Post-Tibial Fracture Surgery: Why Can't I Bend My Knee? - Orthopedics

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After undergoing surgery for a tibial fracture, it is not uncommon to experience difficulty bending the knee, especially if the surgery involved the tibial plateau, which is the upper surface of the tibia that forms part of the knee joint. The issues you are facing—limited range of motion, pain, and a feeling of tightness—can be attributed to several factors, including the surgical procedure itself, the healing process, and potential complications such as scar tissue formation.

1. Surgical Impact: The surgery you underwent likely involved manipulation of the knee joint and surrounding tissues. This can lead to inflammation and swelling, which may restrict movement. Additionally, if the surgery involved fixation devices (like titanium plates), these can sometimes cause discomfort or a sensation of tightness as the body heals around them.

2. Scar Tissue Formation: One of the common complications after knee surgery is the formation of scar tissue, also known as adhesions. This can occur when the body heals after surgery, leading to a condition called arthrofibrosis, which is characterized by excessive scar tissue that can limit the range of motion. If this is the case, it may feel like your knee is "stuck" or unable to bend properly.

3. Pain and Swelling: Post-operative pain and swelling are normal, but they can also contribute to stiffness. Pain can inhibit your willingness to move the knee, which can further exacerbate stiffness and limit your range of motion. It’s important to manage pain effectively, as this will allow you to engage in rehabilitation exercises more comfortably.

4. Rehabilitation: Engaging in a structured rehabilitation program is crucial for recovery. Physical therapy can help improve your range of motion and strengthen the muscles around the knee. A physical therapist can provide specific exercises tailored to your condition, focusing on gradually increasing your knee flexion while managing pain.

5. Consultation with Your Surgeon: Since you have a follow-up appointment scheduled, it is essential to discuss your concerns with your surgeon. They can assess your knee's condition, possibly through imaging studies, to determine if there is significant scar tissue or other issues that need to be addressed. They may also recommend interventions such as manipulation under anesthesia if adhesions are suspected.

6. Home Care: In the meantime, you can perform gentle range-of-motion exercises at home, as tolerated. Applying ice to the knee can help reduce swelling, and elevating the leg can also assist in managing inflammation. Over-the-counter pain medications may provide relief, but consult your doctor before taking any medication.

7. Long-Term Outlook: It’s important to remain optimistic. Many patients experience significant improvements in their knee function over time with appropriate rehabilitation. However, recovery can be slow, and patience is key. If you find that your knee does not improve, further interventions may be necessary.

In summary, the difficulty you are experiencing in bending your knee after tibial plateau surgery can be due to a combination of surgical effects, scar tissue formation, and post-operative pain. Engaging in physical therapy, managing pain, and consulting with your surgeon will be critical steps in your recovery process. Remember, recovery from surgery is often a gradual process, and with the right support and interventions, you can work towards regaining full function of your knee.