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11/29/2010 06:47 PM

Knee Replacement Frustration

napaman
Posts: 9
New Member

Hi -

My first post. Had a total knee replacement (minimally-invasive) a year ago, and still struggling. Though the osteoarthritic pain is gone, total pain is greater - and inflammation is greater. Biggest problem, though, is range of motion. From pre-surgery ROM of about 0/+130 (the other knee is minus 10/+150), a day after surgery it was +10/+70. And a year later, that's still about all it is, despite six months of PT (started two weeks after surgery) and daily exercises (including a stationary bike) at home. Can't kneel, run, or ride a real bicycle. The knee feels like there's shrink wrap around it - perhaps that's the excessive scar tissue and maybe arthrofibrosis (shrinkage and tightening of the knee's joint capsule). At six weeks, the surgeon did a manual manipulation, which only made things worse; the upper leg REALLY swelled up for several weeks. Finally consulted with another orthopedic surgeon who ordered a CT scan which showed that "the tracking is a bit off", whatever that means. He suggested getting another opinion before deciding on the next step, which might be a re-do. Not keen on that considering the blood clot at one week (leg) that set me back and drained all my energy. Or maybe I should consider an athroscopic surgical scar resection followed by another (dreaded) manipulation. Am back to work now, on my feet eight hours a day, but get really fatigued, despite being ideal weight, or slightly underweight. Have been able to walk up to six miles, but not downhill. Guess the next step is to see what the third doctor will say. Anyone out there relate? Thanks for the forum.

Post edited by: napaman, at: 11/30/2010 04:41 PM

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11/30/2010 04:14 PM
keeter

Hi! Welcome to the group! I can see why you are frustrated! That is pretty limited and especially with that tight feeling. I think I would see a third or go back to the second and ask him to show you what he means. It almost sounds like it wasn't put in quite right by the tracking being off. And that could be what is causing the tightness. And it could also be excess scar tissue that is binding it and needs to be removed. I've had some luck by describing what's going on to the ortho doc before he/she does x-rays. That way they can look at it from different angles and sometimes see more.

Good luck! I hope you can find someone to help you make it right!

Take care,

Diane


12/04/2010 09:58 PM
thelma55
 
Posts: 5
New Member

Hi..I'm Marie and I joined this support group because I'm tired of people telling me "looks like you're doing great" when I'm just standing there...if they could feel the tightness. Sorry your having such problems..I related to your under weight comment though. i lost alot of weight and I sure do plan to keep it off...I can't imagine putting more weight on this knee.If you get a third opinion..how do you know which one is right..keep us posted.

12/26/2010 06:40 PM
LauraF
LauraF  
Posts: 15
Member

Hi, I am Laura and I can certainly relate. I had bilateral total knee replacement over 4 years ago and have had many problems. My right knee has a contracture so has limited flexion and extentison. I won't go into all the details but two weeks ago I fell at work on my knees on a cement floor, rushed to the er, what a pain. Have not seen my knee surgeon yet. My knees seem to be okay, well as okay as they can be but need to have him check it out since it is a workers comp issue. I understand the various opinons. I need ot get a third on my neck which may need fusion.

One of the other people said how do you know which opinion to go with, I say it is a matter of percentage and checking their backgrounds. Anyway good luck, I understand.


01/02/2011 10:58 AM
keeter

And sometimes you have to trust your feelings. If you feel llike you can trust the doc, follow through. Ask others who have used him or her to be reassured or discouraged. What I have found is that there are always some people who love the surgeon and some who hate him. Much of the time it is a personality match. You are right to be concerned if you are still having problems. Sometimes a new PT can help you figure it out. I've had some good success with that.

I hope you all can find the answer!

Hugs,

Diane


02/07/2011 07:00 PM
napaman
Posts: 9
New Member

Laura,

Just now noticed your comment. I'm wondering, what is a "contracture"? Not in my dictionary at home. Just curious. BTW, I'm still waiting on that third opinion. Takes a while to get appointments. One thing I've noticed is that after exercise or physical therapy, I'm always much stiffer. Especially after icing it. These days I take a good, hot soak to ease away the pain.


02/13/2011 10:24 AM
BPB
BPB  
Posts: 801
Senior Member

Laura,

A contracture is the shortening of the muscles and ligaments and causes the joint to curl into itslef and not have as much flexing ability-once a contracture sets it it involves stretching the muscles and the ligaments and the tendons which can be painful but necessary to avoid the curling in on itself. I too find I am much stiffer when I use cold and find a warm bath or shower or a heating pad much more comforting. To prevent the stiffness I try and walk or ride a stationary bike daily to keep my muscles, tendons and lignaments strong surrounding my new knees. If I take a day or tow off I start to feel the stiffness and pain and need to move to get rid of it. Ibuphron and Ben Gay help alot. Much lOve, Carol


02/14/2011 05:34 PM
napaman
Posts: 9
New Member

Thanks for the reply. Another question: post-surgical exercises (like riding the stationary bicycle) - is that something will have to be done the rest of life? napaman

02/15/2011 06:17 AM
BPB
BPB  
Posts: 801
Senior Member

napaman,

I highly recommend continuing post surgical exercises-it makes the knees less stiff and keeps the muscles, tendons and ligaments stretched and strong to support the new knees. When I don't exercise I get stiff and sore and end up on Advil but if i walk or ride the stationary bike I don't . You will find what works for you but it is never a good idea to become seditary-exercise just makes you feel better. I know I spent alot of time this past weekend sitting and laying around and my knees were stiff yesterday and I needed to walk it off..I did and I felt better. It's not pain just stiffness and mild soreness. I am in no way pain like I was before my knee replacements....best decision I ever made. During my move last Nov I finally threw away my cane and my walker and said goodbye to them I don't need them anymore. I no longer walk with a limp and you would never know I've had knee replacements unless you saw my scars!!!!Good luck to you and keep those knees moving you'll feel better in the long run. Much Love, Carol


04/26/2011 09:45 PM
napaman
Posts: 9
New Member

Finally got that "third opinion" - sometimes takes a long time to get an appointment (at least one that insurance will cover). Anyway, the upshot (according to this specialist) is that I've probably had all the recovery I will ever see; surgery MIGHT improve ROM 10 or 15%. "No problem with tracking", he felt; but if he did surgery it would be to remove scar tissue and "tweak" the implant a bit. I'm inlined to take the risk in hopes of at least increasing the ROM from 80 to 110 so I could pedal a bicycle and walk downstairs more easily; and maybe straighten the leg more completely to decrease the stress on the good leg. I am not yet 60 and would like to return to being moderately active. The main concern I have is how do I avoid a repeat of that quickly-forming excessive scar tissue. I know now not to wait on the hospital to initiate PT - I need to have an appointment made for the day after surgery. For me, a two-week wait was fatal to recovery! And I still wonder if there is a way to lengthen the muscle fibers to assist ROM. Got to get back with the second doctor now.
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