Dec. 27th Left Lateral PKR

[referee54]

I live in Northern Ohio, and we have tremendous Metro Parks Systems, as well as a National park with 100 miles of packed limestone trails. I will either ride on the road for 40-50 miles a day or on the crushed limestone trails for 40-50 miles once a week, too.

 

[mcirish]

I live in Northern Ohio, and we have tremendous Metro Parks Systems, as well as a National park with 100 miles of packed limestone trails. I will either ride on the road for 40-50 miles a day or on the crushed limestone trails for 40-50 miles once a week, too.

Sounds fantastic. That's one of the drawbacks about living in the Southern California area. Urban sprawl has gobbled up a lot of the open space. On the other hand, we do have moderate weather pretty much year round and there are many pedestrian and bike-friendly communities, but nothing like what you just described.

I lived in Northern California (Santa Rosa) for a while and it was the exact opposite. Lots of bike lanes and pathways, abundant hiking trails and scenic routes. Just gorgeous. I would love to live there again someday, but need to take care of some business here first.

 

[mcirish]

Interesting published study on electrostim as an adjunct to PT when recovering from a TKR. Seems to aid in maintaining muscle tone. I am considering trying this to aid in my recovery and if I do I will comment on any positives and negatives associated with it.

https://www.ncbi.nlm.nih.gov/pubmed/14964588

 

[mcirish]

So I am set to receive my CPM at home. Healthnet did not approve a constant cold machine, but not a big deal since I was not impressed with the unit i had for my last surgery. Question: is a CPM totally necessary? Jeano, I know you did fine without one, but given the option, is there a big benefit to having it?

.........oh yea, Merry Christmas Everyone! Hope everyone is warm and cozy with their loved ones. Good night.

 

[referee54]

The jury seems to be hung on the use of CPM's. For my BTKR, I did not use one at all, as my OS did not believe in them. For my father's two TKR's he used them only in the hospital, as his OS thought that they helped. Other folks here have used them at home, too.

I recovered fine without one; my father hated his in the hospital, but felt that it helped him.

 

[Ziggysmom]

My OS doesn't find any benefit from using CPMs. He told me they have them piled in a closet somewhere. However, others have used them and found them to be of great help. I think it's one of those things that is up to the individual, and as the patient you do as instructed for ultimate benefit, within reason, of course.

As concerns ice, I am using an ice machine my neighbor was supplied with when she had her tkr last year. I like it, although I wish there was more coverage around my knee. I ran it almost 4 hours last night while I slept. My therapist puts a big square gel pad on my leg after exercising, which just about wraps around my knee, and reaches up my thigh, and feels terrific! When I see him Friday, I'm going to ask if we can get one at the pharmacy. If we can, I'm sending hubby out to find one!

 

[jeano]

I honestly dont know about the advantage of using a CPM--someone I know who had a TKR done by the same surgeon as me described the 8 hours she spent on the CPM in the hospital as the worst 8 hours of her life--so he evidently believed in using them when she had her knee done a bit over a year ago. Perhaps he felt it unnecessary with the PKR, or maybe he revised his opinion of the CPM the same way he revised his opinion of PKRs--he was dismissive of the procedure a year ago when I first saw him. So things can and do change.

I was up and walking just fine the day of surgery and started outpatient PT the next day--God knows I felt like that was PLENTY of movement.

Mcirish I dont know what icing contraption you used previously but I LOVE my Breg Polar Care Cube. The problem with any other ice wrap, bag, etc that I have fooled with is they dont stay put and/or they dont stay cold. It is nice to be able to fall asleep with the icing in progress without waking up to a frozen crotch or a soggy bed.....I am now a couple of days past six weeks out from surgery and still spending significant portions of every day using the Polar Cube (like right this minute) although now no longer dependent on it at night. For several weeks I was needing to ice in the middle of the night so the machine would be ready to go at bedtime and I could just strap on the cuff and plug it in at 2 or 3 or 4 AM and get back to sleep. Supplemented with ice from my refrigerator's ice machine, a buck and a half's worth of ice keeps me in business for a couple of days.

