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My Bilateral TKR - Blessing or Nightmare??

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I had Bilateral TKR surgery took about 45 mins per knee, I was walking with a walker the next morning (surgery was late in the afternoon). By week 2 I was off the walker and using a cane (I recommend the Hurrycane!). Although I am post op 10 weeks, and I am still recovering and still have pain and stiffness (this is all normal), I highly recommend doing both knees at the same time. I would never do one knee and then do the other, later! I just cannot imagine going thru surgery then next day or 2 after having surgery again. PT is critical! I walk every day and I go to the gym and do 30 mins on the recumbent bike (no pain when Im riding the bike!). Stairs are great now! No "crunching" in my knees when I go up and down the stairs YAY!!!! Of course I will be honest, this is a tough surgery and you will have to do the work (PT), and it takes time to heal, and I am not pain free (yet), but I know that it is worth it to do both at the same time, for sure! Best of luck to you and use this site for support!!!!
 
katiejarr said:
had Bilateral TKR surgery took about 45 mins per knee, I was walking with a walker the next morning (surgery was late in the afternoon).
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Yep--pretty much the same for me---the next morning, I was out of bed and walking---a little tentative at first-- a little wobbly, but no pain.
katiejarr said:
PT is critical!
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In Britain, there is very little PT---here in the US, we do use it---I had to go for some time (four months) , as I had goals to get back to officiating, but what is also critical is not pushing yourself too hard or working the knees too hard---the harder you work, the slower and more painful the recovery can be.
 
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I'm keeping track of all your advise, Thank you! I found out my surgeon does one knee on a Wednesday I remain in the hospital and he does the second on following Monday. I will ask why on this Saturday when I have the evaluation meeting with him. I've done some research and found that this is a common practice for "older" patients. (I'm 66) Extensive studies show less problems with pulmonary, heart, clotting, and other things I cant spell or know what they mean if the surgeries are staggered. I do have faith in this OS based on my OS who has operated on my back,(losing the use of my legs, he got me walking again), and 3 times on my knees. My OS said when he referred me, this surgeon is who he would choose to do his knees. So....Am I worried? you bet. Am I afraid the second leg will put me over the top with pain? you bet. Now, do I insist on both the same day and get a new surgeon? I really don't want to go against the recommendation of my OS who I trust completely. I know pain and can deal with it.
This all started many years ago. I was a Police Officer severely injured when an undercover drug deal went bad. The bad guy tried to crush me against a building with his van. Injured my back and knees. Many years of pain pills, therapy and all the trappings. After 10 miserable years of pain and immobility I found my OS. He tried every conservative treatment possible without success. He finally said he would operate since if the surgery did not work I would be no worse off than I was. (almost totally unable to walk). 7 Hrs of surgery and a week in the hospital and I was pain free and able to walk. That is why I trust him. My gut is telling me to just go with the flow and let the new OS do his job. My brain is screaming BIG PAIN on a Wednesday and AGAIN on a Monday!!! My wife who is a rock and carried the weight of my injuries all these years understands me and offered that she trusts my OS. But really, what do I know about this? Nothing. Sorry to rant. I'm just very anxious.
 
jhcompliance said:
My brain is screaming BIG PAIN on a Wednesday and AGAIN on a Monday!!!
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honestly, with the anesthesia that I had as well as the nurses, who made it a point to make sure that I was never in pain---my hospital stay was actually pretty much pain free---some discomfort, to be sure, but no agony, no big-time pain.

My nurses made it a point to tell me that I should let them know if I ever had pain---and they were very professional and very precise in their attitude toward pain control.
 
jhcompliance said:
So....Am I worried? you bet. Am I afraid the second leg will put me over the top with pain? you bet. Now, do I insist on both the same day and get a new surgeon?
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I would say, 'no'. With hindsight you won't notice the extra few days.

Whilst it's true that the first couple of weeks are tough, and that having an extra few days there will be tougher, you've proved a thousand times over IMO that you can handle all that. I'd go with what the OS recommends.
 
Jeff - welcome to BoneSmart!

I think my role here will be permanent Devil's Advocate...and you've received great advice here...but...

I had TKR on my left knee this past December 16th. I am 43 years old, great health, no chronic conditions/illnesses (not taking any medications), I exercised regularly (about 4x per week), healthy weight, etc. My OS considered bilateral on me and told me I was the "perfect candidate" considering my age, overall health, fitness level, weight and personal support system. We opted for just the left, as he thought he could get a few more years out of my right knee. I agreed. FYI, I was very proactive about asking how my pain would be controlled post-surgery...

I cannot tell you how happy I am that I only had one done! I know that many here have gone through bilateral and done amazingly well, but I am someone who experienced a lot of pain for the first couple of weeks. I didn't have any major complications, such as infection or blood clots, but I was on massive amounts of narcotics and got very little relief. I had emotional and physical break-downs almost daily and would literally cry when I had to use the restroom because I knew that meant standing up, walking, sitting and getting back to the couch/bed.

I could NOT have made it at home (I came home Day 3) had I had both knees done. Even after that horrible agony was tolerable, I still had pain issues and I have thanked my lucky stars almost every day that I didn't get both done at once, and that I had my right leg to aid in my recovery and mobility.

