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Depuy , Stryker or Zimmer knees/ Quad cut or Muscle Cut?

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Lvc595

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I was told today I need two knees replaced ASAP.

I live in the San Francisco Bay Area and just not sure who to choose as a doctor. I have heard about all of the knee manfacturers above and not sure which is best. Is it best to get the gender knees?

Does anyone have a Dr. they can recommend?

I've heard of Dr. who cut the muscle and others that cut the quad..

I am so confused and this is adding to my stress!

Thank You,
Lori
Redwood City, CA
 

Josephine

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Welcome to BoneSmart, Lvc. This is the place for answers!

My first comment is to forget about choosing a prosthesis. That's your surgeon's job! As is the approach. Some do make a small cut in the muscle over the knee joint to give them better access but though it might improve the immediate recovery, long term it doesn't make that much difference.

I placed this post at the top of the forum titled "How to choose a surgeon and a prosthesis" First read that and then come back and we can talk some more. OK?
 

Max Wallace

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Welcome!

You have come to the right place for answers and support. I had BI-TKR 12 weeks ago with both Quads being cut. Josephine is correct about finding a good surgeon and letting him worry aboout the which knee to use and where to cut. I had a great surgeon here in Memphis TN. and was able to return to work in 7 weeks. My surgeon had another surgeon that he worked with on BI-TKRs He did one knee while the other surgeon worked on the other so I was only under for 2.75 hours and only had one rehab.

Good luck and we look forward to hearing from you soon.

Max
 
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Lvc595

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Hi,

I don't understand both done at the same time. I guess one is hard for me to do. I am also not sure about how to check out a Dr. I will meet with one in 2 weeks but not sure which would be better. My head is about to explode!

It seems like 50-50 as to good experiences and bad ones with having the knee replaced which is really scary.

What about gender knees? How many surgeries should a dr. have that is too many or too little a year?
 

edk

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The differences between hardware seems to pale when compared to the skill of the installation, although there seems to be some data that says the female gate profits from a rotating platform - everyone is right let the surgeon decide what they should install. I'd look for a doc that does a couple of hundred a year. The doc I had did 8 a week most weeks and all he did was total knees and hips.
 

TBONE

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Hi Lvc--I recently went through this process (earlier this month) shortly after I had learned that I needed both hips replaced. I had been to a surgeon already and had more questions than answers. I, was fixated with hardware, intent ongetting the best hips available. Here is my short list of advice:
1. Read through some of the threads on the knee side to educate yourself as much as you need to. You will find remarkable similarity in others' situations and you will learn a lot.
2. Listen to Josephine. Much of what she says she has explained before to others in your shoes, and she has the patience of Job. She is a gem!
3. Relax, if you can. You are in a large metropolitan area and chances are, there are very good surgeons near you. Look for a surgeon using criteria from Josephine and other threads. I visited 3, all good and experienced, and I'm traveling a bit for my surgery, but you may not need that many. I did find the right one for me. And in the end, hardware was factor, but a less important one than the surgeon's skill and the reputation of the hospital.
Hope that helps.
Tom
 
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Lvc595

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Thanks everyone.

Is there a website where I can check out Doctors? I really find that is the hardest part.
 

JudyS

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My advice is to call up some physical therapy places. The therapists have worked with the patients after the surgery. They are vey knowledgable on doctors.
When I first arrived in california from Georgia that is what I did and found an excellent spine surgeon who then referred me to an excellent hip/knee surgeon when he was sick of me complaining about my hip!!!

Good Luck
Judy
 

Simon

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Ask physical therapists or nurses will give you a good list to start with.
Another place to look is at the American Academy of Orthopedic Surgeons (http://www.aaos.org). On the left side of the website is a section for patients that will give you some good info about a variety of things. Another good site is the American Association of Hip Knee Surgeons at http://www.aahks.org

You can also find out about doctors at several websites. If you go to goggle and do a search with the terms Rate your doctor you will get a list of sites. Some are junk and you will quickly see that. One of the oldest is http://www.healthgrades.com where they will give you a list of education, any professional actions, where they practice. Another one is http://www.revolutionhealth.com

The most important thing (in my viewpoint) is that they are certified by the appropriate board in this case the American Board of ORthopedic Surgery (http://www.abos.org). Once you have a short list go there and back sure they are board certified.