And to all, a very Merry Christmas.

 

[Jozilla]

I love the ice machine for sleeping. My PT just told us to freeze five water bottles instead of using ice cubes. Has been working great. I also purchased two large ice bags off amazon that I use in the daytime. They do not freeze all the way, bend around your knee and were like $8 each. I checked the local pharmacies but couldn't find any. No matter what any kind of ice helps!

 

[mcirish]

Thanks everyone. During my last procedure in May I purchased one on Amazon but returned it within several days and went back to ice packs. I did not think about leaving my leg iced before I went to sleep. Never had to do it before but this is probably a different deal. I may have to pick one up at a medi supply store since we are getting down to the wire here.

Another question. Past couple of surgeries I have had I always managed to sleep on side with a wedge between my legs that keeps the leg elevated. Any other "side sleepers" manage to do this?

 

[jeano]

I think I tried for a couple of nights to sleep on my back with my leg up on a stack of pillows but I am a confirmed side sleeper so I grat my teeth, put a pillow (sometimes a wedge, usually just a big firm pillow) between my knees, and tried first to sleep on my right side, reasoning that with the operated knee uppermost that it would be OK. Knee said, uh, no, not really. Then in desperation tried on my left side, which is where I usually end up anyway. You would think that the Knee would not have appreciated having the weight of both the pillow and the other leg on it but you'd be wrong--it's actually more comfortable. I still have to arrange myself a couple different ways and speak sternly to the Knee most nights before it settles down. And it still likes to wake me up from time to time.

I usually have the best intention of having my leg as straight as possible when I sleep but I usually end up folded every which way with a bent leg. So far this doesnt seem to be doing any harm. The first few steps in the morning are pretty gimpy then everything loosens up.

Re icing machines--my horse vet got her leg comprehensively mangled by a horse and while recuperating from her reconstructive surgery used an icing machine made for horses--that sucker is reportedly as big as a big coleman cooler and I think is actually refrigerated as opposed to being a six-pack cooler with an aquarium pump....She had one in her barn to use on horse patients anyway--she's not a big woman so I'm sure the smallest horse cuff swallowed most of her leg.

 

[jeano]

Before I forget, best of luck with your operation tomorrow! I am looking forward to your recovery thread "on the other side."

 

[Ziggysmom]

Good luck with your surgery tomorrow, @mcirish...you will do just fine...see you on the other side!

 

[Jozilla]

Good luck @mcirish! Good healing thoughts coming your way!

 

[icep707]

Lets us know how everything goes. I guess tomorrow is the big day. Best of luck.

 

[referee54]

Most people sleep on their back for a while---with their surgical knee elevated correctly.

I, too, am a slide sleeper, but the pain meds that I took, Oxycontin, made it so I did not care which position I slept in; I just crashed.

You can take a look at this article---it does address sleeping.
TKR Recovery: what to do and what not to do

 

[mcirish]

Most people sleep on their back for a while---with their surgical knee elevated correctly.

I, too, am a slide sleeper, but the pain meds that I took, Oxycontin, made it so I did not care which position I slept in; I just crashed.

You can take a look at this article---it does address sleeping.
TKR Recovery: what to do and what not to do

Thanks ref. I anticipate good ole' Vicodin. The docs around these parts are pretty tight when it comes to pain meds. I am more liable to fall asleep from exhaustion than any narcs they dole out.

 

[Jamie]

As for using the two part epoxy ( super glue ), I was surprised to find out they use the same on TKRs now instead of the old procedure of drilling into the bone and pounding I the replacement.

Actually the material used is not at all like "super glue." It is bone cement that is mixed in the operating room. When it is the correct consistency, it is applied to the prosthesis and into the cavity in the bone and pressed into the porous bone structure. It does set up and there is a specific window of time that the surgeon has to get his work done. The bone still must be drilled out to accept the prosthesis and the implant is tapped (hammered) into position as part of the final placement.

My doctor said he has done several hundred of these and has only seen one other case where the epoxy let go.

