TKA w/ complications and ROM is not good post-op 6 weeks

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1961Mika
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Hi! I am a 55 years old physically very active female.

I ended up staying at hospital for 1 week for a total knee replacement surgery due to low blood pressure and blood clots. At the first post -op appointment my Dr. put me an imovilaizer due to an infection. I was immobilized and had to elevate my leg for 10 daysatvhome  so I was not able to start my PT until almost 3 weeks post -op. 

Now that my scar tissues are forming and my entire leg is stiff. I have a private PT twice a week ( I still cry for pain.) and I do a set of exercise recommended by a physical therapy 3 times a day. My ROM is 77 degree as of 5 and half weeks post-op. My extension of knee is 0 to 1 degree. I have been taking Oxycodene, Tylenol, Canabis with CBD, and started acupuncture this week to control my pain. 

I was feeling so terrified about a manipulation and did some research which led me to this site. I have read all the entries here and gained knowledge about a manipulation and some positive and negative experiences from everyone and I feel more scared than ever. I am scared what if my knee never regain a full range of motion, I am scared about a manipulation with possible more pain and swelling I have to deal with, and I am scared that fact sometimes you may have to have more than one manipulation... When and how doctor or myself determine to have a manipulation that is my question. This whole thing about complications, delayed PT, severe pain even 6 weeks post-op, and low ROM is so unexpected.... 

Appreciate any more suggestions and encouragement. Thank you! 

Mika

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  • Posted

    Hi Mika,let me tell you my story im 55 yrs old had TNR feb 2017 started my physio prob about three weeks later my bend would not go past 55 degrees i was eventually offered a manipulation and got it 18th july was in hospital few days then straight into physio twice a week,i'm now at 80 bend my physio is happy with progress although slow but im now back at work full time on feet all day i get down at times as i feel a bit unlucky with bend my surgeon said last time im aiming for 90 bend physio says same and i can lead normal life again,to be honest i have good days and few bad day's but think im getting there,you have 77 bend so better than me in early day's my thing was knee just wouldint bend by 55 but if you can do it with help from physio brilliant if not manipulation not that bad and everyone iv read who got it have had great bend very quick after few weeks as i said iv prob been wee bit unlucky but i'm still glad i went through with both procedures as in time il get there,i wish you good luck and you will get great advice on this forum,but if it comes to it please dont be scared of manipulation its a very quick procedure and your asleep,vicky.xx

    • Posted

      Victoria, thank you so much for your comment and encouragement. I was not expecting this quick replies from you and other people and so thankful for you and other people who share their experiences and tips. I see you had setbacks and struggled for a while. I was surprised to read that you went to a manipulation 5 months after the surgery. As reading my PT reports and the reactions of my physical therapist, I was so sure that I would need to get a manipulation very soon.  I will work hard but not to be too hard on myself mentally and phychologically and see this as a long journey of recovery. 

      Thank you again and best of luck to you on continuous recovery. 

      Mika

    • Posted

      Hi Mika,i should have said my six week appointment to see surgeon was cancelled it took for a while for my next app so that's why i never got manipulation earlier i often wonder if first app had not been cancelled and i did have manipulation earlier my bend would have been better but i'l never know, and as i say im getting there at a slow pace,take care and dont be to hard on yourself it all takes time,x

  • Posted

    My TKR was May 2, 2017. Post op complications led to my knee being immobilized and "stuck" at a 50 degree bend at 3 months. ( Unfortunately my first PT did not work on extension making it worse ) I developed scar tissue. The surgeon believed I would need surgery to remove the scar tissue to extend my leg. My flexion was at 95 degrees. Manipulation is good for flexion problems but not always the only answer. I got a new PT who was personally recommended and she came out 3X weekly showing me the exercises I should have been doing from the beginning. Because extension was the more critical issue, I did more extension exercises. For flexion, I did heel slides and modified bending exercises. I had a band of scar tissue around the incision (8" long ) due to an allergic reaction the dermabond glue, so began massaging and stretching that area with castor oil and a Gua Sha tool to break up the scar tissue. (Note-the incision was fully healed before I started doing this )  I started Epsom salt soaks in the tub daily and did stretching in the water. I began massaging the areas where there was scar tissue with a Gua Sha tool and magnesium lotion. Magnesium supplements helped my muscles to relax and I wear leg warmers to keep my muscles from getting cold and contracting. After 6 weeks of this, I went back to my surgeon for my 5 month post op checkup and was able to extend my leg to 20 degrees! With flexion of 98 degrees. The scar tissue is stretched out, most of it can't be felt anymore. My PT measured my extension yesterday at 15 degrees and flexion at 98 degrees. There are some keloid scars just above the kneecap which we feel might be preventing my flexion, so I am massaging that area now and expect the scars tissue to break up and reabsorb. I can now stand straight and walk with crutches. Do not let the doctor scare you into believing surgery is your only option. Especially when there are post op complications that cause set backs, we can not be expected to stay within normal recovery expectations. Continued gentle stretching exercises and massage with magnesium lotion and supplements along with allowing time for my body to recover has me walking without any limp. I do have to strengthen my leg muscles but that will come with time and good nutrition. People recover along a bell curve, some recover very quickly, some take a few months and then there are some of us who run into complications and take longer. Be patient and make the decision you feel is right for you. I just turned 67, so youth is on your side. Best of luck!

