My experience - new to site 49 y.o. MD

[ciaobella]

Hi everyone.

I am so glad I found this site.
I am a 49 year old female physician (internal medicine) and underwent a Right TKR on October 23rd. I just passed the 2 month mark.

I injured my knee badly at age 16 doing gymnastics and tore my ACL and Lateral Collateral Ligament and destroyed all my cartilage. I wore a brace for about a year and never had any surgery. I had fairly significant OA by the time I was 43 and the past 3 years it became miserable. But I waited as long as I could and finally found a great surgeon that I liked and trusted. He had done my friends knee several years ago (when she was 47) and she was extremely happy. I had a custom fit knee. This is where they make a 3D model of your arthritic knee using an MRI and then create custom cutting guides and prefit you with the correct size knee.

Being a physician I have access to a lot of information and medical journal articles regarding knee replacements. I read tons of info from the various Ortho journals. Amazingly there is very little information about recovery so I really appreciate everything I have read posted here. I have searched the PubMed for articles on what is considered 'normal' in the months after surgery. There is next to nothing.

I agree with some of the previous posters that I had thought because of my relatively young age I would fly through this without a hitch. I have no medical problems and am not overweight and my other knee is normal. My friend who is a Physical Therapist had warned me that the younger patients usually have more pain/swelling because of their healthier blood supply and nerve endings.
After surgery my leg was swollen and bruised all the way up to my thigh. I had fairly significant pain the first 2 weeks. It took about 5 weeks for the swelling to go down and the bruising to go away. The stiffness at night was terrible. I would wake up and feel like I could never straighten out my leg ever again. The night stiffness has finally improved but it took 2 months. I had Home PT and did my exercises faithfully. Now I am riding a stationary bike about 4 times a week for 20-30 minutes. It really helps loosen up my knee. I went back to work at Week 7 and I think it was a bit too soon. I don't get to rest or elevate it and am up and down most of the day seeing patients. I try to take it easy at night and just keep it up. My right quad still looks like mush. I had good quads prior to surgery (I'm a cyclist) and am amazed at how fast they atrophied. Since I went back to work I haven't been doing my exercises as faithfully.

I guess I am hoping to get back to cycling on my road bike. I would like to be able to do 30 miles. My main problem now is there is still a lot of "popping" in the knee, especially when I go to get up from a sitting position. And I still have discomfort on the lateral side of the knee (it aches lot). It is also tender laterally. There's also still swelling and an effusion on the outside of the knee. But I think I'm doing better and am figuring this will take the good part of a year to heal. But some days I get discouraged.

I appreciate all the posts here. It's been great to read other peoples experiences with recovery.

 

[referee54]

Hi everyone.



My friend who is a Physical Therapist had warned me that the younger patients usually have more pain/swelling because of their healthier blood supply and nerve endings.

Yes,, A PT told me this, after the fact. Everybody told me to go into surgery with quads that were as strong as possible...little did I know that I was doing myself a disservice. By the way, I am typing this at 1:42 Eastern Time, as it is now week 7 and I have had three (countem'!---three) good nights sleep. I fall asleep, sleep for about one hour, and then I cannot get comforable until around five in the morning. My ortho says that this is normal and thant he can prescribe something, but I am hesitant to start taking pills. I teach and am planning on being back in the classroom on January third.

I cycle a great deal, and am looking forward to cycling my normal 25-30 miles a day this summer...I am working now on a trainer that my bike is hooked up to---much better than an exercise cycle, I think. I was at PT today and Itold my PT that my goal, after I retire, was to cycle across the US---she said that I could still do it. Maybe I will get some sleep then...

Best of luck to you,

Tim C.

