Knee flexion after knee replacement

Boston, MA

#742 Mar 25, 2012
Diane---no, I have not heard of that happening before. I don't think it can if it is not something injected into your system via bloodstream. It is injected into the knee capsule. Perhaps it is a coincidence--it happening at same time. I would check with your Dr none the less to be sure.
Kathy R

Little Switzerland, NC

#743 Mar 25, 2012
Sheryl wrote:
In response to Betty's question about not being able to straighten her leg--I have the same problem, which was the situation that led me to have a partial knee replacement. I had 3 surgeries for a torn meniscus, and finally had the knee replacement, which the doctor said would fix everything. Now I not only can't fully straighten my leg, I also can't fully bend it or kneel. And I have a feeling of tightness around the knee, as if it's in a heavy metal brace. My physical therapist says that she thinks the fascia covering the muscle are "bunched up" instead of lying smoothly. So she's trying deep muscle massage in addition to the exercises. I keep hoping for the best, although I get very discouraged at times because of the restrictions to my activities.
It has been since 2008 since you wrote on this blog, your problems are very similar to mine and I was just hoping you could updaate me on your progress now? Thank you Rebecca R..

Lubbock, TX

#744 Mar 25, 2012
I know this forum is mostly for TKR but I am kinda out in the cold with my type of knee surgery, seeing how it only affects 1 in a million people a year. So I am judging things off of TKR surgery. Best thing I have to go off of right now. I just had a baseball sized giant cell tumor removed from my femur about 6 wks ago and am wondering how long most people with TKR experienced significant swelling? Also has anyone with a TKR experienced a complete lack of motion at 90 degree? My knee refuses to move any past 90, even with PT pushing on it. The pain is beyond bearable. Thanks

Batavia, NY

#745 Mar 26, 2012
Buckley---I suspect you will have swelling for awhile, as we all do with a TKR. AS for not being able to move it past 90 degrees--at 6 weeks post-op----it is still early. Give it time, and , yes, it does hurt something awful to move it! With my first TKR, my flexion was only about 80-85 at 5 weeks, and I only got up to 97 before I finished PT. I gained a few more degrees, I believe, on my own after that. Hang in there--but most importantly--ICE, ICE, ICE!!! And elevate! Keep us posted.

Lubbock, TX

#746 Mar 26, 2012
Thanks Kathy. I knew it was going to take some time but was not sure how much. I rely on my legs for my job as a wildlife biologist and I am chomping at the bit to get going. I want to push the PT but not so far as to hurt myself. Guess I just have to hurry up and wait.

Batavia, NY

#747 Mar 27, 2012
Buckley---I understand about needing to be better to work---I am an RN, but I knew I could not return until I could handle the rigors of floor nursing. It too me 6 months before I could return to work last year after my left TKR! This year, I hope to return in May--which I will be 4 months post op--2 months sooner than last time. That is my goal. Seeing my Dr this morning--I hope he agrees! Good luck, and don't rush your recovery! Your body will let you know when it is ready to handle being on your feet all day at work!

Batavia, NY

#748 Mar 28, 2012
Goodmorning everyone! I saw my Dr yesterday and he thinks all is looking great! I told him my plan to return to work May 7, and he wants to see me April 26 to give the final ok and to make sure I am ready to handle floor nursing again. My kids are all in an uproar! At least my daughters are---they don't understand my desire/need to get back to work. They want me to retire(impossible at age 58!), or at the very least, find an easier job. Well, I am always looking, but I can't turn my back on my seniority and pay scale I currently have. Especially with my hubby retiring in August! Not easy, but something I have to do. Well, I have the whole month of April to build strength and endurance. Wish me luck!

