arthritic muscle inhibition

[referee54]

I used two Gelpacs that were 12" X18"---the nice thing about them is that I could use them later on (I still do) for bumps, bruises, and strains.

Many of the folks here now are using the Cryo Cuff, but there are a few that still prefer the reusable Gelpacs.

 

[sandbar525]

I am alternating between using the Cryo-cuff sent home with me from the hospital and gel pacs. I think the gel pacs get colder and are more malleable but I swap them out for the Cryo-cuff, too. The main thing is to ice, ice, ice!

 

[tiredwife]

@lovemydog Sorry, can't help, hope someone has answers for you soon. Maybe you can see if there is anything on the internet. I did a quick check and Dr. Steven B. Haas had 45 reviews and got 4 1/2 out of 5 stars.

 

[toohip]

Hi, - I had Hip replacement at HSS and swear by that hospital. They are extremely professional and made me feel at ease throughout the whole process. But then again, i have no experience at other hospitals. who referred you to dr. haas? I had a different surgeon

 

[Jamie]

We have many members who have been well served by the surgeons at that hospital and frequently recommend it for folks who are having issues after their initial joint replacement. You've made an excellent choice and you should do just fine.

 

[gazelle7777]

I would not use it during the time you are on blood thinners... or prior to surgery as Arnica Montana can thin the blood.

 

[referee54]

Sounds like excellent advice!

 

[referee54]

I am alternating between using the Cryo-cuff sent home with me from the hospital and gel pacs. I think the gel pacs get colder and are more malleable but I swap them out for the Cryo-cuff, too. The main thing is to ice, ice, ice!

That is a great idea!

You have it right, though, the important concept is to ice, ice, and then ice some more---and toss in a liberal amount of resting and elevating.


Here is what I used---

 

[RedRider]

I did a lot of research on activity after knee replacements before my own and came to the conclusion that although doctors are shy to recommend light running/jogging, few actually restrict it. When I had this discussion with my doctor, he emphasized the importance of implant longevity but otherwise gave me the green light for jogging. Granted this was a partial knee replacement, it's all the same hardware essentially.
As more and more people "test the limits" of their joint replacements, I'm confident that data will demonstrate the ruggedness of these modern metals/polymers. Who wants to be the Guinea pig though, that's the true challenge.

 

[RestAssured]

@RedRider,

I think a lot of it depends on if you were a runner before. In my case, even in high school and college, I ran for a different purpose. I played Basketball, and flew up and down the Basketball courts. I did shot put and discus, and ran sprint drills through stadium stands w 50 lb. weight vests.

I never have been a long distance runner, nor have I experienced that "runner's high" that so many speak of. My goal is to walk/jog the Houston marathon in under 4 hours. Most runners would look at that and say, "Oh my goodness, what's the use?"

I have decided that if my foot will cooperate, the use will be the sense of accomplishment of doing what I have never done before. I may not experience a runners high, but I will feel great when I cross the finish line!

I can tell you, I have been training for 10 weeks, and even walking is taking a toll on my body. I have not reached my goal weight yet though, so that is part of it.

So, my point is, do you really have to run to experience satisfaction of doing your best and keeping your implant happy?

Dick Beardsly runs marathons all the time on 2 replaced knees. He also has to have the replacements replaced. Worth it? Not to me.

 

[referee54]

I can tell you that, after talking to my OS and to athletic trainers, as well as runners in general---there are people who have the physique that enables them to run---and they can for long distances.

When I was beginning to experience the very early symptoms of arthritis, my OS told me, "Look, you have X amount of miles left in your body---maximize those miles.

I am 6" 210, and I am built for the sport that I used to play i HS and in college---football. I am not built like a runner---I used to love running and I reffed college basketball for 17 years, but that also took a tremendous toll on my body---my knees burnt out too soon.

If you choose to run, you choose to do so as an adult, informed, and you are making a decision---you may be able to go without a revision; it is possible that you may need one.

I have focused on other athletic endeavors---running, to me, while I miss it, is history. Cycling gets me fit, keeps me fit, and allows me to enjoy the competitive nature in myself.

 

[lovemydog]

Hi All,

Hope everyone is comfortable and healing tonight. I was just wondering does anyone one know what type of prior surgeries or instabilities would not make someone a candidate for minimally invasive surgery, and if the surgery is not minimally invasive, what is the recovery like when the two are compared? I am assumong there would be a lot more tissue damage, pain, swelling, scarring.

 

[skigirl]

I am laughing as I write this. I was DETERMINED to have minimally invasive surgery. I got a top notch surgeon who does 300 TKRs a year. My scar is only 3 inches long and I did have a relatively easy recovery, but it still took almost 6 months to come back from the surgery. I think the MIS is a little easier in the begining---for instance, I could lift my leg and climb over the CPM machine on my bed to go to the bathroom about 2 hours after I got back from the recovery room. I never used a walker--EVER!!! But, I am strong and athletic which also helped.

I still had to rest, rest, rest for the first two weeks and it was 3 months before I began to feel like my old self---just like everyone else.

 

[skigirl]

I did move your thread to the pre-op forum since I don't think you have had your surgery yet, is that correct?

 

[lovemydog]

Thanks for your reply. Yes I did not have my surgery yet, and thank you for rerouting my thread. The surgeon who was supposed to see me next week had his receptionist call me to say that after looking at my MRI he is "not the right MD for me". This is really scaring me, because, like your surgeon, he is tops. He even has 3 patents,one on small incision tools that are 50% smaller than average. He has 29 yrs experience and does only TKR.
The thought that this surgeon cannot help me is frightening. On my MRI I know he saw ACL insufficiency, compromised LCL, MCL, PCL ligaments, and instability. Like you, I have always been an athlete, so I am hoping that my MRI findings would not necessitate such massive surgical trauma that the surgery would have to be done with a huge incision and cutting of muscles, with a long painful recovery and poor outcome. I am 5'0'' and 107#, so I am not a big person.
I did ask his receptionist to inquire what on my MRI makes him hesitant. I got another appt with another surgeon. I am wondering if some knees are just too far gone for a gentle surgery and the chance to get some of my life back.

