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Laborious job after partial

Discussion in 'Knee Replacement Pre-Op Area' started by bowhunter8, May 29, 2018.

  1. bowhunter8

    bowhunter8 junior member
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    Hello, I am curious to hear any opinions or experiences about going back to a laborious job after a partial.

    Some background...I am 34 and had a misdiagnosed sports injury in high school which has given my right leg issues for the past 18 years. Had a medial scope in 2014 and 2018 for torn meniscus and arthritis. Had it done in January 2018 and it was torn again end of FEB. I am bone on bone in RT knee and wear a brace 90 percent of waking hours in a day. That is the only form of relief that I get but I am still around a 7-8 all day. I have received cortisone and visco shots with minimal relief. As of now I can just get through my work day, I hobble everywhere and spend most my time sitting. I have three active little children and it pains me having to watch my wife do things that dads should be doing with there kids.

    My main ortho told me next step is a TKR. I questioned it and he sent me for a second opinion. 2nd ortho, who is also more well known in this area told me I was a good candidate for a partial. His reasons are that the rest of my knee joint is in good shape and they only have to replace the medial bone on bone. My main ortho does not think I’ll be happy with that.

    My main issue is that I am 34 years old and work as a HVAC service technician. That means ladders, attics, crawl spaces and knee work. My concern is that when I come back from this that I will be wearing it out at a fast rate and have to get a TKR even sooner than most people. I am contemplating career change but it’s hard to do when this type of work is all you have known.

    Any thoughts or experiences would be helpful!

    Thanks,

    Joe
     
  2. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Hi @bowhunter8 and :welome:. I’m glad you found our community. You’ll get firsthand opinions from people who have gone through PKRs. Some will be happy with their partial replacements, and others will tell you they wish they’d had a total replacement. In the end, it still falls to you to make a decision.

    Feel free to ask any questions you might have!

    A physical job like yours will be more challenging with ANY knee replacement. Kneeling is never quite the same after, though many people with knee replacements (partial or total) manage to kneel without problem. I, just for example of a total (both knees) can kneel but for a job like yours I would definitely want knee-pads. Nor would I wish to be kneeling for long periods, just modest spells. I hope others stop by to give their thoughts on how knee replacement might affect how you do your job.

    While it’s possible your job or other activities might cause wear to your new knee at some point, this is something all knee replacement patients live with anyway. It’s why our surgeons want to see us every few years (after the first) to keep on top of any need to intervene. Living with the possibility of needing maintenance down the road comes with having artificial parts.

    One thing to consider with any knee replacement is that you are looking at a longer recovery. With such a physical job you probably would not be able to work for three months or more. This would be the case whether you get a partial or a total replacement.
     
  3. Mutti3

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    I initially begged my surgeon for a partial because I only had one compartment with arthritis. Was told by surgeon, still cutting bone, same recovery and would need possibility a revision to a total within 5 years. I am 7 months out from a total knee I can do everything I did before, except now I am pain free. Including kneeling, ladders, ( don’t like height ‘lol) and crawling . Over the holiday weekend I put out 17 bags of mulch.
     
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  4. bowhunter8

    bowhunter8 junior member
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    Thanks for the replies. It’s encouraging to hear that you can mulch 7 months out like that.

    My thoughts are that if I get a partial at 34 and it last 5-10 years, that’s 5-10 years that I still have some original parts of my knee and it holds off the total. If I do my math correctly, I most likely will be looking at 2 total knee replacements through the course of my life no matter what route I go.

    What’s weird is that my main ortho is pretty against the partial and the 2nd opinion is all about doing it. I have been at peace about the partial but will need to ask 2nd opinion ortho some questions.

    I noticed that there are many different makers and styles of PKR. Should my ortho go over that with me or can I ask to have a specific one?
     
  5. Mutti3

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    Important thing to ask , how many PKR does he do a year. OS are usually comfortable with what they know . My surgeon does over 400 total knees year.
     
    Last edited: May 29, 2018
  6. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    How long any of your replacements would last is impossible to say. Partials might last 10 years or more, or last only a year. Total knee replacements might last 30 or more years or much less depending on circumstances. My surgeon said he couldn't tell me how long mine might last because the people getting them haven't begun wearing them out yet; he estimated 30+ years. I'm sure hoping for that!

