What is the best case scenario for walking unaided

[Lefty57]

Robert, I was also offered the out patient option, I declined on both knees, I didn't want to put my wife thru that,, I did go home early the following day, I used walker both times for about 3 days,. first knee, cane for about a week, #2 used cane longer as I had more issues with walking, snow ice cold etc. I did go to my first dr visit at 10 days with my cane under my arm, Dr. chewed me out because he informed me that I could fall and open up the incision, so I stayed with the cane for a little longer. Good luck with your recovery and up coming surgery.

 

[robert johnson]

Thanks Lucky. It's interesting hearing all the different experiences. And thanks for reminding me about falling and opening the incision. I'm on blood thinners and the last thing I want to do is bang my knee on something, not just because of the incision but also because of whatever else is going on under the surface after a major surgery like that.

 

[Jajakio]

Likely if you are going home the same day, that is taken into account when anesthesia and meds are chosen. Just before surgery when I was on the gurney the nurse came around with a handful of preop meds. She asked if I was going home the same day or staying overnight as it was evidently going to matter as to which meds she gave me. I was excited at the idea of going home but she said if they hadnt already told me i got to go home the same day then I wasnt. About half their patients stayed the night and nearly half went home the same day according to the nurse. I asked her what made the difference as i had been told my surgery was going to be uncomplicated. She said it was likely what my insurance would pay for. I've noticed, at least in the US, insurance companies are reducing stays as much as they can. Medicare is pushing same day if possible according to my friend who had knee surgery 6 weeks ago. Complications and even minor issues get to stay longer, of course. I think as the pain balls and injected knee cocktails get more sophisticated, the same day trends will continue.

 

[JDinCT]

I just decided today to have my TKR on 3/6/19. My OS stated to expect 1-2 days in the hospital post-op. The hospitals standard anesthesia protocol for TKR is spinal block and GA.

 

[celticmom2]

I had my LTKR on December 11. Due to my opioid intolerance ( only Dilaudid helped somewhat), I had a difficult time the first 24 hours. The second day I was not ready to go home because they still had not gotten my pain under control.
I think I've been doing great though post op. I'm 4 weeks out and walking mostly without assistance. ROM is 124. It's getting easier and I'm finally sleeping in my bed again! [emoji16]

Sent from my LG-LS993 using Tapatalk

 

[robert johnson]

I will be happy if I think it's getting easier in one month!

 

[pdx]

@robert johnson Is there any concern by your surgeon or your primary care/cardiologist about out patient surgery, since you're on blood thinners? Just being nosey! Thanks.

 

[robert johnson]

@pdx No, they do it all the time. You just have to follow instructions for when to stop before surgery, and when to start again after surgery. Plus the OS needs to get the instructions in the "Cardiac clearance" which also tells him if you need bridge injections with Lovenox.

In my case (Eliquis) I stop 48 hrs prior to surgery, restart 12 hrs after surgery and no bridge injections.

Having said all that, I'm not doing outpatient. I'm staying at least overnight, and going home when everyone thinks it's a good idea. I'm not in a position to make that judgement ahead of time.

My cardiologist overruled the standard instruction to "stop low-dose aspirin 10 days prior to surgery" and told me and the OS to make that 5 days prior to surgery. The OS agreed i need to follow the cardiologist's instructions, and said I could expect to see more bruising.

So I'm going to go with the flow, and hope for the best.

 

[maryo52]

I was walking unaided in about a week. I'm not yet at two weeks and walking really well.

 

[robert johnson]

That's impressive. Thanks for sharing. If you don't mind me asking, what has your original TKR felt like over the years in the cold Maine winters? I went to boarding school in Colebrook NH as a child, and I remember hiding in the foyer during recess when we were supposed to be outside.

 

[Jajakio]

I'm not from Maine but I had my surgery in July and the first winter was rough. At 6 months out 40 degree days were fine but the first time I was out in single digit weather i felt like i had regressed 3 months. As soon as i got back inside and warmed up the stiffness eased off and i was back to normal. I'm 18 months out now and this winter has been much better. No stiffness, no arthritic aches with the cold like before surgery. Hopefully that will work the same for you.

