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TKR Do I need knee surgery?

HappyHunter

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I am wondering if I should consider knee replacement surgery. I have had pain at the back of my knees, a deep aching type of pain, for a few years now, and it’s getting worse. Lately it’s sometimes awakened me at night, and I’ve had to use menthol ointment to get back to sleep. Both my knees are swollen and I’m quite knock-kneed.

However, I don’t have any other of the complaints that I read about here....no pain on standing or walking, no problem bending my knees (can easily touch my butt with my heel, and not painful), I don’t need to use my hands when rising from a chair or sofa, and no pain when I do it. I do use a walker when going out shopping, etc, because I have one that I got after I had hip replacement due to a fall a few years ago. With the walker I can walk normally for as long as I need to, and I like the security it gives me.

Three years ago my GP prescribed Tramadol for my knee pain. It works very well for me, even with the small dose I take (1 1/2 pills a day, plus 1 Tylenol). For the past year I have been taking it only every second day because I want to avoid becoming tolerant. I feel completely normal after taking the Tramadol, and have no side effects.

So I’m undecided about surgery. I did see a doc two years ago who took xrays, confirmed arthritis, and recommended surgery.

i know at my age surgery can be risky, so I’m hesitating. And I read here that recovery can be long and difficult, so it’s hard to know what to do.

BTW, i am 81 years old, married (husband in very good health) and living in a retirement community.

I’ll very much appreciate any advice or comments on my situation.
thanks,

Happy
 

Jockette

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However, I don’t have any other of the complaints that I read about here....no pain on standing or walking, no problem bending my knees (can easily touch my butt with my heel, and not painful), I don’t need to use my hands when rising from a chair or sofa, and no pain when I do it.
Here’s my opinion, and it may differ from the others. It seems like you are handling your knee pain well enough. If it was me, I would wait until I had more issues. As we get older we all have some issues that we didn’t used to, I feel way older than my 65 years, but we still can manage well enough with some of them.

Recovery can definitely be very tough at times, and usually our medical team does not adequately prepare us for it.

Here’s some pre surgery information for you:

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries
 

Sara61

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Just out of curiosity what would your pain level be without taking any medication, Tramadol is quite strong, so it's no wonder that you have little pain, even with just taking it every other day.
I think the only person whom can advise you is your doctor.
 
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HappyHunter

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Just out of curiosity what would your pain level be without taking any medication, Tramadol is quite strong, so it's no wonder that you have little pain, even with just taking it every other day.
I think the only person whom can advise you is your doctor.
My pain level without medication.....well, it’s exactly like the “growing pains” I had at night, when I went to bed, when I was about 12 years old. My Mom would apply Sloan’s liniment and I could get right to sleep. I bought a bottle of this liniment about 35 years ago, still have a little bit left, and it still works ver well for my behind the knee pain. Too bad the original formula is not still available.
 

Bikeknit

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If I were you I'd talk this over with your primary care doctor. Questions to consider:

What other health issues do you have and how much would they be likely to affect your surgery outcome?

Are your knee issues stopping you from doing things you want to do? How important are those activities to you?

My Mom had a knee replaced in her 80s with good outcome but she had severe damage and excruciating pain (Don't wash your kitchen floor on your hands and knees as she did.). Her choices were knee replacement or life in a wheelchair. I've known at least one person with other health issues who had a bad outcome so I understand your concern.

Best of luck to you as you make this decision.
 
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HappyHunter

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Thank you for your response Bikeknit.

As far as I know I have no other health issues, but because of the pandemic I haven’t had my annual checkup yet this year. But I have no symptoms.

The knee pain doesn’t really stop me from doing things I want to do, as long as I can take Tramadol. Without it, sitting, and often sleeping is often a problem. I usually feel better when walking....is that unusual? It’s strange how my knees can be really bothersome at times, and yet other days almost no problem at all. Tramadol works so well for me. OTC medications do nothing for my knee pain, and I’ve tried them all, many times.

i guess what I’m concerned about is that I could go through this surgery and end up worse than I am now.

I’m thankful for this forum, and i appreciate all advice and opinions.

Happy
 

Celle

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Here's a chart to help you assess how much your knees are affecting your quality of life. That ight help you to decide.
Score Chart: How bad is my arthritic knee?

It might be a good idea to have another X-Ray of your knees, to see if anything has changed since your last x-Ray.

My mother had both her knees replaced in her eighties, one when she was 81 and one when she was 84.
She made a good recovery each time.

While she was never very active afterwards, she hadn't been active before surgery.
She died when she was 89 and, thanks to those knee replacements, her last 5 years were pain-free.
 

eaglemom

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You have received some really good advice to think through. Only you can really answer your question. For me it boils down to how does your knee impact your life - are you able to do what you want? Discuss this with your surgeon and you get to decide, not the surgeon.

Let us know how we can support you and what your decision is. And remember, just because you decide to post pone surgery for now, doesn't mean you can't readdress it in the future, if need be.
 
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kneeper

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Knee replacement is a major surgery. As others have said you will want to weigh how much the pain etc. is limiting your life and talk to your doctor about whether you are a good candidate for surgery.

Your doctor could also advise on whether adding a bit more tylenol over the course of the day would be ok. You do have to be careful about how much you take in total and also it may depend on any other medications you take and so forth.
 
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HappyHunter

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Thanks for your response Kneeper.
Tylenol doesn’t help my knee pain at all, not even a little bit. But Tramadol, even a very small dose (1 1/2 50-mg pills a day), works very well. I am concerned tho about becoming tolerant, so skipping every second day.
I’m wondering if others find that Tylenol doesn’t work for them? Or maybe it takes a few days for it to start to work.
I wish it did work for me, as I know I must be developing a tolerance to Tramadol.
i expect to be seeing a doc soon and I’ll see what he says.
 

Jockette

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We have found that Tylenol often doesn’t work for pre op arthritis, but it does very for surgical post op pain.
 

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