    • Posted

      Laurel, thank you so much for your comment and encouragement. I see you went through some complications and have been trying extra hard for your recovery. I am very encouraged by what you have applied to yourself. When were you able to soak your knee in water? I was told not to do for 5-7 months. ( It seems too long to me.) I love taking a hot bath in general and that has been my daily relaxation so not to be able to do that has been difficult especially we are getting into cold weather.  I use vitamin E lotion to give my leg a good massage 2-3 times a day that is my favorite part of exercise routine. ( I do hate other parts... ugh) 

      I will try to be more patient and see my doctor, physical therapists, friends, and etc. as just different perspectives. Each patient is unique and recovers differently. 

      Thank you again and best of luck to you. 

      Mika

    • Posted

      Vit E lotion is very good. Once my incision was fully healed at about 8 weeks, I started taking Epsom salt baths. I had no open area or wounds at that point. You might ask your doctor why he wants you to wait 5-7 months; since infection was one of your issues, he may want to be extra careful.
    • Posted

      I found epsom salt baths excellent! So good for relaxation and muscles!
  • Posted

    Mika,

    Do not be afraid of manipulation. I had TKR 3 years ago and was stuck at 68.  Had manipulation, which you don’t feel, and with ALOT of hard work got to 98 and walk pain free now. All of us are different, and have different issues. Do not be afraid of manipulation. It work great for me. I look forward to hearing how you do . I am 64. smile

    • Posted

      Suzanne, thank you so much for your comment and encouragement. As you said everyone recovers differently, but when you encounter other patients who had surgeries a week ago or so sitting with her/his knee bend in the waiting room of PT and walking with slight difficulty, I cannot help but compare to my progress and feeling discouraged... I am still in an early stage and need to be more patient. 

      Thank you again, best wishes to you too! 

      Mika

    • Posted

      Hi Suzanne,before my manipulatio my ROM was stuck at 50 that was in feb,got manipulation July with help from physio im now at 80 degrees p.t said he's pleased and that i will get there 90 is what surgeon and p.t are looking for i'm 55 yrs back to work full time go to p.t every two weeks now and do exercise at home but after days work i'm so tired to do exercise as much as i prob should be,would you have ant tips for me also i walk faster than before but notice i still have limp and leg still stiff and tight at times again mostly after days work,its just with you having a successful manipulation would be grateful for any advice you have,thank you Vicky x

    • Posted

      Hi Victoria,

      I still overdue , and when I do I need ice, amd I limp a little when I do.  But my knee doesn't hurt anymore.  I have bad arthritis in my right foot, and just came  home from podiatrist and had to get new orthotics, and he gave me a cortizone shot in the foot.  But my knee doesn't hurt anymore.  I can accept that other little pains are happening, but I am grateful my knee doesn't hurt anymore.  So when I overdue, I put my feet up and ice, and then I'm ready for the next day.  I don't walk perfect, but I sure feel better than I did before with knee pain. I hope this helps smile

    • Posted

      Hi Suzanne,thank's so much for advice to be honest i forget to put feet up and ice silly i know but iv started again and do feel the difference,like you i don't get much pain at all only at physio but i can even bear that better now,and yes il deal with limp better than being in agony all the time like before TKR,sorry to hear you have arthritis in foot that's rubbish after having successful TKR but hope you'r getting less pain after cortizone shot,good luck with everything and thank's again biggrin

  • Posted

    Deep breath...slow down that brain...don't play the "What If..." game as it will drive you nuts.  You take this one thing at a time.

    I had 3 weeks of light home PT before I started the real stuff at -14 / +84.  Took 10 weeks at 2X/week plus continuing my own heel slides and squats at home to get to -1 / +123.  It takes time, work and patience...accent on the last one.  Forget about MUAs for now...just do the PT.  You will know within a month if it's working or if you need the alternative.  Don't jump the gun!!!  

    The PT is hard...no kidding.  Most people take meds an hour before to get a jumpstart on the inevitable pain.  But it usually works for the vast majority of people.  Expect advances, setbacks and plateaus...the worst.  I got stuck at -4 for weeks before I broke through.  Give it time...concentrate on the exercises...and keep your spirits up.  Treat yourself good and stop worrying.  Try this...

    http://patient.info/forums/discuss/tkr-and-ptsd-569521

    Stay strong...ditch "scared"...own your recovery!!!

    • Posted

      CHICO MARX,

      Thank you for your comments and encouragement. I also liked the article very much. 

      As you and the article say, I really need to concentrate on bringing that healing, spiritual energy into my body. Trust myself and work hard and be patient. I started to feel so much hopeful and positive after reading everyone’s comments and experiences. 

      Thank you!

      Mika

    • Posted

      We're here anytime you need us...  You are NOT alone!!!

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