TKR TKR June 2, 2025

[DiannesNewKnee]

Hi. I had a PKR on the left knee in 2020. Now I’m doing a TKR on my right knee on June 2nd. I’m trying to do as much as I can now, to help with the pain later. I’m reading about what I should buy like a walker etc.

The last few weeks have been frustrating. I have insurance and supplemental insurance that should cover 100% of my surgery. My first choice surgeon didn’t take both insurances so I looked for one that did. I did a huge amount of research and found a surgeon that I liked.

Everything was ready to go. I contacted the insurance directly and they said it was approved. Last week I got a call from my surgeon’s office and they said that if I was going to use my supplementary insurance I would need to wait until after July 1st. Something about negotiating a contract. They didn’t tell me this earlier. I’m a middle school teacher. I need to get this done at the beginning of summer so I can go back to work. My job is hard enough as it is. I can’t imagine having a recent knee surgery and then working.

I decided to switch to my #1 pick for a doctor, get the surgery earlier, and pay my deductible and maybe the out of pocket maximum. It’s a bummer because I wasn’t planning for this, but I know I need to get this done this summer.

My surgeon is Dr. Ian Weber in Colorado. He uses the Rosa Knee system with robotic assist, so I’m hoping this will go smoother than my left knee. Also the last time I did this surgery, I had so much going on in my life, and now everything has calmed down. I know how hard this is going to be, so I’m going to stay with my sister for at least a week while I recover. She has a super comfortable recliner that I will probably sleep in.

I’m so sick of being in pain and not being able to exercise for fear of waking up unable to walk. There are times that I’ve had to use a walker or a scooter at work just to get through the day. I know this surgery is completely worth it and I will feel better at the other end!

I’m going to read about what I need to buy to help me with recovery.

 

[Jockette]

@DiannesNewKnee Hi and Welcome back! I moved your post and started this pre op thread for you. Please continue to post here.

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

 

[Layla]

Hello and Welcome to BoneSmart! Thanks for joining us as an Insider.
I am sorry you're in pain as you re waiting out these last few weeks before surgery. I'll bet your sister will be great company and a loving caregiver as you begin your recovery.

I slept very comfortably in a recliner for three weeks! Hopefully you'll find it comfy also.

While a recliner isn't a necessary recovery item, many are unable to imagine their recovery without one. Not only are they loved for comfort and convenience, but for the assistance they offer at a time when getting out of a chair can feel like a challenge. While your mobility is limited, a lift recliner makes it easier to sit or stand without straining or pain. Recliners provide a wide range of positions for you to relax, keeping you comfortable while you're healing. You may need to make the recliner sit a bit higher if it doesn't have lift capability, but that can easily be done with a simple wood platform or blocks. Reclining with your feet above heart level “toes above the nose” allows gravity to naturally reduce swelling and inflammation, boosting circulation and aiding your recovery. Be sure to ice anywhere that hurts when you’re elevating.

I will look forward to following your healing journey and wish you lots of comfort as you await your date.
@DiannesNewKnee

 

[DiannesNewKnee]

Thank you! Bonesmart helped me so much during my last surgery. I’ve been reading here about what I need to buy to make recovery easier.

 

[Jamie]

Welcome back, @DiannesNewKnee. I'm glad you decided to join the Insiders Club so that you could take full advantage of all our helpful articles in the BoneSmart Library and the personal attention that our staff can provide to answer any questions you may have leading up to surgery and in recovery. We're here for you.

I think you may find that this surgery may be a little easier than the one 5 years ago. Things have changed quite a bit since then in terms of surgical techniques. I believe you were very wise just to bite the bullet and use the surgeon you really wanted, even if it meant paying the copay.

One thing that's especially nice now is that most surgeons inject a pain medication cocktail into the incision before closing that gives you anywhere from 1 to 3 days that are relatively pain free right after surgery. This is the critical time when you want inflammation minimized and these medications help with that as long as you don't get too crazy with activity or exercises. People who do that find a big pain surprise on Day Three when those injected meds wear off. So, ask if your surgeon does this (so you'll know to expect that there might be some new pain on the 3rd day) and hopefully that will give you a better start to recovery than your first knee.