 

[JuneBug88]

All I can say is THANK YOU! I thought I was the only one having the same problems. I am 41 and had my TRK done on November 27th. While in rehab my roommate was 65 had her TRK done on the same day and she was more mobile and in alot less pain than I was. I was beating my self up thinking I am 20+ years younger than her and I should be doing better than her and my recovery should be faster. I am still having signficant pain, swelling, and stiffness, and feeling a poping/clicking in the joint. I would kill for a good night sleep, and yes I am taking a sleeping pill but only getting 2-3 hrs at a time. Cant get comfortable at all sleeping in a hospitial bed still. I would give anything just to be able to sleep in my own bed next to my hubby! With the way I am currently sleeping we will both be up all night long. I tried to drive 2 days ago and I am not ready for that yet. I am doing my PT in the pool due to the swelling. I mentioned to my PT about the clicking/popping and she said it is due to the swelling that I am still having. This board is wonderful and Josephine is the best cheerleader here!
Take Care,
Debbi
aka JuneBug88

 

[Sue]

Glad you found us, Ciaobella. I had my right TKR just a few days before you had your surgery, and I am still having swelling on the outside of my knee, too. My PT told me to just keep elevating and icing whenever I can, and this does seem to help. I'm fortunate that I telecommute, so I can elevate and ice during the day while I work at home. That is, when I remember to! LOL! Now that I'm feeling better overall, I sometimes forget to do anything about the swelling until the evening.

 

[vmacisd]

Hi, I am 55 and had tkr on Nov 26. I just returned from the doctor and after 4 1/2 weeks he has already released me. I was able to get 127 degrees flexion and my extension is as good as on my other leg. YEAH!! After saying all of that, I have to tell you that I still have medial pain and I still have trouble sleeping at night. BUT, it is so much better than before. I now have hope that one day I will be back to normal. The doc says that the pain is normal and should subside by 4 - 6 weeks. And my husband reminds me that I barely slept at all before the surgery because of the pain. I know there will still be hard times, but I am writing to thank all you for sharing your experiences on this forum. It has helped me immensely and I hope it will help you too. Hang in there.

 

[Josephine]

Fantastic! I like a positive note to end on!

 

[Weezl]

Hi I am a female, just turned sixty, but a young vital sisty who worked out since 12 yrs old. I am scheduled as an emergency next friday as I had multiple blood effusions into my knee joint. Soo painfull. I am gong to HSS in NYC and they want to use the Stryker tri athalon whic they say the different components are sized to your specs. I haven't heard what you describe. Where did you go? I'm terrified. Weezl

 

[referee54]

I had two Stryker Triathlons put in seven weeks ago. Don't be terrified! Nervous, yes---terrified, no. I am progressing very nicely and am going to PT twice a week and four other times on my own.

If you are not sure about the Stryker, talk to your MD and get a second opinion---better for you peace of mind!

The PT is tough but the rewards are many---best of luck; talk to your Doc and see if somebody else has aonther opinion.

Tim C.

 

[Weezl]

I'm new here and thankfull it exists. What is that 3 D model made from an MRI?? have been in constant pain since October when for no reason I bled into te knee joint and it keeps happening. Why don't they just find that cause and stop it?? I'm terrified of the TKR and it's next week. The responses here citing all of the pain are making me ill. Don't think I can do it. Aquaintences, friends, patients of mine only hear positive outcomes. Here everyone has had a long painfull recovery. Hasn't anyone sailed through? I've already not slept since October. I'm supposedly a very strong woman but i feel like such scaredy cat. I want my life back.

 

[Cathie]

Weezl-
Try not to be terrified. Think of the end result. Everyone I have talked to says it is all worth it in the end. I am at 12 weeks today and doing so much better. Yes, it is hard work. I sailed thru the surgery, TKR - right knee. But the therapy has been hard. I am looking forward to the day where I can get up and be pain free - and I do believe that is coming. Its a slow process, but its getting better each day. I am still going to PT 3 times a week and at 107 degrees. Everyone is different tho, so you cannot judge yourself. This is what I have learned from this fabulous forum.
Good luck - keep us informed on your progress.

 

[ciaobella]

Wheezl

Don't be discouraged.
It's unusual to have recurrent bloody effusions in the knee. That usually occurs when you injure something badly like tearing an ACL. So you're having bleeding into your joint spontaneously - without any trauma?
Make sure you get checked for a bleeding disorder such as platelet disorder or coagulation disorder such as VonWillebrands or Hemophilia. I assume you have bad arthritis in your knee and will do great with a TKR.

