June Sunbeams 2013 - Are you having knee surgery in June?
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bichonmom
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That's my date also! Hoping for the best for both of us!
serenity93
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I can so relate to your comment. RTKR scheduled for June 18. Ready to 'get her done' and get into recovery....it's past time! Trying to stay focused on the final outcome rather that the pain following surgery. It's a 'one day at a time' journey!!
gazelle7777
post-grad
So the 4th of may marks four weeks until my surgery date( June 4th).
Today I ordered a new mattress to replace our 20 something old worn out one.. new pillows and new sheets too!
I also order two toliet seat risers for the bathrooms I use. I know that is going to be important as right now with my stiff old knees I have issues getting up and down off the seat. This Monday I am going to a mandatory talk about the surgery. My doctor makes you go to it or he will not do the surgery- you have to sign in to show you went to it. I have read so many books on the surgery I do not think there is much I do not know at this point- other than the actual experience of it.... and that will be lets say interesting. Yesterday I had a HORRIBLE day filled with pain--
every joint in my body hurt! Both knees- my shoulder- my left hip and my back... it must have been some sort of barametic weather pressure change or something.... Today I feel totally better- just my knees ache. Just wanted to share with you and keep in touch these last few weeks prior to surgery. Take best of care everyone!
Today I ordered a new mattress to replace our 20 something old worn out one.. new pillows and new sheets too! I also order two toliet seat risers for the bathrooms I use. I know that is going to be important as right now with my stiff old knees I have issues getting up and down off the seat. This Monday I am going to a mandatory talk about the surgery. My doctor makes you go to it or he will not do the surgery- you have to sign in to show you went to it. I have read so many books on the surgery I do not think there is much I do not know at this point- other than the actual experience of it.... and that will be lets say interesting. Yesterday I had a HORRIBLE day filled with pain-- every joint in my body hurt! Both knees- my shoulder- my left hip and my back... it must have been some sort of barametic weather pressure change or something.... Today I feel totally better- just my knees ache. Just wanted to share with you and keep in touch these last few weeks prior to surgery. Take best of care everyone!
mjmj57inKY
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I am new to Bonesmart. I am really glad I found you! I will be having a LTKR on June 20th. It seems so far away but I know it will be here before I know it.
Dulcimer Diva
graduate
Had my MRI today for the new left knee prosthesis. It was quite different from other MRIs I'd previously had. It was done according to strict proticols for the Zimmer "patient-specific implant." Like other MRI's it's noisier than a construction site inside a dance club on a Friday night; instead of earplugs, I got heavy-duty headphones plugged into the Siemens scanner, which has a hard drive filled with "relaxing classical music" (heavy on the Beethoven--that first movement of the 9th is hardly "relaxing") that the tech controls.
There were several separate short scans taken, each lasting less than a minute, for calibration purposes. The three main scans each lasted 5-6 min. I was carefully positioned on the table, with the left knee cradled in a special elevated "niche" cushion and then covered with a foam shield that was lashed into place with Velcro. Then my right leg was similarly tethered to the left with a Velcro strap. I was told to rest my arms across my chest and into the tube (part way) I went. I was told not to move, but that advice was sort of unneccessary (except, perhaps, the admonition not to wiggle my toes which themselves were unrestrained).
First scan was of the left ankle; second, the left hip; last, the main event--the knee itself. Why not just the knee? Apparently one of the parameters to be measured is the quadriceps-angle ("Q-angle") from the hip through the space within the knee joint through which the ligaments pass. One discovery made within the last 20 years is that women, regardless of frame size, have a wider Q-angle by about 3 degrees than men, which can lead to maltracking of the patella; which explains why the most common acute sports injury in women is a torn ACL (and it also occurs more in non-athlete women than in non-athlete men) and more women runners than men suffer chronic chondromalacia patellae. (Explains why after each of my non-TKR surgeries on either knee I had to get patellar taping at each PT session). The ankle is scanned for analysis of evidence of chronic overpronation (from flat feet), which can show up over time in the alignment of the ankle as well as in bone inflammation from the unusual stress of hypermobility--this, too, can cause patellar maltracking as well as misalignment between the tibial and femoral condyles of the knee joint. Over time, this wears down articular cartilage, et voilá: osteoarthritis, even in many women of normal weight.
