Limited ROM after total knee replacement.

Posted by Ozziegee @ozziegee, Jul 7, 2017

Hi, I seem to be stuck around 90 degree ROM following tkr surgery 20 weeks ago. I went to PT for two months and have been doing post op stretches and exercises daily. I’ve had constant swelling ever since the surgery and recovery has been very slow because of it. I’ve also had several prior surgeries on the same knee so figure scar tissue is at least a big part of the problem. I was wondering what options are available to me without doing a MUA? Any thoughts or suggestions?

@debbraw

@ellerbracke – My doctor ordered in-home PT 3 times a week until I was able to drive, then outpatient twice a week for 6 to 8 weeks. I'm doing this with my left TKR now (surgery 1/29) and I did it with my right TKR (done in April 2017). I thought that the PT was one of the key factors in my successful recovery. My therapists give me the exercises, watch me do them, correct my form when needed, and walk with me when we do outside walks. It's kind of like having a personal trainer. I definitely push myself harder when I'm with the therapist vs. the days I'm on my own. I may be especially fortunate to have GREAT therapists, but both of them have anticipated when I could do more, encouraged me to try harder AND reigned me in when I tried to do too much. Last week, I was at 3 weeks post-surgery and I had full knee extension and 128 degrees flexion. My outpatient physical therapist says we are going to work on balance and functional skills along with maintaining the ROM – and getting up to 130 degrees where I was before the surgery. Bottom line is that I would not have been where I am without these caring and skilled physical therapists.

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@debbraw WOW Debbra, that's wonderful. It sounds like you had a good surgery and great PT. You are very fortunate. I am sure you had a lot to do with having such a successful recovery too, so give yourself a pat on the back. My in-home PT was similar to what you describe. My outpatient one – not so much.
JK

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@debbraw

@ellerbracke – My doctor ordered in-home PT 3 times a week until I was able to drive, then outpatient twice a week for 6 to 8 weeks. I'm doing this with my left TKR now (surgery 1/29) and I did it with my right TKR (done in April 2017). I thought that the PT was one of the key factors in my successful recovery. My therapists give me the exercises, watch me do them, correct my form when needed, and walk with me when we do outside walks. It's kind of like having a personal trainer. I definitely push myself harder when I'm with the therapist vs. the days I'm on my own. I may be especially fortunate to have GREAT therapists, but both of them have anticipated when I could do more, encouraged me to try harder AND reigned me in when I tried to do too much. Last week, I was at 3 weeks post-surgery and I had full knee extension and 128 degrees flexion. My outpatient physical therapist says we are going to work on balance and functional skills along with maintaining the ROM – and getting up to 130 degrees where I was before the surgery. Bottom line is that I would not have been where I am without these caring and skilled physical therapists.

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Debbra: WOW! Sounds like you are doing super well, at this early stage. Even though I had 104 degree flex on day 2 after surgery, it took me about 6 weeks to get to 128, and almost 4 months to finally get full extension. I blame the latter on the fact that I had had a knee scope 11 months before the TKR that was not helpful at all, and I was in pretty much constant pain during those 11 months, and probably underused the knee. I wish you continued success, and it is nice to have someone show the positive result to balance all the negative side effects that people have reported. Way to go!

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I had knee replacement surgery in June last year.l had good movement at first. Then l started to be not able to bend my knee and struggle to go up and down stairs. I attended some physical therapy sessions and on the bike possibly extended to far,, causing severe pain. I was wondering if l could have damaged the replacement, or moved it. I have had a manipulation and also x Ray. Which shows no damage. Have constant swelling also. I did all the exercises daily. I will be seeing the surgeon next week. Do not really want to have any more surgery. Any suggestions on how l could improve this?.

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@donheads

I had knee replacement surgery in June last year.l had good movement at first. Then l started to be not able to bend my knee and struggle to go up and down stairs. I attended some physical therapy sessions and on the bike possibly extended to far,, causing severe pain. I was wondering if l could have damaged the replacement, or moved it. I have had a manipulation and also x Ray. Which shows no damage. Have constant swelling also. I did all the exercises daily. I will be seeing the surgeon next week. Do not really want to have any more surgery. Any suggestions on how l could improve this?.

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Hi @donheads – Welcome to Connect! Glad you checked in here. I am also glad to hear that you will see your OS next week. I've had two knee replacements and I'm happy to say that I didn't experience the kind of setback you are describing. But everyone is different and I have read posts from people who did have this kind of difficulty. I'm going to tag a few others who have had TKR's and might be able to share some insight: @ellerbracke, @cobweb, and @gutthookd. Meantime, could you share some more information on when you had the manipulation? Did the surgeon talk about scar tissue being a possible factor in your losing ROM?
Here is a thread that might interest you:
https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/?pg=39#comment-272223
I'm wishing you the best and hoping we can get a conversation going that will address some of your concerns.

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@donheads

I had knee replacement surgery in June last year.l had good movement at first. Then l started to be not able to bend my knee and struggle to go up and down stairs. I attended some physical therapy sessions and on the bike possibly extended to far,, causing severe pain. I was wondering if l could have damaged the replacement, or moved it. I have had a manipulation and also x Ray. Which shows no damage. Have constant swelling also. I did all the exercises daily. I will be seeing the surgeon next week. Do not really want to have any more surgery. Any suggestions on how l could improve this?.

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Hi @donheads and welcome to Connect from me also. Have you seen your doctor yet? I don't think you can really know anything until you do see him. I doubt the bike would have damaged it, I used the bike a lot, gradually moving the seat more and more forward. I hope your surgeon has some suggestions for you that will not involve additional surgery. I can understand completely not wanting to have to do that. I am interested in hearing what the surgeon does say.
JK

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