Do I or don't I?

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PieMan

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Confused, concerned and cranky - possible TKR

Dear Bonesmart members,
I have osteoarthritis in one side of my left knee - together with reconstructed ACL and now unstable PCL ( lower leg moves foward ) - motobike accident when i was 18. It is getting to the point where i must decide to have, suggested by consultant, a TKR - as quality of life is being affected. Given all the info available i find this a daunting prospect - i am only 45 ( a little chubby hence the name ) but fit and active, lots of walking, swimming and cycling - which i want to continue. Not sure if i should go ahead with a cemented floating bearing ( although i favour the non cemented ) or insist on a unicompartmental with reconstructed PCL.
Has anyone any thoughts - although i realise i have rambled and been a bit vague.
Appreciate any feed back.
Kind regards
 
Re: Confused, concerned and cranky - possible TKR

I waited for years on the insistence of my DR. Like you I was young and active but over the years of waiting I became more and more sedate because of the pain associated with activity. After 10 years of waiting I finally had TKR and now realize I sacrificed a large part of not only my life but my wife and childrens lifes. I should have done it ten years ago!

Make a decision.Don't wait
 
Re: Confused, concerned and cranky - possible TKR

I support what Max said. There have been many members of this forum who had a TKR at even younger ages than you. If you wait, you risk changes in your bones and muscles that will make recovery from a later operation more difficult. As for what to get, my opinion is that you need to find one or more good surgeons to discuss your case with and go with what they recommend. Reading and studying on what devices are available is wonderful so you can talk with them about options. But in the end, it's not the device....it's the skill of the surgeon and the facility in which he/she works that is the biggest factor for success. Hunt for the great doctor. Trust them. They are the professionals. Good luck to you and keep posting!!
 
Re: Confused, concerned and cranky - possible TKR

Hi there, PieMan, welcome to BoneSmart!

First thing you should take on board is that it's now getting to the stage where there is none 'to young' to have joint replacements. The criteria is determined by need, not age.

Secondly, you state "Not sure if i should go ahead with a cemented floating bearing ( although i favour the non cemented ) or insist on a unicompartmental with reconstructed PCL." The issue about total vs unicompartmental is more to do with what is suitable for your situation rather than your choice. Therefore, it will be for the surgeon to determine rather than you to choose. Fact of the matter is, no surgeon worth that title would do a uni now if 2-3 years down the line it ended up needing to be converted to a total!

So, as Jamie said, your choice should be focussed on a good surgeon with a good record and experince. And whatever prosthesis he uses, go with it as it will be one that he is getting good results with. Once it's in and being used, believe me, what prosthesis it is will be irrelevant!

You should also read this post and make a note of the questions How to choose a surgeon and a prosthesis. No reputable surgeon will mind being asked them and will have the answers on the tip of his tongue. If he does mind, exit his office immediately and find someone else!
 
Re: Confused, concerned and cranky - possible TKR

Pie Man
WElcome to bone smart. My first thought is you are not rambling, look at my last 2 posts, that is rambling.

I am a hippy (hip replacement). i thouroughly agree with Jo's and Jamie's advice go with the surgeon. I did that for a few operations and could not be happier. My surgeon is so awesome and so is my hip. I went with his suggestion for prosthesis as well as surgical technique. After finding this forum and reading Jo's advice I told him to use his preferred method.

Now my appple pie is calling me
Good Luck
Judy
 
Re: Confused, concerned and cranky - possible TKR

Pieman, welcome to the forum. I waited because of age, bad thing to do. Replacements last longer now. Besides, why waste your life? You will still be able to cycle, swim and walk after the recovery. Recovery can be longer for some than others. My ROM is taking longer than most (I am a year out today) but it doesn't stop me walking, swimming and I use an exercise bike, (invaluable in recovery). I hope to be visiting family and friends this April in the UK and we plan on going to the Lake District to do some hiking too.

So don't be afraid, it is wonderful to be painfree again after years of suffering, most of us TKR's will testify to that!! Good luck...Sue
 
Re: Confused, concerned and cranky - possible TKR

Hey Pieman, welcome. Go for it! I was 39 and had them both done. The difference is amazing. Really. And this forum is pretty amazing as well. The first weeks (6-8) are a little rough and will have you wondering what the heck you did and why, but it continually gets better and then one day you wake up intears of joy because you can move without pain. Regards.
 
Re: Confused, concerned and cranky - possible TKR

Hi Pieman

What a great name ;)

I agree with everyone else. Get a surgeon you trust and let him make the decision. I was the same as you and tried to push for a partial replacement but my surgeon told me that if he did that I would be back to see him in a year or two.

I am 52 years old and am only 7 weeks post op but when I think back I wish I had done this sooner
 
Re: Confused, concerned and cranky - possible TKR

Pieman, Welcome to the forum. The surgeon is the key to this whole thing, and he will decide what you need, not the other way around. I don't even know what knee I have, don't care, I know I had the best surgeon in the area, I researched long and hard to find him, spoke to people he had operated on, spoke to nurses who worked with him and even spoke to doctors who trained with him. He was recommended by the head of the ortho department at the University who did my scopes. By the time I met him I felt like I knew him and he proved to be all they said and more. This is a big surgery and it takes time to recover from it no matter what your age or physical condition prior to surgery although you want to be in the best physical condition possible for the surgery. It will, literally, give you your life back so long as you do your homework. Remember, while it is good to be well-read you are not the one doing the surgery, it is far better your surgeon be the best. Good luck. Rowdy
 
Re: Confused, concerned and cranky - possible TKR

Welcome to our happy bunch of robo-knees! I will second, third, etc. what all of my compatriots have said. I went with Jo's sage advice and made my decision based on the surgeon. He replaced my knee with a DePuy posterior stabilized prosthesis. Like you, I thought I would prefer to keep my PCL, but I knew that he was an excellent surgeon and had his preferences for a reason. I am now a bit over 5 months out and my knee bends to around 150 degrees. That's more than enough bend for any of the activities you want to continue to pursue. Having the prosthesis put in as close to perfectly sized and aligned as is humanly possible is the most important consideration. Use your time researching surgeons instead of prostheses.
 