 

[rustic]

@Celle I understand. I'm not going to take any crazy chances, that's for sure. I was just wondering if there were any "He climbed Mr. Everest in his first year" kind of stories out there about getting off walking aids.
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I wanted to know that as well! I looked up a few things online, but my main inspiration was a fellow that lives in my area. I raced against him many years ago, and found out that he had TKR surgery and was still doing races. I reconnected with him, and he gave me a bunch of tips. This was a couple months before my surgery, and about two years after his. He keeps records, and has hiked and power walked over two thousand miles on his new knee. Post surgery, he has power walked a couple marathons, several half marathons, and lots of 5/10 K type things.
The most amazing thing he told me was that he was able to do the Imogene Pass run in Colorado, just 6 months after his surgery. He had a 20 year streak of doing that race, and didn't want to break his streak. That race is 17 miles long, very rough, and goes to elevations over 13,000 feet.

 

[Celle]

I'm sorry, but I don't understand the enthusiasm to get off walking aids as soon as possible.
Walking aids are just a tool, useful for reducing the weight load on a new knee, and for helping to prevent falls.

I understand how fed up you can get with having to use a walking aid prior to surgery. I was on two crutches for almost 3 months after my PKR failed and while I was waiting for revision surgery.

I was heartily sick of those crutches, but after my revision to a TKR I was glad to use them again. Not only did they help to relieve some of the pain while I was walking, but they gave me much-needed support until my revised knee grew stronger. In total, I used those crutches for about 4 months, then I graduated to a stick/cane for a short while.

 

[ApricotPie]

My gut feeling, since I have not yet had the surgery, is that I would like to not HAVE to use walking aids, but I WILL USE them in most circumstances so as to minimize any chance of a fall or other injury that will set me back. My goal in waiting to have the surgery is to only have it once on this knee. I don't want to put that goal at risk. A few extra weeks or even months of caution is a small price to pay for good mobility in the rest of my life. And to never have another scalpel touch this knee.

 

[Jockette]

I guess pre surgery we look at a walking aid as a sign of being less healthy and normal, and we don’t like that picture.

Once I’d had my surgery I needed my walker, I was thankful for it! I used it for about 2 weeks because that’s what I was told to do. Towards the end of those 2 weeks I didn’t desperately need it, and when I needed 2 hands to do something, the walker stood there conveniently all by itself until I needed it again.

After I transitioned to the cane, I actually missed the walker. My walker had a little tote bag attached to the front for carrying things. My cane felt more like something I was carrying, even though I did need it for balance. It was inconvenient when I needed two hands to do something, as it wasn’t the kind to stand on its own.

My husband and I stopped at an ice cream shop one day on our way home from PT. It was off season, but the ice cream was still available, but you had to go into the store next door to request it. I waited near the door to the ice cream shop while my husband went in the other door to make our request. As I waited for him to come back to let me into the ice cream shop, a boy of about 10 walked by, saw me waiting, saw my walker, and he asked if I needed help. I was so touched. How many 10 year old boys would offer to help a stranger. I thanked him and told him I didn’t need help, that I was waiting for my husband. Later on after I thought about it I regretted that I didn’t accept his offer. I think he would have felt good to help me and I deprived him of that. It proves the saying, something like it is easier to give, than to receive.

 

[Celle]

My cane felt more like something I was carrying, even though I did need it for balance. It was inconvenient when I needed two hands to do something, as it wasn’t the kind to stand on its own.

A useful little tip that someone gave me was to attach a loop of half-inch -wide elastic to the base of the cane handle. That loop was big enough to go around my wrist. If I needed to use both hands for something, I could let go of the cane handle and the cane wouldn't fall over, because it was still attached to my wrist.

 

[robert johnson]

Post surgery, he has power walked a couple marathons, several half marathons, and lots of 5/10 K type things.

Your friend sounds super-human to me. I never got much chance to really push things after my first TKR in 2010 because my right knee was borderline at the time. I did get to the point, though, where I could recreate a new backyard after we bought a new house in late 2012, which involved carrying heavy bags of stuff all day long for weeks on end. I could have never done that before TKR.

