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Not all TKR patients need manipulation. After any surgery, patients will develop scar tissue to heal the incision. As the scar tissue matures, your goal as a patient is to make it pliable by bending and straightenening the knee. The better you are at bending, the more ROM you get and the more pliable the scar tissue. If you don't get yourself bending soon enough, the scar tissue will mature and it makes it difficult to get the ROM. Your Physical Therapist may be able to help you get there. If not, the surgeon will take you back to the OR, they will put you to sleep and then he bends your knee for you. Most manipulations are done in 6-12 weeks after the surgery date and I have heard of some done 3 months or more after surgery. Ideally, taking your pain medication in the immediate days after your surgery to keep pain controlled helps you to tolerate the bending necessary to avoid

manipulation. If you do need a manipulation, however, realize that it is a second chance to achieve full ROM. You have to use your leg NORMALLY to maintain the function. Alisa Site ModeratorAlisa Curry, RPT - Senior Physical Therapist Washington Hospital Center for Joint Replacement - Fremont , CA "Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity" - Luther King Jr.

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Thanks for the reply. I think i understand Sandy

>

> Not all TKR patients need manipulation. After any surgery,

patients will develop scar tissue to heal the incision. As the scar

tissue matures, your goal as a patient is to make it pliable by

bending and straightenening the knee. The better you are at

bending, the more ROM you get and the more pliable the scar tissue.

If you don't get yourself bending soon enough, the scar tissue will

mature and it makes it difficult to get the ROM. Your Physical

Therapist may be able to help you get there. If not, the surgeon

will take you back to the OR, they will put you to sleep and then he

bends your knee for you. Most manipulations are done in 6-12 weeks

after the surgery date and I have heard of some done 3 months or

more after surgery.

>

> Ideally, taking your pain medication in the immediate days after

your surgery to keep pain controlled helps you to tolerate the

bending necessary to avoid manipulation. If you do need a

manipulation, however, realize that it is a second chance to achieve

full ROM. You have to use your leg NORMALLY to maintain the

function.

>

> Alisa

> Site Moderator

>

>

> Alisa Curry, RPT - Senior Physical Therapist

> Washington Hospital Center for Joint Replacement - Fremont , CA

>

> " Nothing in the world is more dangerous than sincere ignorance

and conscientious stupidity " - Luther King Jr.

>

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Alisa and Group,

Having had a TKR and a Revision within the last 4 months and two

manipulations prior to the Revision I can report some of my own

observations here...

1. Before the TKR I had great ROM in both knees. Still have a very

large ROM in the non-op knee.

2. First Manipulation resulted in black and blue and painful calf

muscle so it was obvious that a good deal of tearing took place there

and not in the incession scar.

3. New surgeon,still orig. knee replacement, did second manipulation

and used epidural block+ 3 days in hospital+cpm. This time the pain

and swelling and surface bleeding took place above the knee in the

thigh muscles. My inside and rear muscle are turned deep purple

withing a few days of the TKR and it was painful for sure.

4. Prior to the Revision, the new surgeon showed me a shadow in the

thigh area which he said was bone which had some how come loose in a

process of the thigh muscle attaching down to the femur where it was

not supposed to do so. He said he was going to cut a larger

incession and go up and clean it out.

5. Post Revision 4 weeks, x-rays in his office showed fractured femur

above implant so he wound not manipulate ever again.

6.PT says I am going to have pain and swelling for 6 monts until he

atrophied muscles are able to do their job again. I am in daily pain

now and do all my PT exercise and do PT 3x weekly.

So sometimes a minipulation is tearing loose scar tissue all over the

leg as the surgeon gains ROM.

I hope this is helpful.

Al Welch

>

> Not all TKR patients need manipulation. After any surgery,

patients will develop scar tissue to heal the incision. As the scar

tissue matures, your goal as a patient is to make it pliable by

bending and straightenening the knee. The better you are at bending,

the more ROM you get and the more pliable the scar tissue. If you

don't get yourself bending soon enough, the scar tissue will mature

and it makes it difficult to get the ROM. Your Physical Therapist

may be able to help you get there. If not, the surgeon will take you

back to the OR, they will put you to sleep and then he bends your

knee for you. Most manipulations are done in 6-12 weeks after the

surgery date and I have heard of some done 3 months or more after

surgery.

>

> Ideally, taking your pain medication in the immediate days after

your surgery to keep pain controlled helps you to tolerate the

bending necessary to avoid manipulation. If you do need a

manipulation, however, realize that it is a second chance to achieve

full ROM. You have to use your leg NORMALLY to maintain the function.

>

> Alisa

> Site Moderator

>

>

> Alisa Curry, RPT - Senior Physical Therapist

> Washington Hospital Center for Joint Replacement - Fremont , CA

>

> " Nothing in the world is more dangerous than sincere ignorance

and conscientious stupidity " - Luther King Jr.

>

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  • 2 years later...

Hi Kim

I will be thinking of you tomorrow during your manipulation.

Please let us know how it went.

I fear I'm headed in the same direction!

Except, I don't see my surgeon until Sept 9 which might be too late!!!!

All the best

Diane

58 yo F

TKR July 20

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Diane,

If things aren¹t going well, you have the right to call your doc and get an

opinion and a plan.

I hope you will do that. You deserve the best possible care.

Best,

Jackie

On 8/24/09 5:19 PM, " Jim and Diane " <jbbooks@...> wrote:

>

>

>

>

> Hi Kim

>

> I will be thinking of you tomorrow during your manipulation.

> Please let us know how it went.

>

> I fear I'm headed in the same direction!

> Except, I don't see my surgeon until Sept 9 which might be too late!!!!

>

> All the best

> Diane

> 58 yo F

> TKR July 20

>

>

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