Another possibility is a local senior center as alot of seniors have had surgery.

One thing to remember is that someone can tell you the surgeon is great, he seems to be qualified etc but you make an appointment with him and you just dont feel comfortable or the old gut check says no. This is ok because he can be great but just not the one for you. You have to feel very comfortable with the surgeon.

Also ask about who he uses for PT as this can give you another clue about him. You do not have to use who he recommends so you should check out PT's as well.

Simon
 

Josephine

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Lvc, did you read the other post I gave you a link to? It's very important that you read that as it answers some of your questions directly. Seriously, nearly all the information you need is in there. Put that with what Simon has told you and you'll be half way there.

Another things - you said it seems 50-50 with good and bad experiences. Are you referring to the comments on this forum? If so, don't take that as a typical picture. We have barely 2,000 members on here - not even 100 have made more than 50 posts which means that the other 1,900 have post a few times and then gone on their merry way! Now put that alongside this in the UK

Cardiff Knee Clinic 2004
Primary total knee replacement in many studies offers greater than 90% survival of the implants at 15 years. Knee replacement is a highly successful operation with over 55,000 operations performed in the UK last year (National Joint Registry). In the same year over 3,000 knee replacements needed revision. This amounts to just over 5% or 1-in-20 knee replacements that have failed and need to be revised.


The the population of US is about 5 times that of the UK which means that over a quarter of a million knee replacements are carried out there of which barely 15,000 needed a revision in the same year. That is a very tiny number!

But choosing a surgeon is done by you getting recommendations as Simon suggested and then interviewing them! Yes - truly! You take the questions I have listed in that post I mentioned and then add to them the questions that others here have suggested. If he is okay - meaning has sound experience and a nice manner - he will not only not mind your questions but will expect you to ask them! If he doesn't or if he waffles about the answers - scoot and go see someone else! A decent surgeon has all these answers on the tip of his tongue and is more than ready to share them. Don't settle for less.
 

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But choosing a surgeon is done by you getting recommendations as Simon suggested and then interviewing them! Yes - truly! You take the questions I have listed in that post I mentioned and then add to them the questions that others here have suggested. If he is okay - meaning has sound experience and a nice manner - he will not only not mind your questions but will expect you to ask them! If he doesn't or if he waffles about the answers - scoot and go see someone else! A decent surgeon has all these answers on the tip of his tongue and is more than ready to share them. Don't settle for less.
LISTEN TO HER ON THIS ONE!!!! If you don't "like" your surgeon, go find one that you "like" enough to feel comfortable asking questions. by "like" I mean that gut-level feeling that someone is a good fit for you.

I chose my first surgeon based on his reputation for doing knees--he's one of the best. Unfortunately, he's also an arrogant jerk and never spoke more than 3 words at a time, and to this day I don't think he's ever said more than a dozen words to me. On the bright side, my LTKR was well done and its a good knee that I'm very happy with. On the down side, I had a miserable recovery period because he didn't believe in pain control and he NEVER answered any questions I had. To this day, I still don't know how the surgery really went or what he found in there (I've had several major knee surgeries).

I found the surgeon who did my RTKR through a serendipitous meeting with an anesthesiologist who recommended him. And he also checked out through the medical organizations. I LOVE this man! He talks to me, he follows up, and he has a pain protocol that is based on patient comfort. I can't say enough good about this surgeon--not only does he have skill and experience, but he is very human and personable. I would go back to him in a heartbeat. This recovery has been much easier in some ways because of better pain control--and I will NEVER underestimate the importance of that again.

