I saw my surgeon yesterday and he took one look at my bend and said he would manipulate it, but not until I was at 12 weeks so that is in another 3 weeks from now. In the meantime I've stopped physical therapy so that I will still have some left for after the manipulation. I had got to 105 under force, but I think that under my own steam I'm only making about 90. My apprehension comes from the fact that his nurse told me they do it under a general rather than an epidural - because it's such a 'rough' procedure. My heart doesn't do well under general anesthesia.
I'm so tired of all the ups and downs - a big up because I made 105 and then a big down because I couldn't keep it. Feeling up because the medication is working one day and then down because the pain is back the next. And now I don't know whether I should be up or down - up perhaps because it might finally get bent and down because of the anesthesia worry.
I don't really have a question. I just know that you are the only people I can talk to who understand.
Hi Joan, Keep taking the pain meds and exercise 1 hour after taking them, I do 3 times a day. I don't know what meds you are on but my doctor prescribed 1 X panadol forte and 1 X panadol Max 4 times a day and that was at 4 weeks and gave me a 10 week supply. 90 degrees is not that bad after 9 weeks, if you can work at getting up to about 120 degrees in the next 3 weeks you might avoid the manipulation. We are all differrent and things can change quite quickly in the TKR world. Good luck anyway, Regards Paul
The good part of the general, you go under deep but not too long as I understand. If that's the case, it's much easier con the system and coming out of it not as difficult as they can use a different drug. I feel your frustration. You may have read my post a few weeks ago about my fall did to a kidney infection and quick drop in blood pressure. Landed on my knees and forehead, splitting my head open and requiring an ambulance ride to the hospital, stitches and 5 day stay to clear up the infection. Didn't think I hurt my bad leg but 3 weeks later pain started and now I'm back in therapy. I had been @ 120° when I finished therapy the last time and in the short time between the hospitalization and gettingvback to therapy I dropped to 105. . I will be going 2x's weekly through Feb. I have a tremendous amount of scar tissue in the upper leg that has to be torn loose. Just because I kow what and how to do it doesn't make it any easier and boesnt keep me from dreading the process. I have really been depressed the last few weeks but know it will get better with time and effort. I turn 78 in a caouplevof weeks and sure didn't want to be going through this again for the 3rd straight birthday. At least they wont have to be trying to teach an old dog new tricks, just reinforcing thecikd ones.
Try and not worry too much about the manipulation and think about the positive side of getting the bend back in a hurry
Hi Joan
I also saw my surgeon yesterday and he's told me I have 3 weeks or I also have to have a manipulation. I've never had my bend more than 80 degrees and even with him pushing it yesterday he could get it to move. Needless to say I cried when I got in the car, maybe tears of anger at myself for maybe not pushing it hard enough or maybe frustration that I've been working really hard and its not good enough.
I'm nearly at my 8 week point and wanted better results from myself at this stage. I have a huge amount of swelling and ice so much during the day, to the point ive burnt myself with it! I'm 34 and thought I'd just get going after. Its hard blumin work!!
I'm scared about the manipulation, 1 I really don't like being put to sleep and 2 I don't know if it will put me back a bit before I come forward. It's taken me 6 weeks to be able to do a straight leg raise. I'm so apprehensive.
So I have 3 weeks to get to 110 from 64 which is was yesterday. I can see a lot of pain killers and tears in the coming weeks.
I hope you find your bend before your time limit and keep strong. You aren't alone.
Julia xx
Hi Joan, Britta had a manipulation under anesthetic a while back, she was very scared but it was all ok. Did your surgeon explain to you the procedure, and what exactly he's going to do?
I will try to find her thread, as she explained it all. What I do remember though, is that she didn't find it too horrific.
You came to the right place though. If you are scared or dubious, there is always a listening friend.
Caz x
When you have the pre-op appointment with the anaesthetist tell them your concerns and ask if it is possible to have it done under epidural with sedation - the epidural does the pain control, the sedation knocks you out so you don't see them having a go at the knee, it is probably a bit uncomfortable for a surgeon to know the patient knows what he's doing! They can only say no. It is also possible it is just a very light GA for a very short procedure which will be different from a longer op.
