Poor range of motion after TKR and manipulation: What to do?

That is very normal …. They don’t tell you that …. Dr tells you I got 120 rom in the Or….but now you have swelling and mad muscles to deal with … I had a manipulation I was 60 going in dr said 120 in surgery … after manipulation you go to therapy everyday for a week well therapy next day 80 day after that 70 than therapy told me to stay home my knee was was swollen can barely bend ….that was my experience …. Does not mean it will be yours …. Ice a lot if you have ever heard of mfr find therapist near you preferably trained by dr barnes …. They can help with the swelling and pain …. Good luck it does get better after a revision I have full range of motion

Four years ago I had a TKR followed by MUA six weeks later. Doctor said “it bends” after manipulation and showed me video. Had PT for 16 weeks. Knee stayed swollen, scar tissue took over, ROM went from 35 to 20 over 4 years. Fast forward - New surgeon discovered original implant was defective & ill fitting. He performed Revision TKR Nov 22’. It took an hour just to remove scar tissue! Had MUA 4 weeks later with ROM at about 60 (to get ahead of repeating scar tissue build up again). No nerve block with manipulation- whew worst pain ever - all in quad. PT daily for 3 weeks following MUA…then 3 x week. Then 2 x week. Now finished 15 weeks total of PT. Used pain meds during PT for several weeks, eventually just needed muscle relaxer and not even that the final 2 weeks. Knee swelling subsided gradually with elevating & icing several times a day. Biggest challenge in PT besides learning to walk normally was getting quad to fire up and then stretching it out after years of not using. Putting heat on thigh - then letting it dangle from side of massage table while letting gravity do its job and massaging thigh helped in PT. I started out using a rolling pin at home to massage thigh area, now using a tennis ball to massage which has helped immensely. I have massage table at home so still using it to dangle/stretch quad. My ROM is 80 and getting better (my new surgeons goal was getting me to 90 degrees). I know 80 not optimum but I feel so much better. I walk normally and can go up/down stairs (with bannister or handrail) normally. I’ll take it - while continuing to do the exercises & massaging. It takes a while to get through the healing, but perseverance and determination not to go back to where I had been helped. My PT’ s were great and bounced ideas off each other, along with my input on what I needed all helped get me where I am. Seems no two stories found on this forum are same but hope you get some useful info, some answers & mainly relief.

A second opinion is a very smart idea. I used a doc from a different company. Ascertain that the device was installed properly and the right size.
Two days after my TKR I felt like I was hit by a freight train, that's how bad the pain was, and so I used drugs and remained immobile for weeks. The inactivity reqd an MUA 6 weeks out but the increased ROM didn't last, scar tissue formed in abundance, and the nerve pain was unrelentling. I've wired a lot of houses, cars and airplanes and know what it feels like to get shocked. At times the shock was above the knee, sometimes below, sometimes both, and all the way down to my foot. It would go on for hours. I researched and requested a nerve block. In the initial phase of the nerve block they injected sedative to find the right spot for the followup shot 3 weeks later. However, the sedative calmed the nerves and I never went for the followup. Six months post TKR I had arthro surgery to remove the scar tissue but it came back in 3 weeks. My knee clicks, the doc says the tendon will not split but I've read research that says otherwise. Therefore, I limit repetitive motion to reduce the probability it may split.
Do your homework, learn what works for you.
Postscript: I've had several revelations from this terrible experience. First, and foremost, I learned that "I" was my best advocate. If your doc is like mine, he's seeing hundreds of people per week and cannot spend the necessary time to study your issues, and he/she may not have the skillset to solve them. If I was going to regain some semblance of a life that was very active, I had to assume the leadership role and figure out what might work for me. Second, I was slightly overweight so I lost weight (no excuses). My greatest gain didn't come from a doc, it came from weight loss. Third, try to determine if anything u eat irritates the knee. Fourth, I exercise everyday, but not to the point where the knee gets so inflamed it will no longer bend. Fifth, I gave up using Oxy and anything else I might get addicted to.
I'm 10 months since TKR, my rage has subsided and "acceptance" occurred. It was my decision to proceed, it was my error, I had to forgive myself, and figure out a solution. To wit, yesterday I worked on various projects from 6am to 3pm requiring lots of standing, walking and climbing on ladders. That's known as progress (for me). Fortunately, Hyaluronic Acid is helping my other knee so I have no plans to do another TKR.
Hope this helps you.

Your perseverance paid off that is awesome…. Just goes to show we are all not going to be 120-130 rom ….but where you are now and where you came from amazing … all your hard work and the team you had with you every step of the way …. You’re a true success story …. I am so grateful I read your story today thank you for sharing your experience…. It makes me stronger if that makes sense lol…continue bend to you

Help me..does anyone have an answer please? I had TK R 2 years ago, followed by Mua the revisional tkr 12 moths ago. Bending my knee past 90° is extremely painful, I have sharp jabbing pains behind my knee when bending . When asleep if I forget a d bend my knee while turning I nearly hit the roof with pain. Surgeon more or less says unfortunately tkr doesn't always work. I never expected it to be 10x worse than before surgery.. I had this procedure so that I could hike without pain...now I can't hike at all. Nor garden.
I did everything I was told...physio, ..Is there any hope? Does anyone else have the same painful outcome?

Sorry for your grief. I found the following article that contained some ideas.
https://orthoinfo.aaos.org/en/treatment/revision-total-knee-replacement
I'm not a doc, but I'd want to be damn sure the prosthesis is installed properly and nothing has deteriorated or infected. The article emphasized weight loss which I found to be very helpful. If my weight exceeds 170, pain increases. Get back down to 170 or below, pain decreases (I'm 5'10"). The second, very helpful idea reqd building up the muscles that allow me to stand on my toes and my heels thereby relieving the knee of some of the workload walking up stairs. My third advance took place after I switched docs. The second doc treated the issues differently, she was much more patient & thorough. Fourth, I just got the results of my MRI which the second doc used to determine damage to a tendon the first doc cut thru during my TKR. I am scheduling "tenex" to see if that will mitigate the damage done to the tendon. Fifth, I use knee muscle building machines at the gym but I don't expect the TKR knee to bend as far as the non TKR knee. Suffice to say, I use the machine to build muscle but both docs told me to AVOID the machine in the photo I attached. Last, instead of ibuprofen, the sec doc prescribed Nabumetone which is easier on my stomach.
I wish I could offer more.

Did you hav revision by same dr that did original tkr?

No..the revisional surgery was performed by a surgeon in Wellington who is supposed to be one of the best. However he apparently trained with the first surgeon

Thankyou..I am waiting for a bone scan on the 11th April to see if they can find anything. I will take your advise and have a mri as well.. I am not overweight, 5' tall, 66yo, Consider myself relatively fit. I have had the cranks on my bicycle shortened and do cycle regularly. A pain management dr I am seeing suggests stopping for 3 to 6 mths to rest my knee. ..
I will look into that site you suggested.
Thank you SO much

The bike hurt me the most after tkr … I had to stop for few months also , I am now little over 7 months out of revision started bike again i built myself up to 20 minutes a day so far…progress not perfection lol…. Here is the website you can find myofascial release therapist…. For me it was so worth it and continues to be.
https://myofascialrelease.com/