Bilateral PKR scheduled for 3 October

[Josephine]

To be honest I'm worried now, I don't know what to think

I thought as much - and I'm sorry I was the one to cause your confusion.

It's bad enough now but he tells me it'll just get worse.

It will, of course.

Having said that he's not even mentioned it, the 3 options were orthotics, physio and PKR

Well that is what has worried me. He really should have talked through the various alternatives with you even if he would then mark one or two off as being inappropriate. From what you've said - or rather haven't said - he's not mentioned that either, has he?

As far as the age thing goes, you are presently not 'too young' to have either a partial or a TKR. Neither of these two procedures are age related. The only reason for doing a partial is because there is only ONE compartment in the knee affected.

So I'm pretty sure you don't know about the compartments in the knee so here's a little info about them. There are three - the medial, the lateral and the patellofemoral - and these are they

In order to do a partial means doing ONE compartment. If there is even a hint of arthritis in another compartment then a partial is not indicated. It has to be a total. You need to know this so you need to get hold of an xray and the report to see what the findings are. You have the right to ask the hospital to provide you with copies though there will be a small fee. My hospital charges £10 admin fee each time and I get copies every time I have an xray!

Having to watch the pennies because my job ends the end of Oct

I understand. But if your insurance expires then you'll just have to transfer to NHS, won't you? There's no reason you can't do that. I do it all the time! Have a private consultation but any treatment is NHS!

 

[Wags]

I talked this over with my husband and he corrected me, my consultant did talk about options, think I was so shocked at what he was saying, I thought it was going to be a cartilage issue and maybe involve keyhole surgery like my husband had, that I zoned out and just concentrated on the diagnosis.

The problems are all located in the medial compartment, I have valgus hind feet, hence the orthotics and my ankles/knees and hips are not in alignment, therefore the patella has not tracked properly and worn the area abnormally. The MRI, done after orthotics and physio, shows micro fractures and fluid in the medial compartment.

He apparently did talk of TKR in the first appointment but ruled it out at this time as the rest of the knee is unaffected. He did say that I was young for either option and said the PKR was a last resort and he wanted to try the orthotics/physio first to see if he could correct the maltracking and improve the pain.

I had X-rays done originally but wonder why he didn't do the MRI sooner as the results of that made him conclude that the PKR was the right option but I guess I know why as he's getting paid for all this!

And my insurance doesn't expire, it's through my husbands job so is still available. We do have to contribute up to a certain amount though. My job was on a fixed term contract and ends on 31st October, funding has ceased so no options of continuing.

My concern is that I need to work to keep the household running without issues, no job at this stage means no sick pay and getting a job after the PKR will be difficult and nigh on impossible for a while at least. And if this treatment were to fail I am concerned about what happens next.

I know there is the NHS but so far they have not been interested, and I'm not deemed as an urgent case so no idea how long I'd gave to wait to get this done. 10 years plus of visiting the Dr just to be fobbed off each time with anti inflammatories which they know I can't take and no other options offered. Not even interested in referring me for X-rays. I felt like I was banging my head against a brick wall!

As soon as the private medical insurance was mentioned though.....oh yes well refer you! Dr was so keen he referred me for my shoulder issue and knees, so this year has been interesting to say the least with shoulder surgery in July and this in October.

I guess any revision would have to be via the NHS unless I have a job by then.

 

[SuperSnapper]

I can see you are between a rock and a hard place at the moment. But your knees will only continue to deteriorate and become even more of an issue. At some time you are going to have to jump , one way or another. There is no guarantee that any surgery will be successful but most are. Surgeons do this every work every day and take it all in their stride. I do think you need a fresh eye on this one but def talk to your surgeon again.

By the way, I had my operation under the NHS at a private hospital but didn't pay anything. We were going to pay but the surgeon said to keep our cash as he was happy to do it as an NHS patient and recommended we forget about makoplasty which was expensive as he could do it just as well. And he did. As you've already seen a consultant who's recommended surgery , your doctor may now recommend it as an NHS case too. It's worth exploring the options as finances seem to be weighing heavily in your decisions. The only difference I experienced as an NHS patient in a private hospital was I did not have to pay for walking sticks but private patients did!

