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TKR April 12 surgery date

Ghost Rider

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I finally made the date. I'm going with a Patellofemoral left knee first. I do this for multiple reasons. I'm 57 and want to continue being active. I know that in if I'm lucky 10+ years I may have to have TKR anyhow. Two things. at 57 I may need a revision later in life anyhow. If I can push it off another 10+ years that would be a good thing. Also I'm very much interested in cement less TKR . They are being used but in 10 years there may be more data available.

Also this is the one doctor that believes it will be harmful to return to working on my knees full time.
 

Jaycey

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@Ghost Rider Congratulations on getting that surgery date set. It's a big step in the right direction. Looks like you are added to the March group. You will find fellow BoneSmart members there who will share this journey with you.
 

Celle

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Hi @Ghost Rider - here are some articles to help you prepare for your surgery:

Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries
 
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Ghost Rider

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Thanks Celle. I read the links before from another thread, always good to look again. I am still very much interested in the Stryker cementless knee. I am running out of time to line up a doctor for that so I'm going for the partial. Am I correct that as far as additional bone loss from doing a partial and 10 years down the road doing a TKR. The only thing that might come into play today my bone are healthy and will likely grow into the implant creating the permanent bond, who knows 10 years from now.
 
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Ghost Rider

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I simply do not like the staff at this office. I asked about ice machines and I was told insurance does not cover it. I could arrange to rent a Game ready machine or I could buy a similar machine from them for $500.
I ran into the same issue when I wanted an MRI, knowing I could get MRIs at 100% coverage by going with the MRI in-network MRI provider, NOT the doctors office. I got huge resistance when they figured out I was not going to use their MRI facility.

So I asked for information about the Ice machine. This is the total response the the email. "What information would you need?"

I said, Links to the website so I can see the options and the cost. Response, " I do not have links to websites. I am sorry. " I said, How about a name of the device Response,

"COLD COMPRESSION: Cold compression is a combination of cryotherapy and static compression commonly used for the treatment of pain and inflammation after acute injury or surgical procedures. Tissue reaches its lowest temperature faster and the tissue maintains its cool even after treatment ends. ..."

So while I was typing this I got a call back and was able to make an appointment with a doctor that uses the Stryker knee for tomorrow. He does knees and partials.

 
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Celle

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Am I correct that as far as additional bone loss from doing a partial and 10 years down the road doing a TKR. The only thing that might come into play today my bone are healthy and will likely grow into the implant creating the permanent bond, who knows 10 years from now.
If you get 10 years from a partial, you will be doing very well. Unfortunately, many partials don't last as long as that, as osteoarthritis can progress into other compartments of your knee.

If/when you need a revision to a total (TKR), the surgeon will have an instrument available during surgery that helps to remove the PKR hardware without a problem.

I started with a medial compartment PKR and it lasted for 11 years, which is really good. When I had my Revision to a TKR, I found that my recovery was no harder than my initial recovery.
I now have a Stryker Triathlon TKR in both my knees and I am happy with that implant.
 

Muscleflex

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look into buying a used ice machine - i bought one online cheap years ago and have used it through many surgeries...
 

FCBayern

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You can get an ice machine on Amazon for $150-$200 that will work just as well for you as their $500 one @Ghost Rider. My original that insurance provided quit but I liked it so much I bought another even though I was 4 months out. I still used it all night at that point.
 

Jamie

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The Game Ready machine provides both compression and cooling, which supposedly is better than just the icing. But quite frankly, it's a very expensive machine if you're buying it yourself and the other machines that just ice do just fine.

I have to agree that the office you were dealing with has pretty poor customer service. Unfortunately some are like that. I hope you can find a surgeon that's a better fit for you.
 
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Ghost Rider

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As far as the icing goes I also bought 2 of these earlier this year and extra ice bags for it, so I can ice constantly through out the day. The Velcro should offer some compression and I can walk around.
Vive Knee Ice Pack
More important than that. I am seriously considering changing doctors. This new doctor told me looking at my images and all 3 compartments having arthritis, that a partial would not be his recommendation. There are several reasons I would rather see him. The 1st doctor after looking at the images started to say he thought a TKR would be best. I said what about a partial and if I can get 10 years out of it wouldn't having a TKR done at 67 be better than 57? He agreed and I scheduled surgery.

I asked him how many knees he does a year he said 150-200 how can fact check that? Do I even want to? That's what I want to hear right. It will push it out another month.

Everything about this possible new surgery is better. Doctors office is close, surgery hospital is close and I will stay at least one night in the hospital. He will be using the Smith and Nephew journey 2 cemented knee. He thinks the variables with cementless are to high and for lasting positive outcome all points of the bone must have contact with the knee or it may not bond uniformly.

I think this is all a crapshoot.
 

FCBayern

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I think this is all a crapshoot.
A partial will carry you far a while @Ghost Rider, but it seems like you are already acknowledging that you will need a TKR down the road. With TKR now lasting 30 years plus I'm not sure why you would opt for surgery that you know will require another, when a TKR might well last the rest of your life. If not revision surgery would likely be much farther down the road the a partial to a full. It's a decision we all have to make for ourselves.
 
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Ghost Rider

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I think this is all a crapshoot.
A partial will carry you far a while @Ghost Rider, but it seems like you are already acknowledging that you will need a TKR down the road. With TKR now lasting 30 years plus I'm not sure why you would opt for surgery that you know will require another, when a TKR might well last the rest of your life. If not revision surgery would likely be much farther down the road the a partial to a full. It's a decision we all have to make for ourselves.
Well the doctors are more conservative about their estimates. You will be very lucky to get 30 years of active life out of a TKR. The crapshoot is not knowing how long either will last and will I outlast my knees. As it turns out both doctors use the Smith and Nephew 30 year knee (cemented) They really have no idea how long it will actually last and having a revision at 87 is less than ideal.

