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TKR New, young, and afraid

Unfortunately a second opinion might just confuse the issue even more. No surgeon is going to demand you proceed with surgery. They will give you all the options and let you chose what you think works for you. If a surgeon has already indicated TKR is in your future I would just confirm with anyone new that they agree.

Do you know if this new surgeon works with younger patients. Age really isn't a factor in joint replacement - but some surgeon needlessly dwell on it.

Please let us know how your appointment goes.
 
No, I don’t know if this OS works with younger patients @Jaycey I just know he was recommended by a family friend And works in a completely different health system then my original OS.
My original doctor told me that for him age is NOT a factor and he treats people based on condition of the knee and not age. He is also a reconstruction/revision knee specialist so I’m sure that plays into his practice.
I will definitely update with what this new doctor tells me. Thanks again :)
 
You do want to know how many knee replacements he does each year. It's important that he specializes in knees and doesn't do a variety of other joints as well. A lot of times surgeons will do hips and knees, but you really don't want more of a generalist that does beyond that. If someone is a sports team doctor, be aware that doesn't necessarily translate into a good knee replacement surgeon. Usually we tell people to try and steer clear of these surgeons who usually don't have good annual numbers for knee replacements.

I would encourage you to be honest with yourself about the condition of your knees and your quality of life at present. Many times the longer you wait for the replacement, the more damage you'll do to your knees and that can mean a bit more difficult recovery. When knees are really trashed, the surgeon may have to spend more time in surgery and manipulate your soft tissues more. That can result in a bit more pain or a somewhat slower recovery.
If you worry about "losing" your summer, remember this is just a short blip in your life and there are many more pain free summers to come. In recovery, you begin to regain the ability to do normal things slowly, but you can enjoy things like summer outings and even vacations if you do some pre-planning. All is not lost when you're in recovery.

Good luck with your appointment.
 
I looked into the doctor I’ll be seeing on Thursday @Jamie and he is exactly what you mentioned I should stay away from….he surgically repairs knees, ankles, elbows, hips, and shoulders. He does more shoulders than anything else. My original OS only does knees and hips. Well I’m going to him just to confirm my need for a TKR. I actually trust and like my current OS. Seeking the 2nd opinion for confirmation and peace of mind. Will update Thursday :) :-) (:
 
Even though he is more of a generalist with joint replacements and you might not want him doing your surgery, he should be able to tell you whether knee replacements are needed. Have him actually point to the problem areas on your x-rays so you see it for yourself. You can even ask for a copy of your images to pull up and view so you're reminded why you may need to go ahead with the surgery as soon as possible. Your knees won't get any better with time, but I can tell you from my personal experience, a bad knee can sometimes get a lot worse fairly quickly. If you do get a CD-ROM of your knee x-rays, we'd love it if you could post it here. Those images help others see what may be going on in their own knees and can be very helpful.
 
Hi guys! My appointment went well but was a completely different experience. X-rays we’re done on both knees. The doctor said he didn’t recommend tkr on either knee. He showed me where i still have joint spacing. I am not bone on bone. I do have arthritis but he believes my pain is from patella tendinitis and IT band syndrome. He asked me who had recommended tkr and apologized for that recommendation. He ordered an MRI of the left knee as the right has already been done and told me that after the MRI he will discuss a treatment plan with me. I walked out confused and upset that the first OS would suggest something that isn’t necessary at this point. He also mentioned an abnormal growth on my right knee and told me to bring the CD of my MRI on my next visit. I’m not sure how to feel.
 
This is why we get second opinions. Give yourself time to process the information, a decision doesn’t have to be made today. Get the further testing done and hear him out when he proposes a plan. Then take some time to think about it. Choose the plan that makes the most sense to you.

You might even want to consider a third opinion, as a tie breaker.

Here is my experience. I had pain in both knees and went to a Ortho surgeon who said I needed a Patellofemoral partial replacement. It never occurred to me to get a second opinion, I figured he knew what he was taking about. I had the partial done several months later. It has not gone well for me. I found Bonesmart after my replacement, and learned that partials are quite controversial, and the Patellofemoral seems to be the least successful. I didn’t know anything about making sure the surgeon had a lot of experience with my procedure, I just assumed he did. I’m sure he does a great total, but he didn’t with my partial. Therefore, I wish I had waited until I was bad enough to need a TKR.

