5 months post op still having trouble...

5 months post op still having trouble bending knee all the way

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Suzie

Malden, MA

#1 Feb 2, 2011
I had TKR 5 months ago and I still can't bend my knee all the way.. My Physical therapist can get it bent pretty well but it hurts still and I can't do it on my own. I have about 120 degrees by myself without to much pain.. Is this normal. What do most people have and how long before all the pain goes away. I'm having a terrible time with the weather up here in New England this winter

Since: Dec 10

Salt Lake City, UT

#2 Feb 2, 2011
I think they say they want at least 110 degrees, if your over 120 degrees your doing good, just keep stretching, I've noticed some are slower than others, I am 5 weeks out and I have 130 degrees, but I'm abnormal, Lucky, It still hurts and I work it out pretty hard so I'm always sore, but my leg is still weak, so I push it harder, it will come, be patient...good luck..Dan
Batya

Knightdale, NC

#3 Feb 2, 2011
Suzie, did your doctor put you on a CPM machine (Continuous Passive Movement)? I had my TKR Nov 1, 2010, and had a terrible time with physical therapy and flexion. My surgeon's goal for me was 120, but after 5 weeks, I was still in the low 30's. He did not have me use a CPM, and I didn't know anything them. A friend finally asked if I was using CPM. I called the surgeon's office and said I wanted one, and the arrangements were made: I had one the next day. My ROM started going up slowly. Then I increased my PT from 2 to 3 times a week and started warming up on a recumbent bike (I still can't do a complete revolution on a regular exercise bike). In my last 3 PT visits, my ROM has been 120, then 122, and now 124.

I forgot to mention that 6 weeks after surgery, because my ROM was still so low, the surgeon strongly recommended I have Manipulation Under Anesthesia (MUA), which I did. I went to PT the very next day and ROM was still in the 30s, as it was the next PT session. That was when I found out about the CPM machine, and I credit it plus the recumbent bike with loosening my knee up. My physical therapist also recommends massaging the incision multiple times a day, which I do.
Frank

Bates City, MO

#4 Feb 2, 2011
Hi Suzie, sounds pretty typical for both of my replacements. I was in the 120-130 range for almost a year until ALL of the swelling went away completely. Normal daily use has me at around 145-150 now, 4 years later. Pain went away around 6-7 months.

Cold weather caused me a problem in the first year or so, after that, nothing noticeable.

Patience pays off...hang in there.
Suzie

Malden, MA

#5 Feb 3, 2011
Thank you everyone for your responses. Frank, my Dr. says the same thing you are saying. I had great range in the beginning and i can straighten to 0.. I think it is the swelling. One section is still very swollen. especially when it snows..Which is all the time lately. LOL.. I just wanted to make sure other people had the same issue and the dr. wasn't just saying this stuff to shut me up..
HaaryB

San Leandro, CA

#6 Feb 3, 2011
Suzie wrote:
Thank you everyone for your responses. Frank, my Dr. says the same thing you are saying. I had great range in the beginning and i can straighten to 0.. I think it is the swelling. One section is still very swollen. especially when it snows..Which is all the time lately. LOL.. I just wanted to make sure other people had the same issue and the dr. wasn't just saying this stuff to shut me up..
I think your ROM is also affected by the size of your legs(especially if you have swelling). I am a heavily muscled ex athlete and 120 is my max. I have a thin legged friend from work whose ROM is in the high 140s. If you are able to press your back of your calf to the back of your thigh a few inches above your knee, that is kind of your physical limit.
I have 110 ROM one month post op and slowly improving with PT.
I had pain for 20yrs before the surgery, which makes even a year of rehab seems pretty reasonable.
Good Luck,
Harry
mindy

Albertville, AL

#7 Feb 3, 2011
HaaryB wrote:
<quoted text>
I think your ROM is also affected by the size of your legs(especially if you have swelling). I am a heavily muscled ex athlete and 120 is my max. I have a thin legged friend from work whose ROM is in the high 140s. If you are able to press your back of your calf to the back of your thigh a few inches above your knee, that is kind of your physical limit.
I have 110 ROM one month post op and slowly improving with PT.
I had pain for 20yrs before the surgery, which makes even a year of rehab seems pretty reasonable.
Good Luck,
Harry
Suzie: sounds like you have a good doctor-which means more than anything. My replacement was 2 1/2 years ago-and my doctor too little too late. He cut my MCL-which keloided-then offered manipulation 5 months after the surgery- which I knew was too late and would result in a probable fracture. So you keep up your therapy-and you will get there. I had therapy in 3 different places with only a range in the 40s. Wish I had used a more reputable doctor. take care
Suzie

Malden, MA

#8 Feb 16, 2011
I finished my PT today with 145 Bend.. It seems that there was some swelling that had gone down and it has made my knee much more nimble.. I guess it will just keep getting better and better as the year goes on!!
Debbie

Stone Mountain, GA

#9 Feb 16, 2011
My doc wanted 120 before releasing me from PT. It took me 3 months. But it seemed like once that clicked I improved almost daily. Hang in there, it will get better. everyone is a little different.
Susan

