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    knee manipulation
    chamberly posted:
    Hello everyone,
    I had TKR on May 24, of this year. Due to little home therapy I have to have knee manipulation this coming Monday. I would like to know what to expect since this whole ordeal has been hell. I'm scared to have this done, I know I need my knee to bend more than 66 degrees for quality of life. Any info will be greatly appreciated. Also I have elevated SED rate and the rheumy I saw said it was due to my weight-I have lost 20lbs since surgery and am still losing. Any commentson this will b helpful. My surgeons office said its not likely. Thank you for youe help.
    Michael P Bolognesi, MD responded:
    It is not that uncommon to have to have a manipulation after TKA. Most studies suggest that the need for this procedure after TKA ranges between 1 and 6%. It is most important to act quickly after the surgery and make the decision to do this if the patient is having trouble gaining motion. The patient is put to sleep and the knee is bent to break up the scar adhesions that have formed. There will be some pain afterwards and it is critical to get right back in to therapy after the procedure.
    chamberly replied to Michael P Bolognesi, MD's response:
    Thank you so much for your reply. I have had the manipulation done and am having pain with weight bearing. I also have extreme pain at 110 ROM. I don't know if I will get beyond that, it makes me cry and I can't catch my breath it hurts soo bad. I am on a CPM machine everyday for 2 weeks for 6-8 hrs and hav been going to OP therapy 4-5 days a weeks also. Hope all this works for me.
    cyndylu replied to chamberly's response:
    Just wondering how you are doing now chamberly. I am facing the manipulation in about a week. Am really anxious.
    Coach_G replied to Michael P Bolognesi, MD's response:
    Dr. Bolognesi, I have had a tkr and had to have two manipulations and still have scar tissue. I am also diabetic and understand that being diabetic it will develop faster. My question for you is this, is there a doctor like your self who specializes in removal of scar tissue? I am totally frustrated because since I became diabetic I have gone to Webmb and educated myself. Purchased a Schwinn Airdyne to keep my numbers down. Could you please direct me to a doctor in Illinois for this treatment. I would greatly appreicate your response.
    Michael P Bolognesi, MD replied to Coach_G's response:
    Coach G
    Sorry for the delay in response. I think it is most important to figure out what the next intervention should be. If you have had two manipulations and are still stiff then you should not have any more manipulations. The scar can removed with an arthroscopic procedure or with an open procedure. It is critical to make sure that the implants are all in ideal position and that all are appropriately sized before having an isolated scar excision. The scar removal procedures are not lkely to work if revision of the implants is needed. It is hard to make firm recs without an examination and radiographs. You need to seek out a physician that has a lot of experience in revision ("re-do") knee procedures if your surgeon has suggested that there is no more that can be done. I have to say that there are times we see patient for a second opinion that have implants that are placed perfectly that become stiff. I wish you the best and would suggest you look at the surgeons at the larger academic centers like Rush University and Northwestern for a second opinion. I should point out that there are likely surgeons outside of these centers that have enough experience to help you out.

    Mike B
    Cjacks2 replied to Michael P Bolognesi, MD's response:
    Hello ,
    I had TKR March 28,2011. Since surgery I have not been able to bend my knee more than 65 degrees. Last week,5/2/11, I had a manipulation after the proceedure I was in recovery the doctor came out and told me he COULD NOT !!! bend my knee he was afraid he would break my leg!!!!
    I went to PT imediatly after and they confirmed I had no more motion.
    The Doctor said we will try more PT.
    All last week we heated it before PT and we gained maybe 8 degrees. Last reading was 68 degrees.
    Will this knee ever have full motion.I can straighten it totally.

    _swank_ replied to Cjacks2's response:
    I think you should just give it time. It took me several months before I could bend my knee all the way. It's still only goes to about 110 degrees or less and it's been 11 months. I'm guessing you probably still have some swelling that can hinder the ability to bend as well.
    chamberly replied to Michael P Bolognesi, MD's response:
    Well here I go again. Im still having pain in my left knee that was done in May 2010. The new problem is my right knee has gone, I can fell the cartlage grinding and it hurt like heckand is unstable. The knee brace has helped with this but if I wear it too long my calf muscle start to hurt. I was told at the same time my right should be done due to arthritis but I had no pain so I wouldn't do it. My question is do I just have arthroscopic and see if that works, stay on a pain management and save my natural joint as long as I can or just go for the TKR? I'm only 44 and I really don't want to have 4 TKRs if I live to be 60.

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