The surgeon's expertise in this procedure is critical for the performance of the knee (or hip). Should the cement not be the right consistency or should he not get it adequately pressed into the bone, loosening can result from micro movement that can occur. This is often what causes a joint to need revision and it's why we stress that it is so important to find an excellent and experienced surgeon! So it's not that "epoxy lets go." It's that the movement, even though very slight, creates an environment where the bone dies back and causes the separation.

Also, using robotics only damaged material is removed and every replacement is a custom fit.

The robotics provide a guide for the cuts, but ... trust me .... every surgeon provides a custom fit. That's another area where a surgeon's expertise counts. I just attended an international conference where orthopedic surgeons were discussing the use of robotics. Even with that aid, a good surgeon will do some custom fitting to be sure an implant functions properly with the patient's ligaments. No good surgeon - robotics or not - removes more bone than is required to properly place whatever implant is being used. The "damaged material" is primarily cartilage, which of course is all removed during a joint replacement. Hence, the arthritis is gone forever. [/quote]

 

[Jamie]

@mcirish.......I think you've done an excellent job psyching yourself up for this surgery. Please try to relax if you get to read this tonight. You may not sleep much tonight, but you'll be resting peacefully very soon. The neat thing about surgery is that, once you are up and on your way to the hospital, things just click along so fast. The next thing you know you're waking up in recovery!!! The waiting you've already been through is THE HARDEST part of the whole deal.

You will be so surprised at how stable your knee feels when you stand for the first time. It's amazing. Like you, I had a lot of instability in both my knees before surgery. In fact, with my first knee I had no idea what was going on. I would just be tricky-trotting along and .... boom....I'd fall flat on my face. I never knew when it was going to happen and there was never, ever any knee pain associated with it. Only my face hurt as it hit whatever I was walking on at the time! It took quite a while for me to realize I needed a new knee on the first one. And by that time ALL the cartilage was pretty much gone. With my second knee, I was a whole lot smarter. The minute I noticed that "giving way" feeling, I was at the surgeon's office and scheduling my TKR. It's been the best and I'm so glad it's done. You're going to feel that way too. Here's hoping that the PKR takes care of your arthritis for a long time!

 

[mcirish]

@mcirish.......I think you've done an excellent job psyching yourself up for this surgery. Please try to relax if you get to read this tonight. You may not sleep much tonight, but you'll be resting peacefully very soon. The neat thing about surgery is that, once you are up and on your way to the hospital, things just click along so fast. The next thing you know you're waking up in recovery!!! The waiting you've already been through is THE HARDEST part of the whole deal.

You will be so surprised at how stable your knee feels when you stand for the first time. It's amazing. Like you, I had a lot of instability in both my knees before surgery. In fact, with my first knee I had no idea what was going on. I would just be tricky-trotting along and .... boom....I'd fall flat on my face. I never knew when it was going to happen and there was never, ever any knee pain associated with it. Only my face hurt as it hit whatever I was walking on at the time! It took quite a while for me to realize I needed a new knee on the first one. And by that time ALL the cartilage was pretty much gone. With my second knee, I was a whole lot smarter. The minute I noticed that "giving way" feeling, I was at the surgeon's office and scheduling my TKR. It's been the best and I'm so glad it's done. You're going to feel that way too. Here's hoping that the PKR takes care of your arthritis for a long time!

Thanks Jamie. Still have some prepping to do, but I will steep later....a good friend at work just loaned me her cooling machine, so NOW I am set.....man, one thing I have noticed now since i picked up my exercising prior to the surgery is....some slight pain on the medial side of my knee. Will have to bring it up with the doc in the morning. Would hate to go through all this and need a TKR in a couple years.

Edit: Whew! I started massaging the inner part of my thigh where the quad attaches to the knee area and the pain lessened. I think it might be tendonitis. Just over did the pre-surg work out. Still, going to be prudent and inform my OS. He said he was going to poke around inside and address any issues anyway.

 

[Jamie]

Glad you have a surgeon who will check out the rest of the knee. Sometimes there is arthritis that can't be seen on an xray and it can change what needs to be done. Hopefully that's not the case for you. I look forward to seeing your thread on the recovery side!!! By now you're probably there!