I hope you come to a decision you can be happy with.

 

[Wags]

Hospital has just phoned and changed my date from 3rd to the 4th October, only moved by one day but was getting psyched up for it, hope they don't move it any more

 

[Celle]

I'm sorry your surgery date has been changed, @Wags .
Please will you post the change of date in the
2017 October Feisties - Are you having knee surgery in October?

Thank you.

 

[sistersinhim]

I hope you can get some satisfaction from all these doctor visits. The feeling of being put-off is deflating. I was also told all my childhood pains were growing pains, and now I'm suffering for not getting them corrected early on. Try not to let this keep going on. There are a vast many more success stories of a knee replacement than bad ones!

 

[Wags]

I'm sorry your surgery date has been changed, @Wags .
Please will you post the change of date in the
2017 October Feisties - Are you having knee surgery in October?

Thank you.

Did that first

 

[Wags]

I hope you can get some satisfaction from all these doctor visits. The feeling of being put-off is deflating. I was also told all my childhood pains were growing pains, and now I'm suffering for not getting them corrected early on. Try not to let this keep going on. There are a vast many more success stories of a knee replacement than bad ones!

Thank you, bilateral partials will hopefully be done on 4th Oct now

 

[sistersinhim]

Wonderful. You have a destination! Only good things are ahead of you after the 4th.

 

[susieb64]

Hi @Celle,

Unfortunately I don't have the option yet of a TKR, they didn't want to do the PKR as said I was young to have it done, seen younger than me having it done on here, mainly in USA though. UK don't seem to want to do things unless they seriously have to, took me long enough to get someone to even acknowledge the pain and do anything about it! Went through Orthotics and physio first but they didn't help so this is what my consultant calls the last resort, he told me it would probably need doing again between 10 and 15 yrs down the line.

Husband and I are due to drive from UK to Spain on 20th December - do you think this will be possible, we take regular breaks and get out and walk around, take the dogs with us so will need to do it for them and me. Usually take it in turns to drive, not to sure if I'll be able to do this? Guess I'll be around 11 weeks by then.

Hello, Wags, I've just read through your thread with interest as I'm in a similar position (although a different diagnosis with arthritis following keyhole removal of a torn meniscus 17 years ago). I'm also 53 and have been recommended a partial replacement in my left knee. I'm having the pre-op assessment on 2nd October with probable surgery in November so I'm right behind you!
My surgeon explained that the partial was most suitable for me as the other compartment was still in fairly good shape and my cruciate ligament was still intact. (I'm going to ask for more clarification on that point at my pre-op).
From what I have read on the NHS site, a PKR can result in a more natural movement because of this - and a smaller incision is made, if that's any comfort!

The other thing I am trying to take to heart is if the PKR can last 3 -10 years, and then we end up eventually with a TKR which can last 20 - 30 years (or more) , well that kind of gives us younger ones an overall longer period of having good knees!
I'm brand new to this site so I'll be reading around avidly at other PKR experiences but yours is the first one I came across so just wanted to say hello.
I also have a place in Portugal and regularly make the drive through Spain. My surgeon told me I would be back to driving in 2 weeks! (???) Although I don't intend making that drive until March.

 

[Wags]

Hello, Wags, I've just read through your thread with interest as I'm in a similar position (although a different diagnosis with arthritis following keyhole removal of a torn meniscus 17 years ago). I'm also 53 and have been recommended a partial replacement in my left knee. I'm having the pre-op assessment on 2nd October with probable surgery in November so I'm right behind you!
My surgeon explained that the partial was most suitable for me as the other compartment was still in fairly good shape and my cruciate ligament was still intact. (I'm going to ask for more clarification on that point at my pre-op).
From what I have read on the NHS site, a PKR can result in a more natural movement because of this - and a smaller incision is made, if that's any comfort!

The other thing I am trying to take to heart is if the PKR can last 3 -10 years, and then we end up eventually with a TKR which can last 20 - 30 years (or more) , well that kind of gives us younger ones an overall longer period of having good knees!
I'm brand new to this site so I'll be reading around avidly at other PKR experiences but yours is the first one I came across so just wanted to say hello.
I also have a place in Portugal and regularly make the drive through Spain. My surgeon told me I would be back to driving in 2 weeks! (???) Although I don't intend making that drive until March.

