I had a right knee total knee replacement 9/23/2009 and at my two week check up with my doctor he was very upset with me at my rom. Dr. gave me an order for outpatient rehab and suggested agressive physical theraphy. I did all home exercise which was only to ride stationary bike 3 x day for 15 minutes. My rom after hospital was 90 and followed all discharge directions and did exercises. At my two week check up the doctor said I was growing scar tissues and said my theraphy needed to be more aggresive. After 17 visits with PT she said she was calling doctor because I was recoiling. My ortho doctor told her he would do a maninupulation of my knee in his office. I was shocked and scared so I went for a second opinion at another ortho doctor. He suggested two more months of pt and at present I am in a splint one to bend the knee and one to straighten my let. I changed physical therapist and now my rom is at 117 and my flexion is at 17. I am sticking with the new ortho doctor. My question is has anyone had scar tissue problems 3 months + out and what kind of help would be best to resolve this scar tissue problem. I am very concerned and appreciated your input.. Also I congratulate all of you on your successes and I am very grateful for the posts. Thank You..
We had TKRs at the same time. Mine was a day later than yours.
I also had a 90' ROM after in-hospital rehab, altho that passive motion machine had me a little higher -- up to 100. I only had a month+ of PT, and the ROM was slow and painful. The ROM would only go a little above 90. To 98 with tearful force. My orthopod said that if the scar tissue became a problem, that intervention could be manipulation ---- but under anesthesia. However, he said to do the exercises on my own and see how I did.
Before I did the exercises, I used moist heat and using cream, I massaged the scar while the knee was still warm and then did the forced knee exercises. I use one of those green straps to help pull the knee. It hurt, but as time went on, it became easier. I still do the moist heat and massage. It feels good and makes the bending exercise feel easier and less painful.
About the flexion -- what is that? Is that when you straighten the knee! I force that, too and use the green strap to pull the hamstrings. I don't seem to have a problem there.
I don't know what my ROM is now. I know it is not as good as my other knee, but I am not kept back from anything in daily living.
My 3 month appointment was this week, and it seems that the knee bend is OK with the doc. No plans for manipulation now.
You were smart to get another opinion. Just as we are all different, so are doctors.
And -- yes. The comments on this board have been really helpful. I found that I wasn't alone!
I am at 12 weeks post op on a right total knee replacement and my rom is only 65. I had over 100 under anesthesia, but never more than 70 in PT or otherwise. At 4 weeks I had manipulation done and nothing seemed to have improved the flexibility. Right now I am trying to do my own thing, masaging the knee, water therapy and homeopatic remedy. This has definitely not gone the way i was told and thought it would be. I have done everything the doctor asked, 6 days a week PT with aggressive pushing but nothing made any difference. My leg just won't bend. i have extension close to 0 at times, 5 deg most of the time. but flexion is weak. I can barely walk and go up the stairs. no issues with the surgery - just with the flexibility.
My knee is still not healed, there is a stong sensation of a belt tight around the knee in the area above and below - and it makes it hard to walk, even though i can do a squat half the way. the stong belt sensation starts as soon as I think of moving the leg.
i am now starting to use the dynasplint, a brace like device that you work up to wearing for extended periods, mostly during the night that has a spring loaded device to bend your leg and the pressure can be adjusted. I hope this will help improve the flexibility.
I was told by mu surgeon everything is well with the implement, but he does not want to see me for another 2 months. meanwhile - i have a lot of questions and fears. The pt team is not giving much information either - they have not seen a similar case. Anyone out there that can help? please write coldnstuck
Sounds like your Dr is just thinking you need more time. If he doesn't want to see you for two months, then he must not be that concerned. He probably thinks this new splint will help. It probably will.