I’ve had 2 second opinions since my surgery and I asked the second one if he did Patellofemorals and he said no. I wish I’d seen him before I had my surgery so that I could have made a more informed decision.

I‘m not saying that you might not need a TKR, I‘m just relating my experience. You also might have gotten 2 very different opinions because they are different types of surgeons. The first one‘s main job is TKR. The second does them, but it’s not his main focus.

I do know we have too many members who have had a lot of surgical procedures before having a TKR, especially in a relatively short time, you can see that in their signatures. Each surgical procedure causes trauma to the knee, and it seems that they might have a more difficult TKR recovery because so much has been done to the knee before. I hope you are not headed in that direction. There are procedures can delay the need for a TKR, but not always worth it in the end.

Take notes when this second doctor gives you his recommendation, come back here, and we’ll discuss it with you. This is a big decision. We’re here for you!
 
Shortstuff26 said:
Hi guys! My appointment went well but was a completely different experience. X-rays we’re done on both knees. The doctor said he didn’t recommend tkr on either knee. He showed me where i still have joint spacing. I am not bone on bone. I do have arthritis but he believes my pain is from patella tendinitis and IT band syndrome. He asked me who had recommended tkr and apologized for that recommendation. He ordered an MRI of the left knee as the right has already been done and told me that after the MRI he will discuss a treatment plan with me. I walked out confused and upset that the first OS would suggest something that isn’t necessary at this point. He also mentioned an abnormal growth on my right knee and told me to bring the CD of my MRI on my next visit. I’m not sure how to feel.
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Hi @Shortstuff26 , Wow! The second opinion you got was indeed completely unexpected ... but that's also good news in many respects! Not least of all is that your doctor seems to be on the ball, thorough, no guess work, letting the facts direct the next courses of action. Looks like you'll be in good hands!

In re the OS who recommended TKRs ... best to chalk the whole thing up to experience and be thankful you found Doctor #2. Maybe curse OS #1 to the wind to get that out of your system ... and then ... let positive vibes reign!

All the best!!
 
You are definitely correct @Jockette! I’m so glad you guys mentioned getting second and even third opinions! I’m definitely taking it as good news @glidefloss for now. One thing that i find very bothersome is the fact that the abnormal growth in my right knee was never mentioned to me buy the first doctor. The new doctor told me it’s pretty obvious and showed me. The right knee stays swollen all the time but i don’t have pain. I thought TKR was only warranted if you’re bone on bone. I am not and have good spacing at the joints. He mentioned that my wear and tear is mainly at the knee cap which is common for runners. I’m so confused. But I’m going ahead with the MRI and will definitely take notes when i get the treatment plan from this new doctor. I’m so glad i found this forum!
 
I wouldn’t just toss out the first surgeon’s opinion. He may be right in the long run. There might be a good chance you will need a TKR eventually.

This is all brand new information, especially since even a year ago this was not even a remote possibility. If it was me, I’d get a third opinion. And/or go back to the first one again, since you did like him, and discuss what the second one proposes, and see what his take is on that.

If the second one does not propose any surgery, it might be worth trying what he suggests. Then you will know you tried more conservative efforts before going with a TKR.

It‘s very hard to make a decision with 2 opposite opinions.
Shortstuff26 said:
He mentioned that my wear and tear is mainly at the knee cap which is common for runners.
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This makes me wonder if he will recommend a Patellofemoral replacement, as that deals with the patella area. While mine has not gone well, we do have a couple of members whose did. If you do consider this option, and please think very carefully about it, it doesn’t last forever like a TKR will, I would not let this doctor do it, I doubt he’s done enough to get really good at it, and experience is what gives the best outcome.
 
I’m definitely not letting this doctor do a partial. @Jockette Statistics show that partials are not as successful as TKR. I do know that much. I don’t know what to think of the first doctors recommendation. I will leave it in my back pocket for now. I will definitely stay with this doctor if what he suggests is more conservative. And if it’s not i will ask my primary to refer me to a third doctor. One thing i do know now is that i won’t be having surgery so easily….
 