Hi @susieb64

Good to meet you, your pre op is just round the corner now, I had mine last Wednesday and all on schedule for the 4th. I think I've come to terms with having the op, guess now I'm just concerned about the pain after and how I will manage as I have a lot of allergies, so concerned about pain relief and what I'll be able to take after, we even had to discuss my metal allergies at the pre op, so much to consider

I'm not sure how long it'll be before I get back to driving, maybe a little different for me having both knees done at once, and patellofemoral, middle compartment and knee cap, my brother in law had a partial on a side compartment and was driving at around 3 weeks.

At the moment stairs are my issue and consultant has said they will be my friend at around 5 weeks, hopefully.

Keep in touch and we can follow each other's progress, I'm also on some of the Facebook support groups which may help you too, lots of support on there also

Julie

 

[SuperSnapper]

I went back to driving 7 weeks after my PKR but that was my left leg and I decided to get rid of my aged manual gear car as it was still too sore on my leg. Two weeks would have been impossible. Even with a partial this is not a short recovery and a long period with leg down at 2 weeks would result in pain and swelling for sure.

 

[Celle]

From what I have read on the NHS site, a PKR can result in a more natural movement because of this - and a smaller incision is made, if that's any comfort!

My first knee replacement was a PKR, followed 11 years later by a TKR.

From a functional point of view, I can tell you that there has been no difference for me. The PKR worked well, but so does the TKR. The TKR moves just as naturally as the PKR did. I think that it's misleading to say the PKR results in more natural movement. Also, the size of the incision depends on how easy it is for the surgeon to gain access to your knee. My TKR scar is no longer than the PKR scar was.

I also have a place in Portugal and regularly make the drive through Spain. My surgeon told me I would be back to driving in 2 weeks! (???) Although I don't intend making that drive until March.

Driving in 2 weeks would be almost impossible. It's misleading statements like that, that make people anxious and disappointed if they don't achieve the promised result.

Most of us started driving again some time between 4 and 6 weeks post-op.
At only 2 weeks post-op, you should still be spending almost all your time resting, icing and elevating your knee. You will still need to take strong narcotic pain medication too, you will be exhausted, and your will have brain fog. You would be a danger to yourself and to others if you tried driving at that stage.

Also, having bilaterals, you will have no "good" leg to take part of the load and work. It's a double whammy of trauma.

Have a look at this, to see what level of activity you should aim for in the early weeks:
Activity progression for TKRs

In spite of what you may have been told, we have found here on BoneSmart that recovery from a PKR takes just as long as recovery from a TKR. There simply is no quick recovery from any sort of knee replacement.

 

[Celle]

I see that , so far, you haven;t been given the recovery reading.
I think it would be a good idea for you to read these articles in advance, so you are well prepared:

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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide for Activity progression for TKRs


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 a 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 history before providing advice.

 

[kneeper]

Wishing you smooth sailing on the 4th!

 

[SuperSnapper]

Good luck with your surgery

 

[PoetryChef]

Wishing you a successful surgery tomorrow.

 

[Wags]

Thanks to @kneeper @SuperSnapper and @PoetryChef for your good wishes, but it's been all change at last minute, op has been postponed for approx 3 weeks due to my nickel allergy and the fact that there is nickel in the implants my consultant uses. Have to be referred to a new consultant and non nickel implants ordered

This all occurred only yesterday, I am really disappointed as had just got myself psyched up for everything, but been told it's not worth the risk because if there is a reaction then I would need them removed and replaced

 

[Celle]

@Wags - I'm really sorry you have this last-minute delay, but it's a good thing your nickel allergy was discovered before you had the implants.

 

[SusieShoes]

Sorry for the delay, but it's for the best. A metal allergy is not to be taken lightly. I know what you mean about being in the headspace for surgery, and now you have to turn that off and go back to "getting into" the headspace again later. It's annoying, however necessary, and just means you have a longer wait.