Since: Mar 12

Brooklyn, NY

#749 Mar 29, 2012
Hello, I am 9weeks post surgery- had my TKR plus a patella release done on 1/23/12. I was in hospital 5 days, another 3 weeks at a rehab hospital, and 4x week outpatient PT currently. I have had major problems with bending knee. I regressed after getting to 60degree bend in 1st week of inpatient rehab to only 30degrees at week #6 but have steadily gained since then to current 55degrees. Had issues with pain control that affected my tolerability of the pain since then corrected with high enough dosage of narcotics. I am going to have manipulation under anesthesia (nerve block) at hospital and have to stay overnite there with CMP machine likely be used. I am not looking forward to this procedure but want so much to get my life back. All I do day and night is think about bending my knee! Have any of you had good success after manipulation? What was pt like afterwards? Was it any different from before the manipulation procedure was done? Pain worse,same, better after procedure?

Aberdeen, NC

#750 Mar 29, 2012
Has anyone been having trouble with this forum. I also got an e-mail notification when there was a new post and for the past 2 weeks, I have not been receiving them. I tried to sign up again, but it's not working. Any suggestions?

Since: Nov 11

Grantham, NH

#751 Mar 30, 2012
HI Robert,

Sorry to hear about your flexion problems, it doesn't sound like much fun.

I had TKR on 8/16/11, had Manipulation under anesthesia on 11/16/11, and am still having issues, although mine are related to extension. The MUA is a breeze, and your pain level will be about what you have now, nothing like right after TKR. After the procedure, you will wake up to find that you can't move your legs, from the nerve block, and thats a good thing. They will put you right in the CPM and keep the leg moving. The block will wear off after a few hours and then you will be able to get up and walk. I was quite surprised by how good I felt the day after, although you will be uncomfortable. Its good they will keep you overnight after the MUA, you need to stay in a controlled environment to keep the leg moving. I had some bruising after but not a lot of swelling until I went back to PT. It was at PT where they started pushing my leg too far and it swelled up like a balloon, and that took away my ability to straighten. The few days before PT and right after the MUA, I felt like the leg was very straight and was standing flat footed at the sink, it was awesome. PT was not fun as they just pushed me too hard and I didn't stop them, my fault.

My best advice is to look at the MUA as a jump start to recovery. It will help break through the scar tissue and get you moving again. Make sure you use the CPM as much as possible, do heel slides and gentle stretching and exercises. Make sure you get plenty of rest, ice, with toes above your nose, and take your pain meds on schedule, you will be fine.

Make sure to ask the OS what your measurements were during the MUA, he/she should be able to tell you and that will help you know what is possible. You are still in the early days and will see progress but it can be painfully slow. Patience is a must have, which is easier said than done. Just remember this is a marathon, not a sprint. Your body has been assaulted and not will take every ounce of energy you have to heal.

At 7 1/2 months, I am still working through my extension issues. I sought the help of an experienced massage therapist who is working on the muscles around the knee, calf and thigh to help loosen and stretch them out, to hopefully improve mu functionality. It hasn't produced a lot of noticeable results yet, but not giving up yet.

You might also try to get into a pool, that could be a help for you. Just a thought.

I wish you all the best and please keep us posted. We have all been through this and have lots of compassion. But as I said at the beginning, the MUA is nothing to worry about.

Looking forward to hearing your update,


Batavia, NY

#752 Mar 30, 2012
annmar---Yes, I, too, have had problems recieving this forum! I always recieved email notifications before, but have not now for a couple weeks. Not sure what the problem is. And for a few days, it was not even showing in the correct format--very frustrating!
Robert--Dawn has given you all excellent advice. Since I have never had a MUA, I cannot advise on it, although there were times I wished I had one with my first TKR last year. Listen to those that have gone through all that---experience is your best advisor. I sometimes say that the Drs should have a TKR so they really know what we go through, because they don't have a clue!
Lately I have been a bit down--realizing that my progression with flexion seems to have hit a brick wall! I think I maxed out as good as I'm going to get at 110! I don't feel like I'm progressing! I am gaining strength, endurance, balance---all the things I need to return to work---but I feel my flexion is not getting any better! I wonder if there is something about me that prevents my knees from gaining terrific flexion?!?! My extension with both knees is perfect--never had an issue--but I struggle so with flexion! And it is not for lack of trying! The past couple days I added a new stretch to my routine to see if that helps. I will keep you all posted--but I will never know a "number" as I do not go to PT, just will know how the bend feels. I do know the flexion is better than the left knee, because that one is giving me issues(protesting) because of all the work on the stationary bike. I do 15 min twice a day on bike. Plus I try to go out and walk twice a day, along with my set of stretches twice a day.
BTW---still waiting for my new 3 wheel bike to arrive. Cannot wait for it to get here!!!

