Being a Registered Nurse, I can say that I AM a medical expert and know that some peoples bodies build adhesions more than others. Adhesions are fibrous bands that occur due to tissue trauma. It happens to some degree with ALL surgery. I had been going to physical therapy three times a week. On the days that I wasn't going to physical therapy, I did the exercises at home. I used Bio-oil on my surgical scar and it healed so well that it was barely noticeable. It's just a thin white line. I didn't have the thick keloid scar as some people have developed. My therapist did the manual manipulation after every session, trying to force my knee more than 80 degrees. It was impossible to do since the adhesions had restricted the muscles from bending. Manual manipulation under anesthesia was not a choice, my surgeon didn't ask "may I?" and it was NOT preventable in my case which it usually isn't in most cases. When I went for my follow up visit after 7 weeks of agony, the doctor knew in 3 minutes that it was absolutely necessary or I would not regain range of motion ever. He didn't give me options. Breaking of adhesions under anesthesia is similar to breaking a bone, there are audible 'snaps' heard when they're released. I left the surgical suite and went directly to therapy. I was finally able to be manually manipulated by the therapist to just a little over 90 degrees which was amazing. Please don't judge people and assume they haven't worked hard at rehabilitating their knee post-op. Things like adhesions happen more in some than in others no matter how much lotion, creams or oils they apply or how much they are working at rehabilitating. People all heal differently, so consider yourself fortunate that you weren't one that required manipulation under anesthesia.View Thread
Hopefully the side effect of incontinence will diminish and eventually disappear eventually. If it doesn't, I would suggest you tell your doctor because there are exercises and drugs that can help. You can try bladder training during the daytime.You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating every two to four hours. Exercises known as Kegles can strengthen your urinary sphincter and pelvic floor muscles — the muscles that help control urination. Anticholer prescription medications calm an overactive bladder, so they may be helpful for urge incontinence. Several drugs called anticholinergics can calm an overactive bladder such as Ditropan, Detrol, and Enablex. Possible side effects of these medications include dry mouth, constipation, blurred vision and flushing.
I still have total lack of feeling on one side of my knee but it's not due to the nerve block for pain management after surgery. It is not uncommon for the skin at the front of the knee and the outer side of the incision to be numb because a branch of a small nerve is cut during surgery. Sensation usually returns to normal within months.View Thread
As I read your post it's now six weeks after surgery for you. If after 3 weeks you couldn't go beyond 95 degrees of flex on your left knee, it sounds as if you might have need for manipulation under anesthesia to separate those adhesions.
I was six weeks post knee replacement when I was told I need MUA. Essentially all the pain and physical therapy wasn't serving any purpose because the adhesions had made it totally impossible to get a greater than 85 degrees of flex. I had wasted six valuable weeks of rehabilitation due to those restricting adhesions.
I'm 3 weeks post MUA and things are better. I can comfortably sit or drive my car and even sleep on my side with no problem now. Right now, I'm still working on going down stairs one at a time.
You're brave to get both done at the same time. I wanted to have both of mine done but my surgeon refuses to to both at the same time and I realized after my surgery why that is. I don't think I could have rehabilitated either knee effectively if both were done together.
Let us know how your recovery is doing. Good luck to you.View Thread
I had several near-accidents during the early weeks,too. I assumed it was a result of the knee swelling and as that fluid recedes, it gets expelled throughout the body and eventually through the bladder. The medications you're taking for pain will also be a factor since most narcotics have an effect on smooth muscle which the bladder is made of. I had to take precautions not to drink too much fluid before going to sleep and I woke up at 4 a.m. to go to the bathroom every night for weeks. Your incontinence will improve as you need less and less pain medication.
I wasn't too concerned about this problem because on the initial visit of my home care nurse it was one of the questions she asked "are you having any problem with incontinence?". When she asked me that, I realized that it's a very common but temporary inconvenience. It will get better and it happens abruptly, One day you just realize that it's no longer a problem.View Thread
Good luck to you. It does feel much better afterwards and the procedure is very fast and painless. The doctor told me that he's satisfied with 120 degrees because that will be enough for most of the normal activities. I've read about people getting a lot more than 120, but I don't think I'll get there. As you said, it's almost like beginning therapy again only now there's more focus on strength training. I found out that my health insurance offers the 'silver sneakers' benefit. This will cost me $12 a month but I'll have access to any YMCA in my area and there are three of them that have pools and exercise rooms. That will be my plan for rehab after I get the green light to be discharged from physical therapy. It might be an option for you also if you check with your insurance. A woman at physical therapy let me know about that benefit. Good luck to you on Friday, you'll do just great!View Thread
It was two weeks ago that I had the MUA (manual manipulation under anesthesia) The most flexion he got under anesthesia was 120 degrees.I was ordered to go to therapy that same afternoon and it was painful (as usual) but I was able to bend it. At the fifth day post manipulation, the therapist bent it to 120 degrees but it was so painful that I was begging her to stop, which she didn't and let out a final scream when she got it to 120. It was embarrassing, but I couldn't help it. I was supposed to go back to the doctor yesterday for a 2 week follow up but the blizzard prevented me from getting there, and I haven't been to therapy since last Friday.
