TKR on right knee / very little range of motion / severe pain / 6 weeks post

[Tokacou]

I had a total knee replacement on my right knee on 10/22/09.  I am 44/female.  I have had 8 operations on this knee prior to the TKR.  I have had bad knees and ankles since I was very young.  Was still very active despite this.  Played ALL the sports in high school college etc.  So in general understand knee pain / how tough PT is and have developed a high tollerance for pain.
Had the TKR on a Thursday...left hospital on Sun....was back in emergency room on Monday night with a huge infection and extensive pain.  My entire leg was swollen three times it size, very hot to the touch, and red.  The leg was so swollen it was almost pulling my stapples out.  Got blood work and IV antiobiotics and IV pain meds.  White blood count off the scale.  Told it was celulitis and severe staph invection.  Was put on cephalexin.
Leg got better after a few days on meds, but still took two week for swelling to go down.  Had reaction to antiobiotics (hives and rash) so stopped meds after 12 days and reaction stopped.
Started home PT two weeks post, as was told not to start while I had that infection.  Had 12 vistis with home physicl therapist so far.  Did make some initial progress.  I can bare full weight on leg now and dont need walker. I can get around house/ on and off bed / toilet/ into shower etc on my own now.  I use a cane on and off during the day.  I do my exercises 5/6 times a day on my own.
Still in severe pain and meds only take the edge off.  I only have 72 degree flexation on my own...can get to 84 degree with passive manipulation but cant hold it there more than 15 or 20 seconds.
I have a HMO and seem now to be stuck in that horror of a HMO.  Home PT has stopped as I have exhusted (12 visits) what they will authorize.  Trying to get into outpatient PT but it is a paperwork nightmare and was told yesterday first apointment is not until 12/24/09 that is 3 weeks away!  So now here I sit in pain, very little range of motion and frustrated.  I have been calling the Dr almost daily and trying to speak to his nurse.  Dr has been out of town since Thanksgiving and will not return until the 10th.  After 10 phone calls I got an apointmentment with him on the day he returns.
My concern is at my age a 72 degree range of motion is NOT acceptable.  The level of pain is not acceptable.
I was told that due to all the other operation I had prior on this knee are the reason why I am in so much pain and why I am not making progress with range of motion.
It has been mentioned that I might need to hae a manipulation operation.  But from what I have read that is only short term gain.
6 weeks post TKR what should I be expecting in regards to where I should be range of motion and pain level?  Are my expectations to high?  I would expect I could bend it..yes with pain...but it would bend.  Last two PT visits....therapist was sitting on floor while I was in chair....I pulled leg back as far as I could (72) then she put pillow on shin and leaned into it as hard as she could.  Yes again tremondious pain, but I expected that.  No matter how hard she pushed leg would not go past 84 degrees.
HELP...I am so frustrated....concerned...and dont know what to do.

[Remm2]

I am 10 weeks post tkr and have 126 extension. My problem is I have se ere tightness across my knees(I had both done) Is this normal ? Am I just a slow healer? Please can anyone help me? What is causing this tightness?

[adminmom]

Do not fear the manipulation!  I have had over 17 knee surgeries in my 53 years.  Had my first TKR @ 41, and at 53 just finished haveing my second total knee re-done (revision.)  Each time I required a manipulation and had great results.  Make sure you have good pain control, and I also had to go to therapy 5 x a week for 2 weeks to keep the range.  I have 117 degrees in my left knee and will be having a manipulation on my right in 2 weeks.  It has been quite effective for me.  Sood luck