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TKR In a quandary...TKR or wait??

Ohknow

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Hi new Bonesmart friends! I have OA in my right knee. It was diagnosed about 8 years ago. In order to avoid/postpone surgery I made numerous lifestyle changes - switched from aerobics and lap swimming to water aerobics and pilates, wear a knee brace, learned to drive with my left foot, etc. Over the years I've had 4-5 cortisone shots and take a prescription anti-inflammatory (Meloxicam) as needed. I was able to manage the knee with almost no pain. Flare ups were minimal and easily managed.
I have always been athletic and recently got into hiking and biking. Well...it didn't go very well. My knee blew up and learned that my AO is now bone on bone in several places.
Here's the thing: I'm not in much pain at all (maybe 2-3). Just a base level of discomfort - almost all the time. The knee doesn't like stairs, and my walking is down to 1 to 1-1/2 miles (I could do 3 miles just fine before).
I've been doing PT 2x week to get the leg muscles as strong as possible. But my PT and 2 surgeons are telling me "it's time to make a decision." I have plateaued in PT. I can go on like this or bite the scary bullet.
I really thought I had 2-3 more years and this is a shocker! Do I really need major surgery?? Is it worth it to do it now? I worry that if I don't, I'll get weaker and make for a harder recovery.
I'm so scared about what life will be like afterward. They tell me "it won't feel like your real knee." What does that mean?? Help me out folks! I'm so glad I found this forum!! I've been lurking but now it's time to open up. What do you all think? Has anyone waited and regretted it? I'd also love to hear from anyone who wants to pursue sports, hiking, biking afterward - how has it gone for you? Anyway, thanks for reading this long post!!
 

Pumpkln

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@Ohknow
Welcome to BoneSmart, glad you joined us! :welome:

Sounds like your quality of life is compromised, this happened so slowing that you have not notieced that you have changed your exercise program, getting into hiking and biking blowing up your knee, you have a hard time with stairs, and you are walking half the distance you used to walk. Your OA will only get worse limiting your life even further a little bit at a time.
Recommend you seriously consider proceeding with a TKR.

I am going to leave you some reading, pay attention to the score chart, you will want to take it so you can clearly see how limited your life has become.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best 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
 

Pumpkln

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We are all scared going into this surgery, it is a major decision.
What you are experiencing is normal.
 

FCBayern

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I know in my own case @Ohknow I wish I had done it earlier, I really believe my recovery would have been easier. The longer that muscles and tendons tighten or loosen to protect the joint, or that we limp just means more soft tissues that will not be happy after TKR. The fact that hadn't been able to move much and had lost all muscle tone also prolonged the time until I felt better. My replaced knee doesn't feel unnatural at all to me, I seldom even think about it anymore.
 
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Ohknow

Ohknow

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Thank you! I'm sorry you had a longer recovery but great to know that the new knee feels good. That is very encouraging to hear!
 

FCBayern

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I'm comfortably doing thing I haven't for 20 years because my knee slowly grew to rule my world, no longer! I'm back in charge again! :yes!:
 

DJL1967

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My BTKR surgery has been put on hold a couple times now due to Covid. I should have had surgery last summer and boy do I wish it had been done. I am an active person with a very high tolerance for pain and these knees are taking me down. I am hoping to have surgery sometime this summer if all goes well with the hospital situation. My condition has gotten worse in the last 7 months and I do not expect it will get any better but, only worse with time. I know its a tough decision and the surgery is nothing to take lightly but I'm done with the constant pain and limitations I am experiencing daily.
I wish you luck with your situation and welcome to bonesmart. This is a great place with great people who have a wealth of experience.
 

Roy Gardiner

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I'd also love to hear from anyone who wants to pursue sports, hiking, biking afterward
100% yes. With straight, strong knees I'm a better cyclist now than before BTKR.
recently got into hiking and biking. Well...it didn't go very well. My knee blew up
Hmm cycling is low impact - why not try gentle riding (to start with) and no hiking. I couldn't walk 100 metres but I could ride almost up to the day.

My take on the decision making process

- if your knees rule your life , it's time
- take charge, don't be dictated to; it's your knee, your future
- don't believe in either horror stories or miraculous recoveries that happened to 'a friend of a friend'
- there is no such thing as too young or too heavy or even obese for TKR
- choose a specialist surgeon who does several hundred TKRs a year. Ask the nurses, if you can; they know who's best
- all replacement knees are very similar, don't believe that a special new one will give magical recovery -- it's the skill of the surgeon that counts
- if you need two done, think carefully about the time gap between surgeries, it's not a trivial decision
- try to plan for at least 12 weeks off work
- your recovery is your time to be selfish and idle; plan to embrace this, you'll need it
- don't think you can work hard (even if you're an athlete ) to speed recovery, healing works at its own pace
- look at our FAQ (Frequently Asked Questions) thread and for full reference the Library index.