As for the info on the 3D model of the knee I had - there are a lot of new computer assisted techniques in knee replacemnts.
Normally when you have a typical TKR the surgeon uses the 'navagation technique'. Most knee prostheses come in 8 or more sizes. With the navagaion technique the surgeon opens up your knee and takes measurements during the operation to decide which size fits best and also where to make the cuts. With the custom fit technique I had - they did an MRI of my knee and made a 3D computer model of my damaged knee. Then they 'superimposed' the various sizes to decide which is the best fit. The 3D model also creates a custom cutting guide that tells the surgeon where to make the cuts. So the actual surgery takes about half the time. My surgery took an hour.

But I think if you have an experienced surgeon the outcomes are the same. The amount of tissue damage they do in both techniques is the same. Also your body still has to adjust to the new components. I think the only real difference is your knee is only open for half the time with a computer assisted technique so there is less chance of infection. The recovery may be quicker in the Custom fit but I'm not so sure. My experience seems to be similar to the others.

Here's some links to what I had. I'm at about 125 degrees 2 months out. every week something is a little better! Today was a good day!
The videos are very interesting.

https://www.news10.net/display_story.aspx?storyid=28642
https://www.news10.net/display_story.aspx?storyid=31821
(Click on Jennifer Smith's Report)

https://www.otismed.com/

I'm curious about the Stryker?
Sounds like something Custom.
Anyway thanks JuneBugg for giving me hope the popping will go away once the swelling improves.
Also Tim - My friend is in the local cycling club - the Sacramento Wheelmen - and they have a lot of retirees that do the century rides. She says lots of the members have had hip and knee replacements. So our cycing future is real...
Thanks for all the encouraging stories.
You're my new found friends!
Ciao - in bocca al lupo! (good luck in Italian)

Barbara

 

[referee54]

Well, it is 3:12 here EST and I have been up since midnight. I tried Tylonol PM---didn't work worth beans. Just can't seem to get comofrtable and the right knee is tender. I have tried more pillows than would keep the Titanic afloat---so I guess it isthe usual---up until around 5:000Am and then sleep for 4-5 hours. My MD is out of town until the 7th---and I go back to teaching on the 3rd! I try to lseep, I get up, I am in discomfort, and I get frustrated---no sleep for me---just like the "sleep Nazi"..

Other than that issue, my knees have been fine. PT is working me very hard, and on the days that I do not go to the PT, I go to the gym and I have my own regimen of exercises.

Any suggestions? I am tired right now, and I feel wiped out, but I know that if I lie down, sleep won't come for a few more hours.

Tim C.

 

[Josephine]

I'm new here and thankfull it exists. What is that 3 D model made from an MRI?? have been in constant pain since October when for no reason I bled into te knee joint and it keeps happening. Why don't they just find that cause and stop it?? I'm terrified of the TKR and it's next week. The responses here citing all of the pain are making me ill. Don't think I can do it. Aquaintences, friends, patients of mine only hear positive outcomes. Here everyone has had a long painfull recovery. Hasn't anyone sailed through? I've already not slept since October. I'm supposedly a very strong woman but i feel like such scaredy cat. I want my life back.

Weezl, my heart goes out to you. We all understand how you feel - we've all been there but those who have been through it are still here to tell the tale! ALL operations are painful. It goes with the procedure. But there are ways of coping with that like painkillers, ice packs and elevation. Sure, it monopolises your life for a while but the outcome is worth it in the end.

And one final thing - EVERYONE is anxious/nervous/terrified of an operation. It's perfectly natural. But try to hold yourself together and see the good future you will have eventually. I'll be praying for you.

 

[Bev55]

Hi Weezl

I've nearly concluded that the hardest part of this whole process is staying positive. It has helped me to have family members around to mop up my tears and re-assure me AND remind me of how much better I am today than yesterday.