The images were reviewed and immediately e-mailed to my OS, as well as to Zimmer. (I got sent home with a CD of them which my Mac can't read--gonna try it on my husband's PC laptop). Here's the really fascinating part--Zimmer copies the MRI images into a CAD-CAM program, which calculates the Q-angle, factors in gait influences from the ankle scan, and generates a 3-D mapped image that is fed to a 3-D printer. The printer produces a model of my actual knee joint, from which molds are made; titanium is poured into the molds and my actual prosthesis is cast. No needing to procure the correct size femoral and tibial components from off the shelf, and much less bone needs to be removed beyond the trashed articular cartilage. Less time on the table, with shorter risks from both anesthesia and infection, less blood loss to boot. And perhaps home sooner?
Here's the really amazing part: I do not have any pre-op X-rays scheduled. Not even a pre-op OS appointment: he has my bilateral films from last August's followup to compare with today's MRI images just in case there will be any leg-length discrepancies to address (and he can forward the x-rays to Siemens as well in case one of the molds needs to be made taller or shorter). Amazingly, in 2012 I had four sets of knee X-rays taken: two pre-op 3 months apart and two post-op. That's not an insignificant exposure to radiation, though at the time necessary. In 2013? None, except for my nuclear heart imaging in January (and had I not had those near-fainting episodes, I wouldn't have had that either).
Sorry this post was so long, but for those science geeks among us, this was so fascinating and totally different from my RTKR pre-op experience.
There were several separate short scans taken, each lasting less than a minute, for calibration purposes. The three main scans each lasted 5-6 min. I was carefully positioned on the table, with the left knee cradled in a special elevated "niche" cushion and then covered with a foam shield that was lashed into place with Velcro. Then my right leg was similarly tethered to the left with a Velcro strap. I was told to rest my arms across my chest and into the tube (part way) I went. I was told not to move, but that advice was sort of unneccessary (except, perhaps, the admonition not to wiggle my toes which themselves were unrestrained).
First scan was of the left ankle; second, the left hip; last, the main event--the knee itself. Why not just the knee? Apparently one of the parameters to be measured is the quadriceps-angle ("Q-angle") from the hip through the space within the knee joint through which the ligaments pass. One discovery made within the last 20 years is that women, regardless of frame size, have a wider Q-angle by about 3 degrees than men, which can lead to maltracking of the patella; which explains why the most common acute sports injury in women is a torn ACL (and it also occurs more in non-athlete women than in non-athlete men) and more women runners than men suffer chronic chondromalacia patellae. (Explains why after each of my non-TKR surgeries on either knee I had to get patellar taping at each PT session). The ankle is scanned for analysis of evidence of chronic overpronation (from flat feet), which can show up over time in the alignment of the ankle as well as in bone inflammation from the unusual stress of hypermobility--this, too, can cause patellar maltracking as well as misalignment between the tibial and femoral condyles of the knee joint. Over time, this wears down articular cartilage, et voilá: osteoarthritis, even in many women of normal weight.
The images were reviewed and immediately e-mailed to my OS, as well as to Zimmer. (I got sent home with a CD of them which my Mac can't read--gonna try it on my husband's PC laptop). Here's the really fascinating part--Zimmer copies the MRI images into a CAD-CAM program, which calculates the Q-angle, factors in gait influences from the ankle scan, and generates a 3-D mapped image that is fed to a 3-D printer. The printer produces a model of my actual knee joint, from which molds are made; titanium is poured into the molds and my actual prosthesis is cast. No needing to procure the correct size femoral and tibial components from off the shelf, and much less bone needs to be removed beyond the trashed articular cartilage. Less time on the table, with shorter risks from both anesthesia and infection, less blood loss to boot. And perhaps home sooner?
