Has anyone else's ROM gone backwards?

I am at 10 weeks post tkr, bought myself a goniometer (to measure ROM). My husband measures it every week, and it's gone from 110deg back to 102. That's all I need to feel like I'm not progressing. Has anyone else had the same problem?**

A TKR recovery is NOT linear…not even close. There are advances, setbacks and plateaus (the worst). This is all normal especially for people like yourself who are very early in their recoveries. I know that my ROM fluctuated a bit before I hit a plateau at -4. Could not break that barrier for weeks…very depressing. But you have to go past that and keep working. At 12 weeks, I was -1 / +123. At 3 1/2 YEARS, I’m about 0 / +133. Everyone is different so comparing yourself to anyone else can really screw with your head. Don’t do that…plus get rid of all your expectations. This is a slow, gradual recovery that very few escape.

Put this on your fridge…

Reality

…and don’t forget your oars for the boat part.

Next up will be the mandatory muscle rebuild which will take up most of your first year…

Muscle Rebuild

Plus here’s some great ROM work you can do at home…

Home ROM Work

Click on my name, Discussions and then View All. I have about 30 out there on a wide range of topics that might be helpful for you. Have fun…

Yes, all part of the process I’m afraid. As Chico says, it’s not a linear progression and many steps backward along the way. Try not to stress too much about it. Maybe put the goniometer away for a while and only bring it out once in a while if you feel you need to. A count of -8 isn’t too much to worry about at this stage. Some days I can walk downstairs with no pain and other days can be a harder depending on how good my ROM is on any given day.

I thought my bend was good until the physio asked me last week what was preventing me pushing my leg back further! I woukdn’t be able to sit back on my heels, but I’m nit that far off. No-one has measured it since I left hospital, but the surgeon and other physios have been pleased with it and my Pilates teacher tells me I have the best range of movement she’s seen in her pupils. As long as I can do the things I want I’m not bothered about numbers.

Apologies for typos, I must remember to read everything through before I hit Post reply!

I would say that’s quite common. You will still get some inflammation from time to time. 110 degrees sounds fantastic to me after 10 weeks. (Although I’ve been stuck on 85-95 since the ops two years ago so I am not the best to comment I guess). In the end and in general I think people get to where they were pre-op or maybe pre-knee issues if they only had them for a couple of years.

Oh yes. Had to have arthoscopic surgery done at month 10 to clean out scar tissue, and ROM went up, but back down , once again, at month 20… I know scar tissue is back, but surgeon doesn’t want to go back in, for fears of infection or scar tissue coming back again… sigh…

may I ask, does your knee still hurt any? I am 20 months post op, and my ROM is around 100, but my knee hurts badly… was just wondering if yours was?! sorta goes hand in hand, the stiffness with pain.?!

Hi Martha. I think I had my second one the same time as you roughly - May 2018. no I don’t have much pain. If there is stiffness it is just that with perhaps a bit of an ache. Every once in a while I get the odd twinge on the outside or anywhere really. The only pain is if it does bend past where it goes to naturally. I have fallen over a couple of times and wrenched it and at the point of maximum flexion it was hell but it soon was ok and no damage to the joint. Any issues I have are really probably long term tendon/ligament/arthritis related rather than in the new joint itself.

Thanks again for your advice Chico, yes, I am in a hurry to get this knee to at least 125deg. I should remember that it is not linear, mainly because the second knee is due to be done in December.

Yes Lynda, the physios are not at all empathetic, they want to push too hard I feel. It would be good to find one that has had a tkr!

My knee pre-op was good as far as ROM was concerned. The left knee which is due in December has had a reconstruction in the 80’s, and has a ROM of 128deg. If I can match that with the the Ieft would be happy. Have you been checked for scar tissue?

Martha, I feel for you. It does sound like having scar tissue removed doesn’t always work too well. Don’t give up, all we can do is keep on keeping on. Hope it resolves for you.

As far as I can tell they don’t really do anything about scar tissue on the NHS in England. I know there is some on the outside top of my knee and the surgeon said that will probably diminish naturally over time but I can tell that’s not what is stopping the bend and I don’t think there is any in the other one. You have to put it in the context of having knee issues and OA for forty years and only having 90 deg flexion for the last 10. I think it is more the ligaments, tendons, hamstring just can’t stretch enough. That’s how it feels. It can’t even be forced further. A tad disappointing but I am so much better off, pain free and standing and walking so much better.

Scar tissue is part of the normal healing process as far as I’m aware and unlikely to affect ROM. Adhesions are more problematic and can recur if you’re prone to them, which is why surgeons are often reluctant to interfere as there is a possibility of doing more harm than good. It’s a minefield really, isn’t it?

the scar tissue I had is /was NOT normal. I had to have surgery to get rid of it, a year ago. it has grown back. the question is, WHY? was sent to the knee guru in charlotte, NC. no help from them either.If there’s one good thing that has come from my TKR, on my left knee, is, the fact that I will go to my grave with an untouched right knee.. And on that, I can promise !!!

I had arthoscopic surgery done for scar tissue, a year ago, but it back !!! Doc showed me the pictures they took of the scar tissue. Looks like cotton candy, but tuff as nails !!!

I don’t think I would ever go for having scar tissue removed after all the negative comments I’ve seen here.
I live in Australia and have private health insurance, but seems useless.
I’m glad you are at least pain free and walking and standing ok. Good luck and Thanks for your comments.

Sorry Martha to hear about your problems. I didn’t mean to indicate that what you had was normal. I may have phrased it badly. Any injury causes scar tissue to form, which is part of the normal healing process, but as in anything there are those who don’t heal in the same way. Some people develop keloid scars or hypertrophic scars and certain ethnicities are more likely to suffer, but I don’t know why. My hairdresser is of Afro-Carribean descent and she suffers with keloid scarring and I know someone else from the sane ethnic background who suffers the same.

Scar tissue is made from collagen so maybe that’s the cotton wool appearance? I hope you find something to relieve the pain you’re having.

that surgery was nothing !!! I was put under and woke up 2 hours later… Minimal pain from that surgery, and my ROM got up to 121, but sadly has gone back down in the past year… and Yes, I went to PT religiously…

The scar tissue Im referring to is NOT on top of my knee, as a keloid would be. Mine was/is inside the knee. the scar on top of my knee looks perfect. Always has. but that’s never been my problem.