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Old 02-16-2009, 04:33 PM   #31
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

The Big Mistake

I am 58 year old male with bilateral TKR in June. I have been an athlete all of my life and spent considerable time preparing for this event. Thus, I felt well prepared going into surgery. I selected a surgeon with an outstanding reputation for whom replacement rate was well above average. The hospital was rated number one in orthopedic surgery in Pennsylvania.
Bone was worn down on left knee along with scar tissue from previous surgeries made surgery longer than expected. Recovery was very difficult with pain and a very bad reaction to pain meds. I completed all PT as requested and continue with PT. I have 122 degrees of bend in both knees with 0 degrees extension in right knee and 0 degree extension in left knee. Pain continues particularly after being on my feet for any time. Specifically, knees begin to tighten and become stiff with decrease in range of motion. Going down steps and getting up from sitting is a real struggle.
My PT (up until January) schedule has been two hours nearly every day with an hour plus on the stationary bike then lifting and stretching. I doubt there is anyone working harder. I am also doing acupuncture and massage therapy.
At eight months things should be better. All of this was suppose to improve my quality of life. Instead I am worse off. Doctor has no answers. I had a 2nd opinion from another Doctor in the same practice who indicated it will take longer. My opinion is that this has been a disaster and I am much worse off now that I was a year ago. I regret the decision to have the knees replaced. I'm not seeing many ways out of this but can't imagine living with this the rest of my life.
Has anyone had trouble with Zimmer knees? Can anyone recommend a surgeon who can provide solid information on what is happening to my knees?

 
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Old 02-18-2009, 10:08 AM   #32
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

I had a Dr. tell me this happened with one of his patients. After much research they found she was allergic to the metal in that particular brand of knee joint. They redid the surgery and used a different joint and the lady was fine. Not sure that is your problem, but something to think about.

 
Old 02-18-2009, 10:37 AM   #33
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

I never thought about an allergy! Thanks for the information.

 
Old 02-18-2009, 10:40 AM   #34
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Thanks for all the infor

I am 46 and will have a TKR on Friday. This will be my third surgery on my left knee. I was athletic and am very outdoorsy. As a farmers wife I have spent 25 years jumping out of potato trucks and tractors and off of other farm equipment as well as 12 years of jumping out of an autioners sound box. I have bone on bone grinding and pain. my Dr said my knees looked like I was 70+ years old. I guess I was just trying to have to much fun. I appreciate all of the information and hope I am well prepared. I suspect this is going to be one of those things, that no matter how prepared you think you are....there will still be suprise glitches. I hope I have learned enough from all of you who are willing to share your stories in hopes of helping others. Thank you.

Last edited by taberrose; 02-18-2009 at 10:47 AM.

 
Old 02-18-2009, 05:16 PM   #35
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Re: Thanks for all the infor

Good luck! Most likely things will go well for you. Nearly every TKR that I spoke to were quite pleased with the outcome, thus my frustration.

 
Old 02-18-2009, 08:19 PM   #36
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

Hi WHS. I just celebrated the 10th anniversary of my bi-lateral TKR's. Not too many people do both at once and it can slow your recovery....not the knee recovery but your whole body.

I'll share my experience with you. I had the good extension and 120* of flexion at 8 weeks. I did everything my doc asked. I wanted to keep up with my PT and said to stop after 3 months. Why? He told me that I just needed time to heal and to stop pushing my body so hard. You can overdo the PT.

The fact is, you just went through having both legs broken above and below the knee. The bone needs to grow into the prosthesis. If you're like me, you came out of surgery taller and you muscles have to stretch and that takes months. I had anemia from the surgery for over a year despite 4 auto-transfusions.

So I stopped pushing myself and just started taking care of the rest of my body. You lose a lot of blood with these surgeries and it is extremely stressful on the body. I am about to undergo my 3rd spine surgery in 2 years and my doc is very worried. He told me ANY major orthopedic surgery such as spine or TKR's or THR's take a full 2 years for the body to recover. And he's right.

I started walking regularly about a year and half after the TKR's and the pain was gone and so was the stiffness. I eventually was able to stand for a 12 hour day at work and walk 5+ miles. But you must give yourself and your body time. Heck, it takes a full year for your body to recover just from the anesthesia.

You may be pushing to hard. My doc warned me about that as I'm a real worker after surgery(I've had 14 knee surgeries). Muscles grow VERY slowly. Bone needs to repair. I've met people with metal allergies and you usually have some kind of localized rash with that. Ask for a skin test. My doc did that prior to surgery.....tapped 2 disks of metal to the inside of my arm for 48 hours....one for each of the 2 major metals in the joint.

I just think you aren't allowing your legs to heal. All that PT may be undoing the healing that is taking place. Consider it.

As for me.....I LOVE MY KNEES! They are as pristine as they were 10 years ago. But here is something to think about. TKR's are like tires on your car. If they are rated for 30,000 miles then you can be pretty sure they will wear out at 30,000 miles. Same for knees. They will wear out if you keep pushing them. My doc restricted me to no more than 10-15 miles/week of walking and would prefer if I kept it under 10. I have and they are great.

Give it time. You're never going to be the athlete your were. That's not what TKR's are for. They are a replacement for a wheelchair which is what you were headed for. I lost so much bone in my left knee I went through the surface of the joint and had to have bone marrow drained each week for 6 months prior to surgery. I came out of surgery 2 inches taller. And since my legs were straighter, I had to get all new shoes.

I'm just glad to be out of pain and walking. You will get there. Give it time and give your legs a rest.

gentle hugs.........Jenny

 
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Old 02-20-2009, 09:57 AM   #37
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total knee and total hip replacement............

