Knee Replacement -  Manipulation...How to decide when? (399 views) Notify me whenever anyone posts in this discussion.Subscribe
From: LinHolt214/9/17 1:48 AM 
To: All  (1 of 10) 

I had a LTKR 12 years ago, very successful.  I had a RTKR this year, Valentine's Day 2017.  I was released by my doc in Calif. to go home to Alaska on March 23 with a caution that if I didn't get my flexion back better before 12 weeks I would need to fly back to have a manipulation.  I have 105 degrees flexion and O degree extension.  I can't remember how it went last time but do recall my doc then had me do PT and work "slow and steady" and not to the pain level.  That seems to have worked well but I am wondering if I am  not far enough along now as I should be and how do you know when to call for a manipulation.  Anyone have this done?  If was it?  Do you stay in hospital or is that something I would be able to fly back home in a day or two?  Is it painful afterward or can you move/flex well?  There is no one here where I live to ask these questions to. Thanks for any replies.  I felt like I was doing well but then we had a long drive to travel home and my knee/leg is very stiff and very painful.  I feel like I may have to do this and don't want to but I don't want it to be too late either, if I need to.  Thanks...Lin, in Alaska

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From: pam1274/9/17 8:10 AM 
To: LinHolt21  (2 of 10) 
 23033.2 in reply to 23033.1 

Hi Lin, I had a RTKR in 2012. At that time my OS wanted me at 90 degrees by 2 weeks later. At 4 weeks I was about 85 and had a MUA. I was terrified but it was nothing to be worried about. I had it done under anesthesia and went directly from the hospital to my PT appt. i form scar tissue quickly I guess. Your 105 sounds normal to me but could you have someone take a picture of your knee flexion and send it to your OS for his opinion. Also at about 7 weeks I started aquatic therapy which was really a turning point for me. I don't know if that is an option for you. I am having my left knee done on May 2 and am hoping it is as successful as the right. Good luck and keep us updated.


From: LinHolt214/9/17 1:59 PM 
To: pam127  (3 of 10) 
 23033.3 in reply to 23033.2 

Thanks for your reply Pam!  I really appreciate it.  I'm not so much afraid of the manipulation as I know it is with anesthesia....just the hassle of the whole thing. (I do want and need my knee to be in the best condition though) I live on a remote island in Alaska and it would entail a long ferry ride to another island and then a couple of flights to where my OS is.  I would have to stay with my mother in law again to do it and the PT.  So...did you do PT every day after the MUA?  Or do you think this is something that could be done one day, go to the PT and then fly home and do PT here?  Yes, I could have a photo taken for the OS...he has been very good in working with us.  My hubby had a meniscus and acl repair a couple weeks before I had my knee done (he had a hunting/kayaking accident and hurt his knee)  He thought we were nuts to come all the way there to do this but there is no medical care where we are.  I am wondering if, as long as there is continued improvement, if there is a point where is won't improve or when I should throw in the towel and go for the MUA?  What was your flesion after your MUA and were you able to keep it?  Thanks so much for your good of you to take the time.  Love this group.  It really helped me out in decisions the first time and allaying my fears and here we are again.  Haha...I thought I would never be back on since I'd done this before.  Each one is different though.  Wishing you wonderful success with your next knee!!!  Lin



From: pam1274/9/17 3:51 PM 
To: LinHolt21  (4 of 10) 
 23033.4 in reply to 23033.3 

Yes that is what I am told-- every replacement is different. After my MUA I just continued PT twice a week and my exercises at home. I have to say I saw improvement well past the first year. Right after the MUA I was at 90-95 degrees for awhile. Every day I would make progress and the next morning it was like my knee forgot everything and I was starting all over again. As I said the aquatics really helped me get more flexion. I still do it. I think now I am about 125. I definitely think you could go for PT and then fly home afterwards. PT was mostly massaging my thigh. It was a turning point for me but I would definitely contact your OS to see what he thinks first. I know my OS wanted to do it at 3 weeks but I begged for one more week to see if I could get to 90 on my own so there must be some certain timing involved. You are still so early in recovery that I am sure you will get much more flexion with continued PT. What does PT think? Try and send that picture to your OS. He sounds like he will respond to you and then you can make the best decision for you. I love this Forum also and it has really helped me too. Good luck.


