PKR Thread

[cruzin4us]

I'm currently scheduled for a PKR on Feb 10th.

Little bit about myself.....I'm 47 year old female. I've had 4 prior arthoscopic surgeries all of which seemed to offer some temporary relief until I would do something stupid (like fall while bowling or fishing).

I've developed arthritis in my knee and my OS suggests I would be better off with a PKR vs a TKR. He indicated that most people fit into the catagory of needing a TKR and very few people would benefit from the PKR. It has something to do with my age, and something to do with my ligaments being in good condition (probably more stuff too, but the doctor lingo was more than I can remember).

I've been reading the different posts, and I see there are very few PKR's, so it would be nice to have a thread that centers around PKR's.

I'm obviously a newbie to this website, but I've been searching high and low on the internet looking for a place that discusses PKR, and this is by the best & most informative site I've stumbled across (thank you!).

Is there anyone else scheduled for a PKR, or that has recently had one? I'd love to chat with anyone that has or is going to have this surgery.

 

[Josephine]

There's been a few folk had partials, so welcome to BoneSmart!

The primary reason for having a partial is not really age but the condition in your knee - meaning the arthritis should be confined to only one place.

The knee has three compartments: the inner or medial side, the outer or lateral side and the space between the femur (thigh bone) and the patella (knee cap) called the femoro-patellar joint. The compartment that is usually first affected in most knees is the medial one. It can then be either of the other two.

Thing to remember is that arthritis is a degenerative condition, meaning it tends to spread. So you need to ask your surgeon how confident is he that neither of the other two, especially the femoro-patellar compartment, is thus far not affected and if he can assure you, with a moderate degree of confidence, that they won't be in the next several years.

I know of many, many people who have had partials which have lasted them satisfactorily for many years, But I also know of people who have had them only to find that two or three years down the line they are in pain again because the arthritis has appeared in one or both of the other compartments. They have unltimately needed to have a revision to a total. Just something you need to be aware of and discuss with your surgeon - if you haven't already that is!

Other than that, a partial takes almost as much effort and endurance to recover from as a total. I've had a couple of chaps at work who, under the impression that because they had had (in their eyes) 'half a knee' done, they should therefore recover and be back to work in half the time!

I don't mean to be negative but it is my policy here to be frank with people. I hope you will be in the group that has had many years satisfaction with the op.

 

[beachcomber]

Hi Cruzin--- Welcome to BoneSmart. I am a 52 year old female and had a medial left PKR a little over a year ago.

I have a really busy job and am working a lot of hours right now, but try to check in here in the evenings and would be glad to chat with you about PKRs.

What would you like to know?

Beach

 

[cruzin4us]

Hi Cruzin--- Welcome to BoneSmart. I am a 52 year old female and had a medial left PKR a little over a year ago.

I have a really busy job and am working a lot of hours right now, but try to check in here in the evenings and would be glad to chat with you about PKRs.

What would you like to know?

Beach

Hi Beach,

I noticed while browsing thru BoneSmart that you were one of very few people that have had this procedure.

I'm glad you responded to my post, because you are probably the one I should be talking to since you've had this done.

My biggest fear is whether I will be able to "walk", I mean walk like 5 miles in order to exercise, or say go to Disneyland and be able to walk to park without being in agony or so tired. I try to walk 8 miles 4/5 times a week, but I'm usually in agony by the time I'm done.....thus the knee surgery.

My other concern is how quickly I can return to work. I have a desk job, so I can stay off my feet. I really need to give my boss some kind of idea on how long I'll be out recooping. I do have the luxury of being able to work a few hours a day until I'm healed. I know everyone is different, but some kind of idea would be very helpful.

I have a pre-op appt w/ my OS next week, but I sure would like to hear from someone that has gone thru the proceedure. Did your OS give you an idea of how long the new knee would last? I think he told me 10 years (or so), but I was a bit overwhelmed when we discussed everything. He did say only a few people qualify for this proceedure (age, location of the arthritis, etc).

Are you glad you did the PKR instead of a TKR? I dread the thought of having to do a TKR if this only lasts a couple of years.

Any insight is very much appreciated!

P.S.......I'm taking it that you leave on or near the beach based on your name? I live on the beach in Carlsbad, CA........

 

[Josephine]

If your PKR is only going to last a couple of years, your surgeon should not be offering it as an option. The criteria for partials is that you should get a minimum of 10 years out of them before a) your knee deteriorates further and b) anything happens to the prosthesis. Having to do a revision any earlier - other unforseen events notwithstanding - is considered to be a bad outcome.

Having said that, though most surgeons cautiously give a period of ten years for any joint replacements, all current data seems to indicate they are lasting a lot longer than that.

As for your activity afterwards, the whole objective of the replacement is to give you back your life. There are many professional/enthusiastic sportsmen who have returned to their chosen sport after total knees, never mind partials. This includes hikers, hill walkers, cyclists, tennis players, golfers, horse riders, swimmers, and much, much more. So rest assured on that.

As for return to work, since you have a desk job, that makes it a bit easier but you should not think that partial knee equates with partial the rehab! Quite the opposite! You will still have had a major op with a major anaesthetic and have major healing and PT to undertake. I've regularly suggested a period of twelve weeks with a phased return to work after but I realise this is not always realistic so far as bosses are concerned!

