2nd Quad Sparing MIS TKA April 10, 2009

[hollie9]

I'm going back to same doc, Dr. Coon for surgery on my "other" knee. This knee was so dependable during my recovery that it has surprised me how it has gone downhill so fast. I can hardly walk any distance without shooting pains down my leg. So I have some motivation to get it over with, especially before summer.

Dr. Coon does Quad Sparing MIS surgery and has done over 4,000 of them. I will spend less than 24 hours in hospital and walk out unaided and head home.

Then I have a painful 11 days, living on pain pills to tolerate the bone ache from cutting the bones, although I can still walk fine. I will be icing with the ice machine they give out and elevating quite a bit. Last time my back really started hurting doing this, so I hope to figure out a way not to have a sore back this time.

Hollie

 

[Judles]

Welcome & Good luck, Hollie! Think positive!

 

[Sandy R]

Hi Holly, I'm another quad-sparing MIS TKR'er. I'm almost 6 months post-op and had the same successful experience with my TKR as you did. I don't understand why more people don't opt for this type of surgery when doing a TKR. Seems to me it's the only way to go.

Pillows were the answer for me... I used pillows to raise my leg above my heart when icing and I used pillows supporting my head and back while in bed and also used a pillow between my legs when I slept.

Good luck on your 2nd TKR... Sandy

 

[hollie9]

I can't understand why more people don't go as far as they need to, to get the quad sparing surgery. The recovery is so much faster, thus better for you and the less time spent in the hospital the less chance of infection.

When I had my hips resurfaced I flew from California to So. Carolina to go to the best surgeon. I don't get why people insist on staying close to home. The quality of surgeon is priority one, and effects the quality of one's life forever.

Thanks for the pillow tip, I will try that. My back was so bad last time my PT started treating me for my back as well as my knee.

Hollie

 

[Jamie]

In some cases a patient's weight is an issue. This type of surgery is not for those over a certain weight or body mass (BMI) level. Or the doctors in a particular area might not be trained in this procedure. People have different needs....to some it is a huge deal to be close to family and friends for support.

But I agree this is GREAT surgery and it will continue to be the way to go for many, many people. So glad to hear it was a wonderful experience for both of you and I appreciate you posting of your experiences so that others can learn from them.

 

[Judles]

Totally agree that everyone should have the most skilled
Surgeon available to them,
I would think there are numerous reasons
People have travel restrictions, financial considerations,etc!

 

[hollie9]

Both the surgeons (hip and knee) I went to were in my insurance network so it cost me no more than having it done in my own home town. The only additional cost was for the flights (hips) and a two night hotel stay (hips and knees) for my husband. Both docs had hotels with discounted rates for their patients. So there wasn't much additional cost.

And when you consider that this choice of surgeon is going to determine the quality of your life forever, I think it's a small price to pay. I know people who have put an additional mortgage on their house to fly to India to the best hip resurfacing surgeon and paid cash. They were not rich and would do it again.

I've seen quite a few very big people in the waiting room at Dr. Coon's office. I don't know if he has any rules on weight. I would think that is even more reason to go to the best surgeon.

I like it that Dr. Coon does only knees. The best hip resurfacing docs I contacted would not have done as good a job as he on knees. I think they have tunnel vision on their specialty. I would not be able to be as active with the hip resurfacing docs I contacted (4), but with Coon I can ski again, and do most anything I used to do.

Hollie

 

[Sandy R]

Jamie... I agree that most OS's are not trained in doing quad-sparing MIS TKR's. I also agree there are other factors in choosing an OS.

Still, I think it's all about supply and demand... as more TKR recipients request this type of surgery, more OS's will seek the necessary training in the procedure and using the special surgical instruments essential in such a surgery. I believe quad-sparing MIS for TKR's will be the norm in the near future.

Hollie... I had the same experience as you, seeing people of size in the waiting room... who had already had the surgery and were seeing the OS for a follow-up.
Sandy

 

[Jamie]

I'm thinking you guys are right....this will be the wave of the future. Good thing too...any improvement on recovery time and pain will be a blessing! I think it's wonderful to read your posts to give people considering surgery things to ask their surgeons about when they interview them. Even if someone is not a candidate for this type of surgery or if they decide on a surgeon who does the more traditional approach, the knowledge is priceless. Thanks!!

 

[hollie9]

I wish they would start doing knee resurfacing as they've done with hips. I know this new surgery will be available a few years after I've had my surgery done, and I'll be PO'd.

There is already a prosthesis made by Conformis for knee resurfacing (no cutting of bone). I called the Conformis rep pretending to be a surgeon, I asked how many procedures had been done so far, he said none. But they may have done a few by now.

Darn it, I wish I could hold out another 5 years!!!

Hollie

 

[Jamie]

I think we'll all be AMAZED at the advances in orthopedic (and other) medicine in the next 5-10 years. There are so many people getting joint replacements, it is becoming a big business. That means money follows and the research goes crazy to find new and better ways to do things. I think it is so wonderful that people who might have had to suffer in the past can now have a new, pain-free life with the procedures that exist today. We live in a wonderful world!

 

[hollie9]

I'm already jealous of the people who will get these great new procedures a few years from now.

Hollie

 

[hollie9]

This is day 3 from surgery, it has been so different from my first TKR last October.