I'm 55 and had a HKR. Compared to some of the descriptions on this forum, I've had minimal swelling and absolutely no bruising. To earn my right to leave hospital I was supposed to have a 90 degree bend. I failed miserably but they agreed to let me out of hospital! Exercises to bend the knee produced pain, but kept hearing the PT's voice (even when not near me) "no pain, no gain".... Religiously doing exercises (even through the tears) has been a bonus.

And.... if it helps your morale any..... I too was totally terrirfied of having the surgery. Am a total wimp at heart. While the whole experience is very much a step into the 'unknown' and you will constantly hear that everyone's recovery is different and you shouldn't swap notes with anyone, I guess you have to keep in mind the level of pain you are in right now and have been for x months/years in the lead up to surgery.

This forum is great for knowing that you are not alone.
Thoughts will be with you for next week.

 

[Josephine]

Wimp? Oh please - NO - NOT EVER!! NO WAY!! NO-ONE is a wimp for being anxious>terrified of having an operation of any kind.

Think about it - you're placing yourself in the hands of people who are not only total strangers but you don't even set eyes upon, having things done to you you don't know about and wouldn't understand even if you did. Enough to the scare the bejeebers out of anybody, don't you think?

Listen, I know all about this stuff, I worked in the operating department I was treated in and the people looking after me were my colleagues and friends and yet it stilled scared the bejeebers out of me for just an arthroscopy! Especially when people keep coming to you and reading out screeds of "what can go wrong" right up to and including death on the highly questionable (in my opinion, but then I'm old school) precept that knowledge is power and consent should be 'informed' consent!

Trust me, being scared witless is part of the script.

 

[JonInce]

Zoics ! 5-7 weeks off ? .........Hmmm may need to rethink my strategy then. My schedule is pre-op admittance 15th Jan, op 16th Jan...5 days in hospital. Home monday 21st....rest thru 27th and back to work on crutches on 28th ? ..........am i way too ambitious ?

 

[JuneBug88]

Zoics ! 5-7 weeks off ? .........Hmmm may need to rethink my strategy then. My schedule is pre-op admittance 15th Jan, op 16th Jan...5 days in hospital. Home monday 21st....rest thru 27th and back to work on crutches on 28th ? ..........am i way too ambitious ?

I had my surgery on November 27th I had my rtk done. I am still not ready to return to work and I work mainly a desk job. What I found in early recovery is I could not handle the pressure of my leg down for a long period of time. Even having my leg reasting on a chair hurt. The only relief I got was by laying on the hospitial bed or the recliner with a pillow under my leg. Plus the medication I was on no way was I able to work.
Debbi

 

[Sue]

Zoics ! 5-7 weeks off ? .........Hmmm may need to rethink my strategy then. My schedule is pre-op admittance 15th Jan, op 16th Jan...5 days in hospital. Home monday 21st....rest thru 27th and back to work on crutches on 28th ? ..........am i way too ambitious ?

You will need to take the month of February off, as well. Plan on going back to work in March.

I had surgery right TKR on Oct. 18th. I was fortunate workwise because I telecommute, doing some editing work, so I was able to get back at it almost immediately, working from my bed and recliner. But it took me about a month until I could sit in an office chair at a computer, and then I could only do it for short periods of time. It was six weeks before I could spend several hours at a desk. And this was at home, without the commute.

If there is some way you can work from home, you can get back to work earlier.

 

[Josephine]

Zoics ! 5-7 weeks off ? .........Hmmm may need to rethink my strategy then. My schedule is pre-op admittance 15th Jan, op 16th Jan...5 days in hospital. Home monday 21st....rest thru 27th and back to work on crutches on 28th ? ..........am i way too ambitious ?

Just a tad! Be kinder to yourself! You are not having a tooth extraction here!

 

[referee54]

I had a double TKR done and I returned to teaching at exactly eight weeks---still moving a little slowly, but getting the job done. You are going to have major surgery on your leg---you are also going to need some PT at home and then at an outpatient center. I learned that after a TKR, the patient, as well as the progress, tended to move slowly.

Tim C.