Ok Joan, I looked back and found Brittas thread, December 6th 2014. It's called
britta217. Survived! Mobilisation of knee under anesthesia. I think it might help put your fear at bay.
Also Suzy97219 wrote a thread called Manipulation complete.
Hope they help
Caz x
I have seen people on here not get to the required "bend" until 18 weeks, so please try & carry on as you are doing, & in that 3 weeks - you may well get there. I am 11 weeks+, I have "0" straight but a useless bend! I have very high blood pressure, so I will refuse a MUA, it is more dangerous than bending the flipping knee! I too, keep having up, then down days - & I'm normally known as "the strong one"!! My physio has told me I would go back to being very bruised, & very sore after manipulation, & that she will help me get there without - & that is what I am hoping for. Too much pressure is being put on us to be text book - see how you go in that 3 weeks, & if told they want to do it - think long & hard - we all repair at different speeds according to this forum (which is my salvation!). I have some very good straightening excercises which I can send you if you need them? - Veronica
Hi Joan & fellow recipients of TKR's.
I would like to know what is the best we can expect regarding bend angle. (Flexion)? My surgeon told me there is a physical/mechanical limit of bend angle due to the construction of the metal & plastic joint.
But he didn't elaborate, I'm at approx. 12 weeks post TKR and am reaching quite a decent bend, but I have no idea what it is or whether I could maybe push a bit harder and get an improvement as climbing and decending stairs is slow due to not enough bend.
My March 2014 TKR is slightly better re; bend but not much. Whilst out walking it is very awkward climbing stiles and the occasional five bar gate is a traumatic and painful obstacle.
Maybe I need to spend a while in the tool shed and manufacture a measuring device (2 bits of batten a screw and an old school protractor might do it) as physio' have discharged me now. I'm a good bit over 90° so perhaps I should not be too curious, it would just be nice to know if there is more to had?
Hi David, someone said there is an app to measure the bend. It's called a goniometer. I found a few on the iPhone store for free. The one that was spoken about is called knee goniometer and it costs. The person who posted said it was good.
if you google image you can get a diagram of the knee bend degrees too.
i hope this helps.
Caz - 16 weeks post TKR Pom in Perth Australia
That was me that posted the app. Its called knee goniometer available at the apple app store. I been using it on the Ipad and while it can be accurate it takes a bit of fidgeding to get it right.
Since the I have purchased a real Goniometer. It only costs 8 dollars so no big deal. The app cost 5. I have also used two wooden 15inch rulers together at 1 end and secure them with wing nut. This method is extremely accurate.
Hi Joan,
I haven't posted to much over the past week or so because of the really wonky ups and downs you mention. I just don't understand the inconsistencies in the way diff PT and surgeons deal with patients in regards to their recovery from this op.
Im at 4 weeks and 3 days and Got my bend to 90 this past tues. thought I was doing well but my surgeon put the thumb screws to me. He Feels that everyone should be at 120 in 6 weeks. As a result, even though I know better, I push the exercises until it feels like my leg will actually snap if I go any further and needless to say, that keeps me in a
tremendous amount of pain.
yesterday I go to PT. she says "remember people, exercise pain free. Don't ever push yourself until it hurts. Listen to your body and the knees will heal in time"
so you hear those extremes and everything in between. Who do you listen to?
No wonder this is such a frustrating op.
To be honest, I'm at the point where I feel like telling them all to hit the road.
I don't like to be bullied into things and have always believed that we should listen to our own bodies anyway. I like the slow and firm but take it easy approach.
This op has put our bodies through a great deal of stress and if we are faithful to exercise reasonably, our knees will bend when our knees say its time to bend and
not before. For some thats sooner and for some later.
Stay strong Joan and don't worry abut the manipulation if you have to have it done.
