Mako Robotic Arm TKR Two Months

Posted by saeternes @saeternes, Jan 24 6:46pm

At the two month mark, lots of things still surprise me about the entire process of knee replacement. On the positive side, I got to 136 flexion today. My data from the pressure-sensitive treadmill shows I am doing much better in terms of equally weighting my two legs in a walk, and rolling through my foot. I don't really experience anything that can be called pain anymore, although I'll explain that more below. I'm able to walk quite a bit and am exercising almost daily, with a 30 minute walk, and either 45 minutes on the bike or 45 minutes on weights, as well as the exercises the PT has given me. On the negative side, although I get 0 degree extension on the table, when I walk, my knee is still slightly bent. PT and I discussed today the difference between ability to do something and ease of use. We want me to get to the point where it is easy for me to extend and bend my leg without thinking or trying. I am going to keep working on the extension with that in mind, even though technically I'm at 0. I notice when turning from side to side in bed that I have to be very careful to avoid something at the low level of the pain scale (not really pain but discomfort), and even pulling my leg up while lying down (sliding foot toward butt) is not without some unpleasant sensations. So although there is no real pain, there is some discomfort. I am working hard on the rehabilitation but wondering how long this will continue to be the case.

@ellerbracke in terms of whether the knee is made to go beyond 135 deg, Alex said he has not heard anything about that but that could be because people rarely get that far when they see him – their benefits run out, so how far they continue after 120 or 125 is not known to him. However, he is going to ask around and see if anyone knows. I guess if your friend can put her foot against her butt in the water, it must be okay!

@saeternes You are doing fabulously. I wish I had your flex. If I recall you had the Starkey knee, correct? Does all Mako surgery use the Starkey? It seems that anyone I have heard of having Mako has had a Starkey.
JK

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@saeternes: I want to second JK’s compliments on your progress. It makes sense that the PT people, as a general rule, don’t see the final flex since in most cases the insurance runs out. I lingered on for about 3 months at PT, however, after the first 2 appointments within one week, my schedule was every 8 to 10 days. There was not really any hands-on treatment by the therapist, other than to check my progress, making sure that I did all the exercises correctly, and a lot of the time answering a lot of questions that I had.
Anyway, one suggestion: even though with your Mako surgery it is unlikely, before you get dismissed from PT, have them measure your leg length. Now that you have 0 extension, any potential difference should show up. Don’t dismiss this out of hand – my extension wasn’t quite 0 at end of PT, so they did not catch the fact that the TKR leg was slightly longer.
Other than that – yes, there will be discomfort for some time to come. I just came back from a vacation in a ski village (no, I didn’t ski), but the terrain was absolutely punishing. To walk anywhere, it was reasonably steep going. Yes, I managed, but the downhill part, especially in the mornings when it was potentially slippery with overnight icing, was really hard on my knee. Will have to baby it for a few days. No damage, just very sore muscles and tendons around the knee and radiating up to the hip.

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@contentandwell it's not the Starkey knee, it is the Triathlon made by Stryker, which also makes the Mako robotic arm: https://www.stryker.com/us/en/portfolios/orthopaedics/joint-replacement/knee.html

@ellerbracke I will ask Alex about the leg length. I once had my leg measured by a doctor with a tape measure who insisted one was an inch longer than the other and I needed special shoes. I tried that and it was a disaster. The entire time I did not feel the doctor could really measure accurately. Is there a laser measuring device or something like that that can accurately measure? BTW I read on another thread that you dislike the stationary bike. I have mine (a recumbent) in front of a large screen TV and watch movies and shows when I exercise. That is the only thing that makes it bearable. I actually only really like playing games like soccer, but haven't been able to do that for a while. So I'm making the best of it with the weights, walking, and biking.

Indeed I am slowly starting to accept that fact that this is really a year or two years coming up of constant attention and effort. When I compare the way I feel now at two months with my sensations at one month (which was basically Christmas day for me), I can see that there has been huge progress, both objectively and subjectively. I am much less tired and able to do more things. But now I am realizing that I will have to do these exercises for a very long time, maybe forever. Argh.

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Forgot one question for all of you: did there come a time when you used heat on your knee? I have heard that it can help loosen things up after the swelling is gone, which mine is either completely or almost.

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@saeternes: Not sure if there’s a scientific/laser way to accurately measure leg length. Let me summarize quickly how mine got diagnosed: 0 extension after 4 months, started daily brisk 2 mile walks. Hip bursitis started 6 weeks later. Initially declined cortisone shot, PT with specific hip-related exercises. No help. 4 weeks later submitted to shot. Some relief. A few weeks later I was unable to take a full stride with my left (good) leg. Got gradually worse. More PT (goody!), after which super experienced PT made me do some back exercises and bridges to loosen back and hip, then tugged and positioned my legs and evaluated where the heels ended up. So another 3 weeks of different exercises to make sure it is not a hip extension issue. No change. Custom orthotics ordered, after 1 week of getting used to them no more problems with stride or hip or knee pain. That’s it in a nutshell.
As I mentioned in a previous post a long time ago, my legs MAY always have been different lengths, but after the TKR it became problematic.
Regarding how long I kept up the TKR exercises, I think it was about 6 months. I tapered off to once a day, and soon only did the flex and extension ones, along with daily bridges and squats. I’m not nearly as active as you are, mostly I walk or swim 5 to 6 days per week, and now that spring has sprung, I generally average 1 to 2 hours of various types of yard work, 4 to 5 days a week. That’s it! To use a recumbent bike I have to go to 1 of 2 fitness centers I belong to, and I simply lack the motivation to do that. I thoroughly dislike watching TV, do not have an iPhone to listen to music, and get annoyed by the grunting of co-exercisers who use the weights or machines nearby. My bad!
Just read what I wrote, and to clarify why I belong to 2 fitness centers without really using them….. one is by default connected to a Country Club membership, the other is a freebie that comes with the use of the indoor pool at senior fitness center.

