New Year, New Knee

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jaschembra

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Which knee would I want done first? The Left

Here is what my knees (and I) have been through so far:

Lost 50 pounds 2014-2016 :)

Bilateral - cortisone injections - Aug. 23, 2016 - no change as of Sept. 9
Bilateral - 4 Orthovisc injections - May-June 2016 - no change
Left - cortisone June 2015 - no change
Right - Arthroscopy April 1, 2015 - torn meniscus and osteoarthritis clean-up
Right - MRI March 2015, advanced IV osteoarthritis and baker's cyst - drained/cortisone/PT - cortisone helped for 2 weeks and then the knee popped and blew up again.
Left - MRI 2007 - advanced osteoarthritis, thinning ligaments
Right - MRI 2002 - torn meniscus, PT
 
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Which knee hurts the most? I'd get that one done first.

You could ask your surgeon if he/she would consider doing both knees on the same day - a bilateral.
Alternatively, would he/she do staged knee replacements - one knee first and the other a few days/weeks afterwards.
 
I had the same dilemma. Since both hurt, which knee to do first??? I finally decided with my surgeon's help to do the right one first. Although it is probably the stronger of the two and the intensity of the pain is worse in the left, the right hurts more constantly and I only have 90 degrees bend in it where I have 110 in the left. So, I chose to do the right, and I will have the left one done "as soon as the replaced one becomes my good knee" in a couple months or maybe 3. I don't know if any of this helps you or not, but that's how I came to my decision.
 
Isn't your right the worse one? Get it first if so.

Or you could do both at once.
 
why not do both at once if your health permits? Only makes sense. I had two bad bowed out knees.. fixing just one would not have helped me out. Fixing both at the same time was the ticket! You will never regret doing it.
 
Just what I was thinking, @Gazelle777 Seems to me like a bilateral is called for.
 
Hi Everyone. Thank you for the comments. I hadn't been able to log in with my log in credentials since this thread was made but now I see I can!! Yeah!!! :)

I don't believe mentally I could go through a bilateral. The OS I plan on using doesn't do bilaterals. He said 4-6 weeks, I'm thinking more like 6 months. I have my daughter's wedding in May, so I was considering one in January and the other after the wedding.

The right one is actually my good knee (if you can call it that) and has been (unfortunately, I think I depended on it too much a couple years ago which necessitated the scope). The left one feels unstable at times and has as much bone on bone (advanced OA 10yrs. ago under the knee cap, thinning ligaments and a small meniscus tear). Pain is almost equal, but often times, the left one hurts the most. I'm seeing my 20+ year OS today for a 2nd opinion. I just want to hear another OS say my knees are candidates.

I plan on using my mother's OS for the replacements (some of you know SpunkyBarb - I'm her daughter who was posting - she's doing really well by the way, 14 weeks post RTKR Since I've just lived through her replacement, I'm very comfortable with the OS and his work)

I think what I struggle with the most is: I have really good ROM (really good) and my legs are straight and for the most part, I have no pain sitting or sleeping. Taking all that into consideration, do I try to wait in order to get older and never need a revision... The OS says they can last up to 30yrs now (testing environment).

I do have pain/discomfort ALL of the time when walking and standing. I feel at times like there is a vice grip or huge tight band around my knees or like I'm walking with knees that are not mine. I've been on the prescription anti-inflammatories daily and don't get much relief (Meloxicam, Diclofiniac, Feldene, Celebrex now) and I take all the supplements for OA.

There are things/places I don't do/go because it involves too much walking or standing in lines. I sit while making dinner if it involves cutting... Although, I regularly get 6,000-8,000 steps in a day due to living on 10 acres with animals. I do water aerobics 3 x a week. I guess I also feel, now is a good time to get it done while I AM in good shape versus waiting and they weaken causing less muscle mass?? I'm so torn and it occupies my mind way too much. Thanks again for all your comments.
 
I think what I struggle with the most is: I have really good ROM (really good) and my legs are straight and for the most part, I have no pain sitting or sleeping.
I recognise that. I was exactly the same! But .....
I do have pain/discomfort ALL of the time when walking and standing.
I can explain this

I had barely any ongoing pain, just what I refer to as a 'stone in the shoe' pain which came and went erratically. Sometimes it lasted for an hour, sometimes for a week but I knew what caused it so let me share that with you.

