PKR Need to decide between PKR and TKR

[lrj]

3) For all of you that have had PKR's, do you think a cane will be good enough to get me around initially or will a walker be necessary?

I used a walker at first, then transitioned to a cane. I'd say I used a walker all the time during the first two weeks, and then for longer distances only for the next two weeks. On stairs, initially, I used one crutch and the hand rail.
I had patella femural PKR. It's doing well and still improving every day. Mostly feels natural, but has its moments. The most unnatural feeling is that feeling is a bit off next to the scar. I can't feel surface touch, but can feel pressure.

 

[EalingGran]

I didn't use a walker at all. I used crutches for first few weeks- can't remember exactly how long, probably 3-4 weeks. Then switched to one crutch for a few more weeks.
I carried on using a foldable walking stick for a few months outside because it was slippy ( autumn leaves then icy) and I was frightened of falling.

 

[sk44tyler]

Hi everyone,

So, since I have several months to go before my PKR (end of August), I figured I would do a little more research into comparing a high tibial osteotomy (HTO) vs a partial knee replacement (PKR). The primary reason being that my surgeon, whom is performing my PKR, still believes that an HTO (w/ potential cartilage treatment on the medial side (e.g. OATS)) is still his preferred path (even though he's agreed to do my PKR). Anyways, I found the following video on YouTube to be extremely informative and helpful. I figured I would share it, as it might help others in a similar situation to my own. At the end of the day, I think I am still leaning towards PKR, but I have time to change my mind (or have others change it for me). Keep in mind - I am the type of person that researches everything to death before I make a big decision.

- YouTube

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

youtu.be

 

[sk44tyler]

1) an ice machine! I have the Breg Polar Care Cube. Instead of using ice per its instructions I use four frozen 12-ounce plastic drinking water bottles after putting in the water to the fill line. Keep another several water bottles in your freezer and its easy to swap them out.

So I ended up finding a good deal on Facebook Marketplace for a used Ossur Cold Rush Compact ice machine. Unfortunately, when I got home I tested it and the knee pad was leaking quite a bit of water. This is the risk you take buying used I guess. Anyways, I found a replacement knee pad on Amazon (screenshot image below) that ended up working perfectly with this ice machine. I'd actually say this knee pad is overall manufactured much better than the original pad that came with this unit. Anyways, I thought this might be useful for anyone who might have the Ossur Cold Rush compact. By the way, I am quite happy with this unit (once I got the new knee pad)... it works well and I wish I purchased one of these sooner for the days my knee was inflamed and painful.

 

[hhilltop]

I don't know where you live, but I would suggest that you consider researching this as an option, too. It isDr. Gaustch in Gattlin, TN. He uses computer assisted surgical techniques with a side angle surgery that I think may just do limited replacements to the worn bone regions. All the patient reports are amazingly short recovery. You probably wouldn't find a BoneSmart patient that would not have appreciated a shorter recovery time. Check it out. LcJudge reported it on BoneSmart. I wish I'd heard of it a year earlier. I do my homework, too.

Have fun searching. Keep us posted.

 

[sk44tyler]

I don't know where you live, but I would suggest that you consider researching this as an option, too. It isDr. Gaustch in Gattlin, TN. He uses computer assisted surgical techniques with a side angle surgery that I think may just do limited replacements to the worn bone regions. All the patient reports are amazingly short recovery. You probably wouldn't find a BoneSmart patient that would not have appreciated a shorter recovery time. Check it out. LcJudge reported it on BoneSmart. I wish I'd heard of it a year earlier. I do my homework, too.

Have fun searching. Keep us posted.

Thanks for the info. Unfortunately, I am in Charleston, SC and Gallatin, TN is an 8 hr drive for me.

 

[hhilltop]

8 hour drive with 3 week recovery or shorter drive with likely 3-6 months even a year of recovery. I still recommend checking it out - then decide. You might want to inquire of Lcjudge how his second knee went.

It is your knee and your choice. I'm just on the sidelines, ready to cheer you on either way.

 

[benne68]

@hhilltop This member (Lcjudge) has not been back on the forum since his initial 2 posts back in January, so it is unlikely we will hear anything more about his procedure. Perhaps his recovery wasn't quite as easy at the surgeon's marketing led him to believe. Either way, I'm sure it's disappointing for people who want to know the whole story.