    All I'm really getting at is you could be totally right... or maybe not. It would be great if these things came with guarantees. Our bodies, alas, don't and neither do prostheses. :sad:

    Your OS is most likely to tell you about the replacement parts he personally uses. Surgeons usually specialize in -- and are really good at installing -- one or two implant brands. This is good because you want an expert at what they do. You can ask about a specific one. If you want a specific prosthesis, your best bet is to find a surgeon who prefers that brand and is familiar with it.
     
  7. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Unfortunately, many partial (PKR) do not last even 5 years.
    We have had people here on BoneSmart whose partials had to be revised in less than a year, and others who had a revision within a couple of years.

    One reason for revision of a PKR are that, once you have arthritis in one knee compartment it can spread into your other knee compartments as well. This can happen fast or slowly.
    Another reason is that doing a partial is a surgery that demands a particular skill from the surgeon and some surgeons do not possess that skill.

    I was fortunate because my partial lasted for 11 years. I have yet to encounter anyone else on BoneSmart whose PKR lasted as long as that. I had a revision to a total (TKR).

    When my other knee needed replacing, I was offered a PKR. I said "No thank you" and choe to go straight to a total.

    Nowadays, a TKR can last for 30+ years, so, if all goes well, you would still only be likely to need one revision in your lifetime.

    If it were me, I would go for the total.

    If you're going to have a PKR and you trust your surgeon, let him choose the model. It will be one with which he has experience and confidence.

    Your surgeon's skill is far more important than the brand of hardware.
     
  8. bowhunter8

    bowhunter8 junior member
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    Thank you for that reply...the more I have been reading the past couple of weeks, the more I can see the value in a TKR over a partial. There is just so much info out there and it gets jumbled sometimes.

    I just can’t believe at 34 I am making these decisions...ugh...depressing...

    The way it’s looking, I will have surgery in July.
     
  9. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I had a partial and it has not gone well and I wish I’d waited until I needed a total.
    In my case, keeping some of my original parts has been an overrated experience. Everything I read about partials before surgery claimed they have a more natural feel, since 2 of the compartments are your own. Nothing about my knee feels natural.

    I also read partials have a shorter recovery. Not in my case. My particular recovery has been very long and very uncomfortable.

    I’m sorry to sound so negative, but I’m really unhappy with how things have gone for me. I will most likely be getting a second opinion soon, and there will most likely be a revision.

    Even if you have an average recovery, it’s still a long process. Not worth the effort for only 5-10 years, in my opinion.

    I thought I was catching my arthritis early and this would be all I’d ever need. I did not know partials don’t last like that. At least you have that knowledge ahead of time.

    You are the same age as my son, and he was also an HVAC tech for about 4 years, so I understand what you said about your job. Time will tell how either a partial or a total will affect it.

    Best wishes to you as you make your decision and go through with your choice.
     
  10. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I would agree with him!
    It's not a question of wear.
    Stop doing the math! There are heaps of things that can happen between then and whenever that occurs.
    Stop doing your math! A TKR these days will last around 30-40 odd years. So if you get a total straight off, you'll be around 70 before you need even think about that. And there are a LOT of things can happen in between times - a big red bus might even come into the equation and render all your calculations invalid! Live for now, my friend, and get yourself a total ASAP.
     
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  11. bowhunter8

    bowhunter8 junior member
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    Good words, thank you!! I am having an MRI done in my left knee this morning for suspected torn meniscus. It finally had enough of picking up the slack of my RT knee.

    Is it common or possible to have a arthroscopy in my left and joint replacement in my RT At the same time or is that not advisable?
     
  12. KenUSA36

    KenUSA36 junior member

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    I'm here for some morale support. I'll be 36 in a few weeks. My left knee has been a horror show since college. ACL terror. ACL terror again. Meniscus tear. For the past few months it's been annoying me almost daily. I always thought the knee replacement was something I'd need past 50. I'll be lucky to make 40 honestly.

    Thanks to this community, I feel better. Nobody wants to go through this surgery, but the odds are in our favor on the other side. 20+ years of a working knee sounds amazing. I'd hope in that time they develop better procedures and hardware so that revisions go even better.
     
  13. Celle

    Celle FORUM ADVISOR Forum Advisor

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    It used to be that knee replacements were the territory of older folks but nowadays, with knee replacements lasting 30 years or more, there is no longer any need to suffer a restricted life as a younger person, waiting for the time when you are "old enough" for a replacement. I was advised to wait for 9 years and during that time my life grew smaller and smaller, until I was almost housebound.

