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RTKR Might Be Postponed Due To Steroid Shot?

Discussion in 'Knee Replacement Pre-Op Area' started by cslasor, Apr 12, 2017.

  1. cslasor

    cslasor
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    After getting a LTKR in September I'm finally ready to replace the right knee too. So I called the OS and scheduled a date for the surgery on May 18.

    The problem is my right hip has also been giving me problems for the last year or so. I finally got an appointment to see somebody about it on May 9 and expect/hope I will get a steroid shot to ease the pain. The thought of recovering from RTKR while also suffering from severe pain in the right hip is not attractive! However, the scheduling nurse for the RTKR was concerned when I mentioned the steroid shot and said she thinks the doctor likes to wait 9 weeks after those shots before he does the TKR. We went ahead and scheduled the RTKR for May 18 and she was going to double-check with the doctor to make sure he's OK with it. Fingers crossed that I won't have to wait until July to get this done!!!!!

    But has anybody else run across this, where the surgeon wants to wait 9 weeks after a steroid shot before doing the surgery? Is it related to infection or something like that?
     
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Unfortunately this is usually the case. There is a wait for any joint replacement post injection. If your injection date is only 9 days before your scheduled TKR I am sure they will postpone the op.
     
  3. cslasor

    cslasor
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    Well, heck! I'm tempted to cancel the injection and do that sometime after the TKR, but the thought of doing the PT with a bad hip is not good. Of course, there is no guarantee the steroid shot will help the hip anyway.

    ...sigh... Ageing wasn't supposed to be like this.... :bawl:
     
  4. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @cslasor if you do some reading here you will recall that PT for recovery is not needed. In fact, I agree with your plan. Cancel the injection and get that knee replaced. Any hip issues will ensure you don't over do the PT.

    In any case, if your hip is bone on bone I doubt there would be any relief.
     
  5. cslasor

    cslasor
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    I'm curious, @Jaycey, if you know how long after the TKR I would have to wait before getting an injection in the hip? I know PT isn't required after TKR but I do need to try to walk after some period of time - and walk PROPERLY, which is hard with the current hip pain.

    Thanks.
     
  6. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    I think this varies according to what your surgeon recommends. I would ask that nurse you spoke to earlier.
     
  7. microwv

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    @cslasor - I had an appointment with my OS back in December of last year to schedule a RTKR. I had received a cortisone injection in that knee in October, so he said I had to wait 90 days, before he would schedule surgery (scheduled for 4/27/17). Funny thing though, he gave me a cortisone injection in my left knee. Maybe since it's your hip, there's still hope.:smile2:
     
  8. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    After the surgery, I doubt you'd have to wait too long. Maybe 4-6 weeks at most. I had a shot in my trochanteric bursa 6 weeks after my 2nd TKR.
     
  9. cslasor

    cslasor
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    I called and spoke to the nurse for the doctor who is/was/will be going to be doing the injection in the hip and found out he wouldn't be doing an injection on that visit anyway since it'll be the first visit to that doctor. So I'm going to go ahead and keep that appointment on the 9th and at least find out what the story is with the hip and what can possibly be done. Then I'll do the TKR on the 18th and after that I'll deal with the hip whenever it is appropriate.

    Thanks to everybody for the advice and words of wisdom. It's amazing what kinds of questions and problems come up when dealing with a major surgery like this.
     
  10. carolm

    carolm

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    The links below show where this practice is coming from. The study showed a higher rate of infection in patients having a knee injection on the SAME side as the planned TKR within 3 months of the surgery date. The data came from a review of insurance company databases tying in knee injections, TKR and post-operation knee infections.

    http://newsroom.aaos.org/media-reso...eplacement-surgery-may-increase-infection.htm

    http://www.abstractsonline.com/Plan...68b&mKey=d5dc0d6c-c6d9-4cb4-acb2-5b30d308f410
     
  11. aepler

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    Yes - my surgeon will not do my knee replacement sooner than 3 months from getting a cortisone shot due to risk of infection. I got a shot on February 17th and was informed this. I wish I hadn't gotten the shot as it didn't help the pain at all and I now must wait to have the surgery. Best of luck to you,
    Karen


    Sent from my iPad using BoneSmart Forum
     
  12. cslasor

    cslasor
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    I have another question. It's probably been discussed here before but I can't find a thread. If somebody would like to point me in the right direction it would be appreciated.

