TKR Surgeon advice - NYC

hlove

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After 4 years of knee pain, steroid shots, gel injections, physical therapy, and weight gain, I've finally decided it was time to have total knee replacement surgery on my left knee (I'm 35 so relatively young to undergo the procedure and I've put off long enough).

I have to have my surgery relatively quickly because I'm switching jobs and I want to do it before I switch or else I'll have to wait another 6 months to a year.

I've met with Dr. Nolan Maher at Mount Sinai 59th street who took over from Dr. Harwin, and I have two additional consultations with Dr. Darwin Chen (Mount Sinai) and Dr. Chalmers (HSS). I was wondering if anyone has experience with any of these doctors? They all specialize in Robotics which is what I was. I already have a scheduled September surgery date with Dr. Maher but am slightly worried about his age though the reviews I can see are positive and Dr. Harwin was well known. I want to hear from the other doctors about their procedure, anticipated recovery process, and timeline but figured I'd also see if anyone on this forum has experience with them.

Also for those with short-term disability insurance in NY, was this hard to apply for? I have both short and long-term disability insurance through my job but the doctor told me I should apply for FMLA, so now I'm confused about which to use or what the difference is.
 
Hi and Welcome!

I am not familiar with any of those doctors, so maybe some other members will chime in.

When do you start your new job? We do recommend about 12 weeks off work to get a good start on this year long recovery.


Here’s some pre op information for you:

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries
 
@hlove your employer may have guidelines as to what form of disability insurance you use. In my case, HR walked me through the process. It was not for my knees but I would expect it would be the same.

As Jockette said, recovery from this surgery takes a while. Personally, I would wait until after I had the surgery to change jobs. You will probably feel good enough to work long before a year unless your job is pretty physical. That said, the first weeks can be pretty tough.
 
Hi @hlove. While I don't have personal experience with any of the surgeons you listed, both my hip and knee surgeries were done at HSS and was very happy with the quality of care I received.

When it comes to choosing a surgeon, you want to know not just how long he/she has been practicing, but also how many of the specific procedures that you are having they do each year. The more the better.

For me it was very important to know that my surgeon would be hands-on for the entire surgery, At some training hospitals, there are residents/others who are doing the actual procedure under the surgeon's guidance. Check out the article @Jockette linked above on Choosing a surgeon and a prosthesis for more.

It's important to have confidence in your surgeon, so if you are uneasy about your current choice, it would be wise to make a change.

Good luck, and let us know how we can help.
 
Hello & welcome to Bonesmart! FMLA is family medical leave act. It guarantees you a job for twelve weeks. I believe your employer must have fifty employees to do this. It’s something that your Human Resources department gets going for you. Once you have the paperwork, there’s a part of it that goes to the surgeon to fill out. You will need your surgery date before you get it to your surgeon.

Short term disability...... assuming you have it through your employer, HR should get that going once you have your date.

Marie
 
Thanks all. I saw my second surgeon today but even more confused by the differing opinions.

So far all my surgeons recommend cementless LTKR with Mako but after that, they differ.

My first one (Nolan at Mt. Sinai) said I'd be probably in the worst pain of my life, I'd need 3 months off from work but if pushed could go back potential at 6 weeks but no early. He was worried about cutting into my scar tissue (left from two previous ALC surgery) because of limited blood flow to scars, so instead he would create a new incision to the right and cut out my previous scar. As part of the procedure, he was planning on doing a resurfacing of my knee cap/patella due to some arthritis on the patella.

My second surgeon (Chalmers at HSS), said it's not that much more painful than an ACL, could probably be back to work in 4-6 weeks (did not need to apply for FMLA) and could start at the gym (elliptical, light weights) at 4 weeks, would use the existing scar for the incision and was not worried about blood flow to the scar, and wouldn't recommend resurfacing the patella unless absolutely necessary (if arthritis was worse than the x-rays show), as thinking out the patella could lead to fractures later. (I've read some medical literature that resurfacing the patella has some diverging opinions)

I was seeing another doctor (Dr. Chen) on Thursday and was able to get an appointment with Dr. Mayman (which a lot of people seem to recommend) next week. So I'll ask them their thoughts, but right now I'm confused.

Does anyone have thoughts about what the two doctors told me? Particularly the knee cap resurfacing, incisions over existing scar tissue, and exercise, pain level.
 
@hlove I would be confused too if I were in your position!! I can only guess that each surgeon is going by his training and experience with similar knee problems. Some surgeons minimize what a patient will experience after surgery, some make it sound much worse that it could be, and some try to be realistically hopeful.

A suggestion - make your self a chart and do your own rating of the surgeons you see - not just what they recommend for fixing your particular problem but also what was their practice like, where the staff friendly and efficient. How did YOU like the surgeon - did he listen well, explain well, did you feel he was truly caring about you and your problems? Is each covered by your insurance? Were there any other issues or concerns that you noticed? This is just for you to try to make an informed decision about how to get YOUR problem fixed.

And don't be afraid to share with the next surgeons you see your confusion about the previous recommendations.
 
Bonesmart recommends 10-12 weeks off work to get a good start on recovery. However, many members have reported varying times off.

could start at the gym (elliptical, light weights) at 4 weeks

This varies, also but here’s Bonesmart’s view:
 
Doctors have no idea on when you can go back to work. They have no idea how your TKR journey will go. I really wish they’d stop telling people this.

Please sign up for FMLA. You don’t get paid from it but it protects your job. How will you feel if you don’t sign up for it and you don’t have a job to go back to?

Marie
 
Being in Cali, I don't know what's happening NY.
Welcome, the only word of advice I can give is 'PREHAB'. Whoever you choose just make sure you 'PREHAB'. You will be so thankful that you stretched and strengthened your body. Knowing what I did and didn't do from my 1st knee replacement, I made sure to get strong for the 2nd. If you can't walk or ride for exercise, get in the pool. At first, I couldn't swim 1 lap, 6 months later I'm swimming a mile, plus that's where I do my 'Cross Training'. I use resistance bands and float tubes. Resistance band for strengthening and float tubes for stretching. Another exercise I'll do while in the pool if it is deep enough, running with a floating belt. It is a great workout, even just doing 1 lap. Takes time to get your balance. Get a smart watch. It is great motivation to watch your progress.
Oh, one other thing, see if there's a surgery center that can do the surgery, do it. You are out the next day. Insist on having a physical therapist and home nurse that day you come home. You will be amazed what you can accomplish so quickly, even the day after the surgery. The surgery center is used only if you don't have any other issues that can complicate your surgery. Good luck!!!
 

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