arthritic muscle inhibition

[RestAssured]

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.

Well, I was swimming a lot about 2 months ago, before we shifted the intensity to marathon training! When I got back in the water, I could have sworn I never swam before! So, I guess it's a matter of passion for the particular sport. I like swimming, I like walking, but if I were able to get back on a Basketball court and play competitively again, all bets would be off!

 

[Josephine]

Hubby actually preferred gel pack to his ice machine. Didn't like being tethered to something!

That's why I prefer the Cryocuff. You just connect the bucket to the cuff when you want to refresh the iced water but then you can unplug it and be mobile! Best of both worlds!

 

[Josephine]

I am in the medical field

Oh? What do you do? (this is just me being nosy!)

but I have what I am starting to realize is a very difficult case

I have yet to see a knee that is truly a 'difficult case'. Once started they all get sorted.

I am a 54 yo athlete with a lifestyle that is more active than anyone I know

Well, you might be an athlete but do remember that your new knee will not be so take it slowly and gently. I give warning of this up front as I know how you young things tend to go at things like crazy in the hopes/expectations that doing more and harder therapy will get you faster healing and recovery. It doesn't. I am putting together a folio of cases where people have seriously damaged their legs by overdoing PT. If you want the link, I'll post it for you but you have to ask for it!

 

[skigirl]

I think that Jamie's reply is an excellant suggestion to you. There is a knee called a "hinged knee" that several of our members with ligament problems have gotten. So far their recoveries also seem to be normal--in that it does take six months before you are anywhere near normal.

 

[1ELISEA]

Hi @lovemydog

The thought that this surgeon cannot help me is frightening.

My first OS would not do the surgery either. Once he found out I reacted to nickel , he told me he would not do it and recommended a couple of other surgeons.
I wrote about it HERE

The OS I chose was also a teacher, inventor, skilled surgeon with a joy at being able to do surgery. When I was admitted to the hospital for my surgery, he was walking the halls waiting for me to get there. He and his PA were overjoyed to see me they were so excited to be doing surgery. And this after decades of performing TKRs hundreds of times a year.

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.

That paragraph, with the exception of the medical background, could be written by 96% of the members on BoneSmart. I am not in the medical field and still asked very detailed and technical questions. With metal allergies, it needed to be right the first time. And the surgeon I chose answered all of my questions fully and completely.

Going into surgery knowing that I had severe metal allergies meant placing a lot of trust on the surgeon and his judgment.

I am a 54 yo athlete with a lifestyle that is more active than anyone I know

What's your favorite sport?
We have athletic skiers like @skigirl , she lives to ski and has spent the last couple of seasons teaching in some of the worlds best snow. We have competitive snowboarders, bicyclists who log hundreds to thousands of miles without breaking a sweat. And we won't forget our blackbelt, I'll never forget ol what's her name .
Me, I'm a casual hiker that enjoys nature and hills.

After my surgery, I had a chance to revisit the office of the OS who turned down my case. I thanked him for saying no and providing such great recommendations. And that's what I'd say to you, thank the OS who said no; because you need someone else and your first OS was wise, confident and knowledgeable enough to let you know he wasn't the right choice. He most likely has highly specialized skills in other types of TKRs.

There is no 100% certainty in life. Sometimes we have to gain as much knowledge as we can, and then take the leap.

All the best to you @lovemydog

 

[kneeper]

The minimally invasive technique is interesting, but I can tell you that lots of us with the "traditional" incision are doing just fine. As you mention, the key is to find a skilled surgeon who you feel confident in.

Then the real challenge will begin--finding the balance between rest, ice and elevation and moving the knee.
Pacing yourself and listening to the boss--that's not you--it's the knee-- are key.

 

[Celle]

@lovemydog
Balancing of your knee ligaments is going to be important.
I don't know how large a field of operation the surgeon would need, but it may not be possible for that to be done together with minimally invasive surgery.

If that does prove to be the case, I think you need to trust the surgeon to do what he/she thinks best at the time.
Be assured that a good recovery is still possible, even if you end up with a larger scar - many of us here can attest to that.

 

[referee54]

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.

