flex? Is that from scar tissue also?
JK

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Thank you for your reply. My consultant and surgeon have said they do not think it is scar tissue. I have had a MRI scan to check that the replacement was measured correctly. So all l can do is wait for my second opinion.

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@donheads

Thank you for your reply. My consultant and surgeon have said they do not think it is scar tissue. I have had a MRI scan to check that the replacement was measured correctly. So all l can do is wait for my second opinion.

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@donheads I didn’t think of that as being a possible cause of limited ROM, but it definitely should be looked into. I knew a woman who walked in pain for two years before finding a doctor who found the problem, the new knee didn’t fit right.

I hope that this second opinion offers you a solution. Please let us know.
JK

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@donheads

Hi l had a full knee replacement over 1 year ago. I still have swelling. But what is really a problem got me is that l cannot bend my knee St all. So getting into a car or stairs is really tricky. I am waiting for a second opinion. Other knee is painful but there is no way l will risk another operation. Feel very down and it is affecting my job.

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Hello
I had a right TKR about 14 months ago and have extreme stiffness in that knee .
I have a stryker prosthesis and I was told by two MDs I cannot have an MRI .
I have since found out that I can and I think that’s the only way to find out whether it’s scar tissue or a malfittingprosthesis .
I cannot climb stairs well in my recumbent bike is a joke the first 15 minutes on it I struggle I just warm up and it takes me a long time to get into the rhythm of it and I won’t say it’s ever gentle on my knee. I only have 86° flexion and I’ve had to manipulations and 60 sessions of physical therapy .
So the first surgery was at the Baptist and I think I am heading into Boston again for a third opinion .

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@mwatts91757

Hello
I had a right TKR about 14 months ago and have extreme stiffness in that knee .
I have a stryker prosthesis and I was told by two MDs I cannot have an MRI .
I have since found out that I can and I think that’s the only way to find out whether it’s scar tissue or a malfittingprosthesis .
I cannot climb stairs well in my recumbent bike is a joke the first 15 minutes on it I struggle I just warm up and it takes me a long time to get into the rhythm of it and I won’t say it’s ever gentle on my knee. I only have 86° flexion and I’ve had to manipulations and 60 sessions of physical therapy .
So the first surgery was at the Baptist and I think I am heading into Boston again for a third opinion .

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@mwatts91757 There are so many great orthopedic doctors in Boston so you can’t go wrong if you choose carefully. A woman I know had a problem for two years and it was finally diagnosed and fixed by a Dr. Thornhill. I believe he’s at Brigham and Women’s. My TKR was done by Dr. Fitz at the same hospital. I think he’s great but I don’t know if he does revisions.
JK

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@contentandwell

@donheads I didn’t think of that as being a possible cause of limited ROM, but it definitely should be looked into. I knew a woman who walked in pain for two years before finding a doctor who found the problem, the new knee didn’t fit right.

I hope that this second opinion offers you a solution. Please let us know.
JK

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Thank you for your reply. I am just waiting for a appointment for second opinion, as this is at a different hospital to where the surgery took place.

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@contentandwell

@mwatts91757 There are so many great orthopedic doctors in Boston so you can’t go wrong if you choose carefully. A woman I know had a problem for two years and it was finally diagnosed and fixed by a Dr. Thornhill. I believe he’s at Brigham and Women’s. My TKR was done by Dr. Fitz at the same hospital. I think he’s great but I don’t know if he does revisions.
JK

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I would be very receptive to go to Brigham and women’s however my insurance doesn’t cover either Dr. Fitz or Dr. thorn Hill Unfortunately. I am limited to go to Beth Israel Hospital .

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@contentandwell

@mclgracie I can understand why you would not want a second TKR under those circumstances. It is just the scar tissued that is standing in your way? How was your ROM after the reconstruction? Did it improve and then get worse again?
I know little about this, I have had two TKRs but if I have scar tissue it's not severe. My ROM never got beyond around 118 in one knee and 120 in the other — depending on who does the measuring.

@donheads When we are in pain or have a medical problem it really does affect us. I have had other issues and am feeling somewhat down about them. I am retired, but they have made me rather cantankerous at home and with friends. What does the doctor say about your lack of any flex? Is that from scar tissue also?
JK

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Thank you for understanding. Unsolved knee issues like low ROM (about 26) creates another issue – – Not enough exercising! Thus, there becomes a weight gain challenge. More weight = more pain. Gain1 pound = 4 pounds of additional weight on the bad and the worse knees. I do not know who to go to. I'm still pushing to do work for my church and Historic Society and American Legion Auxiliary volunteering does make me very tired. But I still have an open mind to any suggestions..Thanks.

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