Introduction and BTKR Conundrum

alexlda

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Hello everyone. I recently joined this forum. I have to have both of my knees replaced and would really like to have BTKR. I am 54, 5'8 and 145lbs, and I have RA but relatively good health otherwise. The only surgeon I have lucked up on (2nd op) who will do BTKR is now discouraging me from doing it saying the risk is not worth the convenience. I am going back to my original surgeon who said I only needed a partial knee replacement, but the 2nd op. surgeon says because I have RA, I have to have a total. So I am going back to my other surgeon to ask if he just missed that or if he has a different opinion. I was wondering if those on the forum who have had BTKR and live in the Atlanta, GA area could chime in with some surgeon recommendations.

Glad to join this community and looking to gain some knowledge to help me make some decisions so I can have surgery in the next few months.
 
I am going to Midlands Ortho in Columbia, SC. Dr. Thomas Gross for bilateral in November. He performs the surgeries two days apart. He came highly recommended.
 
Welcome @alexida! Here is some information about a bilateral tkr. https://bonesmart.org/forum/threads/bilateral-tkr-having-two-knees-done-dont-compare-surgeries.7895/

Also, to help you be prepared for surgery, I will give you some more articles to help you.
Here is some pre-op information for you:

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?

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

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


If you have any questions, fire away - we're here to help! Again, welcome to the best tkr site online!
 
My first knee replacement was a partial. It lasted for 11 years, which is much longer than many partials survive.
Because osteoarthritis tends to progress (sometimes quite quickly) from one knee compartment to another, many partials have to be revised to a total within a short space of time, sometimes within the first year.
When it was time to have my second knee replaced, I chose to go straight to a total.

In spite of what some surgeons say, it can take just as long to recover from a PKR as it does to recover from a TKR.

While many partials (PKR) have a short life span, a total (TKR) can last for 30-40 years.

If you decide to go for a PKR, do make sure that your surgeon is prepared to do a TKR if he/she finds during surgery that your other knee compartments are starting to develop arthritis.
 
is now discouraging me from doing it saying the risk is not worth the convenience.
The convenience or the INconvenience? I really don't understand these chaps who advise against Bilats. Most of the surgeons I've worked with over the years have done oodles of bilats!
I am going back to my original surgeon who said I only needed a partial knee replacement, but the 2nd op. surgeon says because I have RA, I have to have a total.
I agree with #2. You would be much better off having a total.
He performs the surgeries two days apart.
Ugh! I cannot conceive of having this major surgery two days apart! What's the point?
 
@Josephine, I inquired about doing both knees at the same time but was told this surgeon spaces them out to minimize blood loss.
 
Really? I don't see the logic in that. And I seem to remember from my days scrubbing for knee replacements, that blood loss was minimal anyway!
 
My surgeon did not hesitate over BTKR. He is a good guy; if the risks were in any way significantly higher, I'm sure he wouldn't consider it. I wholeheartedly recommend BTKR; one surgery, one recovery.

There are lots of surgeons. Ask nurses, if you can. They know who's best.
 
Thanks everyone. I went back to my original surgeon, who has agreed (with no hesitation) to do the BTKR. I am thrilled and terrified at the same time. I plan to schedule my surgery for early Jan or Feb. 2018.

I am most concerned about how much more painful BTKR will be. I plan on doing a lot of studying between now and then.
My surgeon also said he uses Conformis and Lima implants. I'd love to hear opionions on these implants and also experiences of BTKR patients.
 
I'd love to hear ... experiences of BTKR patients.
100% positive

The first few weeks are tough, without doubt; but it's not more painful, it's just both at once. And you've automatically halved the recovery time as both are healing at once, and after the surgery it's ALL OVER and you just concentrate on getting better.

You will need a good support structure for the first few weeks. Can you live on one level in your house? Do you have someone to help you in that early time?
 
Thanks Roy. That is helpful. I do have a bedroom on the main floor of our house that I can stay in for a while. I expect that I will safely learn how to climb the steps in my house while I am in rehab, as my adjustable bed and walk in shower are in our master.
My MIL, who is a retired nurse, has agreed to come and stay with me while I recover so that is a blessing. I love my hubby, but he will be somewhat useless for anything other than reminding me of his 2 TKRs.
 
I expect that I will safely learn how to climb the steps
Indeed. But you won't want to. It's slow, painful, tiresome. I went from bed to living floor and back just once a day.
My MIL, who is a retired nurse, has agreed to come and stay with me while I recover so that is a blessing
Excellent. You will spend lots of time just sitting and watching telly or reading (although nothing demanding)
I love my hubby, but he will be somewhat useless
Really? That's a bit damning, some of us take it that when our wives (no wait I've only one wife) are ill or incapacitated it's our time to step up.
 
I was definitely not trying to be damning. I just know my husbands capabilities, and he is not a caretaker. He will certainly step up and be as attentive as he can. But a lot of things won't get done until I am able to do them. I understand this & will prepare for that. I also acknowledge the possibility that he could surprise me...& that would be great!
 
My experience has also been 100% positive... and it was so right away. There was pain, but I don't think it was any worse than for a single TKR. Pain meds took good care of that. And the gentle recovery guidelines of BoneSmart meant I had little pain after stopping the opioids.

Walking was difficult at first because, well, I didn't have a good leg to stand on. :heehee: But within a couple weeks I had TWO good legs to stand on!

Rehab in the hospital showed me how to get into and out of cars (painful at first but gets better as you get better) and how to climb and go down stairs using a cane. It's very doable, but slow and painful at first. Roy is right that stair climbing is unpleasant enough you will want to limit your trips. When I came home from the hospital, I immediately climbed the thirteen steps to my bedroom and pretty much stayed up there for a week. As with you, our shower is on the second floor and I shower daily. I needed a tub bench to get in and out of the tub/shower for many weeks.

I needed a walker for three weeks; used a cane for a couple weeks after that; and at two months I was walking well without a cane, but still took my cane with me for long walks or any visit (reason for visits: low toilets and needing a cane to help get up from them).

My home care came by way of my husband. Mr. Shoes could not have been more attentive and he learned how to cook a little. I was back on my feet and cooking again (simple meals and I sat down a lot) in four weeks. He did all the grocery shopping, errand-running, housecleaning and laundry for a couple months. I bet if your mother needs help, your husband will step up to help. :)

I'm now nearly five months out from my surgery. Five months with two new knees. My knees don't hurt and only occasionally feel stiff. I can walk all I want to without a problem, climb stairs without thinking twice about it, and only wish I had done this sooner!:happydance:
 
Thank you for this Susie. I was reading your recovery thread last night & will likely refer to it frequently as you had a textbook recovery. I am going to do everything possible to have a great recovery also.
 
@alexlda, I hope you have a great recovery also! I hung out here on BoneSmart for a few months before my surgery and the information I picked up sure came in handy. @Roy Gardiner was my role model for recovery. I hoped I would have a recovery as good as his. His recovery thread is loaded with great insights and tips, especially about exercises.
 
Good to know. I will study Roy's recovery thread as well.
 
You know, if you go into the knee recovery forum and find a thread with this prefix
Bilateral TKR.JPG
and click on it, it will give you a list of ALL the threads with that prefix.
 
Thanks Josephine. I'll do that.
 
Having a bilateral, I can't compare whether it would be more or less painful than a single, but it wasn't nearly as painful as I imagined (drugs are your friend).

The stabbing and aching bone pain was completely gone, and replaced by muscle pain. Somebody on this site once described it as feeling like you were in a cage fight with a tiger, and for me, that was pretty accurate.
 

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