TKR Its been worse than childbirth! Did I make the right decision?

[Celle]

I think the fit matters most. And we, the patient, can't know what will fit unless we choose a doc who does custom devices.

That's not exactly true, Jane. If you have a good surgeon, he/she will make sure that the prosthesis fits you, whether it is a custom device, or not.
That's because, once an appropriate size is chosen, your bones can be cut to fit the device exactly. Sometimes this cutting is done using a computer-assisted programme and sometimes the surgeon (with appropriate experience) can do it alone.

Custom made or "off the shelf" it is still the skill of your surgeon that is paramount.

 

[kneeper]

Everyone's been giving you good suggestions. I can tell you I was taking pain meds every four hours at least into week 5. I think around week 6 I started spacing them a little. The knee is the boss.

 

[Djbrund]

THE KNEE is, indeed the boss!

 

[Jane B.]

Thanks, Caryl. It hadn't occurred to me that the ortho would cut the bone to fit the device.

I wasn't clear, which often happens. I meant that if we choose our surgeon wisely, chances that fit, alignment, device selection will go well.

 

[kneegone]

Thank you all for your words of wisdom. I really needed it because it seemed so discouraging that I wasn't making much progress. Today is one day shy of my 1 month anniversary and even though I didn't sleep well, waking up in pain, I took 3 dilaudids at 6am and was able to get some good sleep. When I finally got up, I felt like my knee felt stronger. I did some leg lifts in bed and was able to get some good knee slides in. I think I improved, but I'll wait for my P/T to confirm later today. Mentally, I finally feel more hopeful. It's so comforting to know others in the same stages.

I think I was also stressed that I wasn't going over 90 degrees because pre-surgery, that was what my knee could do and I was depressed that after surgery, after all this pain, I wasn't able to improve on that. But I understand it's the swelling and hopefully, I made the right decision with this surgery and will be able to ride a bike, play tennis, and hike one day! I am hopeful. Thank you all again for your good wishes. I very much appreciate the kindness of strangers.

 

[kneegone]

My doctor only requires a 6 week follow up visit for xrays and consult and then a visit one year later. I'm concerned because it seems other doctors require 6 week, 3 month, 6 month, and 1 year visits post op.
In addition, because I'm going on vacation, (pre-planned 6 months prior surgery), the doctor wants to see me at 4 1/2 weeks because I will actually be away at 6 week period. So that means, I will not have an official 6 week visit. In addition, because my insurance plan is changing from a PPO plan to HMO (not my choice), my doctor/hospital will not be covered under the new plan. Therefore, the office offered a "virtual" visit at 1 year, where I can get xrays done locally and have them sent and he will have a consult with me over the phone.

What do you guys think? Isn't it unusual to have only 1 post op visit and then a visit a whole year later? Of course, the office said, if I was having problems, I could contact them, but how will I know if I'm on "schedule" with my recovery?

 

[sjnyc323]

@sjnyc323
Where did you get your surgery done? I went to HSS in NYC.

I had my revision on my 19 year old implant on 7/31/14 at New York Methodist Hospital. Same doc did my original and my right knee. Dr. Henry Tischler

Suzanne

 

[Roy Gardiner]

to ride a bike

Me. Tuesday: 56 miles @17.1mph; today, slow day 45 miles @16mph. Tomorrow, 1 hour of training on the Olympic velodrome.

Yes, you will.

 

[speccybecky]

Nope, normal here. I was scheduled for 6 week post op visit, but as I was I'll it turned in to 8 weeks check up. The next one was at 1 year and will be followed by 5 years and 10 years. I also was told that if I had any problems to phone the hospital as they wanted to be the first to know of any problems.

 

[Layla290]

I had 4 post-op visits. At the last one (4 months post-op) was told I did not need to come back for anymore follow up visits unless there was a problem. I was surprised because I thought I would need to come back in a year for a check up. I guess every ortho is different.

 

[Celle]

It's not a month yet since your surgery. You're already at 90 degrees. Don't worry about your ROM and don't expect it to improve quickly. There's plenty of time. Remember that ROM can continue to improve for a year or more after surgery. There's no need to rush.

 

[joemz]

a week prior to surgery i asked the ortho's nurse what kind of new knees i would get. She said Smith and Nephew, but the exact model and size would be determined in the OR. She said that one of the releases i signed was to allow the manufacturers rep to be in the OR, and she said that the rep will bring in a few dozen knees, in different styles and sizes, and the exact replacement will be decided during surgery. I certainly didn't expect that answer but 4 months post bilateral i can happily say they picked good ones

 

[Josephine]

x

 

[mom2fencers]

Sometimes it is true, we feel like we are now more "The KNEE" than "me"... Meet my friend, "The KNEE." In the book, Total Knee Replacement and Rehabilitation, the authors let readers know that for the first two weeks for sure the knee rules the life 24/7, and everything we do is REHAB of the knee...with no let up. It occupies our minds, its pain takes over at night, giving it ice to help it rest, pillows to elevate, our blood is tested because of it, PTs try to manage it (ha ha), and we go circle again and again... but it does get better.

 

[skigirl]

I had a visit at 3 months that lasted about 5 min---you are doing fine? ok. Really, the only thing a surgeon can do for you is operate--if you don't need surgery, they are not the ones for you!! The yearly x ray is so that they can see any loosening early on.

