TKR Onwards and upwards - my journey continues

[ElanorG]

Yorkimom, I think the only true minimally invasive surgeries are the robotic ones and they are always PKR not TKR.

 

[Brownie51]

Yorki as far as minimally invasive I understood it to mean that the tendons, ligaments and quadriceps muscles were pulled to the side instead of being cut. Doesn't actually have to do with the incision although it ends up being smaller and to the side. They also use different tools that can make the bone cuts from the side rather that directly from the front. They also do not "disarticulate" the joint. So yeah, either way is barbaric and invasive but the procedure is a lot different and is supposed to result in less post-op pain and quicker healing, quicker back to work etc. When I asked my surgeon if he did the minimally invasive/quad sparing procedure he said NO. He said he feels it can jeopardize getting proper alignment.


That is so awful about the nurse and the royal couple having this as a memory of their first pregnancy. The story was world wide so it must have been awful for both nurses involved. So sad for the nurse's children and husband. She was going to work and functioning. It breaks my heart, especially as an RN myself, to think that she didn't feel she could reach out for help. I wonder if her superiors had put her on leave or harshly scolded her. I hope not because now they have to live with that as well. All for a stupid joke. I agree pranking is bullying.

Patricia, Lisa, Janet....Stairs! I am great going up with the good and down with the bad but it's practising going up with TKR knee and then down with my "good" knee that is hard. If the steps are deep you have to make quite a deep knee bend with the TKR knee. Also going off curbs with the good is tricky, nothing to hang on to and I tend to PLOP off the curb when practising down with the good. I almost feel as if I've forgotten how! I got so used to up with the good and down with the bad!

Patricia Janet and others~I would think most folks needing TKRs would need an anti-inflammatory for the general arthritis. When I stop my Celebrex I notice it in my hands, shoulders, ankles you name it. I tried stepping down to Ibuprofen on a regular schedule, like BoneSmart cocktail but I didn't feel any relief from it. I worry about it because of possible side effects! But seems like a lot of patients are just going with the tylenol (paracetamol or acetaminophen).

 

[Brownie51]

I agree Eleanor!

 

[ElanorG]

I agree Eleanor!

With what Marianne???

 

[robynhood]

No Marianne they only found her at the nurses home because she didnt turn up for work. So she wasnt suspended and they wernt given a warning or anything. Its a mystery why she decided to take that course of action. Her partner and children 12 and 14 live in India that why she was living in the nurses home.

 

[Janet2012]

The first report I heard here in the US was that it was suicide. I haven't heard a lot of followup. Such a shame.


EDIT: I just needed to change the channel to hear followup.

 

[Josephine]

Thank you Rose. So i was taking two 30/500 co codamol four times a day. And now I am taking 500mg paracetamol and 2 30mg codeine phosphate four times a day. That seems the same to me. Plus im taking minus the iburofen. So it seems Im worse off and it was all a complete waste of time.

Patricia, you are actually taking slightly less - 60mg codeine and 1,000mg paracetamol before and now 60mg codeine and 500mg paracetamol. You need to take another paracetamol each time. And yes, it is exactly the same as co-codamol if that was the strength you were taking. .

For the poster who suggested Volteran, this is diclofenac, also and NSAID, and ill-advised for early post-operative situations.

 

[Josephine]

I really liked my surgeon, but .... In one of my pre op visits, I mentioned to him about the minimally invasive procedures. He shook his head and said that as a surgeon it really angers him when he hears that. He said the incision might be smaller, but when they get in there they use chisels, saws, drills, and no way it is minimally invasive.

I have said this innumerable times on here, that "MIS" in TKR is actually a 'reduced incision' and nothing to do with the common perception of MIS surgery, invariably interpreted as something akin to keyhole surgery. There is also a misconception that this "MIS" surgery means a faster recovery and less pain.

 

[Josephine]

as far as minimally invasive I understood it ... Doesn't actually have to do with the incision although it ends up being smaller and to the side.

The full explanation of different approaches and implants can be seen here Knee replacement surgery types and suggested videos.

When I asked my surgeon if he did the minimally invasive/quad sparing procedure he said NO. He said he feels it can jeopardize getting proper alignment.

And I would agree with him 100%!!

That is so awful about the nurse and the royal couple having this as a memory of their first pregnancy. I wonder if her superiors had put her on leave or harshly scolded her.

Actually no they didn't. They were extremely supportive of all three members of staff that were involved and assured them that no disciplinary action would be taken. Fact is, King Edward Hospital is extremely proud of it's close association with the Royal family and guards them closely. However, that having been said, it would be extremely unlikely for any senior member of the family to make such a call to the switchboard as all private patients anywhere (and many NHS patients) have their own private line which would be used. Plus the Queen would never have referred to Kate as "Kate" or "my granddaughter" but "the Duchess of Cambridge". Heck, she even refers to her husband as "the Duke of Edinburgh"!! My feeling is that the switchboard operator was probably fairly new and not familiar with this protocol. But given the corporate and professional standards applied, it's quite possible that the nurse was totally devastated by her involvement and felt an overwhelming sense of guilt. I can quite imagine that to have been the case in a kind of "been there, done that" kind of way. If only she had shared her feelings with her manager .....