Feeling frightened, hopeless, and paniking.

 

[Jamie]

Please do not allow yourself to panic! I have never known a case where a knee was "too far gone" to have a successful knee replacement. While it would have been nice if the surgeon would have told you this in person and explained himself (about why he felt he was not the surgeon for you)....at least he was man enough to admit that he was not right for your particular case. That actually says a lot of good things about him!

One of the most critical aspects of a knee replacement is the surgeon's skill and ability to properly balance the knee when placing the implant. In a case like yours where there are ligament issues, you really, really want someone with the expertise to know how to do that for you. You need to be sure and bring all this up with the next surgeon you see. And since you have these ligament issues, I suggest that you talk with more than just one other surgeon.

I see that you are from a relatively small city. Where have you been looking to find your surgeon? Would you consider driving a bit? Like maybe to New York City?

Try not to focus on what people may bill as minimally invasive surgery. The size of the scar is really not important. What you want is a well functioning knee that allows you to live the rest of your life the way you want. Recovery is not faster with a smaller incision. Muscles are not cut in knee replacements these days.....instead they tease the muscle apart where needed to gain access to the joint.

You have every reason to expect a good outcome to your knee replacement providing you find a surgeon who is comfortable with your case and whom you feel you trust. You may be more likely to find such a person at a larger facility such as those in a major city or at a teaching hospital.

Here are some articles from our BoneSmart Library that will help you with your future meetings with surgeons. Please don't hesitate to ask any questions that come to mind. We're here to help you!! And should you be willing to travel to New York City, I can recommend a couple of surgeons to meet with that I'm pretty sure would not hesitate to help you with your knee.

Choosing a surgeon and a prosthesis
Longevity of implants and revisions: How long will my new joint last?
Pre-Op Interviews: What's involved?


Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

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

 

[lovemydog]

Dear Jamie,

Thank you for your reassuring words. I guess I am a difficult customer regarding "the right surgeon"for the following reasons:
1) I am in the medical field, so I am knowledgeable and do my research. As a result I come with a lot of technical questions. The answers have to make logistical sense to me so I can trust the surgeon. I am also terrified of the whole procedure and its aftermath. So it is imperative that my surgeon be patient and compassionate.
2) I am a 54 yo athlete with a lifestyle that is more active than anyone I know, but I have what I am starting to realize is a very difficult case. So I need a surgeon who is highly skilled with predictable outcomes.

I would like to go to Hospital For Special Surgery in NY. The appt that was cancelled was with Dr Steven Haas. I got an appt with Dr David Mayman Jan 12. He does navigation assisted surgery but I do not know if he will be able to handle my case. I looked for reviews on the 2 others that were recommended to me but feedback mentioned they were rude and arrogant, which would not be good for someone like me. Any suggestions from you or anyone else would be greatly appreciated.

 

[Celle]

Hi @lovemydog

On the subject of the size of the scar and the eventual outcome of surgery, I'd like to reassure you. In December 2011, I had a revision of my right knee from a partial knee replacement (which had failed after 11 years) to a total knee replacement.

Revision surgery is often more difficult than the original surgery and I have a scar that is 9 inches long.
However, I made a full recovery, with very little trouble.

My knee bends to somewhere between 125 and 130 degrees and I can straighten it fully. I've got full muscle strength back and I can do anything I want to with my new knee. It doesn't hurt and I often forget that I had the operation. I get quite a surprise when I see an X-Ray that shows all that metal in my knee.

I had my left knee replaced 9 weeks ago and during my recovery my right knee has been my strong knee and has given me no trouble at all.

Full recovery and an active life are possible, whether you have a minimally invasive operation or one that requires a larger incision.

Best wishes in your search for a surgeon who can help your knee.

 

[Jamie]

I would like to go to Hospital For Special Surgery in NY. The appt that was cancelled was with Dr Steven Haas. I got an appt with Dr David Mayman Jan 12. He does navigation assisted surgery but I do not know if he will be able to handle my case. I looked for reviews on the 2 others that were recommended to me but feedback mentioned they were rude and arrogant, which would not be good for someone like me. Any suggestions from you or anyone else would be greatly appreciated.

Excellent!!! This is exactly the hospital I would recommend and here is the surgeon I suggest:

Edwin P. Su - Primary TKRs, works with hand held navigation for better implant placement and balancing of knee ligaments. Hospital for Special Surgery, New York City

Hospital for Special Surgery
535 East 70th Street
New York, NY 10021
212-606-1000
https://www.hss.edu/physicians_su-edwin.asp

About a year ago, I heard Dr. Su give a presentation about working on knee balancing where the ligaments had problems and I was very impressed with what he had to say. I think a discussion with him would be worth your time. At that time he was working with a navagational device that was showing good results in placing the implant and balancing the ligament tensions so that a "difficult" knee functioned properly.

 

[RedRider]

I can tell you that, after talking to my OS and to athletic trainers, as well as runners in general---there are people who have the physique that enables them to run---and they can for long distances.

I feel the same about swimmers. It hasn't came natural to me but I've worked hard to become a good swimmer, while my best friend is like a fish out of water. He can be out of the water for months, jump in and still smoke me at the lap pool. Like you said, some people just have the knack for it.