@sk44tyler Traveling any distance immediately after this surgery is difficult. I half-sat/half-lay in the back seat with my leg elevated and ice pack on it for the 30 minute drive home and it was torture. I think you are wise to stick close to home. Let us know how else we can help you prepare for the big day!

 

[sk44tyler]

@hhilltop This member (Lcjudge) has not been back on the forum since his initial 2 posts back in January, so it is unlikely we will hear anything more about his procedure. Perhaps his recovery wasn't quite as easy at the surgeon's marketing led him to believe. Either way, I'm sure it's disappointing for people who want to know the whole story.

@sk44tyler Traveling any distance immediately after this surgery is difficult. I half-sat/half-lay in the back seat with my leg elevated and ice pack on it for the 30 minute drive home and it was torture. I think you are wise to stick close to home. Let us know how else we can help you prepare for the big day!

@benne68 - Thank you for your feedback. One question I did have was if anyone has used any kind of water proof shower bag for their knee after surgery (like the one below)? Do they work well?

 

[benne68]

Whether you need one depends on how your surgeon closes the incision and what kind of bandage is used.

I suggest checking with your doctor's office before your order to see if you will even need it, @sk44tyler.

I did not -- my TKR incisions (both knees) were closed with glue and covered with a waterproof bandage. The only instruction was to wait until day 3 to shower and not to take a bath or immerse it completely in water. With my hip surgery, on the other hand, I was advised to cover the incision initially. I used a big plastic bag which I taped on with first aid tape. Not as attractive as the device you found, but it did the job.

 

[EalingGran]

suggest checking with your doctor's office before your order to see if you will even need it, @sk44tyler.

I did not -- my TKR incisions (both knees) were closed with glue and covered with a waterproof bandage. The only instruction was to wait until day 3 to shower and not to take a bath or immerse it completely in water

Agree with @benne68 that you may not need one. I had glue and was able to shower from early on.
The shower covers do work though, if you need one. My husband had surgery to straighten his toes and he had a shower cover ( I think it was called Limbo) and it worked very well.

 

[EalingGran]

Traveling any distance immediately after this surgery is difficult. I half-sat/half-lay in the back seat with my leg elevated and ice pack on it for the 30 minute drive home

Agree with @benne68 on this. You really want as short a journey as reasonably possible. I had just a 30 minute taxi ride with my leg as straight as possible.
I was terrified of being jolted in London traffic but thankfully the driver was excellent. I was also worried about getting up the steps to my house on crutches. Try to make the journey as easy as you can.
I would also be wary of excessive claims for a speedy recovery. I love my PKR and my knee is now not far off as good as my perfect unoperated knee. But it wasn't a quick recovery by any means.

 

[sk44tyler]

Whether you need one depends on how your surgeon closes the incision and what kind of bandage is used.

I suggest checking with your doctor's office before your order to see if you will even need it, @sk44tyler.

I did not -- my TKR incisions (both knees) were closed with glue and covered with a waterproof bandage. The only instruction was to wait until day 3 to shower and not to take a bath or immerse it completely in water. With my hip surgery, on the other hand, I was advised to cover the incision initially. I used a big plastic bag which I taped on with first aid tape. Not as attractive as the device you found, but it did the job.

Great info... I will be sure to ask my Dr. (I have the pre-surgery appointment tomorrow actually)

 

[sk44tyler]

Traveling any distance immediately after this surgery is difficult. I half-sat/half-lay in the back seat with my leg elevated and ice pack on it for the 30 minute drive home

Agree with @benne68 on this. You really want as short a journey as reasonably possible. I had just a 30 minute taxi ride with my leg as straight as possible.
I was terrified of being jolted in London traffic but thankfully the driver was excellent. I was also worried about getting up the steps to my house on crutches. Try to make the journey as easy as you can.
I would also be wary of excessive claims for a speedy recovery. I love my PKR and my knee is now not far off as good as my perfect unoperated knee. But it wasn't a quick recovery by any means.

Thanks for your feedback. I will be getting the surgery locally, but it is still about a 30-40 min drive depending on traffic. My wife will be driving me...

