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TKR Experience from those who were "morbidly obese" and had TKR

ncgoaliemom

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Hi all, I'm brand new here and I'm hoping to get some insight for any of you that were considered morbidly obese and had TKR. I'm going to need both knees done, and while I wish I could have both done at the same time, I've been told that's not the best way to go and that I should do them one at a time

I'm 5'8 and about 285. If you are around that range, did you have any complications? I've been on a weight loss journey for the last year and a half and was able to drop 70lbs with 5 days in the gym and calorie deficit, but the knees have gotten so bad that I'm not able to do the gym anymore and the calorie deficit I have to stay in to lose weight without the gym (thanks crappy thyroid) isn't sustainable and then it triggers disordered eating so I've been gaining/losing the same 20 pounds for the last 6 months, so getting my knees done is definitely a needed thing so I can get back in the gym.

If you were obese what did your recovery look like? And how much time did you need to take off work? I work from home now (thanks to covid) so I thought I could take a week off, but I've been told thats probably not remotely enough time. I'm just curious what other peoples experience was like.

Sorry for such a long post, I'm just filled with so many questions and really anxious about how much time I will likely have to take off. Sick pay isn't the issue, I have unlimited, but I run a department with 16 direct reports and I'm afraid all h#ll will break loose if I'm out too long. I have to answer way too many questions every day to be out for very long.
 

Jaycey

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@ncgoaliemom Welcome to BoneSmart! Your recovery won't necessarily be different that other members who might weight less. It's all about how you personally react to the procedure.

Key for you is finding a surgeon who will do the surgery on a person with your BMI. There are some out there! I assume you are in North Carolina (by your user name). If you would like a recommendation for a surgeon who works with patients with high BMI, please give a shout and I will post the details.
And how much time did you need to take off work?
I am afraid you are going to have to set your priorities on this issue. The recommended time off work is 10-12 weeks and then a phased return. You simply will not be ready in the early weeks out. There is pain, loss of concentration and energy drain.

Take a look at this article Activity progression for TKRs. It might help you set more realistic expectations. This recovery can take one year or longer.
 
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ncgoaliemom

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@ncgoaliemom Welcome to BoneSmart! Your recovery won't necessarily be different that other members who might weight less. It's all about how you personally react to the procedure.

Key for you is finding a surgeon who will do the surgery on a person with your BMI. There are some out there! I assume you are in North Carolina (by your user name). If you would like a recommendation for a surgeon who works with patients with high BMI, please give a shout and I will post the details.
I would love any recommendations you have. I'm going to see Dr. Gilbert next week who does the minimally invasive robotic assisted TKR. I don't know what his thoughts are BMI yet. I just know that my MRI is not good and the shots (ortovisc) are no longer working on either knee, but my right (the one that hasn't had any surgeries yet) is the worst and then the left (has had 6 previous surgeries) is right behind it.
 

Jaycey

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This surgeon is on our recommended list:
Dr. Ralph Liebelt
120 William Penn Plaza
Independence Park
Durham, NC 27704

Phone: 877-959-2856

Works with high BMI patients.
 
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ncgoaliemom

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He's actually in the same practice as the guy I'm seeing. I'm just seeing the one that is in Raleigh/Apex because it's closer to home. Durham is about an hour away for me. I feel good that they are in the same practice.
 

leejaa

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I was quite heavy for my knee replacements - I am trying to remember what the weight was - must have been about 230-250 range but I am only 5'4". I had no issues with the surgery and recovery. My main health issue besides the weight was high blood pressure but with medication it was controlled. The BP like my osteoarthritis is a family inheritance but well controlled.

Recovery was not impacted by my weight as far as I could tell. I actually returned to work part time at 6wks which was very difficult but necessary since I could only take 12 weeks off in a calendar year and I had to have both knees done in the same year.

My surgeon actually did not say anything about my weight and I did not either. He was a very experienced surgeon whose primary practice is knee and hip replacements so that might have made a difference.

Best wishes that you find a surgeon you like and trust and who has no issues with your BMI.
 

Roy Gardiner

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Many people with high BMI have successful knee replacement. One unexpected benefit is that your bones will be dense and strong supporting the weight - no, that's not a nasty dig, it's nothing but the simple truth.
the knees have gotten so bad that I'm not able to do the gym anymore
There is much you can do - weight lifting, say - sitting down. You may be able to get a trainer at the gym to coach you. You will put on muscle, which is much denser than fat and requires energy to maintain, which will help lift your body's need for calories. Perhaps also you can still ride a stationary bike?
the calorie deficit I have to stay in to lose weight without the gym (thanks crappy thyroid) isn't sustainable and then it triggers disordered eating so I've been gaining/losing the same 20 pounds for the last 6 months
Allow me to recommend 'In defence of food' by Michael Pollan. It's not a diet book, but helps to define good eating.
 
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Bishop

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Thank you for putting this out there! I was going to post about this today. I have hypothyroid -on high amount of Armour thyroid. I’m up to 214 at 5’4” my Dr didn’t mention weight at all. I smoke 2 cigarettes a day - he did say I need to stop that so I’m trying but w the pain..I do it. I was197 in July but nearly stopped walking and had to cut down to PT at work due to severe pain. Trying not to gain more since now so sedentary. Thanks for the questions and replies!
 