Arthritis has the effect of making our joints crumble like an old concrete step.

ai64.tinypic.com_wb2fr6.jpg


It breaks down, creating lots of grit and debris. Generally this stays in the pouches at the side of the joint but every so often, a bit gets into the weight bearing part of the joint and then we get that extreme pain and can't bear weight on the leg at all! Pain killers do nothing, nor do things like braces. We are just conscious of this horrible burning pain that all of a sudden goes away!

ai66.tinypic.com_vcxieq.jpg



It's every bit as disabling as the constant bone-on-bone pain so many others suffer and is a very good indicator that a joint replacement is needed.

To assess your need for replacement, print off the form in this link, read the instructions and fill it in
Score chart: how bad is my arthritic hip/knee
Taking all that into consideration, do I try to wait in order to get older and never need a revision... The OS says they can last up to 30yrs now
You might wait ages and find that, for unexpected reasons, you need a revision in a year or two. Or never! That's the trouble with this - you can't guess about the future. The only thing to consider is now. So do you want to wait another 5-10 years in pain and an ever shrinking quality of life or live life as it should be right now and to heck with the consequences in the far distant future? After all, a big red bus might come along one day and make this entire discussion totally redundant!
 
I hadn't been able to log in with my log in credentials since this thread was made but now I see I can!! Yeah!!! :)
It was a technical problem. Now we have a new technician on board (hooray!) he is gradually fixing all the problems.
The left one feels unstable at times and has as much bone on bone (advanced OA 10 yrs. ago under the knee cap, thinning ligaments and a small meniscus tear). Pain is almost equal, but often times, the left one hurts the most.
IN that case, I'd get the left knee done first.
Taking all that into consideration, do I try to wait in order to get older and never need a revision... The OS says they can last up to 30 yrs now (testing environment). I do have pain/discomfort ALL of the time when walking and standing. I feel at times like there is a vice grip or huge tight band around my knees or like I'm walking with knees that are not mine. I've been on the prescription anti-inflammatories daily and don't get much relief (Meloxicam, Diclofiniac, Feldene, Celebrex now) and I take all the supplements for OA. There are things/places I don't do/go because it involves too much walking or standing in lines. I sit while making dinner if it involves cutting...
It sounds to me as if the condition of your knees is already having quite an impact on your quality of life. Therefore, I say get those knees replaced asap. It's not good to be taking anti-inflammatories long-term and your knees will not get any better on their own.

I was one who needed a knee replacement when I was 50. My surgeon persuaded me to try and wait until I was 60, when I would be "old enough". Such an old-fashioned idea!, now that replacements can last 30 years or longer. In any case, having a revision is usually no worse than having the original surgery.

I waited for 9 long, miserable, painful years, during which time my life became smaller, my activities decreased and I became almost house-bound. My leg grew weaker and my muscles, tendons and ligaments distorted.
I'll say to you what I felt then - you are too young to feel so old!

My first knee replacement (at age 59) gave me back my life. No longer a semi-invalid, once I had recovered from the surgery, I travelled the world again. I started to enjoy life again, instead of feeling that I would give anything for just one pain-free day.

You helped SpunkyBarb through her TKR - it's good to hear she is still dong well - and I'm sure she will return the favour and help you as much as she can.

Best wishes. We'll be here for you.
 
why not do both at once if your health permits?
I was thinking very much the same. both of my knees were shot and I was able to get the BTKR done.
I don't believe mentally I could go through a bilateral.
IT is a bit more challenging, but certainly not overwhelming. Nothing that one deserves a medal for---If I had to do it all over again, I would go the same route. Some OS's, though, as a matter of protocol do not do them. I asked mine if he would perform a BTKR, and he did not hesitate.
 
I appreciate all of your feedback.

Received 2nd opinion today. I’m getting an MRI on the left knee to determine the true status of OA – x-rays show no cartilage under half of the kneecap, but the other compartments are questionable for a TKR and the Dr. said, if no OA there, I would be a candidate for a PKR on the left (Patella-Femoral, he uses Zimmer). He agreed the right was a candidate for TKR.