 

[sk44tyler]

One other question I just thought of for you all... Do you think I need to worry about having a metal allergy (as associated to the PKR)? From my research, it appears it is quite rare but does in fact happen (occasionally). I found another post stating you can get a metal allergy test done by a company called Orthopedic Analysis (w/ a Dr's order), however it costs close to $500. This seems rather high... Any thoughts on whether or not it's worth it?

 

[EalingGran]

I know some people here have had the tests but I do think it is pretty rare.
I am definitely allergic to cheap nickel in earrings and bangles but I forgot to mention it and have had no problem with my Oxford knee implant.
I did look at some of the recent research in this area and it is both controversial and very interesting. There is a real debate about the likelihood of metal allergy affecting outcomes. The other issue is that apparently most of the metal ions in knee surgery actually come from the cutting blocks the surgeon uses- not the implant. So you could have a nickel free implant but still have high nickel exposure. I am not sure whether MAKO surgery uses cutting blocks- so if you really are very sensitive, it might be worth asking about this.

 

[InkedMarie]

@hhilltop This member (Lcjudge) has not been back on the forum since his initial 2 posts back in January, so it is unlikely we will hear anything more about his procedure. Perhaps his recovery wasn't quite as easy at the surgeon's marketing led him to believe. Either way, I'm sure it's disappointing for people who want to know the whole story.

@sk44tyler Traveling any distance immediately after this surgery is difficult. I half-sat/half-lay in the back seat with my leg elevated and ice pack on it for the 30 minute drive home and it was torture. I think you are wise to stick close to home. Let us know how else we can help you prepare for the big day!

@benne68 - Thank you for your feedback. One question I did have was if anyone has used any kind of water proof shower bag for their knee after surgery (like the one below)? Do they work well?

I did not need to cover my knee. I sat on a shower chair & my leg rested on the side of the tub. It got wet but not soaked & it was allowed to. Don’t buy this kind of stuff without find out from your surgeon. No sense wasting money!

Marie

 

[hhilltop]

You have a point about travelling after surgery. 40 min. with gritting my teeth was my most recent experience.

 

[sk44tyler]

Whether you need one depends on how your surgeon closes the incision and what kind of bandage is used.

I suggest checking with your doctor's office before your order to see if you will even need it, @sk44tyler.

I did not -- my TKR incisions (both knees) were closed with glue and covered with a waterproof bandage. The only instruction was to wait until day 3 to shower and not to take a bath or immerse it completely in water. With my hip surgery, on the other hand, I was advised to cover the incision initially. I used a big plastic bag which I taped on with first aid tape. Not as attractive as the device you found, but it did the job.

Great info... I will be sure to ask my Dr. (I have the pre-surgery appointment tomorrow actually)

Well I had my appointment yesterday... My Dr. informed me he would be doing internal stitches with a waterproof bandage. I will be able to shower 2-3 days post surgery. Therefore, no need for any kind of shower bag.

 

[sk44tyler]

I know some people here have had the tests but I do think it is pretty rare.
I am definitely allergic to cheap nickel in earrings and bangles but I forgot to mention it and have had no problem with my Oxford knee implant.
I did look at some of the recent research in this area and it is both controversial and very interesting. There is a real debate about the likelihood of metal allergy affecting outcomes. The other issue is that apparently most of the metal ions in knee surgery actually come from the cutting blocks the surgeon uses- not the implant. So you could have a nickel free implant but still have high nickel exposure. I am not sure whether MAKO surgery uses cutting blocks- so if you really are very sensitive, it might be worth asking about this.

So I asked about metal allergies in my appointment yesterday. My Dr. said that I do not need to worry about it for 2 reasons: 1) I have an existing screw in my (from over 20 years ago) that would have caused me problems if I had a metal allergy 2) My Apple Watch would be causing me problems if I had any type of metal allergy (e.g. skin irritation).
Also - you're comment about cutting blocks... From my research, I've found that MAKO doesn't use any kind of cutting blocks or guides. The 3D program generated from the CT scan provides the MAKO robot with a digital guide of the cutting path. When the Dr. is using the burring tool (connected to the MAKO robotic arm) to remove bone, the robot will provide positive haptic feedback, thus preventing the bone removal from going outside of the pre-programmed path. This is one of the major benefits of MAKO - more precise bone removal which should lead to less inflammation post surgery.