Knee stiffness, pain during physiotherapy. Normal?

Question

Hello doctor,

My mother had a total knee replacement two months ago. Doctor suggested to put knee splint for nearly a month, and after that, she went to physiotherapy and her knee is very stiff now. She could not able to bend her knee, and having excess pain. Almost her BP is raising during physiotherapy and the pain stays for a day. Is this normal?

Answer 1

Hello,

Welcome to icliniq.com.

You mentioned that your mother had her knee replaced two months ago. I am assuming it is a primary rather than a revision. I will be concerned as much as you are as by six weeks we expect at least a 0 to 90 degree knee bend. By this, we mean that the patient can bend her knee while sitting on the edge of the chair and have her foot planted on the ground comfortably. If this is not the case then we need to look at her progress with physiotherapy. If this is slow but steady and the patient is making satisfactory progress weekly and is able to actively participate in the physiotherapy without much post-therapy pain, then I will recommend continuing with physiotherapy but keeping a strict eye on the developments and progress. If it is neither i.e. range of motion is less than 0-60 and the patient is struggling with physiotherapy then you seriously need to go and see your surgeon. And I will recommend an MUA (manipulation under anesthesia) which will improve her ROM (range of motion) and make her life with physiotherapy much easier. Also, if you wish you could upload her X-rays post-operatively and a picture showing her ROM, and maybe I can help you further and will be able to guide you towards the next steps that you need to take. In the meantime ice the knee after each physiotherapy session.