- finally, if there's any part of this that you aren't clear about, ask here; it's what BoneSmart's for.
 
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Ohknow

Ohknow

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Thank you all for these thoughtful responses! I didn't know about the FAQ or Index. Huge help!
 

Jaycey

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@Ohknow In my case it was a bad hip that I limped on for over 3 years. Waiting all that time just caused more complications and a much longer and more complex recovery. Your body will adapt to trying to stay off that knee pre-op. All that impacts other areas.

Sounds like your world has already narrowed to compensate for this knee. Get it replaced and get back to living again!
 

Carmencita

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Hi @Ohknow - my goodness your post is like it’s me speaking! Have a look at my thread please! I have driven myself nuts with the should I shouldn’t I, I am v active, I dread the thought of what may go wrong, will fell like a false joint etc etc......

But the supportive people on this forum have all been there, and they are absolutely right, and I have gradually come round to the decision that now is the right time (I go in Friday)! Just returned from pre op.

All I can say is (what others have said to me), are you thinking about your knee - a lot? Are you compromising your activities (eg. miles walked, up and down stairs etc) because of your knee? Is your knee stopping you from doing stuff you enjoy? Is your knee ruling your life?

It’s a massive, scary decision. I wasn’t in much pain until I started having bleeds into the joint. But before then I was extremely active and able to manage. Bonesmarties have encouraged me all the way, and while you are fit and relatively young, your recovery is hopefully likely to be reasonable, rather than waiting until quads start to shrink, muscle wastage, pain, etc etc.

Anyway, keep reading on here. There are some horror stories but there are also many uplifting and encouraging ones - and as the moderators point out - most knee replacements are successful and people don’t feel the need to post, talk about it they are too busy enjoying life with their new knee/s!

Best wishes, whatever you decide.
 

Bikeknit

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For comparisons sake, I'm moderately active. I bike, I hike, and I cross country ski. Just not all the time and not super long distances. When I was deciding I realized I had 3 choices as OA doesn't reverse itself.

1. I could never get my knees replaced and gradually become more debilitated, spending my old age in a wheelchair.

2. I could wait a couple of miserable years walking less, doing less, hurting more and getting more out of shape but then have the surgery.

3. Or I could go ahead and get my knees done and start hiking and doing things I love again. Like Roy, I never stopped biking though near the end of a 2 week bike trip I had a couple of days when my knees were so sore I couldn't walk ( but I could bike, go figure).

It's serious surgery and no one should go into it without researching your surgeon and options. If you are still going to a physical therapist you might ask them whose patients seem to do well post surgery. I'm very happy that I picked option 3.
 
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Ohknow

Ohknow

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@Bikeknit
Yes, I am coming around to Option 3 myself. I've started the initial process and have selected my surgeon. Thanks so much for your feedback! It's so encouraging that you can do so much in a relatively short time since your surgeries - wow!
Keep on biking! :loll:
 
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Ohknow

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@Carmencita
Oh my goodness - you're having your surgery on my birthday - tomorrow! I'll be so eager to hear how it goes. I looked at your thread and I'm looking forward to going through this together. I've decided to move forward.....deep breath!
Best of everything to you tomorrow!!
 

Carmencita

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Hey @Ohknow you have a date! I hope you feel a little easier now you have made the decision. I will be looking out for your posts. Good luck and thank you for your messages of support for me.
 
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Ohknow

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@Carmencita
You know how it is....countdown to March 18 but sooo much to do to prepare!! YIKES.
I was hoping for the 25th but we had to move it up a week.
Getting to the decision was really hard...now it's waiting and shaking. :)
 

chimaek

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@Ohknow Your symptoms sound very much like mine. I'm on the fence now about having a replacement. I would like to hear how it goes. Best wishes!
 

Carmencita

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Hi @Ohknow

Just stopping by to say all the best for tomorrow, will be thinking of you and looking out for your recovery posts!
 

BBCG

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Hi Ohknow,

By now you are nearly a month along, and I wasabout to chime in but let me just say I was not glad I had done the TKR on my left knee until about 2 months out! The recovery is the pits but once you are well in the other side, I bet you’ll be so glad you did it! I waited 5 years between, with my activity level lessening every month due to pain and attendant issues.
 

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