Yesterday made surgery appt date for 4/21 for PKR

[petuniafish]

Been whining here off and on for the last couple months. Now I am headed toward the real thing. Mostly happy, a little scared.
I am the one who has a-fib with caines and all opiates. The surgeon I chose said, "Don't worry. We'll deal with whatever happens with other drugs". Same as what the gas man I work with every day says! After speaking with four others the a******s he's THE ONE. I work with surgical patients everyday and many of them have spoken highly of him with outstanding results for partials. But one of the four a****** OS's did recommend a TKR.

Still have to wait for my boss to give her blessing and keeping my fingers crossed. My question to the group is.....I have had 3 arthroscopies in 1 year due to a torn meniscus, left medial compartment. Each time more of that left medial meniscus was scraped off and now it's bone on bone. The lateral side is pristine. Three of the four OS I spoke with said PKR, due to the lateral being in perfect condition, and my age- 57. If a TKR is needed later in life there's more bone to work with. (My regular OS who does not do PKR's recommended PKR too).The OS who I decided on is using the Oxford. He says in Europe, studies show they can get at least 5 years doing the PKR with the Oxford. Fine with me. But studies have not been done long enough with the Oxford to give accurate results. Could be longer if there are no probs along the way.

So many posts say don't go PKR, go TKR- that you'll end up with arthritis bilaterally anyway. My OS did speak of post-op inflammation and that it would not create a happy situation for the healthy side of my knee. but with care and diligent exercise it would have the best chance. I'd be happy with the PKR even if it's just 5 years, or 3 years. My arthritis was caused by the multiple arthroscopies and inflammation medially. Everything else is great.

1) Would you opt for a TKR or go with the OS recommendation. He'll do what I want, but still suggests PKR.

2) Reasonably,with a desk job, some bedside patient care, with a PKR what's the return to work time with a cane?

Thanks so much! Nancy

 

[Josephine]

Nancy, rest assured that the Oxford has been around for years and is a well proven implant. It's the highest used hemi-arthroplasty in the UK. Don't worry about that.

As for your multiple scopes, that's the problem with them, the surgeons are so tempted to debride "just that little bit more" until they effectively achieve what the o/a would achieve only much, much more quickly!

Under these circumstances, it sounds like you are a perfect candidate for a hemi or partial and should go for it. The longevity is always a matter of debate but I've known people who've had hemis for many years and have not needed a revision to a total. That's because they too were ideal candidates and were well selected for the op.

But as for a return to work, the op is still pretty close to a total in terms of recovery and rehab. It still takes the stuffing out of you and you'll still need lots of rest to get over it. I would suggest you aim for around 8-10 weeks for return to work, if you can.

 

[Judles]

Good luck, Nancy,,,,,whichever way you go! Just hope you get your
Relief soon! And thts great about getting your date!!!

 

[Jamie]

Nancy, in my non-medical opinion....I would leave the choice up to my surgeon as to whether a partial or a full TKR is needed. Pick the surgeon you are most confident with and then do what they recommend.

With my knee (I was 58 at the time), I also had damage only on one side due to arthroscopic surgery a year prior. My surgeon said he would see how things looked once he got in there and would do a partial if it was the best option. Once he was inside, he found arthritis in the kneecap that didn't show up on the xrays. So he opted for the full TKR. Your case could be different and the PKR would be more appropriate. It's all about trusting the person you have chosen.

 

[petuniafish]

Thanks so much for all the encouragement and info. I am really excited about getting rid of this pain. I REALLY like my OS and feel that is half the battle. Feel confident that immune system is going to be much happier for me. Thanks for the good word on the Oxford too Josephine. That is enormously encouraging. Three things frighten me 1) the time off from work. They will give me a desk job, sitting around doing pre-op visits and maybe just half a day- have hubby take me to work. Don't you think it could be more like 4 weeks back to work in this situation. Tell me yes! I want hope!!!

2)I'm still a little frightened by my reaction to caines and pain meds, but as the good doc says they'll take care of it. There is always a cardiologist around. 3)But the other thing that concerns me in the long term. Many lives ago I was married to an MD who insisted my boobs were too small. I got breast implants for his joy. I did not have a problem til a few years later, fevers, muscle aches, Sjogrens syndrome, always sick. Got the implants out- the symptoms all gone. Anyone have these sort of symptoms with a TKR/PKR? The body often does not like foreign substances and tries to reject. What do you think Jo?

 

[Jamie]

Petunia, I don't think you can equate the metal, plastic and ceramic joint components with breast implants. The latter (breast implants) have created the symptoms you describe in several women I have known. Like you, the symptoms disappear once the implants are removed. So you were wise to do that!

While I'm sure there might be a case out there where someone experienced the problems you describe with a joint replacement, I think the chances are so minimal that you should not even give it a thought.

Will you be able to phase back in to your work? That should let you return sooner than if you have to face full days from the beginning. The 4-week timeframe seems to be pushing it a bit, but everyone heals differently and you'll just have to see how things go. It's impossible to predict in advance of the surgery and if I were you, I wouldn't discuss return dates with your employer unless you have to (and then....give yourself PLENTY of time). If you say 8 weeks and go back at 6, your employer is happy. If you tell them 4-6 and it takes 8 as some people do....they will only remember that you told them 4 and now you want more time....unhappy bosses.

 

[Josephine]

Breast implants are made from silicone which has been documented as having adverse side effects in some people. However, the plastic in joint replacements is high density molecular weight polyethylene which is nothing like silicone. Just because you've had an adverse reaction to one implant doesn't mean you'll have a similar reaction to another implant, especially when it's off a completely different material. Don't worry about it.

 

[JudyS]

Nncy
I am so glad you have found a surgeon you like a lot. I would not consider going back to work in 4 weeks though. Even though your knee may not be a total , it still is major surgery. I would not have wanted to go back to work after 4 weeks with any surgery I had.
You will still be tired, if nothing else. You will probably want to rush off pain meds too soon as well as 4 weeks goes by so darn fast.
Take all the time you can and remember there will be time needed for physical therapy as well.
judy