Since: Jun 10

Richfield, MN

#753 Mar 30, 2012
Welcome Robert and good luck with your progress. I have not experienced a MUA, so I'll leave you with Dawn's advice.

I read on here the other day someone saying they ride their stationary bike using their heel. It was comforting for me to hear. I have my stationary bike seat pretty high, but have only managed to get to the arch of my left foot (left TKR on 11/17/11). Unless reading it here, I wouldn't have known others struggle with this as well. I do push to pull my foot back further the longer I'm on the bike to force more flexion as it comes around.

Kathy-NY, you're lucky to be able to get in so much exercise right now. When I went back to work full time it was hard to get as much in. I know you're pushing to get back to work.
Have a great weekend everyone!

Batavia, NY

#754 Mar 30, 2012
Jolly---Yes, I do exercise alot now, but I know I will not be able to once I go back to work. Same thing happened last time--there is just not enough time to do everything! Not to mention, I remember well being totally exhausted and sore from work, so exercises did not especially appeal to me once I was home. Getting chores and cooking done was all I could handle! Although during the summer months I would come home and swim---but we all know how short the swim season is in WNY--3 months if we are lucky! As for the riding the bike with just my heels--that is all I can do with left foot(LTKR 11/22/2010), but I am able to force my arch and sometimes the ball of my right foot(RTKR 1/9/2012), but it slips back to heel. I have to really concentrate to keep from that happening so that I can force better flexion on the right knee. My seat is pretty low because I am short, so I know I am getting a good stretch. As soon as you are able to tolerate it, lower your seat to give that knee a better stretch. You may only be able to use your heel--don't beat yourself up over it--I've accepted it and bought a different bike for outside to accommodate my abilities(or disabilities). Think ahead to the (arthritic)pain-free days. THAT is what makes this surgery so worthwhile. To function without pain. I felt great by my 1 year anniversary(in regards to that left knee) which made the decision to go ahead with my right TKR so easy. I knew how I would feel 1 year down the road. Good luck!

Since: Nov 11

Grantham, NH

#755 Mar 31, 2012
HI Kathy,

Sorry to hear you are feeling down. You know thats pretty common after TKR, but it can challenge us. Keep looking ahead and the days will get better as the weather improves.

Also, don't be so quick to give up on your flexion. You are also very early in your recovery from #2 TKR. You can keep gaining flexion for a year or more, so there is plenty of time. Your activity level seems great and building strength and stamina will help you in so many ways. I would focus on functionality to measure progress. If you can do most of what you want to do, then the numbers don't really matter that much.

I did hear about an application for the iPhone or iPad that will measure flexion/extension. I plan to download it this weekend just to try it out. I don't know what my ROM is but it would be good to know, especially since I am still at this impasse with extension.

Was supposed to go to massage yesterday but fell out of my chair in the morning and decided I had enough excitement for one day. Thankfully it was a gentle landing and I only jammed my knee a little. No lasting effect, just a bruised ego!

Hoping for a quiet weekend. I need to go find a suitable outfit for my nieces wedding, not looking forward to prospect of a dress! My knee with so many surgeries on it looks like a science experiment gone bad!! Oh well, thats life!

Be well friends,


Batavia, NY

#756 Mar 31, 2012
Dawn---Thanks for the encouraging words. Yes, I know I could gain flexion for awhile to come. I just need to keep positive and keep working on it.
I, too, had to go looking for some new clothes to fly out for my son's "wedding" in Texas. I say "wedding" because it is really just their renewal of vows after 13 years of marraige, but because they were married in Vegas, his wife wanted the wedding she never had. So, it is a full scale wedding with bridesmaids, reception, etc! I am flying out, along with 2 of my daughters, in June. I wanted a dressy pant set(to cover both scars) but ended up with a dress. If I find a pant set I will return the dress. I also got some new other clothes to bring. Can't wear heels, so I will settle on dressy flat sandles, as Dallas in June is HOT!!
We had a snowstorm last eve which means no walk outside today! But since temps should be back to 50 tomorrow, I should be able to resume my walks.
Happy Saturday, everyone!