I agreed to surgery fairly quickly, because I was hurting. However, I was not bone on bone either, and my pain was in the kneecap. I regret that. Both my knees hurt equally, but I’d had a minor injury on my left knee, so that’s the one we did.

Interestingly, my other knee hardly bothers me now, but I do take some ibuprofen every day, (which I know is a risk, but I’m willing to do it) and I drink a turmeric tea, and had the steps rebuilt into my house so that they are shorter and less stress on my knees. It makes me wonder if I’d done these things before if I could have avoided the partial, and the poor result, which in my case, made my knee worse.
 
I’m not trying to talk you out of a surgery that you might need. But I hope my experience will help you make better plans than I did, in my ignorance. It’s good that you found Bonesmart before your surgery, I wish I had, so I would have had better information. My medical team actually gave me very little, but I didn’t even know that. All I knew was that my knees hurt bad and they said they could fix it.
 
@Jockette Nothing you say influences me one way or another. :flwrysmile:It does however remind me that I need more information. A lot more, and I’m so thankful you share your experience.
I’m a Med-Surg Nurse and I’m used to doctors telling patients they need surgery when they do indeed need surgery. Like not a recommendation. But a medical emergent need. You don’t ever hear “ I’m recommending your gallbladder gets removed but it’s up too you” it’s more like, “ we need to remove your gallbladder and surgery will be scheduled.” I have very little to no experience in ortho. So when my knee issues started i assumed that ortho surgeries were the same. It wasn’t until i found bonesmart that i realized it was a recommendation. I also know that i have not exhausted all conservative measures so i take that into consideration. Especially now with this second opinion. I do hope that if you ever need a TKR in the future you have the right doctor to facilitate that.
 
Shortstuff26 said:
I do hope that if you ever need a TKR in the future you have the right doctor to facilitate that.
Click to expand...
I desperately hope the same thing! I certainly didn’t choose wisely the first time. But, I’m a lot smarter now, than I was then, thanks to Bonesmart. My knee is at a manageable stage. While far from good, I’m happy it’s as good as it is. It will have to get far worse before I consider another surgery on it, not that anyone has offered me any surgery to fix it.
 
Your comment about experience @glidefloss made me look to see what the difference was in experience between the two doctors. First doctor has 6 years of experience. The new doctor has 25. That’s a pretty big difference. I ignorantly hadn’t checked this before.
 
That's a huge difference in the years of experience. It doesn't mean that a new surgeon wouldn't be a real crackerjack and do a fabulous job, but there is some comfort in knowing that a surgeon has many, many of these procedures under his belt. The benefit of experience is shown to me in a couple of things surgeon #2 did. (1) He took time to explain his diagnosis and recommendations and show you what he was talking about on the x-rays. (2) He asked to do some additional imaging to better understand what may be going on in your knees before jumping into a surgery recommendation. And (3) he advised giving some conservative treatment a try.

With knees, it can be very difficult to see patellar damage on the underside of the knee cap. Many times a surgeon won't see this at all until he's actually in the knee during surgery. If your kneecaps are damaged enough to cause you pain, the therapy might not give you much relief. But....on the other hand, if you do have IT band issues or tendonitis, some targeted therapy might buy you some time before you have to think about knee replacements. It seems worth a try, since you were able to see on your x-rays that you are not bone on bone in the joint itself.

I'm glad you saw this surgeon. Don't hesitate to see a third doctor if you want reassurance that whatever decision you're considering is the right one for you at this point. I'm glad to know BoneSmart has helped you be a more active participant in your joint health.
 
Hi guys, had my appointment this morning to go over MRI’s on both knees. The right shows some arthritis in the knee cap. Some muscle strains. I have tendinitis and some atrophy in that quad. The left Showed some tendinitis and some muscle strains. Cartilage was good and joint spacing in both knees looks good. The reports were pretty uneventful. MRI of lower back showed some bulging discs. Overall good news. Recommendation was physical therapy and weight management.
I’m pleased with the recommendation and will start PT next week. So thankful for this forum!
 
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