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@ellerbracke sounds like you are plenty active. For TV when biking I only watch streaming films or shows – no ads. I gave up watching network TV long ago when the ads started coming every ten minutes. Six months of these exercises sounds doable, I was doing mental prep for forever.

I haven't had any leg or hip problems yet, but I will pay close attention. Any comments on the application of heat to the knee?

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@saeternes

@contentandwell it's not the Starkey knee, it is the Triathlon made by Stryker, which also makes the Mako robotic arm: https://www.stryker.com/us/en/portfolios/orthopaedics/joint-replacement/knee.html

@ellerbracke I will ask Alex about the leg length. I once had my leg measured by a doctor with a tape measure who insisted one was an inch longer than the other and I needed special shoes. I tried that and it was a disaster. The entire time I did not feel the doctor could really measure accurately. Is there a laser measuring device or something like that that can accurately measure? BTW I read on another thread that you dislike the stationary bike. I have mine (a recumbent) in front of a large screen TV and watch movies and shows when I exercise. That is the only thing that makes it bearable. I actually only really like playing games like soccer, but haven't been able to do that for a while. So I'm making the best of it with the weights, walking, and biking.

Indeed I am slowly starting to accept that fact that this is really a year or two years coming up of constant attention and effort. When I compare the way I feel now at two months with my sensations at one month (which was basically Christmas day for me), I can see that there has been huge progress, both objectively and subjectively. I am much less tired and able to do more things. But now I am realizing that I will have to do these exercises for a very long time, maybe forever. Argh.

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@saeternes I didn't mean Starkey, I did mean Stryker. So Stryker is the only knee with Mako surgery. Oh, and Starkey is actually a hearing aid brand, I just got them confused!
JK

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@contentandwell That is very funny, I searched for the Starkey knee but could not find it! Stryker seems to have more than one kind of knee, but I think only one can be used with the Mako machine. Did you ever use heat on your knee?

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@saeternes

@contentandwell That is very funny, I searched for the Starkey knee but could not find it! Stryker seems to have more than one kind of knee, but I think only one can be used with the Mako machine. Did you ever use heat on your knee?

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@saeternes I did not use heat, no. Initially I did use ice but I tend to be inconsistent about that, I always forget to ice things. I really should be icing my bursitic hip but never remember to.
JK

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@contentandwell I'm going to start another thread asking if anyone has used heat. Very curious.

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@contentandwell Thanks for that link and the info. I will try it later. I have had a bit of a setback due to my own decision to lay off elevating, icing, and resting. I was doing so well I thought hey, I can stop all that now and just exercise more. I think I triggered some bursitis or another kind of reaction by overdoing and exercising too much, and by forcing the bend too fast. Now I am resting for a few days and hope I can get back to exercising next week. This is truly a long process no matter what, and I have learned my lesson: be conservative about stopping the usual RICE (rest, ice, compress, elevate) – also the lymphatic massage, which helps with swelling. I see PT next Friday and it will have been two weeks, since I was out of town. Thanks again.

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@saeternes

@contentandwell Thanks for that link and the info. I will try it later. I have had a bit of a setback due to my own decision to lay off elevating, icing, and resting. I was doing so well I thought hey, I can stop all that now and just exercise more. I think I triggered some bursitis or another kind of reaction by overdoing and exercising too much, and by forcing the bend too fast. Now I am resting for a few days and hope I can get back to exercising next week. This is truly a long process no matter what, and I have learned my lesson: be conservative about stopping the usual RICE (rest, ice, compress, elevate) – also the lymphatic massage, which helps with swelling. I see PT next Friday and it will have been two weeks, since I was out of town. Thanks again.

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@saeternes, Thank you so much for admitting that you were pushing your TKR rehab a bit too fast including forcing the bend too fast. Last month I reviewed most of the posts about problems with TKR recovery. It does seem like those that had the best results set a moderate rehab pace. Here are the results……..for your review.
https://connect.mayoclinic.org/discussion/what-can-you-do-to-extend-the-life-of-your-tkr-and-mobility/
And thank you @contentwell for finding those tips and tricks that will benefit all of us.
Be safe and protected. Chris

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@artscaping Thanks for the link, lots of good advice there. For me I think it was more that I thought everything was okay and thus slacked off on RICE. I did add walking to my usual exercises (recumbent bike, weights, stretches) and they also may have tipped me over the edge. I'm not really "admitting" anything – I am happy to post the good and the bad, so as to have a true record. I have no desire to make things seem better than they are. Thank again.

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@saeternes

@artscaping Thanks for the link, lots of good advice there. For me I think it was more that I thought everything was okay and thus slacked off on RICE. I did add walking to my usual exercises (recumbent bike, weights, stretches) and they also may have tipped me over the edge. I'm not really "admitting" anything – I am happy to post the good and the bad, so as to have a true record. I have no desire to make things seem better than they are. Thank again.

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@saeternes Oh dear, I am so sorry that I chose the word “admitting”. May you be free of suffering. Chris

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