I’m 6 days post total left knee replacement and struggling! I have no muscle strength to help my rehabilitation. The Physio is expecting me to lift my operated leg up and to bend it but I just haven’t got the physical strength to do so. As a result my rehab is way behind and there is a possibility I will need manipulation under anaesthetic to get any bend in my knee!
anyone else experienced similar?
What was your strength like before the op? Would you have been able to do those exercises, knee not withstanding, before? It might be that your starting level is just lower and the physio needs to adjust for that. Is the need for manipulation due to adhesions building up or some other reason and is it of your new knee or the other one?
The adhesions problem is a very common effect post TKR - it tends to be a major threat used to patients they perceive aren't trying hard enough.
starspt.org/breaking-stiff-...
I had adhesions after a knee op for cruciate graft (hockey) and the swelling stopped my movement so adhesions built up. An anaesthetic was threatened. I had a nightmare and leapt out of bed and a vomit inducing, sickening crunch later my knee was cured. The consultant was very pleased and said I had saved both of us a lot of hassle.
Not sure if they still use it or for new knees at all but when I had a mangled knee and broken leg here in Italy, first thing in the morning the day after surgery a physio arrived with a contraption into which my leg was fixed, and it proceeded to bend and straighten my leg for me with no input from me. It was used every day I was in hospital and it certainly ensured the knee was mobilised!
Agree with PMRpro, physio need to take notice of your personal situation, not assume you can do what the rehab booklet may say.
Plus as SnazzyD says - what condition were you in pre operation - it's all relative.
It is the tick off mentality we have to put up with nowadays.
My OH has had two knee replacements. At day 6 you will still have a lot of post op swelling , things tend to come better together after a couple of weeks, when you will be able to push yourself harder. As per PMRPro, even the passive knee bender kit was limited in this early phase. Your Quads will already be a bit weak due to the OA in your knee. Do use your ice packs at least 3 or 4 hourly esp after exercise, and bend your knee as far as you can; it will definitely improve over the next weeks, dont get discouraged.I would have thought forcing it under anaesthetic would be something of a no-no. Hubby has more than 90deg bend in both of his at 2 years post op, even though he gad a post op haemmorage in one of them.
"I would have thought forcing it under anaesthetic would be something of a no-no"
It is the standard protocol as far as I can tell from others who've had it done. Only way they can undo the adhesions that cause the problem. Sounds brutal - but you don't know about it!
??day 6 a bit early for adhesions. Also risk of setting off bleeding or second anaesthetic so soon in someone already at risk of DVT. I wonder if its a physio threat or whether toffeeboyblues surgeon has suggested it. DL and yourself rightly comment about what seems like lukewarm physio input which has worried T'blue.
I suspect it is a physio threat having decided the patient is being reluctant (lazy) to do the order rehab - without thinking about there being a valid reason for that!
Not sure about modern protocols but the movement under anaesthetic was certainly an option back in 1999 when I had mine. I was got out of bed early on the day after the operation and walked around the room to make sure that I used my new knee. After a few days I was able to do it myself with a frame. I wasn't allowed home until I could walk up and down stairs unaided. Suspect things may be a tad different now.
Hi i 've had both knees replaced around twelve years ago.If you are only six days in recovery you have time on your side.I used to lie on my bed and slide my heel up and down.It will become easier every day.Try using bag frozen peas wrapped in tea towel to numb pain several times a day and use painkillers.I used dressing gown belt to lift knee onto bed for the first few weeks.It is difficult but try to do exercises every day.Physio is looking for a 90degree bend + if possible.My physio on second op put ankle weights on to get leg straight.Next day i could hardly move behind my knee was badly swollen.If it is agony get them to stop.Obviously we expect pain but not torture.My second op was not as good because she forced my knee to much to get it straight.Just remembered i used a skateboard sat on a chair and moved it back and forward.I wish you well in your recovery try to rest up also.
It sounds to me like the physio is way too aggressive and scaring you unnecessarily. I. have had two knee replacements. First of all, I was on strong painkillers — 8 weeks the first time and three weeks the next. My knee each time was in an all-night ice pack for about a week. There was a whole panoply of meds. I always took painkillers about an hour before physical therapy. I had two weeks totaling 4-6 in-home therapy sessions and had exercises to do multiple times a day but no deep bends or full leg lifts. I had to lift my leg up with my hands and put it over a rolled up towel and do gentle lifts/bends from the knee down. Not lift my whole leg. Bending it was excruciating for a while. I had a strap that I put under my arch and pulled it toward me. Ditto. YOU MUST MOVE. I also had to shuffle around my living room a couple of times a day on a walker. There weren’t any big knee bends for weeks. I started going to the outside physio at two weeks with my walker and the sessions started with heat and massage. I think it was 24 sessions covered by Medicare. It took two months before I could go all the way around on a stationary bike. Can you get another physio assigned??? One with more knee replacement rehab experience?
PS. I had to ice and raise my leg on a wedge pillow multiple times a day and put a raised seat on the toilet so I could sit with leg stretched out in front of me — not bent! The recovery process is painful and no fun but it is gradual and not too late to start.
PPS. Can’t eat a lot of it with PMR, but friends brought ice cream
I had both knees done a year ago,first one then six weeks after the other knee. Both times I rented a passive movement machine I used morning and night to move the knee through full range of motion. Also started physical therapy at a P.T. place six days after surgery and went twice a week (three times was too much). I did exercises at home with a strap slowly pulling the knee into a bend and holding it as they showed me to do (as well as bridges, leg lifts (no weight at first) and other excercises. I highly recommend doing the stretches the first few weeks, don't add too much weight till later. I had to remind the PT folks repeatedly I have PMR that leads to weak muscles and lots of inflammation. When I couldn't lift my leg at very first THEY lifted it for me gently thru the range of motion. ICE is your friend.
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