Mako Robotic Arm TKR Week Six

Posted by saeternes @saeternes, Jan 10, 2020

Visit to doctor yesterday who is very happy with my progress, called it fabulous. PT today who put me on a pressure-sensitive treadmill and showed me the results. For 6 weeks it's fine, but I roll through my foot from heel to toe much better on my good leg than the surgery leg. He now wants me to find a good place to walk (mall?) where it isn't wet and the ground is flat, and concentrate on hitting with my heel and rolling all the way through on the surgery leg. I am at 126 for flexion (with pulling on leg, but only trying once) and 0 for extension (all those painful exercises are paying off) but only when on the table; when I walk the knee does not get perfectly straight. He also assigned me a kind of isometric clamshell where you put the bad leg on top, a few inches in front of the good leg, and hold the leg in clamshell position with a band on it for 30 second. Not easy!

In terms of feeling normal, far from it yet. Big numb patch that seems to be shrinking slowly. In bed hard to move without the knee waking me up, various twisting movements don't work at all. Small sharp pains now and then. Certainly nothing like the good knee. I started weight lifting again and hope that will have some effect as the muscles strengthen.

A few additional comments:

Sleep: I sleep 10 hours a day but wake up several times, and sometimes need a nap. Did any of you experience this? It is hard to get much done with all the exercises and icing and elevating and then having to sleep so much. I feel sleepy through much of the day even without the meds. Is this the body repairing itself?

Bowl movements: I had to switch to the "gentle laxative" (Bisacodyl) as the prescribed one made me throw up. It works fine, but it would still be tough without my bidet toilet seat. On the strongest setting it is like an enema, and very helpful.

Glad to be here where people talk frankly about their problems and avoid the Instagram curse of performative posts. I've learned a lot. More soon.

@ellerbracke

@saeternes : Next time you see Alex, could you ask him something? Once I reached 132 degrees (more now, that was about 6 to 7 weeks post surgery) one of the PT’s mentioned that 135 to 138 is about the upper limit of what an artificial knee is designed for. When I asked my surgeon, he did not seem to set any limits (probably figuring that knee function after TKR is self-limiting). I’ve always been curious what the consensus is. Your therapist sounds like a dedicated specialist, so his answer might be interesting. Thanks!!
I personally know 1 lady, about 65 or so, that can actually touch her heel to her butt – but only once she has done a 45 minute water aerobics class. And supporting/pulling ankle with hand to get the leg bent all the way.

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@ellerbracke Your flex is enviable. No matter how much I pull there is no way I can get that leg nearly to where the woman you mention does. One of the water instructors I had said to do my back knee bend on the side of the pool, putting my foot as high as I can on the pool wall. When I did it in open water I wasn't really straight and she said doing it on the side would be better for me so that's what I do after I've finished my water workout.

@saeternes I too have heard that @ 135 or so is the best you can expect to achieve but I suppose it is possible that you can do more with the newer knees. I don't think it is ever expected that you will be able to touch your heel to your butt but your friend is proving them wrong. I think I did hear that going too far could actually damage the knee but it was a while ago that I heard all of that discussed, well before my last TKR.
JK

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5 weeks after MAKO robotic arm assisted TKR

Though I made good progress the first three weeks or so after surgery, I feel like lately I’m stuck in neutral and not progressing. Knee is still tight and swollen and sometimes sore and feels pretty much as it did a week ago. ROM is 113 but has been the same for a couple of weeks. Anyone else encounter this issue?

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@clbs

5 weeks after MAKO robotic arm assisted TKR

Though I made good progress the first three weeks or so after surgery, I feel like lately I’m stuck in neutral and not progressing. Knee is still tight and swollen and sometimes sore and feels pretty much as it did a week ago. ROM is 113 but has been the same for a couple of weeks. Anyone else encounter this issue?

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Hi @clbs, you'll notice that I moved your message to this related discussion where people are talking about expectations of Mako Robotic Arm TKR at 6 weeks. I can sense your frustration that after experiencing progression for the first 3 weeks, you feel like there's been no progress for the past 2 weeks. I'm hoping that @saeternes @ellerbracke @bushy @lecoeur13 @phoenixpal and @artscaping will share their experiences from the 5-6 week period and offer tips of getting over this hump.

Clbs, are you continuing with PT and exercising? How's the swelling?

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@colleenyoung

Hi @clbs, you'll notice that I moved your message to this related discussion where people are talking about expectations of Mako Robotic Arm TKR at 6 weeks. I can sense your frustration that after experiencing progression for the first 3 weeks, you feel like there's been no progress for the past 2 weeks. I'm hoping that @saeternes @ellerbracke @bushy @lecoeur13 @phoenixpal and @artscaping will share their experiences from the 5-6 week period and offer tips of getting over this hump.

Clbs, are you continuing with PT and exercising? How's the swelling?

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Oh, yes! Going to PT twice a week and doing exercises at home. My knee is still very swollen.

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@clbs I think I posted this in another thread, but during my search on all things TKR, I eventually came across the site of a doctor who believes that one should not focus on strength building, but push harder on bending in particular, and extension as well. He recommends thinking in terms of hours rather than minutes. That seemed extreme to me but I did push harder to hold a bend longer, push more at the margin, then release after 10 min or so and repeat. I think that improved my bending. Also, when PT told me that my leg was not completely straight when I walked on his magic testing treadmill that took video and tested how hard my legs hit the flat surface, I added more of this exercise: lay on stomach on bed with legs off bottom, attach a weight to surgery leg, try to relax and let the weight pull it down. Rest, repeat, etc. That did it for me. I will try to find the website on bending but I remember it was deep into my search. I think it is a matter of doing it three times a day for half an hour or more, very tedious…

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PS, i.e. not focus on strength building until down the line, when the bending/extension is in good shape. This doctor argued that walking in the early stages of recovery should not be the focus, since it does not help with bending/extension; what he means, I think, is to not imagine that you can substitute walking/activity for the bending/extension exercises. I still walked but for up to 4-5 months, my knee would swell if I walked too much.

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