I know that for many, both knees are equally bad and you need both done - at Day 3, there would've been no way on God's green earth I would've gone ahead with getting the second TKR.

So I'd advise doing both in one surgery and have a great rehab clinic in mind - or - scheduling them further apart than 3 days. Just my opinion...

Good luck to you. :)
 
Hi Jeff, @jhcompliance
It seems that you are worried quite a lot about post-operative pain. This is something that you should discuss with your surgeon and anaesthetist before the surgery. I did that and I can honestly say that my pain never got above level 5, even at its worst.

You seem to have found a surgeon whom you trust. I say go with his recommendations. It's more important to have a good surgeon than to have one who will do both TKRs on the same day. I'm not saying that surgeons who do both knees on the same day are not good surgeons, just that it may take time to find one who comes as well recommended as your current surgeon.
 
Lunula and Celle,
Thanks . I wish I had one good leg to hold out with but I don't. I did discuss one at a time with my OS. He said the random collapsing I get in both legs ruled that out. I guess I'm just worried. Sorry I was ranting. I do appreciate your support.
 
I agree with the others - you trust your OS and he seems to have sound reasoning to stage them and a history with you. I totally get the big pain concern but I'd say that you are unlikely to have that just a few days apart - if anything that will give them enough time to know what your first leg's pain is really contributing - my first day and a half was almost no pain - the past day and a half is quite a bit more so having to get the meds worked out. At least this way you'll know what leg one is up to and have that adjusted before starting leg two! But they are close enough together that you'll rehab them just one time. My only concern would be the going under twice - do you know if he's going to use a spinal or a general? I had a spinal and some happy juice and it worked out great!
 
Good point Teresa. I've been reading here about working out the pain meds. I don't really understand what needs to work out. Do you mean how often or what to take?
 
You need to know what pain medication regime your surgeon will order - the drugs, dosage and frequency - and to make sure that it is written in your notes.
Unfortunately, some people have experienced some delays or reluctance on the part of hospital staff in bringing medication as ordered. You need to know what is charted, so that you can insist on getting what your surgeon ordered, in the correct dose and on time.
 
Hi Jeff - yes - for me I had both the numbing agent in the joint itself and the spinal - until those were out of my system I really didn't know what my pain levels were. Now that I do it's too much for tramadol but I am having nausea issues with the percoset and Vicodin doesn't work for me. So - it's finding out what your body responds too and how much is enough without making you feel worse! I know that knees are different but presumably your body will respond to pain in the same way so it should still be helpful to get that all sorted out while in the hospital rather than come home in the middle of that and try to figure it out. I know that bi-lats stay longer but I think it would be great to have that part sorted while dealing with the pain of just one rather than two.
 
Celle and Teresa,
Understood. I'll definitely ask the surgeon what pain medication he starts with at this Saturday's meeting. i appreciate your advise.
 
Jeff, I know it must seem like a huge undertaking to go right back into surgery for the second knee so soon after the first. But...let me remind you that you will be under the influence of some pretty healthy doses of pain medication and I doubt if it will be a worry for you. There is a lot of advantage to the "happy" state that these drugs can establish for you. Once you're out of the second surgery, you'll be just like any other bi-lateral TKR patient in recovery and you'll be surprised at how stable your new knees are. Certainly, you'll have surgical pain and possibly swelling. But the arthritis pain will be gone and you'll feel the difference.

Since you say both your legs are at the stage where they are giving way unexpectedly, I'd say you are a perfect candidate for having both done at the same time or a few days apart like you are scheduled for. We've had many folks go through this same process and come out just fine. It's natural to worry, so I won't tell you not to. Just try and keep yourself busy between now and surgery day so you don't think about it so much. Do things for preparation....do fun things that you can do with bad knees (visit friends, go out to eat, read, watch favorite television shows or movies, etc.)....chat on the phone...come here and talk about how you're passing the time....whatever it takes to get through the waiting. It's definitely the worst part of this whole process.
 
Hi, Jeff. Chiming in with my experiences, too. I've just had my second knee done, five months after the first. My surgeon doesn't like to do bilateral because of the length of time in surgery, and for me, this has been a good choice. It is two surgeries, etc, but it has worked out well. The two surgeries a few days apart does seem as if it would help spread the stress of the surgeries.

Just want to add, too, that even though TKR is a big undertaking, I am finding it so worth it. My left knee feels so great and I know the right will join in and by summer, I'll be hiking with pleasure again. I hadn't even realized how many things I had given up, a little at a time, until I got to the other side.

Barbara
 
Jamie, Barbara and all,
Sorry about yesterday. I seemed to have bottomed out while anticipating the surgery. I forgot what Referee said about listening to people tell horror stories and I listened to a nurse tell me "You will feel the worst pain in your life". I'm a bit embarrassed to say the least. Thanks again for the encouragement. shoulders squared, marching on! I"ll post Monday with the report from the Saturday appointment with the OS.
 
No worries, Jeff. You don't have to be embarrassed, ever. I'm sure most of have panicked about our surgeries many times. I felt so sick with nerves both times that they didn't have to tell me not to eat--I couldn't.
 
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