TKR: Pre vs Post surgery ROM related?

Posted by Paul @phoenixpal, Jan 16 4:46pm

Hi all,
I've been trolling here for awhile. I've esp appreciated @saeternes , @ellerbracke and others' back and forth, blow by blow recovery notes.

I'm scheduled for my TKR next month here at Mayo Phoenix. It's roughly 12 years after a running injury that smashed my left meniscus ( the right is still good as new)

My question: Is there a relationship between the before and after ROM? Ever since that fateful morning 12 years ago, by knee swelled up like a grapefruit, and despite 2 arthroscopes, I have been unable to touch my heel to my butt. It's 5-6 inches away (pulling by hand). And I have never, since then, been able to squat down, putting my weight on that leg.

I'd like to think that ROM issues are related to the new TKR, and that the physical blockage that exists PRE- surgery would be removed. (?)

Can anyone squat down, putting all their weight, on their new knee (eventually) ?

Thanks

@phoenixpal I wish I could help you on this with my own experience but I am only 7 weeks post, so I cannot still pull my surgery leg in as far as my other leg. However, I just had lunch with someone who had knee surgery about two years ago and he can almost do that. In terms of squats, how far down do you mean? Do you mean sitting on your heels? I have never been able to do that (or at least not for a very long time, I guess I could when I was a kid) so not sure if I will be able to do that eventually now. Before TKR I had excellent flexibility and both legs could hairpin in to touch my butt – my right still can, I'm aiming to get as close to that as I can; on meds I can pull it in very close, but it will not go there without. I suspect hard work on bending is the key, but that alone may not be enough. How's that for "who knows?" Best of luck in your TKR.

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Hi, @ phoenixpal. Welcome to Connect. As you have already seen there are many of us post-TKR people here. I think it’s unusual to be able to really bend your leg back far enough to touch your butt, knee replacements are simply not able to do that. I come nowhere near but I think I may not have pushed myself enough.
I don’t know if flex after surgery is related to flex before surgery, but I doubt it.
Good luck with your surgery. I hope it is as successful as my two have been and more successful than mine in flex. My first physical therapist, an in-home one, was great, but my outpatient one was not as good. I hope you find a really good one, that does make a difference.
JK

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Good evening @phoenixpal, it is great to have you on Connect, especially since you are preparing for your TKR next month. So many folks have an opportunity to improve their quality of life with this very effective surgery, especially with the new materials and a realistic adoption of effective rehabilitation techniques. We will be here to support you no matter what time and what you have questions about.

I would like you to read the link at the end of this reply. It was posted just a few days ago. This is my own TKR education and as I read about others who make wise choices meant for longevity, I have renewed faith in my choices. I know that each patient is different…..age, gender, lifestyle, health condition, etc. That is precisely why it is important to plan a rehab based upon your specific situation. For example, you state that you suffered an injury 12 years ago. That means that you may be younger, in better physical shape and not suffering from the wear and tear that most 60+-year-olds encounter. I am 77 and my knee developed what are called "crystals" perhaps from climbing and hiking for many years. With the special care and guidance of my surgeon and my MFR (Myofascial Release) therapists and /PT practitioners, I can walk along the river, and play "horsey goes a walking" with my grandchildren.

In my daily gentle yoga practice, I can hug my knees, do the pigeon, the child's pose, and scoot across the floor on my knees to get something. I don't need or want to do more at this age. I want to keep the strength and mobility I have without risking injury or being too aggressive.

There are lots of TKR patients and former patients here. So many are happy with their new pain-free knee and we are glad to hear from them. You said you have been trolling on Connect, Do you have concerns or a need for more information about the procedure? What has been most valuable from your trolling perspective?
https://connect.mayoclinic.org/discussion/what-can-you-do-to-extend-the-life-of-your-tkr-and-mobility/
May you be free of suffering and the causes of suffering. Chris

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Thanks for that Chris. And I appreciated your link.

I'm still wondering if I'll eventually be able to squat all my weight on my TKR knee the way I still can on my good knee. I'll just have to wait and find out.

You've got 11 years on me. I'm 66. But I ran daily for 30 years since college. Running one morning in a new place in the dark and landing fully extended in a pothole brought an abrupt end to 30 years of running. But swimming has always been my first love. So much more technical with hundreds of little adjustments to improve than running. I now bike and swim. I've upped my workouts for the surgery by peddling 22 miles (r/t) to the pool and back. Turns into a 3hr workout 🙂

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Squating is a succer movement. They outlawed it in Professionhal footfall Your semil lunar discs in a normal person could be torn. Regular squats up and down are no problem, I do it all the time holding onto the sink. But squatting and duck walking in a squaiting position will damage your knee. If you sqat,, put a chair behind you and hang onto the sink or ballet bar. Sqaut to the chair or stool, but avoid the full squat. Sorry, we pay a price don't we to keep the T-K functionalI . I swim all the time. Watch the vigor of the pool push off. Balance is a good exercise. Simple one leg for 10 seconds or more, Progress in Ti Chai with caution only after ballet bar poseing and balance. Let your body tell you what you can do with out some support. Some of this depends , of course, on general conditioning and how much extra weight you are carrying. Good Luck……Bill

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Hi my range of movement is very limited after a full knee replacement. I cannot bend my knee to go up/ down stairs. Driving is tricky and sitting on the floor is out of the question. I have been told l might need to have a 2nd knee replacement. Has anyone else experienced this? I can do squats sometimes.

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I am sorry to hear you are having so much problem. Recovery from a Total knee is slow. If you are two or three years out, your total knee may be hydrolytic syndrome. This means, the part going into the bone is not secure with the glue and is moving..sloppy. Do you have a surgeon that does Total knees all day long? Get him, review your case, determine the cause. If you need Physical Therapy, go to the best sports Medicine and ask for. heat, interferential electrical current,, deep massage, contract, release stretch of hamstrings, re-ed to the vasrus medials, balance and proper gait. Medicare will pay along with suppliment for a different diagnosis, such as knee exascerbation, or look for a code they can use. Get active in your own care. googel, read, question. Do not ber a go by the book guy. Step up to the plate. Ask for me for support. I am there….good luck,,Bill54321.

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@donheads

Hi my range of movement is very limited after a full knee replacement. I cannot bend my knee to go up/ down stairs. Driving is tricky and sitting on the floor is out of the question. I have been told l might need to have a 2nd knee replacement. Has anyone else experienced this? I can do squats sometimes.

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@donheads How long ago was your TKR? Do you know what your ROM is? If you are not too far out from your TKR it will probably improve. If you are, I would see the surgeon and get things checked on. Depending on what the original surgeon says, you may want to schedule a consult with another orthopedic surgeon also — the best possible one you can find, who is not affiliated with the same medical center as the first surgeon.
JK

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