Nope---many times, a surgeon will actually get inside the knee and find out that it is worse thatn he thought it to be---and the end result was a fullly functionaly knee and a tremendously enjoyable lifestyle.

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.

:iagree:It is not the size of the scar---it is the quality of your life that you have when you are all recovered.

If that does prove to be the case, I think you need to trust the surgeon to do what he/she thinks best at the time.
Be assured that a good recovery is still possible, even if you end up with a larger scar - many of us here can attest to that.

Let the surgeon be the judge on what needs to be done and what is in your best interest in the long run. When you find that surgeon that you trust---your gut feeling, so to speak, you will allow him to make the decision as to what you need and what will be best for you.

 

[referee54]

If that does prove to be the case, I think you need to trust the surgeon to do what he/she thinks best at the time.
Be assured that a good recovery is still possible, even if you end up with a larger scar - many of us here can attest to that.

Again, :iagree:---both of my scars on each knee ar about 8"-9"---and my life is better now than it was three years prior to my BTKR.

 

[referee54]

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

Prior to my BTKR, I was hoping to have two partials done. When I asked the OS if two partials would work, he chuckled (laughed is more exact) and showed me my X-Rays. (My surgeon does 100's of TKR's a year.)

I told me the only surgery that would work was two TKR's---I was somewhat disappointed, but I realized that I had to trust his judgement ---he was the expert, and he knew what was best for me.

I have no doubt that, when this is over, you will get the correct knee for you and you will regain the lifestyle that you crave so much. Find that right surgeon and trust him to get your life back.

 

[lunula]

Others here may disagree with this, but I asked my OS about minimally invasive surgery and he immediately shook his head and called it a "marketing ploy" that makes it more difficult for surgeons to properly position/align the implants. They apparently tried it at their practice, but didn't feel the results were on par with a "regular" surgery and the recovery was no different. After looking at my leg/knee, he estimated i likely wouldn't need more than a 5-6 inch incision anyway (he said I had "skinny knees") - so why bother if it makes it harder on the surgeon?

Again, just his opinion - but his practice doesn't do minimally invasive at all.


Sent from my iPad using Tapatalk

 

[Celle]

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.

Hi @lovemydog

The proponents of minimally invasive surgery may well market it as "a gentle surgery" but it is not. Any knee replacement is going to involve cutting, sawing and hammering. As you are in the medical field, you will know that orthopaedic surgery is often far from gentle. This is true of all knee replacements, regardless of the approach.

It is not common practice nowadays for surgeons to cut muscle (especially the quadriceps). Instead, they tease the muscle fibres apart.

Knee replacement is major surgery and the recovery period is long, regardless of the approach that is used. It can take as long as a year for full recovery. That doesn't mean that you will be an invalid for all that time. Rather, it means that healing takes time.

 

[referee54]

 

[Lovestoread]

@lovemydog, I know I am in the minority here, but I had "minimally invasive" TKR's and I believe my recovery was so very much easier than the dozen or so people I know that have had it done the more traditional way. My incisions are 3" and 4" and I went home the same day. My PT was so impressed with my recovery that she had her husband go to my surgeon for his TKR. She has been a PT for over 20 years and has worked with Ortho's who specialize in TKR's and knows her stuff. Yes, bones still had to be sawed and parts were hammered in, but honestly I can say I had no more pain than when I had my arthroscopic procedures done by a different surgeon. I searched long and hard for a surgeon who did this type of surgery and he does over 500 a year like this. I believe finding someone who is very experienced makes a huge difference. Like your surgeon, he designed the instruments used in the surgery and trains others in his technique. I was driving to PT in two weeks and went back to work (in a middle school…on my feet all day) very quickly with no problems.