Has anyone heard of the Smith & Nephew implants with the textured surface and screws versus cement? He said it is used for younger people and the bone attaches to that textured surface.
 
Well, I had my follow up visit with my OS today regarding the left MRI. There is more than one compartment with the bone on bone osteoarthritis and warrants a TKR.

I had been doing some comparison of surgeons (my mom's versus my OS) processes, ratings, etc. and had decided my OS would be the doc of choice. What I didn't expect is that I would leave with a date on the books. I had a date range in my head but now it's on paper! He waits at least 3 months before the right knee would be considered - I plan on waiting 6 mos. or so. Wedding May 5 is my goal to feel good on my left side!! He told me to keep a list as any come up and email him. He has always been great about answering emails via his patient portal.

The implant of choice will be the S&N Legion (porous, no cement). He said it takes a longer for the "ache" of bone growth to go away, but he likes to use this one on younger people. He said I should be 1 or 2 nights in the hospital. My plan will be to leave the hospital and stay at my mother's home for a couple of weeks. She leaves for FL on Jan. 5 - This will allow me a bed and bath on the main floor and my 150 lb. defensive dog will not be around to knock into me or scare away home health! My sister is going to stay with me. My husband will visit daily but he will stay home to take care of the critters (horses, dog, cats, and chickens). 4-6 weeks prior to surgery, he likes you to start drinking protein drinks with each meal - I'll need to work that into my diet - I am a Lifetime Weight Watcher and have been at goal for 6 mos. - I don't need to be gaining any weight prior to this (or after)!

From this point forward I must have all positive thoughts - If you hear or see differently, feel free to remind me!!
You are all so brave and are such role models. I will keep reading and learning from the articles and stories.
 
ut the other compartments are questionable for a TKR and the Dr. said, if no OA there, I would be a candidate for a PKR on the left (Patella-Femoral, he uses Zimmer).

There is more than one compartment with the bone on bone osteoarthritis and warrants a TKR.
In a way, I think that this is a better option---many PKR's end of becoming a TKR down the road. I guess, in my perspective, that it is better to have one surgery than to possibly have to go back in and have another surgery.
I don't need to be gaining any weight prior to this (or after)!
I would not worry about this at all---in fact, many of us, after the TKR or the BTKR, actually lost weight---I lost close to 15 pounds. Look long term in this regards----what the TKR and the protein will enable you to do in terms of activity and in terms of a much more enjoyable lifestyle.
 
@jaschembra

Glad to hear you have your surgery date. You'll have plenty of time to prepare before then. I was instructed to drink 2 protein shakes a day for the month I waited for my LTKR. I found that I couldn't eat too because it filled me up so much. Hopefully that will help you maintain your weight.

Jen
 
Hi @jaschembra! As with all the fab posters here I was fascinated and impressed with the Story of Your Joint. But the following statement caught my eye:

"My husband will visit daily but he will stay home to take care of the critters (horses, dog, cats, and chickens)"

I see that you have a :horseriding: Me too! That's him as my avatar. (Of course everyone thinks this :fasthorse: is what it's REALLY like!) Not being able to ride consistently for almost a year has really taken a toll on me physically and emotionally. Have you had similar problems? I would LOVE to chat!
 
That's great that you have a surgery date. I was told that I had to wait until 60 for a TKR and I lost out on so many activities while waiting for that birthday to roll around. I've had problems with this knee starting back when I was only 18 so I suffered and continue Ueda to get worse by over 40 years. I'm glad I finally have it over with now.

I have a knee that is not cemented in as many are. The bone grows into the device over the first 12 weeks or so and it is now very strong. I wound up with that type of knee when I had my revision 8 months after my original TKR ( long story). I could still walk on it on day one.
 
I'm not sure that protein shakes are really necessary, as long as you have enough protein in your diet anyway. You can't store additional protein as protein. Any protein that is excess to your body's daily need is just converted to carbohydrates and you would store that as body fat.
 
It definitely helped curb my appetite. I don't get anywhere near enough protein in my diet, so I suspect that was the reason for it? Not sure, but it seems to have worked out fine. :)

Jen
 
If you know you aren't getting enough protein in your diet, then the protein shakes are a good idea. Even better, though, is to eat a regular diet that includes enough protein.
 
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