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    knee manipulation after knee replacement
    hockeyjohn posted:
    I had left knee replacement 2 months ago, my rehab has gone along without incident. My range of motion has increased from 85 to 112 degrees but has now stalled. My doctor says that manual manipulation under twilight anesthesia is the only way to increase the range. His concern is the longer we wait to do this, the more scar tissue will develop and the less effective the manipulation is...Has anyone had this procedure? What were the results? What will the pain/swelling be? I have been instructed to go to Physical Therapy 6 days in a row after the procedure. Will that do the trick?
    ocknees responded:
    If your range of motion has stalled, you might ask your doctor about wearing a splint first. When I was two months out of my total knee replacement, I stalled, too. My problem was extension, not flexion. Still, it's all about range of motion - whether bending it or straightening it.

    My physical therapist talked to me about a Dyna splint. He contacted my surgeon, who approved it. It's not comfortable at first, but it sure does the job. I couldn't keep it on for more than a few minutes at a time for the first month. I'd make sure I wore it at least an hour every day, even if it took five hours to finish that one hour. Over time, I could wear it for 20 minutes, then 30 and eventually nearly an hour straight.

    My extension started at negative 22 degrees. When I finished my three months of physical therapy and wearing the splint for three full months (an hour to two hours a day, everyday), my extension was zero degrees - flat and straight!

    To answer your question, the splint worked. I never needed the procedure your speaking of.

    I had my TKR is Sept., 20112 I began wearing the splint in Nov. and stopped wearing it the end of Jan., 2013. My physical therapy (3 months, 3 days a week) ended the end of Dec. 2012.

    Good luck with your knee and post back to let us know what you decided to do.
    jenss89 replied to ocknees's response:

    Physical therapy does so much in improving the injury. They offer the exercise that might help in fast recovery with less risk involvement. Physiotherapists use innovative methods to bring more comfort to the patient to control pain. You cannot use cold compressors, painkillers and non steroidal anti inflammatory drugs for long time; at least I cannot do that. The process involves a message treatment that relaxes the joints and reduces the incidence of muscle spasms. They teach you gentle stretching exercises for a few minutes daily if you are a beginner in treatment session. They suggest diet high in fruit and vegetables that might work as remedies for pain and weight loss as it would be dangerous to carry weight during recovery. Exercises involving light, precise movements can relieve the tension in the muscles and realign the bones in the body. Sudden and jerky movements may cause pain and damages. These are some pints about physical therapy after knee replacement process. For more details you can make a session with your consultant.
    ocknees replied to jenss89's response:
    If you re-read my answer above, I completed three full months of outpatient physical therapy. I went three days a week, two and a half hours on each day. The therapist massaged my knee, manipulated it, measured it and taught me numerous exercises.

    One and a half months into physical therapy, I was stalling on my extension. I've had arthritis in both knees for 30 years (since age 23). My ligaments and soft tissue were not responding timely.

    I continued my physical therapy, but my therapist consulted my surgeon and the splint was ordered in addition to therapy. A splint can be used to either aid in bending (flexion) or extension (straightening).

    Who told you that you cannot use cold on the knee or take pain killers? Both are necessary. Every physical therapist and surgeon recommends ice wraps on the knee after surgery to reduce inflammation and ease pain. And every doctor prescribes a pain medicine because TKR pain is miserable.
    enuff81020 responded:
    Hi there,
    I had my left knee replaced with no issues and then my right knee done and things went crazy. I couldn't stand being touched at all and there was swelling and any number of other issues. Finally, we had to do a MUA in order to get and keep my leg moving and bending. It was a good diagnostic tool for my docs and for me, it told me that my knee could both straighten and bend. I went to PT immediately after the procedure and was going 5 days a week, but my inability to stand being touched really caused the problem.

    I had a second MUA with similar results, but this time the manipulation helped to break up scar tissue that had formed. A second ortho was brought in to help out with my issues and recognized it was RSD. After a series of sympathetic nerve blocks in conjunction with immediate PT, we started making progress but by then, the scar tissue was too much to deal with. I needed a second replacement in order to make things function.

    The manipulation was not painful or problematic. It gave us information on my knee that we couldn't get any other way and led us to a successful treatment. It was well worth what I and my docs invested in me and I would do it--and all of this again. My knees stayed pain free since then and it has been 9 and 8 years respectively. I got my life back from the torture that my knees had been.

    Best of luck to you,

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