TKR 3 days -- the known and the unknown!

[Nan47]

The surgery is scheduled for Friday. Possibly PKR unless there is more damage than can be seen in the x-ray. After dealing with this for over a year and gradually getting worse I'm still wondering if the known is better than the unknown. After a stress fracture in my left knee in 2016 and eight months of healing, I finally got back to my 7500 to 10,000 or more steps daily. True, I was having to monitor my discomfort level, stop and rest -- but I was still able to do what I wanted which included wandering the streets of Rome, hiking in Cinque Terra, Canyon de Chelley, climbing the pyramids outside of Mexico City, and strolling the streets of New Orleans. During that time I was carrying my own backpack and making my connections on foot at the airports. My current step limit is now at around 2500 steps daily.

January of 2020 -- I turned around in the kitchen and suddenly my left knee was in excruciating pain and I was unable to stand. Went to an orthopedic out-patient clinic -- cortisone shot and follow up with a doctor in 6 weeks. Without looking at my x-ray or asking questions other than how far I can bend my knee -- he diagnosed it as inflammation and said that it would get better over time. So COVID hit. By August I was beyond belief -- I was still dragging around, my walking was terrible, my whole body hurt -- I was depressed, frustrated, angry, and in pain.

Long story short --I was finally able to see my primary doctor. That began the saga of 5 doctor appointments, more x-rays, and an ultra sound, a half dozen PT appointments, I finally got my primary to do a referral to the doctor who managed my stress fracture. He referred me to my current orthopedic surgeon. The premise is that at my age (74) the knee is going to continue to deteriorate and surgery will not be a possibility. During that time (August - May) I was also seeing my acupuncturist as the only one that really gave me any relief from the pain, stress, and discomfort.

So here I am scared of what is to come. Will it be better or am I just trading current discomfort for more pain and discomfort and possibly less range of motion? (My current range of motion is 8-135). My big problem is the pain when walking -- I have no problem bending or getting down on my knees. I was told that with a TKR, I may lose up 20% or more range of motion which may interfere with my yoga practice.

After all this, I find that I am extremely depressed and am afraid that may also be a factor in the recovery process. I have found that the last couple of weeks I'm having trouble putting one foot in front of the other -- and I just want to sleep (not me at all!) So that's my pre-op story. Guess next week I get to start the recovery story -- I so hope it is short and sweet!

 

[Pumpkin]

The premise is that at my age (74) the knee is going to continue to deteriorate and surgery will not be a possibility.

Just curious who told you with deterioration you knee would become inoperable?
Yes, your knee will continue to deteriorate, but would still be operable.

I have had a revision my knee ROM is 0 degrees to 135 degrees. Every one heals differently, at a different rate, with some such as myself gaining ROM for a full 18 months post surgery.

Here is your copy of the Knee Recovery Guidelines to help you prepare for surgery, the articles are short and will not take long to read.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

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rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

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a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

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the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Jamie]

You know, feeling nervous and wondering if you made the right decision for surgery is something just about everyone goes through as the big day approaches. It is a good thing that your surgeon has told you he may do a full knee replacement once he gets into your knee and has a look around. Partials many times don't last as arthritis manages to get in the other knee compartments and causes the need for a revision to a full TKR. If he sees any arthritis in other areas of your knee a full TKR will be the most successful option. So please don't fear it as recovery from a partial and a full knee replacement is just about the same.

Knee replacement surgery is one of the most successful surgeries done these days. People have it, recover and do get back to their lives again. Some must make a few modifications in their activities, but it's usually nothing major. If you have good range of motion now, the chances are it will be good after surgery as well.

BoneSmart was created to help people like you get through surgery and whatever challenges may come up in recovery. You're part of our family now and we'll be here for you. We understand what you are feeling and going through because we've all had joints replaced. Sometimes it's difficult for people (even surgeons) who haven't experienced it to understand some of the fears and concerns. We can help with all that.

Pumpkln is correct that your knee can't deteriorate too much so that surgery wouldn't be possible. But, it is for sure that your arthritis would worsen and you'd become more disabled and in pain if you delay getting the knee done. You've made the choice to fix the broken parts so you can get on with your life. That's a good thing!

Hang in there and be sure to ask any questions that come to mind. Information is power and we have years of experience helping people just like you.

 

[FourCats]

@Nan47 first, welcome. This group of folks has been such a ray of sunshine amidst the ups and downs of recovering from major surgery. I, too, was scared and nervous for several days before my surgery. If I hadn’t been, I would have been concerned. Try to occupy your mind with positive thoughts. You have a long road of recovery ahead and it may or may not be “short and sweet” but it will be worth it. My pre-op pain, on a scale of 1-10 was at least a 12. My post-op pain has been almost nonexistent; there is discomfort but nothing like it was before. I actually only took a couple of pain pills in the first couple of days after surgery and have been using acetaminophen regularly since then. Ice and elevation has been the key for me. I did have a few weeks of in home PT which I was very pleased with and my ROM is 0-115. My surgeon was amazed at my appointment last week, saying I was a few weeks ahead of where he expected me to be. It’s one step at a time … and you’re not alone … there are lots of friends on this journey with you. I will be praying for you and look forward to seeing you on the other side!

 

[Nan47]

@Pumpkln @Jamie

Pumpkln is correct that your knee can't deteriorate too much so that surgery wouldn't be possible. But, it is for sure that your arthritis would worsen and you'd become more disabled and in pain if you delay getting the knee done.

And I may have misunderstood exactly what the doctor said. I'm pretty overwhelmed right now and it all sounds so ominous.

I really appreciate your feedback. I have read through the Recovery Guidelines several times and plan to spend time today and tomorrow reading through the articles.

I wish I had found this forum a year ago when the issue with my knee first got serious. I've felt so uninformed with this whole process.

Thank you again for your support. I'll keep you posted during recovery.

 

[Pumpkin]

@Nan47,
We were all scared and were overwhelmed by this surgery.
Just remember while this is your first time, and your surgeon has done lots of TKR's and has loads of experience.
If you have any questions, concerns, or you just need a little support, we are here.

 

[Nan47]

@FourCats

First off -- I love your user name! It made me smile.

Thanks so much for responding about your experience. My pain seems to be more moderate but constant when I'm walking and just ongoing discomfort every time I move. So the pain comparison will be interesting. I was doing great with the positive thoughts (travel plans etc) until this week and the anxiety just slipped up on me and grabbed me.

Again, thank you so much for sharing and your good wishes.