The phased return I always recommened at the factories was something like this

week 1: Tues, Thurs 10-3
week 2: Mon, Wed, Fri 10-3
week 3: Tues, Thurs full day
week 4: Mon, Wed, Fri full day
week 5: normal duties

Of course this is not to say you couldn't get back earlier. One member here went back the second week after a total! And regretted it big time but somehow she coped and managed to come out the other end okay. It's up to you, really, but be prepared for a struggle if you don't give yourself time to get back to strength and stamina first.

As for wondering if you'll regret the choice, I'm not awfully sure how anyone could because they'd have nothing to compare it with! Be interesting to hear what beach has to say to that, though!

 

[cruzin4us]

Thanks Josephine........

I really appreciate your insight to the battered knee world .

My OS did say that the PKR could/may last as long as 20 years, but some only 10. I'm not trying to be a pesimist, but after 4 sugeries, I thought my knee problems would be solved, but unfortunately, my knee still hurts and I'm facing a much more invasive surgery. I'm afraid to put so much hope into my surgery and then find out, I'm worse off than I am now.

I'm sure I'm not alone in my fear, but it's fear none-the-less. My OS feels super confident this procedure will work, but the more I read, the more scared I become. Maybe this is because a lot of people with sucessfull surgeries don't post on these boards. Sometimes the boards appear to be a good place to vent when things go wrong.

I know I bounced back VERY quickly after my arthoscopic surgeries, but I'm not foolish enough to believe this will be the case with a PKR.

Seriously, I just want to be able to walk and sit without having that dull ache in my knee......or just to walk down a flight of steps without feeling like there is a knife under my kneecap.

Thanks for giving me "some kind" of an idea about going back to work. My DH would like me to postpone the surgery until the end of summer, but I just want to get it over with.....The sooner the better in my mind. I don't think he realizes the sense of anxiety that goes along with surgery.

 

[Josephine]

Oh they do! But they become innured to it. Everyone feels that way. I am currently waiting for a TKR and even writing that has given me the collywobbles! So I do sympathise.

The longevity he has cited is the same for both a partial and a total but that is not the issue for you here. What you need is for him to discuss in plain terms with you is there any evidence of arthritic changes in the rest of your knee and if so, why is he so committed to doing a partial now instead of a total right away. In other words, why is he risking your having to have a revision in a few years?

And you are spot on about the membership of such forums. Very often they are self selecting, meaning mostly people with specific needs or problems are going to come looking for a discussion board. But this forum is a little different because we have been able to get that family atmosphere. It's not just a 'one question, one answer' type forum that I've seen so much elsewhere. We have a equal number of good experiences to bad experiences. And a many members stay on long after they have healed and returned to life because they feel a sense of committment to the community here and because they enjoy it.

I hope you get your answers soon. Partials aren't poor options, they just need to be chosen for the right reasons.

 

[Linda2]

Actually, I think this board is very positive. We are realistic, but positive. The really negative folks don't seem to "stick" here.

 

[Josephine]

You got it, girl!

 

[gloucesterman]

I'm currently scheduled for a PKR on Feb 10th.

Little bit about myself.....I'm 47 year old female. I've had 4 prior arthoscopic surgeries all of which seemed to offer some temporary relief until I would do something stupid (like fall while bowling or fishing).

I've developed arthritis in my knee and my OS suggests I would be better off with a PKR vs a TKR. He indicated that most people fit into the catagory of needing a TKR and very few people would benefit from the PKR. It has something to do with my age, and something to do with my ligaments being in good condition (probably more stuff too, but the doctor lingo was more than I can remember).

I've been reading the different posts, and I see there are very few PKR's, so it would be nice to have a thread that centers around PKR's.

I'm obviously a newbie to this website, but I've been searching high and low on the internet looking for a place that discusses PKR, and this is by the best & most informative site I've stumbled across (thank you!).

Is there anyone else scheduled for a PKR, or that has recently had one? I'd love to chat with anyone that has or is going to have this surgery.

Hello Cruzin4us, I am not sure you have seen my thread regarding my failed PKR. I had an Oxford Knee PKR and it failed at 6 months leading to a TKR with bone grafts and all sorts of fun stuff. If I were you I would do an extensive search of failed PKR's on the net use the brand name of the implants you are looking for and you will see quite a bit of info. If the installation is not aligned extremely well you could be in for a bumpy ride.
Good Luck!
Gloucesterman

 

[beachcomber]

Hi Cruzin...
I'm home from work and checking in. I see you have gotten some great advice from others on this forum, but I will put in my 2 cents worth too.

I agree with Jo about making *sure* (as much as possible) your OS can tell you why he believes the partial is the right option for you. Like you, my OS said I was a "perfect" candidate for the partial since my OA was confined to the medial compartment and the rest of my knee was healthy. My OS said it should last at least 10 years, then I would need a revision. At your age you are likely to need a revision some day and it is easier to revise from a PKR to TKR than TKR to TKR--- assuming your arthritis does not spread prematurely.