 

[benne68]

Welcome back, @DiannesNewKnee!

I think you were wise to get the surgery moved up to June so you have the summer to rest and recover before going back to work. Be sure to take things very slowly at the beginning of your recovery, and remember that your knee is in charge!

We are here for you, so let us know how we can help.

 

[DiannesNewKnee]

One thing that's especially nice now is that most surgeons inject a pain medication cocktail into the incision before closing that gives you anywhere from 1 to 3 days that are relatively pain free right after surgery. This is the critical time when you want inflammation minimized and these medications help with that as long as you don't get too crazy with activity or exercises. People who do that find a big pain surprise on Day Three when those injected meds wear off. So, ask if your surgeon does this (so you'll know to expect that there might be some new pain on the 3rd day) and hopefully that will give you a better start to recovery than your first knee.

Thank you! I didn’t know about the pain cocktail. So if they do the pain cocktail, are you supposed to keep up with the pain medication every 4 hours for the first couple of days, even though you aren’t hurting? I can see how the pain might all of a sudden hit.

 

[DiannesNewKnee]

Welcome back, @DiannesNewKnee!

I think you were wise to get the surgery moved up to June so you have the summer to rest and recover before going back to work. Be sure to take things very slowly at the beginning of your recovery, and remember that your knee is in charge!

We are here for you, so let us know how we can help.

Thank you! One question. I’ve been looking at ice machines for after the surgery. Have you heard of the Polar Active Ice 3.0 Cold Therapy Machine? It seems similar to the Breg machine but a bit less expensive. The cold lasts for a long time and has a control that cycles it on and off, and it’s possible to change the temperature. Maybe I should just go for the Bregg? Thank you for your advice.

 

[Jamie]

It’s not quite as critical sometimes to take prescription pain meds right after surgery if the pain cocktail works well. It varies in the effect from person to person and depending on what medications a surgeon chooses to use. Many people get the prescription pain meds, but only need Extra Strength Tylenol on a schedule right after surgery. You would take two 500mg tablets every 6 hours through the day and night for a total of 4000mg in any 24-hour period. Be sure to count any other medications with acetaminophen in them when you figure your dosage as 4000mg is the maximum safe dose per day of acetaminophen. If you are able to do this, you would then have the prescription meds, if needed, for any breakthrough pain when the cocktail wears off.

Talk with your surgeon about all this and see what he recommends. It’s good to have the prescription pain meds as a backup. But some people actually do so well they don’t need them. The important thing will be to keep inflammation and pain minimized, so don’t be afraid to take what you need during the early days.

As for the ice machines, there is no magic in the Bregg product. The less expensive option sounds like a good option, given the adjustments that can be made. The important thing will be to get one with a large enough pad so that it wraps completely around your knee, including the backside. People often don’t think to ice the back of their knee, but swelling appears there sometimes that can be quite painful.

 

[benne68]

Agree with Jamie about the ice machine. The size of the pad is the most important element. I see that the Polar Active offers a variety of sizes -- get the largest one available.

 

[DiannesNewKnee]

Thank you Jamie and Benne. Good advice about the ice machine. I liked it because it has lots of room for frozen water bottles, and it has good reviews. I will get the biggest pad available. Also I will follow your advice about pain medications. I will keep lots over the counter medications on hand and have the prescription meds ready to go. I’ll ask my doctor but that sounds like a really good plan.

Thank you!

 

[benne68]

You've got this, @DiannesNewKnee! Since it's not your "first rodeo", you know what to expect. During my second TKR recovery, I was surprised by how much things seemed to go. I'm convinced it was because the fear factor was gone. While the aches and pain were still there, they didn't concern me as much.

Not long to wait. Three weeks from today, you will be in recovery.

 

[DiannesNewKnee]

Hi. I just went to my pre-op appointment and wow was it overwhelming. I’m going to ask two questions.