Here's the really amazing part: I do not have any pre-op X-rays scheduled. Not even a pre-op OS appointment: he has my bilateral films from last August's followup to compare with today's MRI images just in case there will be any leg-length discrepancies to address (and he can forward the x-rays to Siemens as well in case one of the molds needs to be made taller or shorter). Amazingly, in 2012 I had four sets of knee X-rays taken: two pre-op 3 months apart and two post-op. That's not an insignificant exposure to radiation, though at the time necessary. In 2013? None, except for my nuclear heart imaging in January (and had I not had those near-fainting episodes, I wouldn't have had that either).
Sorry this post was so long, but for those science geeks among us, this was so fascinating and totally different from my RTKR pre-op experience.
Dulcimer Diva
graduate
Oh, yeah, nearly forgot: Saturday I finally got to move the big weight on my scale down one "clunk!" Since I went low-carb, I've lost 21 lbs. (down 25 from last year's pre-op appointment and down 30 from the day I got my RTKR)! Down a dress size too. MY FP is thrilled. My goal was to lose 20 by surgery day--I'm shooting for 25 instead.
gazelle7777
post-grad
I have a question about kneeling... will I still be able to get down on my hands and knees and say scrub the floor with a cushion of course after double knee replacement?? I have heard that many people say they can not do this. I would hope I still could. Thanks!
trailspud
graduate
Diva,
Zimmer has some great technology, but the imaging done is to create patient-specific instruments (chiefly the cutting guides) and surgical computer imagery rather than the implants themselves. Some of Zimmer's tibial tray are made of titanium (or an alloy w/titanium), but I don't think even that is made for each patient. Their femoral components are made of different materials ( there are lots of different Zimmer products) ...CroCrMoly and a unique metal, tantulum, which Zimmer touts for its unique properties.
The imaging indicates sizing and which of the gender shapes to use so that can speed up the surgery and provide a better fit (sizing combined with the two different shapes offers a larger range of implants to choose from). It also eliminates the need to violate the intramedullary canals with guide rods which is true of how many surgeons use CAS (computer assisted surgery), but I am not sure about reduction of bone resection (although the better the fit, the less bone resection is required all other things constant). I have one Zimmer knee and one that is individually manufactured. It will be interesting to see how they compare long-term, but I do think orthopedic implants will move in the direction of individualized manufacturing.
Dulcimer Diva
graduate
Trailspud, between the time I posted and you replied, I was doing quite a bit of thinking, and I believe you are correct--especially about the tibial tray. I have a slight leg length discrepancy, and it makes sense that the size of that tray may not be decided until I'm on the table. (During last year's RTKR, the deterioration of more of my tibial bone-chips-epoxy matrix necessitated removing more matrix & screws than originally planned and implantation of a taller tray base). But I was just repeating what the tech told me yesterday. This is an unusual development in any case due to my OS' long relationship with Stryker.
How are you doing with having a "mixed marriage," so to speak, of knee implants?
Was able to commandeer Bob's PC laptop to read my MRI films last night. I looked at that left knee and winced. But was even worse were the ankle and hip images. The ankle and fifth metatarsal still show considerable inflammation (actually a bit more than during the stress fx and cuboid syndrome episode back in '09).
But what was far more disturbing about the hip films was not my hips' condition--they looked pretty ok. At least my hip doesn't look arthritic--smooth cartilage around that little ball-and-socket. No, what was disturbing was the full-frontal image of my hips--unlike an X-ray, an MRI shows all the fat as well.
. I'm printing it out and taping it to my fridge (masking out certain areas for modesty's sake), bearing the legend "Is this trip really necessary?"
Had my first pre-op PT session (7 more to go) today--assessment and initial exercises. 8 months after my last PT session I still have 130 deg. flexion and full (0 to -1) extension in my R knee. Not bad for not having done my rehab exercises since Sept. But though I was able to get to 120 in my left (last year I couldn't even get past 90 in my pre-op R knee due to a progressively-shredding lateral meniscus and all that extra avoirdupois), I got a rude awakening--I could achieve only 7 degrees of extension. Oops. So it's no surprise that besides strengthening my quads & glutes and improving balance, we are working on stretching my L hamstring and loosening up that R iliotibial band and iliopsoas muscle (the source of what I'd thought was "hip" pain).