I still have that tight band feeling around my knee too, my surgery was 12 weeks ago. I find it hard to walk when it feels so stiff and tight. Mine is mostly at the top. If I do short arc quad sets, it loosens up right away, I walk great, and then it will tighten back up if I stand or sit too long, however it is loosening up much quicker than it did before. I really got frustrated with that too. If Pt has you doing quad sets, straight leg and on a basket ball bent, ask them about it. That is the thing that helped me the most.
I think this tightness will be there for quite awhile. My Dr said maybe 6-12 mo as the tissues, muscles etc are still swollen and get inflammed with workouts. I use ice sometimes, but heat also. I found that heat helps it bend, but not too much heat as you dont want to cause more swelling in the area.
thank you for the reply - I am just now finding this board and reading all the messages - so let me just add a bit more. I'm not sure my surgeon is on my side, after the manipulation did not produce the expected result as far as flexibility, he suggested another one, daily, inserting a catheter in the back, and if the knee did not bend, drip anestetic and manipulate. I refused, as the stay in the hospital would have been over 2 weeks. Then he said I should just do the daily pt, but he did not want to have any more involvement. An assistant doctor wrote the pt order, and since then I had no advice from the surgeon. The pt team didn;t know what to do to get the flexibility - so I started looking around. before I found this board i already decided to go for aquatics, and daily exercises to strengthen - I must add that for the 10 weeks I tried the pt regimen I also used the CPM machine for 18 hrs a day - and that really caused all my body's muscles to atrophy. So one day - I got up in the morning and I no longer fel fear, but rather take charge - so i decided i was going to walk around cane or walker, and try to get stronger again - I was a runner before, champion at 10K in my youth, and so i started to do my own PT even with a knee that did not bend.
Then I found out about this company that makes the splint, and I purchased it. My surgeon did not recommend anything other than PT - and that was aggressively pushing for flex. in the last 2 weeks - with 5 session of aquatics, my own exercises and jsut regular careful walking, including backwards on the stairs, and forward up - I moved to 78 from 65 in the flex. But it is very tempermental - strong cramps, both in the calf and hamstring, and around the lower side of the knee, right side there is an area with no feeling, but very strong feeling of cramped tendon - I now wear a compression sock around the knee to keep the tendons from cramping, and it reduces the feeling of tightness that does not allow me to bend when walking. I walk very slow, about ah hour is the most I can stand without sitting, or sitting without walking.
12 weeks after surgery - and still far away from being able to use the new knee. But I am confident it will get better when it heals - after reading all these posts in the last 24 hrs - i see that my gut feeling was right, I am healing slower, or else the damage was so great to my knee that it takes a long time to heal. The assistant surgeon told me I had a 50,000 miles knee and I put 100,000 on it. After that - I was on my own as far as information and understanding what the knee was telling me. The manipulation set me back the first 4 weeks, no doubt, without gaining any flexibility. Some of the posts i read present a difference of strategy depending on the surgeon. I only wish I knew more about what to expect after the surgery. thank you to all that have written - even the fast recuperating people - i did not compare myself to others, I just didn't know what to expect. The PT that came to the house in the first 4 weeks told me i was expected to bend it 90 deg or better - and it was not happening. I got scared, I was on the cpm machine even more, I was trying to bend aggresively , my son was helping me, maybe 3-4 time s a day, and nothing produced any lasting results. Now I just accepted the fact that I am slow at healing, and it will come in time, I just keep doing the exercised - mostly squats, walking the stairs - I cannot ride the bike yet - walking sideways with the rubber band, doing some yoga to stretch the back of the leg, hamstring and now using the splint. The homeopatic remedy was aimed at core personality and acute trauma, and I believe it it helping - i am no longer scared and full of anxiety. Once again - thanks, and thanks to all
The following user gives a hug of support to coldnstuck: Tmayhan (03-12-2011)
For what it's worth, I had that tight band feeling too, and wondered when it would go away. Then one day at 4 months post op I realized it was gone. Thank heavens. I was starting to think it might be much longer. Now I am 5 weeks post op with my other knee and happy knowing this feeling will indeed go away.