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knee manipulation
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knee manipulation


Hello
I had a rtkr on May 1. I went to see my os two weeks later and he was talking about a manipulation. He gave me a week of agressive therapy went from 82 to 90. Went back to see him and he wasn't to happy. He has given me another two weeks to improve.  He just wants me to get the most out of my new knee which is understadable. I really don't want to do this. I talked with my pt and asked about pool therapy. So I have been going on my own twice this week. It seems to help. I have a book total knee replacement which showed some exercises to do in the whirlpool and then walking in the regular pool. Has anyone had this done and what were results? I am told some people get big numbers and others remain the same. The pain and more aggressive therapy is what I am told will be for a couple of weeks. If  I don't get this done will I always be at those numbers? Can I improve this over time? Please help I don't know what I am going to do.
thank you
Earthlady
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21 Comments Post a Comment
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Avatar_n_tn
Like you i have just had TKR surgery and after five weeks of following all the exercise routines i have a badly swollen knee and restricted movement.

My physio has informed that the surgeon will carry out manipulation some time next week ( like you i am not looking forward to it).  I note that it was July when you posted your comments on this web site. I would be interested to know how you are today.

Thanking you in advance
Ron
Lancashire UK
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Avatar_n_tn
Hi,
Though we are having a lot of advancements taking place in our field, it is really not possible to replace the nature's gift.
Once you have an artificial total knee replacement, you are expected have good range of movements and activities as close as possible. But this does not mean that you can run about all over the place as it would have been with a normal joint.
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Avatar_f_tn
I had a lt. Total Knee replacement 5/17/07, and a manipulation on 10/25/07, while the Dr. was able to break up a good amount of scar tissue and had my knee to 110 degrees under anesthesia.  I did intense physical therapy every day for 14 days and then every other day for 14 more days. When I finished with PT my range of motion was only 85 degrees and the debilitating pain I have had since surgery returned.  The manipulation procedure of course cause me no pain and my surgeon filled my knee full of anesthesia so I had about 18 hours pain free.  When the anesthesia wore off it was painful but I just took my pain medication and did my PT faithfully.  Unfortunately, the manipulation did not help me and by one month later I was back to the horrid pain & 85 degrees of flexion.  On Dec 7, 2007 my surgeon removed massive scar tissue arthroscopically and is hopeful that this will take care of my pain & limited ROM.  All componets looked good and he felt no need for a revision TKR.  Today as I write this my pain is back and my motion is about 65 degrees.  I hope your manipulation turned out well and that things are going well for you.  I have been on Opiods for pain and am following with a Pain Mgmt Dr. for my pain meds as my orthopedic Dr. is being pressured by his clinic manager to get me off of the Opiods.  So many people do not understand the importance of having your pain controlled.