Wyoming, Canada

#10 Mar 7, 2011
Suzie wrote:
Thank you everyone for your responses. Frank, my Dr. says the same thing you are saying. I had great range in the beginning and i can straighten to 0.. I think it is the swelling. One section is still very swollen. especially when it snows..Which is all the time lately. LOL.. I just wanted to make sure other people had the same issue and the dr. wasn't just saying this stuff to shut me up..
I have the same problem..Good straightening it out and I have 112 degrees now and my physio therapist if pleased with it... I am still working to 120+ but is OK if that's all i get... its a little over 3 months for me and i still have swelling especially over my knee.... and when I go outside... wow! the cold affects it... can't wait for the snow to go away.... the tight band feeling around it really gets worse as I go outside... hope that leaves soon too....
Adam

Rockville, MD

#11 May 8, 2011
Hi all,

I have a question for everyone. What are the causes of poor bend after TKR surgery? I'm just 4 weeks post op and am really concerned and scared that my bend isn't what I think it should be. I can straighten my knee completely, but I think my bend is only at 80 - 85 (it fluctuates). I keep asking my therapists what actually causes the inability to bend and I get varied answers. I've heard that it could be swelling. I've also heard that it could be lack of stretch or poor strength. I don't see my surgeon for another week or so, but found this forum and thought I'd ask. I've read horror stories about what some have gone through and don't want to wait too long if some intervention is needed.

In my case, it feels like there's a tight band going vertically (up/down) across the front right side of my knee. Almost like it's attached at the top and bottom of my knee, holding my leg straight, so that it won't bend. There's also a moderate amount of swelling at the top of my knee. I ice my knee daily, so the swelling is going down.

I'm also pretty young for TKR, or so I've been told (mid 30's) I have a very lean build. I'm not overweight at all. I had a total hip replacement (same leg) about a year and a half ago, and had absolutely no problems. I actually progressed almost too quickly, which was chalked up to my age.

At any rate, I'm starting to get pretty frightened that I'll never be able to bend my knee. Asking someone who's never gone through this seems fruitless to me. Are there any of you, who've gone through this, who can give me an idea what to expect?

Many thanks, in advance,
Adam
Jan

Raleigh, NC

#12 Jun 1, 2011
Hi everyone,

Adam, I'm at about the same place post-op as you are! I'm now at 5 wks post op and could bend at 103 degrees at my last pt appt. It seems like there is quite a range of what is to be expected. I felt better reading on a site that said that expectations after TKR is 110 degrees. I had both knees done, and it has been really painful.

My question for everyone is about having the therapist bend your knee. How much is too much? It really really hurt yesterday and then my knees were swollen the rest of the day. Is this normal & ok? I was ready to quit pt yesterday, but today I feel fine. Do I just need to deal with the pain? It hurt SO MUCH!

Any comments are appreciated! Thanks,

Jan
phyllo

Marion, IN

#13 Jun 1, 2011
I am almost 4 months on my total knee replacement. Therapy has been grueling but I could finally make it through without tears which was encouraging for me. Just one week short of the 3 months after surgery my pain finally stopped and I no longer needed pain pills to survive. I was thrilled.

However, ten days later I woke up so weak I could hardly stand and my knee pain had returned. It crunches everytime I stand up and I could hardly walk on it. My therapy yesterday was torture. I had lost all progress in my bend. I went from 127 down to 114 and the straight measure was also not as good.

I am terribly discouraged. I thought I was over the hump but evidently not. I am just so tired of being in pain.
Evelyn

Milan, Italy

#14 Aug 5, 2011
Jan wrote:
Hi everyone,
Adam, I'm at about the same place post-op as you are! I'm now at 5 wks post op and could bend at 103 degrees at my last pt appt. It seems like there is quite a range of what is to be expected. I felt better reading on a site that said that expectations after TKR is 110 degrees. I had both knees done, and it has been really painful.
My question for everyone is about having the therapist bend your knee. How much is too much? It really really hurt yesterday and then my knees were swollen the rest of the day. Is this normal & ok? I was ready to quit pt yesterday, but today I feel fine. Do I just need to deal with the pain? It hurt SO MUCH!
Any comments are appreciated! Thanks,
Jan
Hello Adam, yes I think you have to keep at it regardless of the pain. I am still at it after 6 months and my PT does it for me and it HURTS, but just like you afterwards its fine. What I do is take half of my pain medecine at least 1 hour before I have a PT session. The important thing I think is to bend that knee as much as possible within the first 3 months. For the swelling even better than ice (not everyone is fond of ice) try gree clay, mix a little with water until it becomes likes a heavy paste (not liquid) put in all over you knee and keep together with ordanary plastic celephan normallyl used in the kitchen. It really does the trick. Keep the paste on for as long as you cand then just wash off. good luck
Diann

