Guest viewing is limited

When to do the deed

Status
Not open for further replies.

edk

senior
Joined
Jan 24, 2007
Messages
413
Location
Champaign, IL US
Excuse me if this has been discussed to death before but I haven't been on this side of the
discussion for a long time. I'm almost 4 months post op on a single TKR. I know there is a lot of discussion about how long a prosthesis lasts. But I really really think that the more important issue is to do the surgery before you have too much misshapenness and loss of muscle. It seems that people who have long and hard recoveries are those folks who put off the surgery til they have a lot of misshapeness and muscle loss. So I think the time to do the deed is when your functionality falls off the cliff.

I was in a moderate amount of pain controlled by NSAIDs, good ROM and nice musculature for years. Then over the course of a year my ROM fell off a lot and I started compensating with my good leg leading to some atrophy in my bad leg. When you see this kind of thing its time to do the surgery within a year or so I think.

Just my opinion.
 
Good to see you post and hear that you are doing well edk!

When to actually go through knee replacement is a big question I think all of us here have faced or about to face. My knee had gotten so bad that I could barely walk. I was in pain day and night, even when taking drugs. My leg was 20 degrees out of alignment, my quad was atrophying (is that a word?) and I now have arthritis in my foot and ankle because I put the replacement off way too long. My OS said I would have a less then perfect outcome from the surgery because I had waited too long. I was 46 and had previously been told by another OS to put surgery off because of age so I did just that. I put it off until I could barely walk across the room.

My recovery from the first tkr last fall, was long, frustrating and painful not to mention all the emotions that get wrapped up in all this. It took me well over a month to regain 90 degrees ROM. I suffered with excessive swelling and the whole bit. My back got knocked out of whack and I suffered from sciatica throughout recovery. I finally had a manipulation that brought my ROM to 120 and -5 but I still have some pain in the knee that I guess I'll be living with. Not as bad as the prior pain though! I am happy with the outcome but it did not come without a lot of sweat and tears.

I am now 3 1/2 weeks out with the second tkr. Prior to surgery, I was having daily pain, even with NASIDs but the knee was nowhere near as bad as the first. I could still walk and function to a certain limit. I was determined not to let it get as bad as the first and take over my life. My recovery has been quite remarkable. I'm only taking about 2 pills a day and have been quite active pretty much from the start. I've walked Costco, Target, Walmart and even the mall from end to end without problems. My ROM is easily 120 and 0 with about 20% of the effort I went through with the first knee. I almost feel guilty posting this because I know what others are going through because I've been there. I went into this second tkr expecting the worst and I've been pleasantly surprised. Even my husband is shocked at the difference as are my physical therapists.

The point of my response is yes, it is important not to let your knee get so far out of hand that you can't function. I did that with the first one and I paid, big time in the recovery process. If you are in daily pain that is slowing you down, stopping you from doing what you want to do and you've tried all the conservative treatments of shots, PT, et al.....then it might be time for you, too, to have this surgery and get your life back. Good luck to all the lurkers out there researching knee replacement. Okay....off my soap box :-D Karen
 
Wise words, both. I can tell you that when the bone ends get deformed and the leg gets bowed, the surgery from the surgeon's point of view is TOUGH! Takes longer, takes more sweat, more creative thinking. A 'normal' TKR is hard work, how much more so an abnormal one! And if it's tough for him, think how it's tough for the patient too. Longer surgery time, more pulling around = more swelling, more pain, tougher rehab.

On the other hand, you don't want to get it done too soon either. Nor before you are really ready psychologically or emotionally (though are we ever ready emotionally?!). Crucial point is you can't beat your own, God-given knee but there comes a point when ...

Reminds me of when you have an old but much loved car. There comes a point when you have to look at how much it is costing you to keep it roadworthy and wonder wouldn't it be better to give up and get a new one? Choices we all have to make in many areas of our lives.

Tough choices. Only you will know.
 
Dittos. I'm of the thought that certainly once you reach the point of no daily function it's time. But probably sooner. I had both knees done March 18 and haven't turned back. One knee bothered me for years adn I tried the litany of remedy protocols on both as the 2nd began to act up. As Ed discussed,the good began to compensate for the bad. I was probably truly due to do something at least 1 year before I actually did. But the first OS I saw pushed me off because of my age and weight. Though truly I was not emotionally ready at that point, physically yes, mentally no. Needless to say 1 year more of pain and progressive agony and degeneration only exaserbated the weight issue by rendering me very in active. Not even grocery shopping or walking around the home. Avoiding that in itself was reason enough to do it sooner than I did.
OK, Point is... like it was said, waiting too long can be worse, but until you're ready (in the head), it ain't happening. this surgery is also a very major emotional decision.
 
As everybody has told me---you will know; you will know when it is time. You will know it is time when you have had enough of the pain and you want your life back. I decided to get mine done sooner, rather than later.

tim C.
 