Shelly3582
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Avatar_f_tn
shelly I been going through the same problems you have with my rt knee i had knee replace on july 2009. I have had three manipulation in 2010 went thru pt like i was supposed to,my doctor on mar 2010 taken out scar tissues was able to manipulation at a 110. when im at pt i cannot get it bend at 85 if pt force it it will bend at 90.i had another manipulation on may 2010 i still at the same degree after going thru pt. My knee had pain and alway's swollen,my doctor say there nothing else he could do. everyone i talk to said get a second opiono i dont what good that would do, because i am not going to be cut on again.
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Avatar_f_tn
I'm 54, and I felled on ice on Jan. 30 2010. I had to have a knee scope on Feb. 5. The pain was weight bearing, so I had to have a TKR on May 5. I couldn't bend my knee but up to 75 degree with extensive PT. My knee had build up a lot of scar tissue and it was very painful,so I had to have a manipulation on July 13. Immediately after my manipulation surgery,my anesthetic wore off and I was in so much pain.I had to go to PT right afterwords. My PT forced my knee to bend 120 degree. I screamed so loud because I couldn't bear the pain but they wouldn't stop bending my knee.  My  knee began to swell up so big. After that, I decided not to return to PT. I decided to use the CPM machine at home and to work on my own knee.I can bend my knee with the machine up to 125 degrees. My scar tissue has come back and I am still in much pain. I don't know what else to do to get rid of the scar tissue. Putting vitamin E oil on it has help some but its still preventing me from bending my knee. I definitely don't want to have another surgery. I am physically and mentally tired, but I am continuing to pray everyday.
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Avatar_f_tn
Hi, lola
OMG is all I can say, I totally can understand where your coming from. I am so sorry I am in tears as I write to you. I had my TKR on my left knee on Dec. 28th 2010 I can only bend my knee 55 degrees my ortho surgeon wants to do a manipulation this week but I'm so afraid that the pain will be so bad that I might go insane because I'm just about there now. I have been going to therapy 3 x a week since the surgery not to mention I was in an accident and have a messed up back and neck and now my hips hurt and my good knee is in horrible pain I take pain meds every three hours just to try and keep it under control when I wake up in the morning I can barely walk it takes hours to get this pain fix to where I can some what function I don't know what to do please let me know how your feeling.
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2032854_tn?1329630929
Hi, I'm 33 yrs old and had a tkr in Nov. I can only bend my knee 55° and have to wear a dyna splint to help with my flexion every night. I'm having a knee manipulation on Monday, I am concerned about my recovery... I just want to walk normally. I have been dealing with my pain since I was 16, when I had my 1st sx..... I do understand where u r coming from and I hope ur knee gets better!!!
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Avatar_f_tn
I underwent a TKR May 7th 2012, developed a serious infection. I have had a PICC line in since 6/12/2012 and am receiving infusions 2x per day 7 days a week.  To date I've received 43 treatments. I'm  getting 2.5.gms Vancomycin 2x day and another 2.5 gms in afternoon along with Rochepin.  Because of this I could not take P.T. for 11 weeks which screwed up my window for bending then knee.   At present I have a 65 degree bend.   My ortho wants to do a manipulation, however, I am concerned  about another infection.  I get about 4-5 hrs. sleep @ the most per night and that's broken up, not consistent.   I work very hard at P.T. my pain lever is never below  a 5  and that's with taking 15mgs of oxycodone every 4-6 hours. To be quite honest I don't know if I can take the pain of the manipulation, I'm at my wits end, plus I'm not very happy with the surgery that my M.D. did, the fact that he went on vacation for 4 wks after my surgery.  If it weren't for my General Practitioner I probably would have lost my leg.  Is there any suggestions out there from anyone who has experienced this or something similar? I appreciate  any input anyone may have............Thank You, Goldie
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Avatar_m_tn
I am 62 had TKR on Jan 15,2013. Saw my surgeon on Feb 13, he gave me 2wks to improve rom. Only got to 68, had manipulation March 5, pt right after got rom to 76, was given cpm, did 2hrs 3 times a day went to 92, but as soon as I ice it the knee goes stiff again at pt yesterday march 12, the therapist massaged knee and without warning tried to bend the knee farther. I screamed so loud the next building heard me now can not make it to pt today, pain is just like it was after the manipulation. Will see Dr. today, will let you guys know....Great site
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Avatar_m_tn
I am 62 had TKR on Jan 15,2013. Saw my surgeon on Feb 13, he gave me 2wks to improve rom. Only got to 68, had manipulation March 5, pt right after got rom to 76, was given cpm, did 2hrs 3 times a day went to 92, but as soon as I ice it the knee goes stiff again at pt yesterday march 12, the therapist massaged knee and without warning tried to bend the knee farther. I screamed so loud the next building heard me now can not make it to pt today, pain is just like it was after the manipulation. Will see Dr. today, will let you guys know....Great site
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Avatar_f_tn
Read your post about the manipulation on your knee. Did it help?
I had one 6 wks after my surgery and I am able to bend to 121 with a struggle, but that's not my problem. If I'm on my knee more than 30 mins to an hour, I swell or just get real tight and it's difficult to walk. I can sit and bend and stretch it and it gets better, but the night pain is the worse. If I lay on my side, it seems to shift and the pain wakes me up. The doctor and therapist says this is normal and it will improve. The surgery was 11 weeks ago and the manipulation was 6 wks ago. I am able to the therapy without too much problems at this point.
I was wondering if you went thru the same thing and did it finally improve? I know I should trust the medical professionals, but I would like to hear from someone who experienced the same thing.
It just worries me that the implant may not be a proper fit, especially when I feel worse when lying down.
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875863_tn?1271606985
TKR December 10th 2013. Manipulation May 15th, 2014. Came here to read your blog. I want to know what to expect, and from what I've seen, it doesn't look too good. I wish you all well and hope that you will regain your bends and get relief. I will let you know how mine goes. Thanks for your inputs. It really helps to know from actual people how things really are. Dr. sites seem to sugar-coat everything and seem so out of touch with reality.
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Avatar_m_tn
Hello! Welcome to MedHelp! I am the Orthopedic Community Leader for this site. I will try to explain manipulation, based on my experiences as a Orthopedic First Assistant. If you have a manipulation scheduled that far in advance, you can avoid it by reaching the ROM (Range of Motion) set forth by your surgeon (95 degrees, 96 degrees, whatever he/she said). You just may have to be agressive to achieve your goal. When the Doc manipulates your knee he/she is actually tearing the scar tissue, to increase your ROM. I'm sorry, but there will be pain and swelling afterwards. You survived the TKR, so you can handle this. If you would like any further info, please don't hesitate to contact me. Best wishes! jd1963
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875863_tn?1271606985
Hi! Thanks for your input. It means a lot! Had manipulation on Tuesday- Not sure if I'm supposed to call Physical Therapy or wait and let them call me- was not clarified and I was too doped up to know to ask. So far- a little pain, but nothing NOTHING like the pain I was in before. I'm trying to exercise and bend on my own, because I don't want to go back to where I was before the manipulation. Am I moving too fast? Saw your post and thought maybe you could answer this for me?? Thanks!
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Avatar_m_tn
Hey jme, I wish all patients were that aggressive with their PT! In my opinion you are doing exactly what your surgeon would want, but please don't injure yourself! By now I'm sure you know your limitations. If you don't hear from PT in a few days, I would give them a call. As you said, because of the anesthesia you may have missed something. Please feel free to keep me updated or if you have any questions, I will try to respond as soon as possible. Have a great day! jd1963
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875863_tn?1271606985
Thank you. Your input means so much and puts my mind at ease. I'm still pretty swollen and know that I am able to double up my meds to get to bending. I just want to be able to walk, bend and be pain-free soon. You have helped put my mind at rest and I will keep you posted as to how things are going. Now- on to exercise!!
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Avatar_m_tn
That's great jme! I'm glad I could help you feel better, it makes me feel better! Talk with you soon!