Essentially I'm trying to keep exercising on my own until I can make it back to therapy and bending my knee against the arm of my couch as far as I can. I have pain when I walk and I'm still not going down the stairs one-foot, one-step at a time. I had done that accidentally when I had adhesion and felt like my knee exploded, I cried for five minutes from that pain. I'm going to wait to get to that point in physical therapy which by the way costs me $40 co-pay every visit. I go 3 times a week, so it's expensive.
Basically I feel as though I'm a brand new post operative knee and beginning therapy all over again but this time with a much greater degree of flexion. I use heat and I also massage my knee and scar. There are no adhesions under the scar, my therapist told me it's nice and loose beneath it. But there's still swelling present especially after therapy and I ice it up right away. The rest of the time, I use heat. This is such a slow healing process that it becomes depressing. The progress happens in tiny increments that are barely noticeable. I can count the number of times on one hand that I can stand or walk with no pain at all.
This has to get better, or I'll curse the day I decided to do this knee replacement.View Thread
I had my TKR on Dec 4th and adhesions formed almost right away, Physical therapy was excruciating and I feel a waste of time, money and pain since I ended up going to manual manipulation this past Monday, Jan. 28th. He said he got a 120 degree flexion in the operation room and sent me for P.T. that same day and every day this week. It still feels restricted but the therapist got it to 120 degrees yesterday with manipulation and a few loud screams from me. I do my exercises at home but it does not feel better. I wish I never had this knee replaced. Living with the pain I had before was much more tolerable than this and far less depressing.View Thread
My total knee replacement was on Dec 4th, 2012. So it's seven weeks tomorrow and I have just seen my orthopedic doctor for a follow up. He tells me that I'll need manual manipulation. I have been dreading to hear those words, but I have and I'll have to deal with it. I don't know if there's anyone else that has needed to have adhesions manually manipulated under anesthesia, and if so, what was your result.
I have been going to physical therapy 2 to 3 times a week, but since the second week post operative, I had felt as though I had a tight band along the side of my knee and beneath it. It felt stiff and even manipulation by my therapist couldn't break through that tightness despite getting it to an 85 degree flexion. I'm a bit concerned that after going through manipulation that it will again be riddled with adhesion despite going to therapy next week every day. Has anyone had this done? After all the pain these past weeks, I'm really not looking forward to any more.View Thread
I think you're going to be surprised that you'll feel ready to return to work in 2 months. I'm six weeks post op and I'm able to drive or ride in a car comfortably and have stopped using my cane a few days ago. I never really had the unsteadiness but I was using a walker when I came home, then crutches, then the cane. The only scary time and it still is scary is taking my shower every day. I have one of those handles that sticks with suction cups to the shower wall for me to hold onto. Getting in and out is always something I do very slowly and carefully. I sill have swelling and some discomfort but I no longer need the Vicodin and Alleve works to control the pain. I have a long way to go with therapy and I'm just beginning to do some exercises that I couldn't do a week ago like stepping down a half-stair in p.t. This is a big one for me. There's a few things that validated my decision to get this knee done last month, and one thing is that I can stand with my full weight on that one leg and not have any pain and it's straight! Just remember something here, and it's probably the most important thing for anyone to remember. Your recovery will feel very slow and you may even begin to feel depressed and defeated...BUT this is normal because recovery happens in such tiny increments that it's hardly noticeable. Then you'll reach a point one day when you say 'oh wow, yes it is better than it was!'. Keep in mind it's a very long process. You'll have redness, swelling and pain to some extent for months. Manage your swelling by elevating it and keep ice packs on it. Manage your pain with Vicodin at first for a few weeks then begin weaning off it. The surgery itself is pretty easy and the nurses will make sure you're medicated for pain. The journey really starts the day of your discharge. Reading this forum and contributing to it also helps. Good luckView Thread
Have you gone the conservative route as far as treatment for your pain such as synvisc or cortisone injections? I had conservative treatment with injections for more than 10 years before my surgery but those failed eventually and didn't help with pain. Surgery was my final option. Both my knees were very arthritic and I had a deformity where they were severely bowed. This caused my hips to be out of line when walking so that was additional pain. I had one knee replaced Dec.4, 2012 so I'm almost 7 weeks post operative. My surgeon does not do bi-lateral knees at the same time. If you can wait by getting relief through injections, then do that and put this surgery off as long as you possibly can. It's major surgery and the recovery is different for everyone but it's generally six months to a year to be totally rehabilitated. The physical therapy is extremely painful but necessary. The heat and swelling and redness last for months. It's a journey that's for sure. I'm hoping that the final outcome will be positive for me and I won't have this pain forever.View Thread
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