Las Vegas, NV

#15 Oct 17, 2011
I am 2 weeks post op of TKR and can't bend my knee at all, when I try to bend it I can feel something rubbing on the inner side of the knee, almost as if something is slipping, the swelling is really bad so I keep ice on it which does help. Beside the tkr I had a fall that fractured the tibial plateau, this is what led to me having tkr. I get horrific spasms in my knees while I am sleeping making it impossile to get a full nights sleep. I also have terrible soreness in the calve of my leg, making it hard to stand on it at times. My PT comes to my house and has me doing leg strenghting exercises which is very painful, I am also using a CPM machine which causes my thigh muscles to spasm. It just seems that I have everything going against me at this time. I want to just get up and start walking normally again. This is just one of the worse and hardest surgeries that I ever had to endure. Hopefully my dr will have some news for me after seeing my post op xrays. It does sound that after reading all the comments that manipulation may be in order for me, and if that is what it's gonna take to get me to get my knee moving then I am ready to do it.
Suzie

Malden, MA

#16 Oct 19, 2011
Diann, the first 2 to 3 weeks are really really hard. It was the worst pain I have ever had in my life. It DOES get better quickly. I wish you luck. I am doing great now and am so happy I had it done. but at 2 weeks I was in the same place as you. I was wishing I had never had it done and crying. Now I'm walking and jogging a tiny bit. IT WILL GET BETTER and You will look back and be thankful you had it done.
Wanda

Chesapeake, VA

#17 Apr 16, 2012
I am 2 1/2 months post tkr and rom is only 94 and still having pain all the time! I am going to therapy 3 times weekly and can hardly make it through but I force myself and then exhausted the rest of the day. Is it normal to still have pain? I can't say at this point I am glad I had it done!
Adam

Potomac, MD

#18 Apr 17, 2012
Hello everyone-

So, here I am, almost a year later, and everything is fine. I did end up having a manipulation procedure. My earlier issues were related to a couple of things. Because my musculature was so tight, I wasn't maintaining any of the flexion I achieved in therapy (even with home exercise). This allowed for the buildup of scar tissue in the joint. It was the scar tissue that as keeping from achieving the desired flexion. My orthopedist broke it all, by performing the manipulation. He then prescribed a CPM machine for a few weeks. That, along with therapy, did the trick. Things progressed pretty rapidly from there.

Now, I'm so much better and continue to have very little swelling. My replaced knee bends almost as much as my good knee. It bothers me that I can't really kneel (or rather shouldn't), but that's a small price to pay for being able to walk without pain.

Good luck to anyone who has recently gone through the surgery. Hang in there and know that everything you're worried about right now will soon be a memory.
Paula

Clyde, OH

#19 Sep 7, 2012
I had a TKR over 9 months ago and can only bend my knee 90 degrees. I was still using a cane and walker when my PT sessions were up, my insurance will not pay for more. I blame my dr for my bad knee. He operated on my knee at 7;00 pm. I was suppose to have surgery at 2;00 pm.(He had problems with the previous knee patient). Anyway, the nurses did not get me up and moving until 9:am the next day. By then a lot of scare tissue had developed.I hate my knee because it is very difficult to move and my hips and lower back hurt after short walks. I will be having more surgery in a few weeks. I hope it will help. I honestly believe that one leg is slightly longer, too. I have a bad limp that won't go away. I would never recommend TKL to any one!! I honestly don't know how older people are able to do it either.( I am 58 years old) My knee often feels like it is in a tight vice. I still take pain pills that help a little with the pain management. I can't go up or down stairs in fact I have more limitations with my new knee as opposed to my old knee. I can't wait until I get this thing fixed!! Thanks for listening.
Ron

Delphos, OH

#20 Sep 26, 2012
I am 50 years old and I am 2 months post-op from my 2nd TKR.. 3 years ago I had my other knee done.. I know that is kind of young but my knees were a mess due to arthritis ..That surgery went fine.. ..Only down fall is, i wished it bent more.. I am very active.. I have read some of these blogs which some are very good and some are not so good.. I thought I would jot down a few things with my experiences.. I just finished my PT and my flexibility was 120.. My straightness is fine.. Although at times PT was very very hard.. Due to swelling and just overall pain in the knee.. There is alot of discomfort that goes along with these types of surgeries. TAKE YOUR PAIN MEDS.. Dont be a hero and try to manage without them.. Your irritable and grumpy when your in pain.. I always take a pain pill 1 hour before I go into PT.. It helps with flexibility.. And makes things go easier.. But you have to have a routine at home on days you don't go to therapy.. Don't just sit around, I know its hard but it will be twice as hard when you go back to therapy.. I also take on occasions IBProfene which helps with swelling because it is an anti inflammatory and of course, ICE, ICE, ICE... As I stated I am very active I have 3 boys that are very active in sports.. And my self I am a coach as well as a licensed football and basketball official for the past 27 years.. I am still looking forward to refereeing high school basketball this winter..I got out yesterday and walked 1 1/2 miles, then I slowed jogged one lap around the track.. So the knee is coming, its just takes time.. I am a semi muscular man which doctors and therapists both tell me it will take longer to heal besides of the muscle mass in my body.. Muscles and bones with fight your knee before it accepts it.. I really hope this helps.. Everyone hang in there.. Hopefully you get what you want out of your new knee.

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