I wish that I had found this group before I chose my first surgeon--if I had seen Jo's advice I most likely would not have chosen the first one. I never thought about interviewing surgeons; I just chose one of the top rated knee guys in the area, but I would have been better off to choose one of the other top rated knee guys in the area!

Weezy
 

Josephine

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serendipitous
I love that word!

But c'mon - let's have this guy's name and place of work. We like to let them know when they've had rave reviews on this forum.
 

edk

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I guess I have three things to add

1. don't let the bureaucracy turn you off - you're renting the surgeons hands.

2. you need someone who will work with you about your issues

3. chat with people in the area its amazing how many people have had joint replacement and are happy to talk about it.

I saw one surgeon in central Illinois, good reputation and has done work on me before, but when I asked about skiing he gave me a blanket no but was winking. So I couldn't talk to him about my concerns. Got a recomendation for a guy in Chicago, very big busy clinic. Took me forever to get through and felt like I was on the assembly line, but the interview with the surgeon was relaxed and he took as much time as necessary. Also, there seemed to be a big wall preventing access but once you were on the docket you were sort of treated like family. When I was thinking about having the surgery done in Colorado, I would chat with people on ski lifts blah blah "...gonna have to get my knee replaced." Suddenly would come "Oh I had mine done, its great..." and it was always a Dr. Hass? in Denver. So if I had it done there he's who I would have seen.
 

mwolf

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Dr. Hass did mine. They are amazing at the Colorado Joint Replacement Specialists. He said skiing was fine, but NO moguls. They are pretty strict about No, No's. They said NO running, horse back riding, no moguls or jumping out of airplanes! They are all about rehab, rehab and more rehab. All the doctors there are great. Spent plenty of time with you and are so confident, they put you at ease immediately. I think great surgeons and great rehab are essential for a good outcome.
 
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Lvc595

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Thank you.. I will spend the weekend checking out the websites!

You've all been great.. and I am lucky to have found this website.

Lori
 

Weezy

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I love that word!

But c'mon - let's have this guy's name and place of work. We like to let them know when they've had rave reviews on this forum.
The surgeon I love is:

Lyle Sorensen at Virginia Mason Hospital in Seattle, WA.

I sing his praises every chance I get! And the only complaint I have about the overall Virginia Mason hospital system is that their food wasn't that great (in reality not a big deal!). Everything else was VERY VERY GOOD and they seemed to have more nurses and assistants than the last hospital I was in and I never felt ignored or put off.

Weezy
 

PRGal

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I love that word!

But c'mon - let's have this guy's name and place of work. We like to let them know when they've had rave reviews on this forum.
I assume "raving fans" goes for hip surgeons too! (Sorry, not to hijack, but couldn't figure our how to quote and start another thread in the "hippie" area. I'll leave it to your expertise to move this as needed.)

My OS was Jonathan Yerasimides with Norton Orthopaedic & Sports Medicine Specialists in Louisville KY. He specializes in hip & pelvis surgery, is an associate prof at our university med school, & is the only surgeon in the area who does direct anterior approach, having done more than 700 in the last 2-1/2 years. He's quite young, but sharp as a tack and as personable as can be--I'd recommend him to anyone! (P.S. Our university hospital is one of 2 primary trauma centers in the state. For him to be on the med school faculty a mere 3-1/2 years after completing residency is a testament to his skill.)
 

Gretchendz

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TKR odds are WAY better than 50-50.

Probably 90-95% of the people I meet who have it done are SO HAPPY they did. They usually say (as do I) "I only wish I had done it sooner."

Didn't need to suffer so much and lose mobility.

The recovery is NO fun the first 6 weeks or so, so if you talk to someone during that time period, you'll get a different answer. But talk to them six months or a year out, and you will usually get a different result.

Yes, there are complications for a few (like infection) but these are actually quite rare.

You need realistic expectations, that's what those books and places like this forum are for.

Best wishes!
 

Gretchendz

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Hey Jo--how about starting a new sticky thread of surgeons people were happy with?
 
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