Doctor insights on:
Numbness After Total Knee Replacement
What can cause severe pain 1yr after total knee replacement surgery? My mother has numbness in foot and knee. Sometimes swelling. Thanks
Varies: There are multiple possibilities, but one general way to look at it is either there is something wrong with the knee replacement surgery outcome, or your mother has another condition causing pain in that area. The most common "other" cause is a condition calked spinal stenosis, which is essentially a pinched nerve in the back that can cause leg pain and numbness. ...Read more
Scar tissue: After a knee replacement, achieving maximum knee motion is often a race against your bodies natural healing process. Though your pre-operative range of motion can ofter predict your maximum expected post-op range of motion, aggressive physical therapy is crucial to achieve the best result. ...Read more
Yes: I'm assuming you are referring to the low impact exercise machine. A gazelle would be very good exercise, as would most other low impact machines such as an elliptical, stationary bike, etc. Generally anything that isn't high impact is a safe option for exercise and sports participation after knee replacement. You should avoid high impact activities such as running, jumping, etc. ...Read more
Strength and motion: Patients lose 30-50% of muscle strength after tka and have to exercise to regain that strength. Leg raising, walking, and progressive exercises to improve the quadriceps function will help. Motion exercises include bending the knee to regain flexion and full extension (straightening). These should be done 3-4 times/day. Bending, biking, and pulling on the leg in flexion will help. ...Read more
Knee locking: You should have this discussion with your surgeon. If he does not give you a satisfactory answer and solution, it is okay to get a second opinion. ...Read more
Yes: It varies quite a bit. Some parltients do really well even within a couple weeks of surgery, while others dolly improve over several months. If your surgeon is happy with how your knee and X-rays look, I would not be too concerned. Hopefully you will soon turn the corner and start feeling better. ...Read more
It depends: Full recovery after knee replacement usually takes more than a year. Most patients reduce their use of pain medicines within two weeks of the replacement, by 6 weeks they are comfortable and usually by 3 months the knee is fading into the background, and life doesn't revolve around the new knee. Everyone is different and this is a general time line. If you are concerned tell your doctor. ...Read more
You will do many: Different exercises. However, there are two main areas that a pt will work with you. First, you will need to work on stretching your hamstrings, making sure you get your knee in full extension. The second, which is very close to this, is quadriceps strengthening. Overall gait stabilization is also important. Pre-surgery exercises programs have demonstrated success in better post-surgery outcomes. ...Read more
Forceful bending: A total knee replacement that has not regained adequate knee flexion after surgery can by treated with a manipulation under anesthesia. This procedure involves the manual disruption of fibrous scar tissue that can sometimes develop within the knee joint. Dedicated range of motion exercises, with a physical therapist and done independently, are critical to the success of this procedure. ...Read more
Not sure what....: ..."extreme crunching" is, but if that knee was operated on nine months ago, you need to see your surgeon for an evaluation. ...Read more
Fairly: It is not terribly uncommon, especially with the hips. The recovery from a total knee replacement does involve some degree of limping, favoring one leg over the other, and not uncommonly causing a bursitis of the hip. Thankfully they usually it resolves over time as recovery progresses. ...Read more
Is it common to fx leg during manipulation knee after total knee replacement? What other complications can happen? Mine being done in 4 weeks
No: It is very uncommon to fracture a leg during a manipulation. It would be most likely in a patient with osteoporosis or severe weakening of the bones. Manipulation is most effective in the 1st 6-12 weeks after total knee replacement, although in some cases may be helpful beyond that time frame. ...Read more
Yes, but not often: Knee replacements can feel like "seizing" or "locking up" on rare occasions and they are usually not due to the device. The most likely phenomena you are experiencing is either "crepitus" or "clunk" which is when scar tissue surrounding the front of the knee gets trapped within the device creating a sensation of locking up. When severe enough, it can be alleviated by removing that scar tissue. ...Read more
May not be complete: Some are fortunate to have the surgery and shortly there after once the wounds healed, they have no pain at all. Many will have great improvement of pain, but never completely resolved after the replacement surgery. It is a big surgical procedure with significant risks/benefits, so do your research and discuss with doc thoroughly. Good luck to you. ...Read more
Recovery: Typically is about 2-3 months. It is an inpatient surgery you are in the hospital 2-3 days and then either go home with PT or to Rehab. You are up walking either the day of or after surgery. Stitches out at two weeks. Typically off crutches in 3 weeks once you can stand walk with good quad strength. ...Read more
Research: The orthopaedic community continues to improve outcomes through a variety of avenues. It is necessary to speak to your surgeon directly. After surgery, most people spend 3-4 days in the hospital, and then go home or to an extended rehab stay. Therapy is typically 8-12 weeks. Weight bearing is started immediately, with a rapid transition from a walker to a cane to independant activity. ...Read more
Many things: There are a number of things that can cause pain. Infection should be ruled out first. If it is not infected, xrays should be done to verify the components are not getting loose, a bone scan is also a possiblity. A rare cause is metal sensitivity, but this is controversial. Sometimes impinging scar tissue in the knee can cause it, or it can be refered pain from the hip. ...Read more
Is there anything that can be done to strighten or bend my knee after total knee replacement waiting for answer?
TKA: Firstly pt is important if this does not work then manipulation of the knee can be done. You also have to be very active in stretching etc... ...Read more
Pillow: There is no physical reason preventing you from sleeping on your side. You might try a pillow between your legs if you find it uncomfortable while your knee recovers. ...Read more
Your PT should be --:
Able to help you, as he/she'll be able to determine which (or all)muscles need to be strengthened in your thigh (both quads ; hamstrings). They'll be gauging your response to the pt and giving you a home exercise program, all in an effort to rehabilitate you, to attain the best function you can achieve after rev surgery.
Do them religiously ; you'll enjoy the results of the surgery.
Good luck. ...Read more
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