TKR Looks like I'll need left TKR sooner rather than later...

montanagal

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My left knee always seemed so strong, not like that other BAD knee! But there were hints that not all was right, then recovering from my right TKR in 2018 really stressed it out. Esp the first week, when I was leaning on it way too much.

I had the knees X-rayed last summer and everything looked fine, except I was have some kind of bursitis-type pain in both knees. Now, it's really gone downhill and I had to get out the cane again. I did a lot of walking last year but also put on weight and that's probably what put me over the edge. It feels like something is broken in there. My BMI is probably 28 now.

Appointment with the surgeon was moved up to March 24 and hopefully I can get a cancellation sooner than that.

I'm 72. Is US Medicare still in-patient for TKR? The beds at the preferred hospital were a nightmare, they kept moving around automatically and it made no sense at all. I may insist on our other hospital.

Also, they were really stingy with the meds. I hope they're not going to send me home with acetaminophen this time.
 
@montanagal Welcome to BoneSmart :welome: What with the COVID pandemic going on it's hard to say how long a patient will stay in the hospital following a knee replacement. These days hospital stays tend to be much shorter than they used to be. Hospital and surgeon will, of course, make sure each patient is medically OK and able to get about and take care of basic functions before releasing person to go home. Be sure to let the surgeon know that last time pain management was NOT adequate for your needs.
 
Welcome back to BoneSmart!
Is US Medicare still in-patient for TKR?
Medicare will pay for what is medically necessary, everyone is not a candidate for same day surgery, and will have longer stays.
Talk to your surgeon about pain meds before your surgery to be sure you are given the medications you need when you are discharged. He may also allow you to pick up your pain meds prior to surgery.

While you are waiting for your appointment, here is some reading for you.

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
 
@montanagal Welcome to BoneSmart :welome: What with the COVID pandemic going on it's hard to say how long a patient will stay in the hospital following a knee replacement. These days hospital stays tend to be much shorter than they used to be. Hospital and surgeon will, of course, make sure each patient is medically OK and able to get about and take care of basic functions before releasing person to go home. Be sure to let the surgeon know that last time pain management was NOT adequate for your needs.

I did talk to them last time, because I'd heard attitudes were changing, whereas in 2006 I had osteotomy and the doctor was very easy going about it. There seemed to be no problem with pain meds but laws or FDA oversight or something changed because in 2018 we had to go through so many hoops to get refills, and had to physically go in and get the paper Rx and my spouse was not happy about it!

Then I developed hyperalgesia, basically weird chronic pains all over that stopped when I quit the meds! So I don't know what to think of it all. That never happened before.

At least now the surgery will be in spring hopefully. I had thought November surgery would be ideal but then we had the worst winter snow ever and I was afraid to go out walking in it.
 
Well, I went to the surgeon and all he did was pull out the x rays from October 2020 and said everything looked fine. Yet my whole leg is giving out, it hurts when I walk, and it hurts when I'm not doing anything. He said it just sounds like arthritis. He said we could do an MRI to see if there's a torn meniscus or cartilage moving around.

What I wished I'd asked was, isn't it almost always arthritis that ends up in TKR in the elderly? Is it just a matter of how bad it is? I dread TKR again mainly because of the recovery period but I'd rather do it sooner than later

Also I fear they couldn't do much about meniscus or cartilage problems.
 
Well, I went to the surgeon and all he did was pull out the x rays from October 2020 and said everything looked fine. Yet my whole leg is giving out, it hurts when I walk, and it hurts when I'm not doing anything.
I'd be inclined to go back to your surgeon and ask for new X-Rays of your knee. It is possible for a joint to deteriorate quite quickly.
My husband's hip X-rays, taken only 4 months apart, show a rapid deterioration, with no cartilage left at all now.

It might help if you fill in this form and show it to your surgeon too, as it will show how much your painful knee is affecting your life.
Score Chart: How bad is my arthritic knee?
 
Well I had my MRI Monday, in one of the big machines which was a surprise because I was expecting the small leg-only MRI. I can't believe I lay still for 20 minutes like that.

Anyway there is some arthritis and two torn menisci, and inflammation. The doctor said it's an "in-between" knee, obviously going bad but really not bad enough for TKR so I got a cortisone shot instead, the first for that knee. And it does feel better.

I guess I could push for TKR at this point but I don't know if that's wise or not. Like last time, with my husband in declining health I'd like to get it all out of the way before he's on dialysis or in a wheelchair or whatever it's going to be.
 
@montanagal So sorry your left knee is on the way out. In my experience it's better to get the joint replaced as soon as you can. Not limping around for a long time pre-op means there is less impact on other areas.

Having said that, since you had an injection they won't allow you to have surgery for at least 3 months after the procedure. But I imagine if it's anything like it is here, getting on a surgery list now might be beneficial.
 

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