Both Hips Replaced - How about a Knee?

[dcdowden]

I am happy to report that my two hip replacements (March and June) this year have gone very well. Now my right knee seems to be the limiting factor in getting totally back to normal. Just went to see my OS, and he gave me a cortisone shot. X-Ray shows bone on bone on the outside causing me to become somewhat knock kneed. An MRI also shows torn medial meniscus. I have moderate pain along the front inner part of the knee and occasional sharp pain behind the knee on the inside when I walk for more than a couple hundred yards. So, I have two questions for this group:

First, my knee doesn't hurt any where near as much as my hips did before surgery, but I now feel I waited far too long to get them replaced. So now I wonder whether I should go forward with the knee replacement sooner rather than later. I am 56 years old now and feel I will have to have it done at some point. Or should I take a chance and let them scope the knee first to see if it helps. There have been various reports recently that scoping a knee that also has arthritis is not effective.

Second, going through my hip PT I heard many times that knees were harder than hips in terms of the rehab after surgery. I would be curious as to the experience of members of this forum on that question.

Thanks much,
Doug

 

[JudyS]

Hi Doug,
I had my right hip replaced on June 6th. I think I started complaining about my righ knee to my surgeon in Sept. so, I have had 2 cortisone shots, 5 Hyalgan shots, MRI and 2 weeks ago a knee scope. All the injections did nothing for the pain. Good news for me after the scope is I do not need a replacement any time soon. I only have damage on the pattello-femoral section. The doc did microfracture surgery on the trochlear groove so no weight bearing for 6 weeks, also cleaned out a lot of scar tissue.

I believe knees are much more involved in rehab and pain than hips and that you should hang on to your knees as long as you can.

I am lucky that so far I can hang on to mine.
I am having my other surgeon work on my spine, not sure where it compares to hips and knees.

Judy

 

[Simon]

Doug

I had knee problems since my teens so they were in pretty bad shape. About 2 years ago, I fell and tore the right meniscus. That did cause more problems but I just thought it was more of the same. The 2 years I waited with all the additional swelling from the torn meniscus caused a 10 degree flexion contracture (not spelled right) that made it very difficult to achieve a 0 degree extension post op.

Waiting will not make things better, my OS when he saw the MRI he said the scope to fix the menicus would not help.

Simon

 

[Josephine]

I had a scope for diagnostic purposes - was the surgeon's routine to do so. But it resulted in me being able to put off the TKR for 2½ years! BUT the difference is, make sure your surgeon doesn't go overboard doing any debridement as this will only exacerbate the arthritic changes. A good washout is all you need. Some surgeons just cannot resist the temptation to give the knee a good ol' tidy up while they're in there! Make sure he knows he doesn't have permission to do anything like that apart from removing a torn cartilage or such.

 

[1jt@atime]

Hi Doug, we're the opposite! I've had two knees replaced, need a hip replaced and wondering when is the right time to replace it. Also agree that I waited too long to do the knees.

Your questions: Knowing when to go forward with replacement is the million dollar question, isn't it? Bone on bone means it's in pretty bad shape and it definitely won't get better but how much is it interferring with your life? That's the ultimate question you need to answer when deciding the right time... I had a scope prior to a replacement and it only made the knee pain worse but others have had success, like Jo. I would think you would want to try the conservative options prior to replacement but that should be between you and your surgeon. Knee replacement is not a surgery to go into lightly which leads me to your next question.

I have also been told by many professionals and others on this forum that knees are a much harder recovery then hips. It's not the actual surgery that is the problem. You lose ROM from knee replacement and it is very, very painful to recover. Physical Therapy starts while you are in the hospital and lasts at least 4-6 weeks if not months. The goal of PT is to push, push, push that knee back and also flat. Once PT ends, you will have to continue your exercises to keep the ROM. I think most people will tell you the recovery was much more difficult then they had imagined. I don't want to scare you or anyone else off because it was definitely worth it and I would do it again if I had to.

Karen