    When it comes to icing the knee after surgery, is a continuous-icing system like a Cryo Cuff for about $115 really better than the gel packs my OS gives me for free? For my LTKR I used the gel packs and while it seemed like they worked OK, they don't stay cold very long. I can't help but wonder if I would have had less swelling with a continuous-icing system than with the gel packs. It's not really the cost since I'm sure at some point in our lives either me or DH will have to ice another joint, but I don't want to waste money either if the gel packs are just as good. And there might be an aspect to using the continuous-icing systems that I'm not aware of, like maybe being difficult to get up and move around.

    Any comments? Pros and cons for each way of doing it? Thanks in advance!
     
  13. Lovestoread

    Lovestoread Sr Bonesmartie

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    My back was really hurting after my TKR's and I was hoping to get an injection or dose-pak of prednisone. My back was hurting much worse than my knee! Unfortunately, I was told I would have to wait at least 6 weeks post-surgery.
     
  14. SusieShoes

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    @cslasor My mom had both her knees replaced a decade ago and I took care of her post-surgery. I knew nothing at the time but followed what her doctor ordered: bags of frozen peas. Mom packed her knees with those frozen peas in rotation and she did just fine. She now has 140 flexion (can sit on her heels) and full extension. I hope I do as well as she has done!

    I'm going to try gel packs myself, with frozen peas or corn as a backup. I spoke with a pre-op nurse at the hospital whose husband has a BTKR and he used frozen corn. Again, doing just fine. As she said, use whatever works and you are comfortable using. One plus of gel packs (and frozen veggies) is they are easy to put aside when it's time to get up out of my recliner. They are also quite portable for when I am recovered enough to go to a family member's house one day on a weekend (Italian-American family means weekend visits). Put a couple in the host's freezer for use during visit. Or use her peas. :heehee:

    People swear by the Cryo-Cuff and other units, and if I find the gel packs and frozen veggies don't control my swelling and pain, I can always order one of those... and I will if I need one. Hope you get a few more opinions to help you decide.
     
  15. stadx

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    I used ice bags one on the front and one on the back and moved them around on my knee useing a towel wrap to hold them in place. Worked great for me. Used the gel packs a little but they didn't stay cold very long.
     
  16. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    I actually used both. I used the ice machine almost continuously in the first month. It stays cold for a long time and many use their ice machine all night long. Later when I was more active I used gel packs because it was easier to grab. Be sure you have the larger gel packs that will wrap around the knee, not just sit on top of the knee.
     
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  17. Celle

    Celle FORUM ADVISOR Forum Advisor

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    You can use the smaller gel packs as well. as long as you put one on the front of your knee and one on the back. I iced my knee with gel packs every time I was sitting down or lying down. I bought 6 gel packs, so that I would always have some frozen.

    I did find that they lasted for at least 45 minutes. Towards the end of that time, they became softer and were easy to mould to the shaped of my leg.
     
  18. cslasor

    cslasor
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    I decided to go ahead and get a used Cryo Cuff from eBay. That way if I don't like it I'm not out all the cost of a new one.

    Next question. I've always had general anesthesia for surgeries, including my LTKR, and have never had any problems. But I keep hearing that the local block is better for you so I'm considering doing that for my RTKR. Can anybody who has done both explain how the experience would be different for me would be different?

    Thanks.
     
  19. Celle

    Celle FORUM ADVISOR Forum Advisor

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    A general anaesthetic leaves you woozy and possibly a bit nauseous afterwards.
    A spinal anaesthetic, plus some sedation, lets you wake up clear-headed. I can't have them and have to have a general, but everyone who has had the spinal seems very happy with them.

    This article gives more information:
    Anaesthetics - spinals, femoral blocks, GAs and everything else
     
  20. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    I had both within a month apart. GA for my TKR left me wonky, woozy and unable to stay awake. After the spinal a month later I was having perfect conversations about Cyber Monday shopping with the post-op nurses. But it all was dependent on the anesthesiologist. The first couldn't get the spinal into my back due to my arthritis, but with the 2nd I had eaten that day so this anesthesiologist had to get the spinal in and promised he would in pre-op.
     

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