Just do the best you can. No one can ask for more and you will come out a winner
After telling David about the ap I bought it, it is accurate, but fiddly until you get the hang of it.
Thanks, where did you buy your real goniometer?
Caz x
Hi Joan,
Went to see my surgeon Wednesday, he measured my bend at 105 which he said is good enough for now, he is adamant it will get much better , he told me to be patient and I would get there in the end. I asked if he would manipulate it under anesthetic, but he said no not yet, he only did it as a final resort if the bend was bad & knee very stiff, he said mine would get there eventualy if I kept up with the exercises, we all heal differently he said, some quicker than others. So I'll carry on & hope the bend will get better in time. Actually, today I managed to do full turns on my exercise bike, that is a first for me, meybe things are looking up.
Keep us informed about your manipulation, if you go ahead with it, all the best
Hi caz,
Got mine off amazon. Loads to choose from. Think mine was 8 dollars + shipping. Still waiting for it to arrive. In the mean time I made 1 using 2 rulers. This was just for fun of course but its very accurate.
I overlaped two rulers on the end. Drilled a small hole in each then secured them with a wing nut. When you loosen the nut, the two pieces move like scissors. Just adjust it to your bend. Transfer the angle to paper and measure it with protractor. You have to do something when your up all night!
haha
I have just read your question and 14 responses and have a little bit to add. I have had 5 reconstructive surgeries on my knees in 37 years and now 2 replacements in 2014. Knee surgeries are painful and the recovery and learning to walk and build functional knees takes a LOT of work and dedication over a lengthy period of time 4-6 months is the minimum time for good recovery and full recovery takes about a year. I DO NOT believe in manipulation under anaesthetic unless there is some extenuating circumstances as you are right back to square one with bruising and major pain. If you are over 90 degree bend by about 10 weeks you are ON TRACK! If you are better than that you are a STAR! Any surgeon who pushes you harder than that has their own agenda. The physiotherapists who guide you will be more honest. If you are progressing and doing the work, you will get there. There are NO shortcuts! Do the work before the MUA or do it after the pain starts again! It is difficult to do the work but the work IS simple. Tbat is my honest advice. If you think you can, you will. If not, you won't. I believe that our mobility is the most important thing we have other than our health. And it IS up to us!
Hi David, My first replacement is now 11 months old and at 125 degrees flexion. This is nearing the mechanic limit of the hardware according to my surgeon. The good news he tells me is that the limit to the ability of my knee is dependent on how much slow steady work I put into the recovery. He said that running and jumping will wear out the knee and downhill or water skiing, tennis and any other sport that requires jarring and twisting motions could be an issue to the longevity of the knee. I do not intend to do these. But building muscle, cycling, classic skiing, swimming, hiking and the like are great as long as I build up to them. I am heartened by this news and I can confirm that this has already been the case with knee #1. Knee #2 has been slower in recovery but the journey is moving along the same road. I hope this helps you out. Keep smiling and keep improving!
I'm on oxycodone. I'm still exercising, but getting to 120 in 3 weeks sounds like an impossible task. Still, I'll keep trying.
I did read your post - gosh you have been through the wringer. I should think about that and stop complaining.
Perhaps you are right about the general. I don't expect I will need to be under for very long. The surgeon said he was not worried about manipulating my knee because I can straighten it. He said it was much harder if the knee wouldn't straighten. Then he would have to go in and cut the scar tissue away. He also said that I would be going home the same day. It's just one of those up and down things again. I was feeling up because I thought I could avoid it, but the surgeon didn't hesitate. He looked at my bend and said 'I'll manipulate it'. No maybe's at all.
Julia, I'm keeping on with the exercises but I don't really think I'll make that kind of gain, and I am ahead of you in that I have very little swelling now, so the swelling is not stopping the bend for me.
Please don't be frustrated at yourself. You can only do your best and it sounds like you have been doing that. My surgeon said that previous surgeries tended to complicate things but he really didn't know why.
Going under anesthesia is always scarey, but I guess we just have to bite the bullet. I did read Britta's posts and they are very encouraging.