 

[Celle]

I just had my check up at 6 weeks and my OS doesn't want to see me again until the one-year anniversary. I can phone for an appointment any time that I am worried.

 

[Baileysmom]

Dear knee gone, I am speaking to you from the perspective of bilateral tkrs that are four months old. Absolutely no one is prepared for the length of recovery that this surgery requires. Before the tkr. I was a veteran of five other knee surgeries and I can tell you that I had never experienced this much pain. My own thread reflected ongoing frustration with little to no sleep, constant pain, stomach upset, incredible mood swings brought on by very heavy pain meds and everything you are describing. For two months I questioned the wisdom of what I had done. At three months I was moving considerably better with pretty good ROM . At four months life is returning to normal. I can climb up and down stairs, something I could not do for years before surgery, I can walk at least a mile a day comfortably and I ride a stationary bike 1/2 hr. Every day. Mostly my point is it takes a LONG time, longer than you think to begin to feel normal again. Hang in there, please take the meds, ice it regularly as in three to four times a day, elevate your leg every chance you get and keep sharing on this site, it is the only place you are going to find everyone has been through the same experience and they are only interested in helping others get through to the other side. In addition to the PT that you are doing you might want to consider aqua therapy which feels really great on a rehabbing knee. I hope you begin to feel better physically and mentally very soon.

 

[susanc]

Hello KneeGone - what a great name! wish I had thought of it. Maybe I shouldn't but I just wanted to tell you that having my knee replaced was the most traumatic event in my life (and I'm 60!) I'm sure there are many worse illnesses and surgeries that people go through, but for me I would never consider having my other knee done. (ask me in a year, maybe I'll change my mind!)
My OS said that I would hate him for the first two weeks, but I actually hated him for the first two months! I am almost 6 months out and finally feel better now. Still swollen though at the end of the day after work (I was home on sick leave for 3 1/2 mos.) and just recently stopped oxycodone which was a horrible experience (withdrawal) in itself. I had to stop taking gabapentin because I couldn't wake up in the morning. I too stayed at 90 ROM and at 6 weeks , my OS strongly recommended a Manipulation. After that, was another 10 days of more pain but I could then get to 110, it took another month to get to 120. It was really the best decision , going for the manipulation. They said it is best to have it done within the first 6 weeks for best results.
I try to go swimming at least 3 -4 times a week and that really helps, more water aerobics than lap swimming. I take a "noddle" and use it as reisistance to bend my knee in the water.
Now I feel bad that I said so many negative things but I know what you are going through. I wanted to buy several boxes of Kleenex along with a batch of cookies to give my PT as a thank you when I graduated Therapy. There wasn't one day that I didn't cry in pain and went through many boxes tissues! But by my 3rd month - no more crying!
I asked my OS why are all these 80 year olds w/ knee replacements running circles around me ? He said that is very true, because "our mid-century patients produce more scar tissue ". I had to laugh because I never heard that term used before to describe my age!
Anyhow, pls. take care and I hope I didn't make things worse for you, I am much better now and finally see the light at the end of the tunnel!

 

[kneegone]

@susanc,
Thank you for your back story. I also wondered how these 80 year olds can stand the pain and recover, while I am having such a hard time. I really appreciate your honesty, not negativity. Sometimes, reading all the success stories and how people are running miles, etc, is depressing and discouraging because I am young, healthy and in pretty good shape physically, but seem to be having a hard time at this, so I truly appreciate your honesty. And yes, I agree, you're gonna have to literally drag me in for another knee replacement. Someone told me that it's like childbirth, you forget the pain. I really really don't think I'm gonna forget this ordeal too soon.... and I had a pretty bad pregnancy, going thru two days of labor and finally a c-section, with a 10.6 lb baby!

@Baileysmom, @momtofencers, @skigirl, and everyone else, Thank you too for your honesty and encouragement! It really helps to hear that others went thru similar experiences.

 

[dtmbf]

I too am almost 6 months out and traveled a very similar road to recovery that you are on. I am only now beginning to actually believe I can be "normal" again. At least with my left knee! I also need my right knee replaced & swore it would be a cold day in hell before that would happen. And now that day may be coming sooner rather than later as my right knee is giving me major problems.

My OS also warned me how difficult the recovery would be but I really didn't get it till it was too late - the knee had been replaced! My 86 year old mother had a TKR 4 months before me and sailed thru it - my OS told me its cuz the older patient has looser soft tissue and they dont have the inflammatory response someone younger would have. And that was true for me. I needed lots of pain meds for the 1st 6 weeks - I took pain meds for 3 months, then all of a sudden I barely needed them. I knew my ROM was not going to be any better than 125 as that's what he was able to get in the OR under anesthesia. What you have preop means very little post op. I was at 90 degrees around 5 weeks and he was happy. once I stopped catharting about my ROM it gradually improved and I'm at 123 now and very happy with that. My knee still feels weird but it's fully functional with no pain.

My OS told me the hardware he was planning on using, I checked to make sure there were no recalls or problems with it, and then promptly forgot what I have. I do know the 3 components are different sizes.

A TKR is no walk in the park, I despaired I would ever recover many times, and am sure I am still in recovery. Am I better than I was preop - yes, but it was a struggle to get here. Hang in there, take your pain meds, don't let anyone hurt you in PT, and ignore ever number they throw at you. You'll will feel better!