From: Jaborla4/17/17 1:09 AM 
To: LinHolt21  (5 of 10) 
 23033.5 in reply to 23033.1 

Hi, Lin,

Did your doc give you a number, as to what degree of range of motion you need?

You sound pretty good to me. I'm assuming you can make the stationary bike wheel go all the way around. Yes?


From: LinHolt214/17/17 1:32 AM 
To: Jaborla unread  (6 of 10) 
 23033.6 in reply to 23033.5 

Hi Jaborla, Thanks for your reply.  Yes I can make the bike pedals go around.  I am finding if I go for a walk, my knee swells a bit and then I can't do the bike.  If I do the bike first then walk, I can.  It'll come.  No he did not say what rom I needed, just that I should come for a manipulation if I wasn't improving a lot. I was 102 degrees at the time but had been higher than that but my knee had swollen that day.  I was only 5 weeks out at the time, too.  What is normal that I should be striving for, do you know?  I don't know why I didn't think to ask.  I was so ready to get back home to Alaska I just wanted to get out of the office, I think. Normally I am full of questions.  Oh, walking, doing my exercises and the bike, I am guessing I am likely at about 120 now.  I need to get one of those measuring tools. 

Thanks again! Lin


From: PWNH4/18/17 4:12 PM 
To: LinHolt21  (7 of 10) 
 23033.7 in reply to 23033.6 

Hi Lin,

If you are 120-125 at your point in recovery I can't imagine why you need a MUA.   I had one after my second knee because I was at 5 weeks and still  barely at 90.    I had  problems after my first as well but unfortunately the OS never mentioned it and I was unaware of such a procedure.  That knee is still at 95.  Cannot get a bike pedal all the way around.   Second time around I was with a different OS and more educated thanks to this website.  

After my MUA I went directly to PT and then continued a few times a week for a couple of weeks.  My end all was 115 which works well for me to be able function normally. 

Good luck with whatever you decide!





From: LinHolt214/18/17 4:56 PM 
To: PWNH unread  (8 of 10) 
 23033.8 in reply to 23033.7 

Thank you so much Patti!!!  I think I have chucked the idea of manipulation.  If I never got beyond where I am now, I could still function fine.  I need to be able to get in and out of boats, kayaks and canoes.....haven tried yet but I am pretty certain I could.  LOL...I can always fall out of the kayaks and plop into them so no worries there.  I need to hike and did tat yesterday over boulders and logs, through the forest and beach so I think I am good to go and I know I will have more improvement as the year goes by.  Each day, depending on how much I work it, my knee swells just a little and can't get it around the bike pedal but I can each morning and it's getting just a hair easier.  If my doc were close, I might go for the manip but it would involve two ferries and two flights to get there, a couple weeks at the mother in laws and then the same coming back...nope, at this point, I am not going to do it.  I love this helped me so much 12 years ago and again this time.  I hope I can be of some comfort or help to someone as well sometime....will stay on for a while.  Thanks again, Patti, for taking the time, it does encourage me to know I am not doing so bad.


From: spider2204/26/17 9:14 AM 
To: LinHolt21  (9 of 10) 
 23033.9 in reply to 23033.8 

If you are 120-125 degrees flexion, I can't imagine any OS suggesting a manipulation! The natural, normal knee flex is 135 degrees! And most people don't have that much! You are only 2 months out so there will still be swelling when you exercise hard--continue to ice afterwards and be patient!  Sounds like you have fantastic results and will be able to resume your outdoor activities soon! 


From: LinHolt214/26/17 11:55 AM 
To: spider220  (10 of 10) 
 23033.10 in reply to 23033.9 

Thanks Spider220!  When I wrote the original inquiry, I wasn't at 120 yet, or when I would be, the next few days I would be way back down.  I am at 12o now.  No, I am not going to have a manipulation as I do believe I will get where I need to be over the next few months.  Thanks for reminding me to be patient and that I will still have swelling and helps.  Most of the time I feel so great I forget I am still healing and will have setbacks.  Thanks for your reply and have a terrific day!!!!  Lin


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