    I can't see the point of doing that now. Why wait around with a life limited by pain, when you can get the replacement and, after a period of recovery, go back to a more normal life?
    The only thing that should decide whether or not you have a knee replacement is the state of your knee and the effect that has on your quality of life. Your chronological age shouldn't come into it.

    I think that these are the only ways in which you are "too young" for a knee replacement:
    • You are too young to be living your life in constant pain.
    • You are too young to have your mobility so badly compromised.
    • You are too young to be giving up the lifestyle you enjoy.
    • You are too young feel so old.
     
  14. bowhunter8

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    Amen to that...I feel way too old for 34. Thanks to all for replies.

    Meeting with a new ortho in the same network next week who does A LOT of replacements/year. He came highly recommended to me by a friend who is a nursing supervisor with a sister company that works with my orthopedic here in PA. Hoping I get some good answers and feel for him.

    My friend also said if my meniscus is torn in my left knee they may repair that first to have a good leg to stand on for the TKR in my right knee. I actually wish they would do the opposite as the pain in my left isn’t nearly as bad as my right.

    Anyone have experience with this!?
     
  15. hedgehog

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    Hello,

    I have had a total of 5 meniscus repairs (3 on left, 2 on right) prior to my LPKR.

    -I can say conclusively, for me, each and every recovery put more of a strain and load on the non-operated knee.
    -I also found that achieving stability, while moving through the recovery process each time, was anchored by the so-called “good knee”...a relative term to be sure.
    -my meniscus repair surgeries hurt more than my PKR has (so far...my surgery date was 5/14).


    So many people have bilateral replacements or replacements very close together. I cannot imagine the additional challenge this presents during recovery. I could be dead wrong, but if there is an approach that enables one limb to be pain free while repairing the other, in my experience, I would take it. Challenging decision as the knee needing to be replaced isn’t getting better day by day. Good luck!
     
  16. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Bilateral replacements are a bit more challenging, though not so much I couldn't do stairs right away or walk to the bathroom, or get up from a recliner. Two very painful knees at first is how to describe it. On the plus side, both knees work!

    Whether to repair the meniscus first or not is a decision you should make with your surgeon, @bowhunter8. You got some good input from hedgehog. Having a stable "good knee" is important. In my case that meant two knee replacements because neither knee was up to the job of "good knee." For you, the situation may be meniscus repair first, but that won't solve your main complaint and may just be postponing the inevitable.

    I think you should find out what the highly recommended surgeon you're seeing next week has to say.
     
  17. bowhunter8

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    So I went and saw my 3rd opinion today. An orthopedic who does a lot of replacements. I will try and sum it up in few words.

    He believes at my age, I should change careers from high labor to more sedentary(which I agree with), go to a pain management clinic to help alleviate pain and wait until my 40s.

    His reasons were that by his stats, young males usually need a revision after 10-15 years and after I get a revision, there is no garuntee of later revisions working which would leave me without a lower leg in later years. He says I won’t be able to hike, field dress or drag Animals(I’m a big hunter) and even go in creek to fish since I run the chance of slipping and messing up replacement.

    I believe he was giving me worse case but I have felt hopeless since I left there.

    Should I go try and get another opinion from a completely different orthopedic system? I just feel like I have to put my life on hold for years and deal with chronic pain?

    Any thoughts?
     
  18. Mutti3

    Mutti3 graduate

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    If your knee is bone on bone a knee replacement is the surgical fix regardless of age. Everyone thinks about the balance of putting their life on hold due to pain, or taking the plunge. Weight all the information, and you will make the correct decision.
     
  19. Celle

    Celle FORUM ADVISOR Forum Advisor

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    What a wet blanket that last surgeon was!
    Read these examples - Stories of amazing knee recoveries - and then go ahead with a knee replacement.

    Nowadays, knee replacements can last as long as 30+ years. No need to wait until you are "old enough".

    And, by the way, we have had lots of examples here on BoneSmart of people who have had more than one revision.
     
  20. Celle

    Celle FORUM ADVISOR Forum Advisor

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    PS: Don't get a partial knee replacement (PKR) Get a total (TKR). Some partials don't even last a year.
    My first knee replacement was a PKR. It lasted me for 11 years, but that is the longest of anyone I've met on BoneSmart in the past 6 years.
     
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