I'm looking forward to this one, because I'll have two good legs after recovery for the first time in a long time. Maybe since 2006ish.

I'm sorry, but I don't understand the enthusiasm to get off walking aids as soon as possible.
Walking aids are just a tool, useful for reducing the weight load on a new knee, and for helping to prevent falls.

Celle, you have to admit though, the stories are interesting.

but I WILL USE them in most circumstances so as to minimize any chance of a fall or other injury that will set me back.

My sentiments exactly. Falling is not an option. The only difference this time is that while I'm still in the hospital and still under the influence of whatever they put in my knee, I'm going to see what it feels like to stand on it without aid, even though I'll have a walker near me just in case. I'm going to be more conscious of what's going on than I was last time.

 

[skigirl]

I had my tkr one week after the mountain closed when I had skied 100 days. My legs were in great shape. When I was in the hospital, the nurse asked me if I could raise my leg and it shot straight up into the air---she was shocked. I did not use a walker because I lived in a small house and it would not go through the door ways. I used crutches when I was out at the grocery store or something like that in the first two weeks. After that, I was fine. My quad responed to e-stim very early and I could ride a bike with full rotations at day 3. There is nothing WRONG with walking aids which are just that---aids. If you are unsteady or if you have not been very active because of knee pain, then by all means use whatever makes you comfortable.

I did not feel like a superstar because I did not use walking aids---that was just my body which happened to be in peak shape at the time. We are all different and it is not worth it to try to keep up with someone else who may or may not lead a completely different life than you do. Just trust yourself and your own common sense---of course you don't want to fall---especially if you fall because someone else told you not to use a walker or cane. I prefer crutches to a cane---just because I have had so many knee surgeries I am a pro at using them!! But seriously folks you cannot decided what you are going to do before the surgery---after the surgery you will make many decisions on your own and with expert help--those decisions will be the right ones for your body and your condition. If your muscles are weak, the joint will not have the support of the quad and hamstring and therefor all of your weight will be resting on the joint. Needless to say, the new joint does not like that at all and will let you know with pain and stiffness.

 

[robert johnson]

especially if you fall because someone else told you not to use a walker or cane.

At my daughter's wedding in 2013, when I had to give my speech, I told the story about how when she was 2 one night she was getting a little cranky so I sternly told her to go to her room. She took two steps to her room, swirled back around towards us, stomped her foot forward and growled at us at the top of her lungs, then went to her room. We never told her to do anything again after that. We explained things instead.

My wife says she got that from me.

I prefer crutches to a cane---just because I have had so many knee surgeries I am a pro at using them!!

I still have a perfectly good very well made pair of crutches from when I had a hip injury in 1997. I was on them for 4 months and have a good understanding of how to use them where you walk upright and use arm strength rather than having your weight on your underarms (something I could never teach my wife when she broke her foot). I was thinking of trying them out in the early days post-op, because if they feel comfortable, I think I'd prefer to use them when out. Not at first though. I'm going to use a walker until I'm sure.

If your muscles are weak, the joint will not have the support of the quad and hamstring and therefor all of your weight will be resting on the joint.

Yes, I am a little concerned about that. That's one of the reasons why I've been taking my bike riding so seriously. My leg is much stronger today then it was 5 months ago, so I'm hoping that will help, but I do plan on being very careful until I'm sure, since I've been walking with a cane for roughly 2 years.

 

[BluesmanVT]

I had a TKR (Right Knee) at Dartmouth Hospital on 1/22/19. Prior to the surgery they said I was a "candidate" for same day release based on risk-assessment, but provided I meet certain goals. However, by the time the PT got to my room to teach me how to use a walker (and climb steps with crutches) it was after 5pm and I was feeling light-headed. I ended up staying overnight and spent a total of 30 hours in the hospital. In retrospect, I'm glad I did the overnight.
This is my 7th day out of surgery. I've been using a walker to get around and don't feel nearly ready to transition to a cane.