Reminds me of when you have an old but much loved car. There comes a point when you have to look at how much it is costing you to keep it roadworthy and wonder wouldn't it be better to give up and get a new one?
Tough choices. Only you will know.

I thought you were going to say take it behind the barn and shoot it
 
Funny you said that Ed. My surgeon has quite the personality and once told me that someone should take me out back. I asked him if he'd been talking to my husband! he he....
 
1J, they only say that cause we can't run.... But if we could they better get to steppin'!
 
I think you've received some very good advice above. Karen's recuperation from her two TKR's have been worlds apart, and I believe that it is because of the amount of deterioration prior to surgery. I am almost 3 weeks post-op now from bilateral TKR, and my OS wanted to do just the "bad one" this year and then wait another year for the "good one." I said, "no way: I'm not going down this road twice." Long story short: The knee which was much worse is really a bear now in PT. I can barely do leg extensions because the pain in the middle of the knee is just so intense. The better knee, however, is coming along at a much better rate. I think once you let those muscles and tendons deteriorate, the recuperation becomes much more difficult.

Whatever your decision, good luck to you.
sharon
 
I thought you were going to say take it behind the barn and shoot it

I said 'car' not 'cow'!
[Bonesmart.org] When to do the deed
 
I'm nervous about my upcoming LTKR (July 28th), but I feel more secure in my decision after seeing my conservative rheumatologist yesterday. He looked at the xrays I brought him and said the surgeon was correct--nothing but surgery would help. When he found out my last cortisone injection only lasted three days, he said he would have sent me to the OS at this visit anyway. He's a new rheumatologist for me, and I was worried he would be offended because it was not his idea (you know how some doctors can be!). He confirmed my high regard for him with his reasonable reactions and suggestions. I'm going to Stott Pilates training to get as strong as I can before the surgery, and he thought that was an excellent way to get ready. It's odd--I can't walk with any speed or for any distance, but I can push with my legs against great resistance and my knee won't hurt. The rheumatologist was also shocked at the deterioration of my right kneecap. He wondered why the OS wasn't replacing that knee as well. It is reassuring to have my decision validated by a professional who will not profit in any way.
 
Hi,
I am new here! According to my OS, both of my knees are rotten. Moderate osteoarthritis
and down to bone on bone on both. It is really quite painful everyday. He finally told me that I have no reason to put TKR off. I am 55 years old and he told me that the TKR should last my lifetime. I have been reading several forums and I must say that I have so much to learn about this surgery. It's pretty scary, especially some of the photos. He suggested not to do both knees at once, because it's just too much surgery at one time.
I have had both of my knees scoped and Sinvisc injections in my right knee which is the worst of the two. I am assuming that it's better to have the surgery in the warmer months. I'll keep reading the various posts. There are some great tips to read up on.
Best Regards! Kathy
 
hi buckeye, welcome to the forum. Don't let the pix scare you. The scars are our badges of glory pain free joy and if you saw that ugly inside shot Pattipoo posted way back, that is just to remind you to give yourself a break as you heal. How refeshing to hear of a doc who says 'Get 'er done" when it comes to knees. So many seem to want folks to wait until they old and are good and suffered. I had both done at the same time and I am glad I did. But you and your OS have to decide, there may be reasons he thinks it is too much surgery for you at once. Anyhow. Welcome again.
 
Buckeye, Having had mine done in mid Jan, I would recommend the surgery be done in warmer weather. In fact, if you could find our posts for that time period, you would find a number of us were depressed with the weather and being house bound.
My mother had her TKR two weeks ago. She very much enjoyed it when I helped her outside to sit in the sun for awhile.
 
Why to have surgery when the weather is warm:

1) It hurts to have things (clothing, bedding) rub against the new scar so it's nice being able to wear shorts all the time.

2) It's much nicer icing that knee in warm weather. Burrrrr in the winter...

3) The new knee tends to ache in the winter, especially when they are new
 
Thank you so much for your responses, Jennifer, Doug and 1jt.
Jennifer the pics I saw might have been on the Knee Geeks forum. I know that every case is different and I shouldn't draw conclusions based on a single picture w/o the history.
My OS is actually a friend who my husband and I occasionally hang out with, so he might be trying to take it easy on me. I am not in the best of shape, so that might be a factor in doing the knees one at a time.
I am going on a family boating vacation in early August, so I am thinking I
should "get 'er done" by September at the latest.
It does make sense to recup when the weather is warm. I had an achilles tendon repair done in September 2 years ago and was on crutches for 4 weeks. It was nice to sit outside on the porch.
I am worried about handling the stairs in my tri-level home after a TKR. I don't have a bedroom or bathroom on the main floor.
Don't want to go to rehab, no,no,no! Just kidding, I will if I have to.
Thanks again!
 
oh Buckeye, stay here, our forum is so much better. We have all the fun.
 
Status
Not open for further replies.

Staff online

  • Jockette
    Staff member since March 18, 2018
  • Jamie
    Staff member since Feb, 2009
Back
Top Bottom