Since: Mar 12

Brooklyn, NY

#757 Mar 31, 2012
Dawn- thank you so much for your advice and comments. I ago would like to say thanks fort the welcoming to this forum from all else.
I Start my MUA next Wednesday. I will be discharged from hospital on Thurrsday. I definitely will share with all on this forum.
My situation regarding bending knee is complicated by the patella release I had along with TKR. My patella was completely off to the side for some 45 years. I am now 62 and my tendons and muscles were shortened by the operation. I am hoping the manipulation helps my bending but I know stretching exercises need to continue as I need to lengthen those tendons + muscles on my knee. It has been very hard and painful to do these exercises. I do take my pain meds but do not like taking too much of the narcotics. I recognize, however, I must take them and continue to work hard. I just want to be normal again. The effect on my wife and family has been extremely stressful! Hoping for the best after the manipulation. Thank you for hearing me out.

Since: Nov 11

Grantham, NH

#758 Apr 1, 2012
HI Robert,

I hope the MUA offers some help with the lack of ROM. I have no experience with the patella release, but based on what you have written, it sounds like there is some muscle contracture going on. Have you tried massage at all? I have been getting myofasial massage specifically on the TKR leg as I have muscle contracture as well. Lacking extension, I have walked on my tip toes for years, and think this may help me. It is somewhat painful, I won't kid you, but it might help.

Most people are anxious to get off the pain meds but in your case, you will need to manage the pain so you can get through PT. I wish you all the best and will look forward to your updates.

Kathy, i hope you can find a pretty pant suit. The low heel sandals are a good idea. I am headed to Texas in late April so it won't be too hot just yet. My niece being young has picked on me for my old lady shoes, but she doesn't realize how difficult it is with this kind of issue. And she's an RN. I tend to be a no nonsense type, so comfort and practicality come before all else!

Hope everyone has a good April Fools Day!


Leitchfield, KY

#759 Apr 4, 2012
Thelma wrote:
I am shortly to have a manipulation after a TKR which I had on 5th Nov.2007. Could anyone who has had this please e-mail me on thelma_rue@ I need to know more details about this and what it involves.
Many thanks.
I had total knee replacement 2011 then had manipulation 1 month later and aggressive therapy. the doctor will put you under and proceed to manipulate you knee which is really frozen knee to get back movement. It really hurts I was crying when woke up. went home same day. Make sure you do your therapy and follow all their advice. It will hurt bad but it has to be done. Use ice packs to help with swellng. You have to get back your muscle and stenght, good luck

Batavia, NY

#760 Apr 9, 2012
Hope everyone had a nice Easter weekend! My hubby out my new bike together on Good Friday, and we rode all weekend! When I went to use my stationary bike this morning, I noticed a big improvement in my flexion! So, I guess my big red trike is helping!! And hubby did not seem as embarrassed to ride next to me as he initially let on that he would be, so that was a good thing!

Mcminnville, OR

#761 Apr 10, 2012
I am one year post op on one knee and 9 months on the other. One of the first things I did was to purchase a goniometer to measure my motion progress. I subsequently discovered that there is a wonderful goniometer app for the iPhone. A few times a day I would sit on a chair and move my foot back as far as I could. Then I'd push myself forward on the chair. Painful, yes. Then I'd measure and never allow myself to go lower in flexion from last reading.
You will have bad days and wonder why you didn't just go out and buy a scooter, but then a good day comes along.
Long and short, I can easily get 145 degrees flexion (Stryker triathlon) and can spend a day walking and standing pain free.
I got my goniometer from Amazon for less than $10, and the iPhone app was only a few $. These allow you to take an active part in your rehab - at least it did for me.
I wish all of you the very best!

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