 

[Janet2012]

Maybe it should be called LIS, for less invasive surgery. Because there certainly are surgeons that do/have done More invasive surgery. MIS seems to be the accepted, if misunderstood, term within the orthopedic marketing industry. I don't think that anyone who is getting knee replacement thinks they are getting arthroscopic knee replacement surgery. Maybe those on the outside, with good knees, would be clueless. MIS in this context is what it is, and we're stuck with it. Not MIS is something else again, and exists, even as it becomes less and less common. The industry has chosen how to make the distinction.

 

[robynhood]

Well the last four days have been very busy and today my knee is telling me please slow down, sit down and put some ice on me. It is very swollen so I'd better listen

 

[kneeper]

Or SIS-small incision surgery. I have no problem with my scar. It has faded quite a lot and besides it's sort of a badge of honor. I'd rather have a good knee than a small scar.

 

[Brownie51]

Patricia which activity do you think put you over the edge? 4 days in a row...oh my! But you sure had a good time! I hope the swelling will go down completely today. Really get your leg up there above your heart.
Josephine thanks for that. So maybe the old way is better. Wonder what the stats are for misaligned legs with quad sparing vs. cutting/disarticulating etc. Will read that.
Oh my thanks for the rest of the story. So glad the nurse wasn't scolded. Imagine seeing all the attention on the incident on World News. We are getting updates several times a day. So sad. Also so sad she was not living with her family. Maybe she was also very lonely. I wish she'd felt she could confide in someone...

 

[robynhood]

Well to add to the swelling last night and today I have the most awful back ache which I guess is another sign of overdoing it too much. I had LTKR but my ache is to the right at the bottom of my back and hurts so much I havent slept at all last night. Tried warmth that didint help, ice that didnt help so I just kept taking painkillers. Hopefully with rest today it will go as Ive never had a back ache like this before.

 

[ElanorG]

Patricia, I am lying here with a heating pad on my back as ever since I baked cookies last weekend my back has been complaining. Same area as yours except on same side as my TKR. Now last night I did sleep, but the night before I was up most of night from it. I am so sorry. I know how you feel. I ask myself, did I exchange one debilitating for another??? I hope this is only temporary. I use ice and heat and have not found that either helps me. Stretching seems to help but it is temporary and walking in the pool helped too. I hope you feel better today.

 

[robynhood]

Thank you Lisa. It really is worse than the post op knee pain isnt it. Ice and painkillers seem to fix that. I dont know what to do to ease this. Im lying on my bed now as it hurts so much to walk but even this isnt helping. I cannot get comfortable at all and am just hoping this will pass but it seems yours has been here for a while. Please keep me updated it helps just to speak to someone who is going thru the same thing.

 

[ElanorG]

Patricia, This back issue is not new for me as these flareups as a result of standing have occurred for 10 years or so. But after the surgery, as the weeks went by I was noticing that I could stand in the kitchen for 15-20 minutes and I was OK. I remember thinking that my referred pain was now gone! and if I could have I would have danced a jig. But then I baked cookies for a couple of hours and did myself in. I don't know if this will help, but what worked for me once the pain started (as my was mostly muscle spasm) was 24 hours in bed with a heating bad, anti-inflammatories and NO WALKING, just to the john and back. Really boring, huh? But that seemed to calm it down and then as long as I would take it easy with the standing for a few days I would be OK. But that was my pre-surgery treatment and I am finding things are different now. First, I had developed the habit of standing with a bend in my knees to take pressure off them and also a little tilted. I am still breaking that habit and I notice that maintaining correct posture when I stand and walk is very important in terms of not starting up pain in other areas of my back. I feel like I am practicing walking with a book on my head! Did you have these kinds of pain before your surgery? If not, I think you body is still adjusting to the "new you".

 

[robynhood]

No Lisa I have never suffered from back pain before. To be honest I think mine was caused with not bending properly. I dont bend from the knee since the op I keep my legs ram rod straight and yesterday I did quite a bit of bending dressing the christmas tree. I think mine is self inflicted. My extension on my operated leg is 0 and has been since day one so walking has been quite easy for me. I have just had a lovely warm bath and that seems to have worked a little. Now a heat patch, tea and painkillers.

 

[ElanorG]

Patricia, Sounds like you right. I am jealous about the walking! Good plan there with the heat patch and tea! Grab a good book while you are at it! Hope you feel better soon.

 

[Brownie51]

Patricia I am sorry for all this procedure talk ending up on your thread! But wanted to respond to Josephine re: the procedure.Josephine are you saying that its fairly archaic that my doctor cut my quads and ligaments up to do my surgery? I agree that the most important thing is to get the leg in the proper position and whatever he has to do to make that happen is ok. I'd rather have my long incision and more discomfort but have my leg perfectly aligned and I do feel my leg was put back on properly! But he did cut up everything like in the old days!