My OS said I could return to my teaching job at 2-3 weeks post-op, but that would have been really pushing it and not full time or at my usual speed and endurance levels. It really does take a long time to regain your stamina after this very major surgery, not to mention dealing with pain and swelling.

I was driving and walking without a cane at 10 days, but it wasn't very comfortable and I tired easily. I worked hard at my PT, and had very good results. My ROM is better in my new knee than the other knee and six months after my PKR I was traipsing through airports and resorts in Mexico and even snorkeling!

My scar is shorter than a TKR and off to the medial side. It has healed great and is barely visible now at 13 months post-op.

That's the good news---- but I am having problems with both my knees now and we don't know why yet. My new knee is swelling above my kneecap and seems to be pinching some tissue and is very painful. I am awaiting the results from some blood tests my rheumatologist ordered and then we will decide what to do from there.

I think a PKR is a great option for the correctly chosen patient, but it can be a bit of a gamble in some cases.

And yes--- I love to walk on the beach in Oregon but no longer live there. I now live about 45 minutes from the beach and can't wait to get back over there soon.

This is a great forum. I hope it is helpful to you as it has been for me. Keep asking questions. There are so many great people here who have "been there-- done that" and are so willing to share.

Beach

 

[cruzin4us]

Thanks to all of you for responding to by question(s) and concerns.

I'm now more nervous than ever about the PKR, but I would be worried if I was going to the dentist to get a filling too .

I would love to hear from someone that has had success w/ the PKR.

At my pre-op appt next week, I should get some of my questions answered, but until then, I will keep picking your brains!

I do know the device the doctor wants to use is the Biomet Oxford Partial Knee Replacement.

Gotta scoot back to work........

 

[Josephine]

The Oxford knee had a sound pedigree - has been on the market for many a long year but also had the usual regular 'improvements'! You couldn't do better.

Well, as for hearing from folk who've had 'success' with this, that's not really going to happen because most of the people on here are early in their post-op period. Mostly people move on after a few months and are never heard from again. There are a handful of old faithfuls like beach who have a fondness for the site but even they cannot tell you yet that they have had 'success' with their knee. That's only something that will come in hindsight. Mostly all anyone can ever give you is their considered opinion as I did. Not much more we can say.

As the saying goes - you pays your money and you takes your choice!

 

[cruzin4us]

Thanks Jo......I do appreciate your advice (more than you probably realize!).

I do have another question for you (if you don't mind). My insurance sent me a pair of crutches, but nothing else. After reading a bunch of the posts, Do I need a walker, a cane & possible a toilet extension? Crutches are not really my friend, although I've been on them for months before.

I just want to be somewhat prepared. Those 5 steps into my house are going to be the killer. Once inside I'm not moving

Any other advise on what I might need besides the meds?

Thanks!
Laurie

 

[Josephine]

Well, that's what I'm here for but thanks for saying so.

As for the aids, yes you do need more. Raised loo seat, shower seat, grips here and there if you need them, walker, leg lifting strap, long handled grabber, plenty of ice packs (pags of frozen peas would do) - I'm sure others will chime in with more suggestions.

I suggest you read this book here Total Knee Replacement & Rehabilitation for in it is some wonderful advice about preparing for your return home.

 

[Nursepair]

Welcome Cruzin, I found a body pillow invaluble to drape the leg along at night, helped get me some sleep. Let your family and friends know you will need their help if possibe.

Oh yes, make sure you take the stool softeners they offer you!! The meds and lack of exercise will screw up you digestion a bit.... Sue

 

[beachcomber]

I *do* consider my PKR a success! I don't think my current problem is related to my PKR--- but is some kind of inflammatory response. I have one of the autoimmune diseases that does weird things to me and this is probably the newest manifestation. We're trying to figure it out and develop a plan--- but in the meantime I am working more than full time at my job teaching high school culinary arts and running a catering enterprise with my students. I put in an 10 hour day today on my feet including setting up for a breakfast for 50 at 7:30 tomorrow morning. That is much better than before my PKR for sure! I couldn't even walk across my classroom without limping and terrible shooting pain. So I call that a success!

 

[mj5]

Good luck w/ your pre-op appt. I am learning a lot from your thread! I am going to be scheduled for a PKR soon (I think...long story) and it is helpful to have as much info as I can.

 

[cheryl50]

Hi,
I am scheduled for BPKR on 2/2/09. I have been reading this board and soaking up all the tips and hints I can before my surgery. At one point I was very concerned about getting the partials. There is some negitive experiences and the posibiltity for advancment of the diease into the rest of the knee, but the bottom line is: I have an expert OS who I trust and is well known for being the best in my area. He is making the call and I feel confident it is the right one for me. I am getting the Oxfords. I'm getting very scared about the actual surgery, but from everyone's help here, I know that is normal. I'm grateful for the help and support!
This final week before is going to be very busy, tieing up loose ends at work and stocking up on things for the house (stool softners). I'll go in knowing all of you guys are out there somewhere for me. I'll try and report in asap post new knees! Wish me luck!
God bless you all! Cheryl

 

[Nursepair]

Will be thinking of you Cheryl, good luck...Sue