Just a question, BTW--should I expect any "bumps in the road to recovery" due to not having an ACL in my L knee? My other ligaments (MCL, PCL) and tendons are fine.
How are you doing with having a "mixed marriage," so to speak, of knee implants?
Was able to commandeer Bob's PC laptop to read my MRI films last night. I looked at that left knee and winced. But was even worse were the ankle and hip images. The ankle and fifth metatarsal still show considerable inflammation (actually a bit more than during the stress fx and cuboid syndrome episode back in '09).
But what was far more disturbing about the hip films was not my hips' condition--they looked pretty ok. At least my hip doesn't look arthritic--smooth cartilage around that little ball-and-socket. No, what was disturbing was the full-frontal image of my hips--unlike an X-ray, an MRI shows all the fat as well.
. I'm printing it out and taping it to my fridge (masking out certain areas for modesty's sake), bearing the legend "Is this trip really necessary?"Had my first pre-op PT session (7 more to go) today--assessment and initial exercises. 8 months after my last PT session I still have 130 deg. flexion and full (0 to -1) extension in my R knee. Not bad for not having done my rehab exercises since Sept. But though I was able to get to 120 in my left (last year I couldn't even get past 90 in my pre-op R knee due to a progressively-shredding lateral meniscus and all that extra avoirdupois), I got a rude awakening--I could achieve only 7 degrees of extension. Oops. So it's no surprise that besides strengthening my quads & glutes and improving balance, we are working on stretching my L hamstring and loosening up that R iliotibial band and iliopsoas muscle (the source of what I'd thought was "hip" pain).
Just a question, BTW--should I expect any "bumps in the road to recovery" due to not having an ACL in my L knee? My other ligaments (MCL, PCL) and tendons are fine.
trailspud
graduate
First, good luck and best wishes to you and the rest of the June TKR folks. Next, no ACL no worries as it is not retained post-TKR.
Some of the large orthopedic device manufacturers are doing quite a bit of direct marketing and some of it is rather disingenuous. Stryker's "get around knee" tv commercials being the worst I have seen. Zimmer has been guilty, too. For awhile they were marketing an "all terrain knee." Their use of the term " patient specific" also creates some confusion. Both good companies with good products, but can hype = $$$.
Some of the large orthopedic device manufacturers are doing quite a bit of direct marketing and some of it is rather disingenuous. Stryker's "get around knee" tv commercials being the worst I have seen. Zimmer has been guilty, too. For awhile they were marketing an "all terrain knee." Their use of the term " patient specific" also creates some confusion. Both good companies with good products, but can hype = $$$.
Dulcimer Diva
graduate
Yup, as far as Stryker goes, it's still a Triathlon. (Though the day I ever run one is the day that hogs will wing their way down to Hades to play hockey).
trailspud
graduate
Sounds like the makings of a (possibly) great song.
Dulcimer Diva
graduate
I actually wrote and recorded "If Pigs Could Fly" on my solo CD back in 2001. It's a twisted kids' song for twisted kids. The second verse wonders "if pets could drive;" the song was inspired by the old Pets.com commercials with the tag line "Because pets can't drive."
Well, yesterday, scientists announced that they've taught a dog to drive. (SNL's Toonces the Driving Cat is still very much fictional). Back to the drawing board......
Well, yesterday, scientists announced that they've taught a dog to drive. (SNL's Toonces the Driving Cat is still very much fictional). Back to the drawing board......
Dulcimer Diva
graduate
The album was "Ghosts & Angels" (a couple of hard copies remain on CDBaby, but downloads are on iTunes & Amazon). The sequel, which I'm currently recording, is "Candy Apple Red Herring."
newkneesbarb
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I am scheduled for bilateral knee replacement for June 14th and I am very nervous and scared. Glad to have found this site!
newkneesbarb
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Please ad me to the calendar so that I can be part of the support group! I really feel like I need it! Thanks. Anyone can also feel free to private message me if they would like. Thanks!
Titianlady
post-grad
barb 6/14/13. I'm having my second knee replaced on June 14th as well. We can be recovery buddies my dear.
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