 

[icep707]

I think weight maybe a factor in running with a implant. At 106lbs you shouldnt have a problem. As for me at 255 lbs my surgeon said absolutely no running ,however i do just about everything else ,even light jogging on a treadmill,elipitical machine ,biking,jogging up and downstairs. Things i couldnt do prior to my surgery without knee giving out and severe pain . 10 months after my surgery i work 8 hours at a Costco as a butcher than go straight to the gym for hardcore training and nearly 1hour cardio with no affect at all in my new knee. Its truly miraculous and i feel 20 years younger. You will be so happy with your results,follow the mantras and you will do great, best of luck , Iceman

 

[RestAssured]

Well,

People are finding out no matter what they weigh, if they run, the implant will wear out faster! If you are set on running, ask your OS first. He might tell you it's ok, but most of them say no.

 

[lovemydog]

Dear Bonesmarties,

I have been reading the postoperative threads, and have gotten some very good advice from them, so thank you all for that, and I am also grateful for all of your quick replies and support.
However, after reading the postoperative threads, and the amount of pain that people are experiencing, I am starting to question whether I will be able to endure that. I have had several orthopedic surgeries in the past, and have found my post surgical pain difficult to manage- arthroscopy, bunionectomies, and most recently ganglion cyst removed from L ankle where I had to take 15 mg percocet.
These are minor surgeries compared to TKR. I am concerned that if I have to endure terrible pain over a long period of time I might not be able to do that and will chose to end my life. How do people keep going on like that?

 

[Jamie]

The best thing for you to do is have a frank discussion with your surgeon regarding your concerns about pain after surgery. Express your fears, tell him about your past surgeries and find out exactly how he will handle any post op pain you may have. There are plenty of options to make sure you're comfortable.

While I'm glad you're reading threads here on BoneSmart, please do remember that hundreds of thousands of these surgeries are done annually. Most people do just fine and don't even need the support we offer here on BoneSmart. You will see a higher percentage here of people who either have pain or are worried that something they are experiencing is not normal. So it's easy to start thinking that problems are inevitable. They are not!!!

The most important things to a successful outcome are to find the best surgeon you can and to openly communicate with him at all stages of the process. Should you have pain at any point, it is critical that you convey that to your medical team so it can be quickly dealt with. As I said....there are LOTS of options for good pain management out there!

 

[LondonLady]

Hi @lovemydog,

Have a discussion with your OS before you make the decision not to have an op due to pain issues. There are a lot of good pain control medications and schedules out there, and although it might take a few tries to find the best one for you, it can be controlled properly. If you don't have a problem taking tylenol, the. That's a good start! While some stonger meds are needed in addition to it, good ole Tylenol makes a good start! (Not to mention our friend Ice!). They will often add codine, morphine, and/or other types to help it. However, as is apparent from the boards, not all surgeons are sensitive to pain control, and many folks need to contact their GP in order to get the right combos.

Each knee acts differently--and I'm finding that each op is different. I had a PKR about a year and a half ago. it didn't work out well, so earlier this month I had it removed and replaced with a TKR. Although the TKR revision was a "bigger" op, I'm finding that I'm experiencing much less pain than I did on the first op. So, hey, you never know! I suspect stress is a contributor--I knew what to expect the second time, and while I wasn't looking forward to it, I wasn't nearly as scared/nervous/emotional about the 2nd op.

The other thing to keep in mind is that over time, your surgical pain will lessen, whereas your untreated arthritis will not. soon I'll be able to be back to my old self, not my disabled self! This thought helps a lot if there's some breakthrough pain, or if I overdid it on a day.

Seriously, if you follow the advice you see here in the terrific forum, you may have some bad days, but it's nowhere nearly as bad as you are fearing! Next Thanksgiving, you'll have another thing to celebrate!

 

[Clipless]

...
These are minor surgeries compared to TKR. I am concerned that if I have to endure terrible pain over a long period of time I might not be able to do that...

What does "long period of time" mean to you? Everyone experiences post-op pain. To me, knowing that this pain would (and did!) diminish over the first few weeks made any initial discomforts more tolerable.

Also, I sincerely hope no one rushes into TKR without weighing all options. In my opinion anyone contemplating knee replacement or any other *elective* surgery must accept that the proposed benefits (in their individual case!) outweigh any risks and short term issues. For me, it took nearly a year from diagnosis to feeling 100% ready to move forward with surgery. At some point I had an epiphany about my pre-op deteriorating quality of life. After that the decision was easy.