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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19443
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am very worried about my husband, who had a total knee replacement

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I am very worried about my husband, who had a total knee replacement on 7th September, following severe pain from May. We paid £15,000 for the procedure, and he initially made a good recovery, apart from having a problem straightening the new knee - the new joint was flat on the operating table, but the muscles behind it are tight and the lower thigh muscles in the front are wasted die to the months of walking with a bent leg. But he was working on that, doing exercises, and not having much pain - until about a month ago a physio pressed all their weight on the knee to straighten it, which was agonising, and seems to have arrested his recovery and set him back. Since then, my husband has had a lot of pain, he can't straighten the knee as well - although he is doing a lot of exercises and seeing a different physio; he can't walk very far as both knees are bent, he still takes the stairs one step at a time, he uses one or two sticks when walking, and he has difficulty getting out of chairs. He's really back to where he was before the operation, only with less pain, and I'm worried that that physio caused some damage by pressing on the knee, and that my husband will be crippled. He's an otherwise fit 67. Looking online at what he should be doing at 3 months after the op, it seems he is way behind. He was standing straighter four days after the operation. I know recovery times can vary, but he was doing so well until he saw that physio.
Hello from JustAnswer.
With this history, there certainly should be concern that there could have been damage sustained by the physical therapist.
When did he last see his surgeon?
Has he seen his surgeon since this injury?
Customer: replied 2 years ago.
No, this was just after he was discharged to an NHS physio, after seeing private physios at the hospital where he had the operation. He is due to see the surgeon in January - he is keeping an eye on the other knee. But should we wait that long?
No, it would be better to be seen sooner.
The greatest concern is that there has been a tear of a tight muscle/tendon or ligament. Tightness after a surgery can also be related to scar formation, but it usually takes some time to develop contracted scars, so it is much more likely that the tightness is from muscles, as you noted in your question. With the trauma from the physical therapist, it is reasonable to have given it a short time to see if it will heal spontaneously, as would be seen with a muscle strain, but since his symptoms have persisted for a month, it would be appropriate for him to be seen.
The first step in the evaluation would be an examination by the surgeon, but there also may need to be an imaging study, such as an MRI. If the replacement is titanium, then an MRI can be readily done. If it is a more traditional metal implant, then an MRI can only be done once there has been sufficient healing so that the hardware is stable.
If I can provide any further information, please let me know.
Dr. D. Love and other Medical Specialists are ready to help you
Customer: replied 2 years ago.
Thank you. We will seek advice now.