JD1963
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875863_tn?1271606985
Finally called Therapy myself today. They said they didn't get an order from my Dr. , so I went ahead and scheduled my own. I'll be seeing them Thursday. Yay me! lol
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Avatar_m_tn

Hey jme!

Unfortunately, I'm not surprised PT didn't get a follow-up order. You practically have to write it down on a "sticky" and put it on your Doctors forehead!!

Anyway, that sounds wonderful! I hope the therapy goes good for you! Please keep me informed as I am concerned.

Best of Luck!  JD1963





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875863_tn?1271606985
I saw the Therapist today and was he NOT happy! Said I should have been seen the next day if not sooner. Put me on a 3x a week schedule for 4 weeks. Got my bend to a 100 degrees, which I know isn't good after manipulation, but I now at least know what I need to do to better myself. So if any of your read this and have not been scheduled- I recommend you take the initiative and do it yourself. Waiting helps nothing. Can't wait to see the Dr. next week and see what he has to say?? Yikes! Can't blame me though. I had no clue what was supposed to happen. I'll keep you posted on my progress. I'm determined to make this happen! :o)
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875863_tn?1271606985
More therapy this week. Don't feel like I'm making much  progress. Either can't bend or can't straighten. Why can't I do both without pain and be walking? The weather here has been horrible and windy with freezing rain. Doesn't do much good for my Fibro, either. I feel weak and just want to be in bed, but I know that is not an option, no matter how bad I want it. The Hydrocodone is making me ill anymore. I'm just miserable. Thanks for listening. Trying to stay "upbeat" in the freezing rain. Only 2 more days of this to go! Whoohoo! (I can do it)!!!
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