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ncgoaliemom

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Many people with high BMI have successful knee replacement. One unexpected benefit is that your bones will be dense and strong supporting the weight - no, that's not a nasty dig, it's nothing but the simple truth.
the knees have gotten so bad that I'm not able to do the gym anymore
There is much you can do - weight lifting, say - sitting down. You may be able to get a trainer at the gym to coach you. You will put on muscle, which is much denser than fat and requires energy to maintain, which will help lift your body's need for calories. Perhaps also you can still ride a stationary bike?
the calorie deficit I have to stay in to lose weight without the gym (thanks crappy thyroid) isn't sustainable and then it triggers disordered eating so I've been gaining/losing the same 20 pounds for the last 6 months
Allow me to recommend 'In defence of food' by Michael Pollan. It's not a diet book, but helps to define good eating.
When I say I can't make it to the gym, I mean the amount of walking necessary just to through the gym parking lot and to do my workouts leave my pain significant enough I need pain meds, that's before I attempt a workout. I had given up on legs months ago and have been staying with upperbody/abs. Then the last couple of months, just getting to the gym is too taxing. I've been doing leg lifts and resistance band work at home, but it's not the same level of workout by any stretch of the imagination. The stationary bike is a huge NO. I tried my spin bike a few weeks ago and each rotation was painful.

My diet is on point. I'm vegan, I count macros, I'm in a deficit, but unfortunately, without being able to work out my deficit level to lose weight without exercise is really low and just not sustainable long term.
 
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ncgoaliemom

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Thank you for putting this out there! I was going to post about this today. I have hypothyroid -on high amount of Armour thyroid. I’m up to 214 at 5’4” my Dr didn’t mention weight at all. I smoke 2 cigarettes a day - he did say I need to stop that so I’m trying but w the pain..I do it. I was197 in July but nearly stopped walking and had to cut down to PT at work due to severe pain. Trying not to gain more since now so sedentary. Thanks for the questions and replies!
Right there with you. I'm on 180 Armor every day.
 

Bishop

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I’ve been doing my upper body free weights while sitting in an exercise ball to keep my core a little good.
 

Roy Gardiner

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When I say I can't make it to the gym, I mean the amount of walking necessary just to through the gym parking lot and to do my workouts leave my pain significant enough I need pain meds, that's before I attempt a workout. I had given up on legs months ago and have been staying with upperbody/abs. Then the last couple of months, just getting to the gym is too taxing. I've been doing leg lifts and resistance band work at home, but it's not the same level of workout by any stretch of the imagination. The stationary bike is a huge NO. I tried my spin bike a few weeks ago and each rotation was painful.
Fair enough, no disrespect was intended and I apologise if I gave that impression.

I thought I was bad enough, but not being able to walk across the lot - wow. And I could ride my bike up to a couple of months before surgery.

Best of luck with the upcoming surgery.
 
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ncgoaliemom

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When I say I can't make it to the gym, I mean the amount of walking necessary just to through the gym parking lot and to do my workouts leave my pain significant enough I need pain meds, that's before I attempt a workout. I had given up on legs months ago and have been staying with upperbody/abs. Then the last couple of months, just getting to the gym is too taxing. I've been doing leg lifts and resistance band work at home, but it's not the same level of workout by any stretch of the imagination. The stationary bike is a huge NO. I tried my spin bike a few weeks ago and each rotation was painful.
Fair enough, no disrespect was intended and I apologise if I gave that impression.

I thought I was bad enough, but not being able to walk across the lot - wow. And I could ride my bike up to a couple of months before surgery.

Best of luck with the upcoming surgery.
oh, no offense was taken. Sorry if I came across that way. Yeah the bike is a HUGE no. I think because my patellas are the worst of all. My MRI says HIGH grade of chondral loss/fissures - which I'm translating to, my patella is grinding on my femur. They told me I needed a patella replacement on the left knee 6 years ago, but the synvisc seems to keep me tolerable, but the right... not even the shots help that one any more. It's well over due I suppose.
 

Roy Gardiner

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oh, no offense was taken. Sorry if I came across that way
no apologies necessary. It's hard on boards to detect nuance, I just wanted to make sure.
It's well over due I suppose.
It really does sound like your knees rule your life (they did mine). If so, yes it's time.
I'm going to see Dr. Gilbert next week who does the minimally invasive robotic assisted TKR. I don't know what his thoughts are BMI yet.
Many people with high BMI have successful surgery, and it sounds like you're doing everything possible to control weight; let's hope he's OK with you.
 

Grammy1

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I had TKR in September so approx 14 weeks out- I weigh about 230 lbs 5’7
I hated to walk through the parking lot, go to grocery, Christmas shop or anything else where I had to walk.... I knew I was done and ready to get it taken care of, weight was not an issue with rehab, I lost weight the first few months .... but you must be prepared to take off work for at least 8 weeks, you will be so sore, and groggy, and just tired, it’s takes alot out if you, BUT
You will get there, listen to these recommendations these people are giving you, they work!!!
PT hurts, you already hurt and this makes it hurt even more, your scared because you don’t know what to really expect. This procedure and recovery is just as much mental as it is physical!
I am soooo happy I did not wait any longer to have this done! I can now walk without the pain!! Good luck!!
 

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