First I saw Dr. Coon who had planned to give me the same high flex Zimmer gender knee, I told him I wanted the Stryker X3. The Stryker has natural bend to it so it acts a bit like a rotating platform. I asked if there was any downside to having different prostheses on each knee and he said no, they were within a millemeter size difference.

Had the surgery, didn't wake up this time during surgery (they probably got tired of me yelling down to them as they were hammering away). I stood up in the hospital and my new knee wouldn't support me, it kept moving around from being hyper extended to going left then right....made me think I made a bad decision going with Stryker, although my doc loves Stryker.

I was given Lyrica the evening I was staying in hospital and had a terrible reaction, I became tense all over, felt like I was on speed, felt terrible. I called the nurse and asked "what is the antidote to Lyrica?.

There were a bunch of nurses there soon and they basically knocked me out with Ativan and God only knows what else. The next day when I was supposed to be released, Dr. Coon wouldn't let me go because I was slurring my words and out of it from the "antidotes". So I spent and extra night in the hospital.

On my previous surgery I was immediately able to walk unaided and assumed I'd be able to this time also, but no, I couldn't. I got up from the hospital bed to take a couple steps to get my walker and fell down, didn't hurt myself though.

Now that the swelling has set in I don't feel that super flex motion I felt at first. The doc said it was just muscle weakness, but I think it is the Stryker.

So now, on day 3 at home, I still need the walker mainly because the pain won't let me put full weight on new knee. This is a very different pain than I had with first knee. I had terrible bone ache whether I was walking or not, this time I get pain from using the joint only, so I am actually in less pain and need fewer meds.

Anyway, I hope this Stryker works out for me, I feel kind of stupid for not having the same prosthesis in both knees, but the doc did say it wouldn't be a problem.

We'll see how I progress now. I have full extension already, and would guess I'm about 110 flexion.

I sure hope this new knee doesn't continue to "have to be ridden", like getting on ice skates.

A real experience in hospital.

By the way, Dr. Coon is starting to do knee resurfacing...I am so bummed I couldn't have had that!

Hollie

 

[Jamie]

Hollie, I know you're feeling low because this surgery is presenting so many different issues for you as opposed to your first replacement. But try to keep positive.

After all, your surgeon is still happy with the result, right? And you trust him as an excellent professional, right? I'm assuming he's telling you that your movement will improve as your muscles get stronger, right? So....these are positives that you need to believe in!!! The fact that your other knee went so easily is a bonus in this whole process. It gave you a VERY strong knee to help you through THIS part of your recovery journey. You'll get there, hon.....just keep posting and we'll give you whatever support you need to get through this little "blip" in the road.

 

[hollie9]

Oh, I'm not feeling low because of the walker, because I don't have the high pain I did on the first surgery. My new knee really hurts when I use it, but nothing like the deep, overall ache I had on the first surgery. I'd trade the pain for a walker anytime. I'm hardly taking any pain meds...knock wood.

Yes, there are a lot of positives. The main one is that I can now finish rehab on the first knee. It had gotten to the point of not being able to do some exercises because this second knee was too painful. My PT finally just gave up until I got it done.

If the Stryker works as well as it's supposed to, that will be wonderful too, a more natural, fluid knee.

It's funny now that my "good" leg is my 6th month leg which I've been babying, but no more...it's gotta work.

What I am bummed about is that I am going to miss out on knee resurfacing which I knew would be coming, but my own doc is starting to do them. I missed it by such a small margin.

Thanks for your support Jamie

Hollie

 

[Josephine]

Don't fret - I wouldn't want it done too soon, not until they had some useful statistics to publish!

 

[hollie9]

I'm now in the high pain phase of this TKR, it happened later than I remembered. I am in day 9, and last time I called about why am I still in pain now, they said it is from aching of the bone due to the bone cuts and will probably last until day 11 or so.

This is a time where my knee is the most swollen and I crave ice on it. I really need pain pills now. My knee feels hot although it's not red.

I can't wait to get through this and be on the other side. This is when I like to look at my first TKRd knee which isn't swollen and doesn't hurt, to remember that eventually it gets better.

Hollie

 

[Josephine]

Are you not getting pain pills and ice? If not, why not? And is the pain in your knee or your thigh? If it's in your thigh that will be due to the tourniquet.

 

[hollie9]

Oh, Josephine I didn't mean it like that. I have plenty of pain pills and a wonderful ice machine, I meant that I really needed them now when earlier, just after surgery I didn't.

Actually this is different than my last recovery when I needed pain pills all day and night for a period of time. This time I am fine in the AM until about 4 PM, then it gradually worsens. Pain does wake me up from sleep at times...I hate that.

The doc's assistant told me I didn't bleed much during surgery which accounted for my first week or so of hardly any pain, then I had a second bleed, evidenced by the purple bruising at my low ankle which somehow caused the pain. He also said my knee is quite inflamed and I'm not to work on flexion right now. I get off Coumadin at the end of this week and can be put on a steroid for the inflammation, then back to a regular recovery.

I've read my old posts and notes and know I have a long way to go still, I doubt I'll be out of this painful part till 3 weeks or more.

I took a walk on Sunday that was much too long and ended up with a really swollen knee and increased pain. I think biking is so much better than walking early on in TKR recovery.

I'm hanging in here, because this is my second TKR I think I am much more impatient to get to recovery.

Hollie

 

[Texas]

We all want it to get better as in yesterday ,but you made it thru one and now you are doing another. I applaud you. Hang in the it will get better. You sound like strong person. Keep us up dated........