Bilateral TKR Specific Information

Atlas_aus

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Hi all,

I have done a lot of reading on here and other areas of the web but there does not seem to be a lot of specific information for bilateral TKR.

Clearly there is some advantage to having one good leg whilst the other is recovering, but what if you don't ? I read things like "using your good leg".....

What I would really like to know from those that have had a bilateral TKR is how it went, what was needed and what 'hurdles' you faced and how you overcame them.

One of my biggest 'worries' is sleep. I have always slept on my side, usually starting on my left and finishing up on my right, have never been able t sleep on my back unless very intoxicated ! And with 2 bung knees I am not thinking that is an option ! :heehee:

Thanks in advance.
 
If both of my knees had been bad at the same time I would have done bilateral. Mainly all of the other issues, like pain management, taking off work, anesthesia, etc. These are all done at once. I hate to say it but sleeping will be an issue even with one knee, but it eventually gets better. Good luck!
 
As you can see, I have moved your threads into the pre op area. In pre op you are allowed multiple threads, while in post op, we ask our posters to maintain one recovery thread. Since your surgery is not until May, I have placed your posts into the pre op area.

If you go to the lists of threads and click on a label for "bilateral replacement" you will see the other folks who have had bilaterals, and you can then post to them for information.
 
I read things like "using your good leg".....
Well I would have thought it wouldn't take much common sense to interpret that as 'using your best leg' as an alternative?
One of my biggest 'worries' is sleep. I have always slept on my side
Everyone gets that problem. However, it's usual that the overall effects of post surgery and post anaesthetic would render the individual so 'schlumped' they wouldn't worry too much about it. I never did. Plus the sedative effects of the pain killers.
 

Thank you, very handy. I will figure this board out yet ! :heehee:

Well I would have thought it wouldn't take much common sense to interpret that as 'using your best leg' as an alternative?
Everyone gets that problem. However, it's usual that the overall effects of post surgery and post anaesthetic would render the individual so 'schlumped' they wouldn't worry too much about it. I never did. Plus the sedative effects of the pain killers.

Having a BTKR I am not sure I will have a good leg, but here's hoping :loll:
 
I haven’t had a bilateral but from what I understand, most members who do, have one leg better than the other.

@maryo52 recently shared one reason why that is. She can tell you better, but she observed this surgery and the surgeon did more on the first leg, testing the implant, checking different things, so that this first knee was handled more, so had more to recover from. The surgeon didn’t have to do all that in the second knee.

I thought it was really interesting to know that.
 
@maryo52 recently shared one reason why that is. She can tell you better, but she observed this surgery and the surgeon did more on the first leg, testing the implant, checking different things, so that this first knee was handled more, so had more to recover from. The surgeon didn’t have to do all that in the second knee.

OMG !! observed this surgery

My worst nightmare waking up during it ! It makes sense with what is said, all except the "watching" part :yikes::loll:
 
I learned from my BTKR that a factor that can make the knee operated on first in BTKR a harder recovery is the fact that they generally do the more damaged knee first. My surgeon explained the reasoning is if there is a problem (bleeding, cardiac issues, allergic reaction, etc.) the surgeon can stop after doing one knee. You'd definitely want the worse one fixed. The worse knee may require more manipulation and may inherently have more damage and stretching due to your own condition (severe bowleggedness for example).
 
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@ulrich2000

That sounds reasonable.

I think he may have to play a game of "scissors, paper, rock" to choose mine :heehee:
 
Lol!

That’s the truth! 2 years ago I would have done just one. Circumstances didn’t allow and things worsened. The right was definitely worse on X-ray, had the most varus deformity (bowlegged) and felt worse walking and standing. The left had crazy popping and scraping feelings that would literally make me see stars. And the left couldn’t be comfortable at night and kept me awake with it’s antics.

Now that it’s done I’m glad I took this path. It’s scary, and no I don’t have a good knee to lean on. But I do have 2 fixed knees and as nature takes its course and the swelling and inflammation settle down things are looking bright. The nurses, PAs, and residents all tell you how brave you are getting both done. Early on there are some serious limitations to what you can do. And what felt like 2 sausages which might split if bent too far a few weeks ago still hurt now, but it’s the pain of healing tissues, and it gets better day by day. The arthritis was getting worse day by day. Standing now is great, and walking feels good within limits.

The recovery guidelines on the forum are very, very helpful with pain, ROM, exercise, sleep etc. Read every link. Make yourself a nice nest. It will be really hard to sit on low furniture or on normal toilets for a few weeks. Make sure you have a good icing setup something for elevating.

I’ve always been a side sleeper too. I had to sleep on my back for months after a spine surgery in November 2018 so I became somewhat used to it. I sleep on my back now but still try the side with some pillows between my legs. It feels nice for a bit but becomes too uncomfortable to sleep pretty quickly. Someday.

What helps me sleep are my pain meds as prescribed, dual release melatonin, no caffeine at all after dinner, trying to nap during the day but not too close to bedtime, not doing much to make me sore before going to sleep, and icing right before or even while going to sleep. A small snack (spoon of peanut butter or something) before bed seems to help me too. If I wake up I put nature sounds on my phone and keep plodding through The Complete Sherlock Holmes on my Kindle till I nod off again. And If the pain itself has woken me I take meds if due and do a Body Scan meditation guided by a Jon Kabat Zinn video on YouTube through headphones. I won’t lie, some nights are better than others. But I make it up in naps.

I did a lot of “prehab” strengthening in the month before surgery. I was pretty deconditioned from limited activity. PT after the spine helped with core strengthening. In the last month before the BTKR I did quad and hamstring strengthening, adductor and abducutor work, and lots of walking in the pool. Also some upper body work will help as you’ll need to push yourself up and out of seats, use walker, crutch, cane, etc. I’m sure this extra work is paying off.

The early weeks are rough but you’ll persevere. Stay positive. This is worth the effort. Best of luck. Feel free to reach out.
 
Hello @ulrich2000,

Seems we are having similar journey, I too have had lower spine surgeries, 2 in fact and I am better for it, hopefully I will be able to say the same post BTKR ! :)

It sounds like you are doing really well and I look forward to following your journey.

Take car of yourself :thumb:.
 

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