I'm seeing a different Orto today for a 2nd consultation I can get a 3rd opinion.
 

Celle

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Whichever surgeon you choose, do make sure that he/she is prepared to to a TKR rather than a PKR if there is any sign at all of osteoarthritis in more than one compartment of your knee. Many PKRs fail early because arthritis has invaded another knee compartment.

I have had both a PKR and a TKR and I have experienced no difference at all in the activities I was able to undertake.
 

Jamie

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More important than that. I am seriously considering changing doctors. This new doctor told me looking at my images and all 3 compartments having arthritis, that a partial would not be his recommendation. There are several reasons I would rather see him. The 1st doctor after looking at the images started to say he thought a TKR would be best. I said what about a partial and if I can get 10 years out of it wouldn't having a TKR done at 67 be better than 57? He agreed and I scheduled surgery.
If you have arthritis in more than one compartment and your first surgeon agreed to do a partial knee replacement, you need to switch surgeons. It is highly unlikely that you would get anywhere near 10 years out of a partial knee replacement as the arthritic degeneration would continue in the remaining compartments. Frankly, I've never heard of a surgeon agreeing to do a partial replacement if he knew arthritis was present in all the knee compartments. It doesn't sound like your first surgeon was reading the x-rays properly.

Even if x-rays show arthritis in only one compartment, you always want an experienced surgeon who will evaluate your knee once he's in there. You cannot always see everything on an x-ray. He should be flexible to do either a PKR or a TKR, whichever is more appropriate.

Please try not to let the idea of a revision down the road scare you. You may only be 56 years old, but your knee could very well be "much older" in terms of damage done by arthritis. It's important to have a surgeon who can evaluate your situation and completely repair whatever damage is there so you can move on with your life. Revisions are successfully done when needed....even multiple times. It's very possible you could have quite a long run with a full TKR done now. Not taking care of your arthritis completely with a PKR will just about guarantee you additional pain and problems in the near term.

I asked him how many knees he does a year he said 150-200 how can fact check that? Do I even want to? That's what I want to hear right. It will push it out another month.
It can be difficult to find out the truth behind numbers a doctor tells you. Mostly you must take them on their word. However, "doing 150-200 knees annually" wouldn't tell the whole story. If you were considering a PKR, you'd want to know how many of THOSE he does. And does the 150-200 mean knee replacements or just knee surgeries? You'd want to know his success rate and his infection rate.

Here is a site where you can find out a bit more about a surgeon's rating in the orthopedic community. The figures are taken solely from Medicare data, so even this doesn't give the whole picture.
 
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Ghost Rider

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More important than that. I am seriously considering changing doctors. This new doctor told me looking at my images and all 3 compartments having arthritis, that a partial would not be his recommendation. There are several reasons I would rather see him. The 1st doctor after looking at the images started to say he thought a TKR would be best. I said what about a partial and if I can get 10 years out of it wouldn't having a TKR done at 67 be better than 57? He agreed and I scheduled surgery.
If you have arthritis in more than one compartment and your first surgeon agreed to do a partial knee replacement, you need to switch surgeons. It is highly unlikely that you would get anywhere near 10 years out of a partial knee replacement as the arthritic degeneration would continue in the remaining compartments. Frankly, I've never heard of a surgeon agreeing to do a partial replacement if he knew arthritis was present in all the knee compartments. It doesn't sound like your first surgeon was reading the x-rays properly.

Even if x-rays show arthritis in only one compartment, you always want an experienced surgeon who will evaluate your knee once he's in there. You cannot always see everything on an x-ray. He should be flexible to do either a PKR or a TKR, whichever is more appropriate.

Please try not to let the idea of a revision down the road scare you. You may only be 56 years old, but your knee could very well be "much older" in terms of damage done by arthritis. It's important to have a surgeon who can evaluate your situation and completely repair whatever damage is there so you can move on with your life. Revisions are successfully done when needed....even multiple times. It's very possible you could have quite a long run with a full TKR done now. Not taking care of your arthritis completely with a PKR will just about guarantee you additional pain and problems in the near term.

I asked him how many knees he does a year he said 150-200 how can fact check that? Do I even want to? That's what I want to hear right. It will push it out another month.
It can be difficult to find out the truth behind numbers a doctor tells you. Mostly you must take them on their word. However, "doing 150-200 knees annually" wouldn't tell the whole story. If you were considering a PKR, you'd want to know how many of THOSE he does. And does the 150-200 mean knee replacements or just knee surgeries? You'd want to know his success rate and his infection rate.

Here is a site where you can find out a bit more about a surgeon's rating in the orthopedic community. The figures are taken solely from Medicare data, so even this doesn't give the whole picture.
Thanks I already made up my mind to switch surgeons. I even was able to read the results from my MRI saying all 3 compartments a arthritis, although all of my pain is from behind the kneecap. I had my 3rd opinion today and he also said I should get a TKR. The new doctor only does a few partials and he has been mainly using the Smith and Nephew cemented knee. He has used the Stryker but SN is what he likes now, for what ever that is worth.
The other option is hospital I have the surgery done at. An older hospital walking distance from my house done 3/25 or a brand new hospital 20 minutes away done 4/12. Also with this doctor TKR stay one night in the hospital.
 
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Ghost Rider

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You can change my date to 4/12 I'm for sure going with the new doctor. I spoke with an attorney who knows all the local doctors today and just by chance I told him I thought about using the first doctor, the one wanting to do the partial. He said "he's no good" So I'm good with that.
 

Celle

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I've changed your surgery date, removed you from the March Musketeers and added your name to the April Rainbows team surgery thread.
 

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