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Bilateral PKR Been waiting for a decade for this news!

Muscleflex

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I was on this site years ago, then had a long time away. As some history, I've gone through over a decade of issues with both knees - chondromalacia patella, tracking issues, advanced osteoarthritis - bone on bone pain. I've tried a million things before - drugs, cortisone, multiple rounds of synvisc, PRP, lateral release, microfracture surgery - nothing has helped. For years doctors have told me I need a replacement, but they say I'm far too young for that (I'm 40 now). I've seen countless surgeons for different opinions, but all end in the same way - until last week.

Got in to see one of the top orthopedic surgeons and he offered me a bilateral patellafemoral replacement. I'm not actually getting the surgery until the fall/winter (due to work situation), but trying to learn all I can now. Spent a couple hours earlier reading up on some threads here specific to partial knee replacements.

I'm (relatively) young and very active and looking to hear from anyone who has been through a patellafemoral replacement and what the recovery is like. The surgeon told me recovery should be similar (or maybe better than) recovery from my lateral release and microfracture which were pretty brutal.

Curious what type of activities people were able to get back to after the replacement and what kind of time frames to expect for return to activity?
 

Celle

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Hello @Muscleflex - and :welome:

Thank you for starting your new thread.

Please will you tell us the full dates of your knee surgeries and which knee it is each time, so we can make a signature for you? That way, we'll be able to see the history of your knees at the bottom of each post you make, instead of having to come back to your first post.
Thank you.:flwrysmile:

Even though your surgeon is offering you pattellofemoral replacements, do make sure that he is prepared to go to full knee replacements if he finds any osteoarthritis at all in the other compartments of your knees. Unfortunately,many partials (PKRs) fail too soon because arthritis has spread to other compartments of the knees.

Recovery from a partial (PKR) usually takes just as long as recovery from a total knee replacement (TKR), which can be as long as a full year. That does sound a very long time and you should be able to do most things long before that, but there will still be healing going on beneath the surface.

AS for what you may be able to achieve once your recovery is completed, have a look at some of these stories:
Stories of amazing knee recoveries

You will need to follow the same recovery protocols for a PKR as for a TKR, and this is teh approach that we recommend:
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:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
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

5. Try to follow this

6. Access to these pages on the website

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.
 

Celle

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Jockette

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I have a Patellofemoral and I’m sorry to say that I do not call mine a success. I was not bone on bone. And looking back, I honestly think I should have waited until I was. Maybe things would have turned out better.

My best advice is to be sure your surgeon is very experienced with Patellofemorals.

I also had a lateral release done during the surgery and it’s where most of my discomfort is, still, at 3 years post op.
 
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Muscleflex

Muscleflex

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Thanks for the links! Gives me lots to read into..

As for my details, I had microfracture in February 2016 and lateral release January 2017 - both on my right knee. awaiting double patellafemoral replacement later this year.
 

Celle

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Thank you for your surgery details. I've done your signature.
 

Chelsea23

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Hi @Musclflex ! I am Canadian as well and now nine weeks post op, patellofemoral anthroposty. Where are you having your surgery done? Who is your surgeon?
 
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Muscleflex

Muscleflex

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Hi! Sorry, just saw this now! I'm going to Mount Sinai - Dr. Backstein. Where did you go? How was your experience? I'm having them both done two weeks today!
 

Chelsea23

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Wow! Two at once!!! I am now 12 weeks post op and definitely seeing why I did this! That's what my surgeon said - "You will know why you did this at about 12 weeks. Actually, I knew earlier. I went to the Holland Centre ( connected with Sunnybrook ). My surgeon was Dr. Tomescu. All the best to you!!!
 

Chelsea23

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Ask me any questions if you have them. Unlike many people on this site, I was very into and active with physio. I went into this an active person and I planned to return to an active lifestyle. I worked hard at it! I was actually told by my surgeon to ease off a bit. I had great range of motion in a short amount of time. I did my range of motion exercises twice a day. Once you get past the first two weeks, things definitely get easier. The recovery is long but I already can do so many things I haven't been able to do for years!
 
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Muscleflex

Muscleflex

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how was the pain after the surgery itself? I've had microfracture and lateral release and those are both known for being quite painful - wondering how this will compare? did you have difficulties sleeping in the early days/weeks? were you able to put weight on your leg right away? anything else I should know (I haven't found many who have had patellofemoral replacement as opposed to TKR, so really interested in anything specific to the PKR)! thanks!
 

Jockette

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What was your recovery like from the lateral release? After my one year check up I learned that my surgeon did a lateral release during my Patellofemoral replacement surgery. At 3 years post op I still have a lot of discomfort in the lateral area.
 

Jaycey

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did you have difficulties sleeping in the early days/weeks?
Unfortunately sleep problems are a part of this recovery. There is an article about this in the list Celle left you (above). Nap during the day and ice as much as you can.
 

Roy Gardiner

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You may regret bilateral in the first weeks, but it IS the way to go, IMO. Just one recovery. See my sig below for one story; partial and total are much the same, again IMO.
 
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Muscleflex

Muscleflex

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What was your recovery like from the lateral release? After my one year check up I learned that my surgeon did a lateral release during my Patellofemoral replacement surgery. At 3 years post op I still have a lot of discomfort in the lateral area.
it hurt like :censored: in the early days/weeks, but I don't remember it being too bad after that. I didn't have any ongoing/long-term problems as a result of it, but don't think it really helped either (hence the replacements I'm getting now).
 
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Muscleflex

Muscleflex

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You may regret bilateral in the first weeks, but it IS the way to go, IMO. Just one recovery. See my sig below for one story; partial and total are much the same, again IMO.
I agree! Would much rather get it all done at once - I can't imagine doing a year recovery on one then starting the process again with the other!
 

Celle

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@Muscleflex - We're into December now and I'm wondering if you have a date for your bilateral PKR yet? If you do, please tell us and I'll add it to your signature. Thank you. :flwrysmile:
 
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Muscleflex

Muscleflex

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@Muscleflex - We're into December now and I'm wondering if you have a date for your bilateral PKR yet? If you do, please tell us and I'll add it to your signature. Thank you. :flwrysmile:
yes, was supposed to be TODAY, but got rescheduled to December 16th. keeping fingers crossed that covid doesn't push it back any further!
 

Celle

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I'll put your date as the 16th, but please let us know if it gets re-scheduled again, won't you? I do hope it won't.
 

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