Re: Confused, concerned and cranky - possible TKR

Dear Bonesmart members,

Thanks for all your replies - it does help to reset perspective, you can get a little obsessed with prothesis rather than trust the surgeon - i think the overall gist is to get the best surgeon possible - sound advise. I will start that process now. Anyone got any idea's on who they may or may not recommend/trust in London or Southeast England ???.
Once again thanks for your replies, they really do help - maybe i'm being a bit girly about the whole thing but the thought of someone slicing my bones about almost puts me off a pie.
Kind regards
 
Re: Confused, concerned and cranky - possible TKR

Welcome, I'm new here too :)

I'm only 30 but I've already had a hip done (nine years ago) and I'm getting ready to have my other hip and one knee done in March. I'm really looking forward to a pain-free life, and being able to hold my baby again!
 
Re: Confused, concerned and cranky - possible TKR

Well, PieMan already knows (via pm) that I rate the #1 hospital in the UK as

THE ROYAL NATIONAL ORTHOPAEDIC HOSPITAL!



Just in case you're in any doubt, PM!!
 
Re: Confused, concerned and cranky - possible TKR

That's a dead link, akvenkat.
 
Re: Confused, concerned and cranky - possible TKR

Seconding and thirding everyone here, PieMan. I waited until I was 51--my former orthopedic had started recommending it when I was in my late 30s but I thought putting it off longer was better. BAH! PTOOOOIE!

basically I lost a little over a decade of quality of life and became increasingly crippled and developed hip and back problems because of walking so funny. Get it done, get through the recovery, and start enjoying walking again!

I can't wait until after Thursday to be on the other side of my second TKR...and I'll be biking miles and miles by summer WITHOUT pain!

weezy
 
Re: Confused, concerned and cranky - possible TKR

Seconding and thirding everyone here, PieMan. I waited until I was 51--my former orthopedic had started recommending it when I was in my late 30s but I thought putting it off longer was better. BAH! PTOOOOIE!

basically I lost a little over a decade of quality of life and became increasingly crippled and developed hip and back problems because of walking so funny. Get it done, get through the recovery, and start enjoying walking again!

I can't wait until after Thursday to be on the other side of my second TKR...and I'll be biking miles and miles by summer WITHOUT pain!

weezy

Dear Weezy - why did you wait from late 30's to 51 to get the TKR ? was your reasoning that it wasn't bad enough to under go this invasive surgery, you seemed to be functioning on an OK level ? and so to warrant the op you had to wait until pain levels were such that you had no choice? So if you had the time again would you have had the TKR much earlier ? or did you wonder about revisions ? I have always known that i will need a replacement at some time i would like to put that off for as long as possible but yet at the same time i still want to continue to ride my bike in cyclo races - last year did 300k in a day in sweden ( needless to say there was some pain involved but topography was in my favour ) and walk across the scottish highlands ( this really hurts ). I must admitt that "good" knee is taking a bashing at the moment and that worries me - already have popped something in there ( lifted daughter on to shoulders and put all weight through good knee and pop - not nice ) have a bit of a bump there now. As i said i'm certainly confused, definietly concerned but probably more grumpy than cranky.
 
Re: Confused, concerned and cranky - possible TKR

Hey PieMan---so----what is your favorite pie? :)

I waited because 20 years ago the norm was to NOT do TKRs until the patient was in their 60s or older. My OS at the time was great, and while he recommended I get it done, he also told me the down sides of having it done that young--but that was back then and now there is another 20+ years of experience with TKRs and longevity.

So...I waited for two reasons--one was the fear of having the knee wear out when I was in my 40s or 50s (and apparently this has not been the case with most younger TKRs), plus I had had so many major knee surgeries throughout my life that I was very hesitant to do it because recovery from my last major surgery had been pretty miserable. I knew how debilitating it would be, and I was single and living alone and decided it was easier to just live with it as best I could.

HOWEVER--knowing what I know now, I would have done it sooner if the technology was as good then as it is now. :) Plus, I'm married now to a fabulous man who it very supportive and helpful during the rehab, and that makes a big difference too. I have nothing but admiration for people who live alone and get do this!

I'm looking forward to this summer with two bionic knees and minimal to no pain and hubby and I are planning on being on the bikes by March (I have an exercise bike inside).

Weezy
 
Re: Confused, concerned and cranky - possible TKR

Aahh Weezy - thats a good question - whats my favourite pie - just lovely to mull the words over in my mind. Probably easier to tell you what pies i don't like - none !. Never met a pie i couldn't unhinge my jaw for.
Once again good luck in your surgery.
Kind regards
 
Re: Confused, concerned and cranky - possible TKR

I am having my TKR under Mr Moftah at The Darent Valley Hospital, Darenth, Kent I am having the op 4 weeks today so I cannot vouch for his surgical skills but he has an excellent reputation. He put me off for a couple of years because of my age but finally agreed that surgical inervention was required in September. I had a look at the comparison of hospitals in the area for this op and it comes in with a higher percentage rate out of 3 hospitals.
My only gripe about the procedure so far is the lack of information, as I mentioned on another thread I have learnt more about the procedure from this forum than the hospital, although I appreciate its up to me to ask questions!!
Good Luck
 
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