1. I get a good ice machine through insurance. I have the option to rent a machine that has compression and that I wouldn’t need to add ice to. That’s definitely a great idea but it will be over $300 to rent. They won’t bill my insurance. I can try to get reimbursed it there is no guarantee. Do you think that’s worth it? I’m leaning towards yes because I remember the pain with my first knee.

2. I would like to do home health care the first two weeks because I want to stay with my sister. She lives about an hour from my PT place. She’s a good cook, has a really nice recliner, and I think it will help me heal.

They are pushing me to go to PT at the hospital instead. They said they see better results with on site PT instead of home health care. What do you think about this? I don’t know what to do.

Thank you!

 

[Jockette]

You need to do whatever PT you are comfortable with. Hopefully with PTs who will be gentle and encouraging, not ones who will be aggressive in their approach. So if you have a choice, choose the one that you want.

How far is the hospital from your sister? If it’s a long ride, I wouldn’t want to do it. I “only” had about a 15 minute or less ride to where I went for PT, and it was very uncomfortable, especially that first one, when I could barely bend my knee enough to get in and out of the car. And, I went to my first out patient session, 48 hours after surgery. (I didn’t qualify for home PT, for some reason) I went because I didn’t know any better, and I now know that was a bit aggressive in and of itself. I should have been home, resting, icing and elevating, at that point.

They said they see better results with on site PT instead of home health care. What do you think about this?

You will see the best results with a gentle rehab that allows you to have plenty of rest, especially those first weeks.

Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[DiannesNewKnee]

Thank you Jockette. I’m going to take your advice and stick with the home care for the first two weeks. PT is about an hour from my sister’s house and that would be brutal. I remember my first PT visit after my left knee and it was so difficult. I cried all the way there and back. I would dread having to do that again.

 

[benne68]

I'm going to second what jockette said above about PT -- with the words of my surgeon (who is with Hospital for Special Surgery, the world leader in orthopedics).

"During the first two weeks post-op, your ONLY job is to rest and recover. You do not need to exercise. All you need to do is get up and walk for a few minutes every couple of hours to prevent blood clots."

The home PT's job is to make sure you are moving safely around your home, on stairs and that you can get into/out of the tub or shower when the time comes. They will also make suggestions for tools that can make things easier for you. And, like the nurses who come, they check your vitals.

 

[Jockette]

During the first two weeks post-op, your ONLY job is to rest and recover. You do not need to exercise. All you need to do is get up and walk for a few minutes every couple of hours to prevent blood clots."

I can’t tell you how much I wish my surgeon had felt this way. He was really into the exercises. I didn’t know any better, and the general voice of the world out there believes that also. Sadly, the common sense of the Bonesmart approach is like a foreign language to many.

 

[DiannesNewKnee]

I'm going to second what jockette said above about PT -- with the words of my surgeon (who is with Hospital for Special Surgery, the world leader in orthopedics).

"During the first two weeks post-op, your ONLY job is to rest and recover. You do not need to exercise. All you need to do is get up and walk for a few minutes every couple of hours to prevent blood clots."

The home PT's job is to make sure you are moving safely around your home, on stairs and that you can get into/out of the tub or shower when the time comes. They will also make suggestions for tools that can make things easier for you. And, like the nurses who come, they check your vitals.

I’ll keep this in mind. They are already saying I should have a certain ROM at 2 weeks out. It’s stressful to think about this. I just want to recover and ice. Thank you for the advice.

 

[DiannesNewKnee]

I can’t tell you how much I wish my surgeon had felt this way. He was really into the exercises. I didn’t know any better, and the general voice of the world out there believes that also. Sadly, the common sense of the Bonesmart approach is like a foreign language to many.

I remember this from my last knee. There was so much going on in my life that I was pretty slow with the ROM, but everything turned out fine.

 

[Jockette]

I remember this from my last knee. There was so much going on in my life that I was pretty slow with the ROM, but everything turned out fine.

Exactly. There is no Window of Opportunity. We all regain our ROM at our own pace.

You have been through this before and everything turned out fine. Don’t let them repeat any part of your last recovery that you don’t want them to. Stay in charge and make the best decisions for you.