I found out in 2006 I had end stage osteoarthritis both knees and both hips.
I was only 49 at the time but had a history of arthritis in my family.I also had played football in hs and college and rugby after that.I applied for social security disability and was denied twice(joke)despite contributing for 29 years.I had only charitable care while I waited for SSD to schedule a hearing
with a law judge.I could hardly walk and the pain at times unbearable.A social
worker found an orthopedic surgeon and a hospital willing to perform rt hip replacement on me.I had the surgery September 07.Tough surgery and physical therapy but it went well. I finally heard from SSD and got a date for
my hearing.two weeks later a letter came from the judge saying I was unfairly
denied and reversing the decision.(hoorah-notyet)At the bottom of the letter
it said this wasn't the final decision,my case would be reviewed by SSD and
they would let me know their decision in 90 days.Suffering daily with intense pain,very limited mobilityand no income I waited for their decision.(JOKE)
Finally I recieved the letter saying the judges decision was the final one.
(two years of waiting)I had my rt knee replaced June 08.very tough surgery and long physical therapy but it went well.I finally have one functioning side
and it feels good.I was scheduled to have my left hip replaced April09 but
that has been put on hold.I had an precautionary endoscopy and it showed barretts esophagus and tha the nissan fundopligation I had in the 90s wasnt visable.I started having symptoms of gerd and esopagitis just like before the
N.F. in the 90s and put on every rx available,but just like then with no significant improvement.(severe side effects from all the rxs)I am now scheduled to see a surgeon for possible nissan fundopligation redo.
This is especially disapointing because my left side is so bad at this point.
Sorry to rattle but I wanted to get my whole story out.........

 
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Old 02-21-2009, 09:15 PM   #38
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

I posted here earlier in October. At that time was still recovering from my second TKR. Well now I have had my third, yup you read right, my third. I went to see my surgeon for my 6 months postop visit, I was finally walking pretty good, swelling was finally pretty much gone and the only problem I had to report was a tendency for my leg to just buckle right out from under me. Well the minute the doc heard that he had a set of xrays done and saw a shadow that was new, his guess was my implant has somehow broken. So he ordered a CT scan for that same day (fortunately he is chief of surgery so able to move mountains) and had his partner also look at my films. Radiologist didn't see anything but my doc and his partner sitll felt something was wrong but were surprised that I didn't have extreme pain and they could manipulate me so easily. My docs guess was that the plastic portion of the implant must has a small break of some type that made the prosthesis slip in and out of place, when it was out, my knee would buckle and then it would slip back in. He opted to do surgery immediately but first checked with the manufacturer of the implant, J&J DuPuy knee, to check their data base and see if any other surgeon had ever seen this. My doc said it was his first experience in 30 years of doing knees, my luck, huh.

Well I agreed to go under the knife and they opted to reopen the incision and be prepared for a total revision as the worst case scenario. Ends up that was a good plan as I had the total revision of all the plastic components. Bottom line is I am so happy I trusted my doc and went along with his plan. I was up and walking same day, which was same as before, but this time walked even better. Most of the time the nurses were fussing about me moving around my room without a walker. I went straight home on day 4 and felt so good that on the way home, I talked hubby into taking me to the store to pick up some supplies. I was up and about non stop after that and going out and about on errands with hubby every day. By about day 10 I wasn't even using a cane unless I was outdoors and the ground wasn't stable (ice, grass, curbs). I still had awful pain but I didn't care because this knee was really working well. Other than the at home therapy and nurse visits I was released from therapy at the two week mark. My range of motion was so great my doctor and I decided I didn't need any more therapy and could just build back into my exercise routine at my comfort level.

The moral of the story I have come to believe is that if all the factors come together this surgery can really be as good as other posters have stated, just took me three knees to finally get it right. For a few weeks I found that I cut my TED stocking and made it into a sleeve (thigh to calf) and that it was amazing in stopping the swelling which is why I was able to get around so well. It is now 7 weeks after the revision and for the last three weeks I have been getting out of bed most days feeling like a total normal knee. It is only when on my feet all day long that I have some swelling and elevating the leg for an hour or two with ice does the trick, if I think I am going to be doing a ton of walking I take my little TED sleeve with me and just slip it on at the first sigh of swelling. My only residual complaint is soreness as the incision site, having the old scar being only 6 months old and totally reopened again has really frazzled the nerve endings so just a tiny bit of swelling sets off nerve pain and throbbing but that will get better and is just a bother but doesnt make me limp or keep me from doing stuff.

If I had to do these three knees all over again, I think after reading all the posts here I would insist on having spinal for anesthesia versus general, would insist on my own pain pump so I could control my meds, would ask for aggressive antiinflammatory solutions (like celebrex), would have ice on hand all the time (ice packs, ice machine that circulates water), would have compression sleeve for knee to contain swelling. As for therapy, I think the only reason I didn't need it this last time around was that after the first two total knees, I knew what I could do and not do and was not afraid to really bend and straighten my knee. Having that confidence made me relax and just push myself and surprisingly it was easier knowing that I could get a good range of motion (I was at 110 by the time I left the hospital on day 4) so just the knowledge made it easier to get it done. Sort of like having babies, lol, the first is the hardest and after that it isn't strange anymore so it gets easier.

Good luck to all those who still have TKR ahead of them, drive your doctor crazy asking questions and take a stand and demand to be in control.

 
Old 02-22-2009, 09:31 AM   #39
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

Dear I will survive,
Tough situation but great outcome......
I am sure you positive attitude had a lot to do with it,after multiple joint replacements and more ahead I want to emulate that P.A.because I truly feel
that goes a long way in PT and longterm success........
thanks
Piedpiper

 
Old 02-23-2009, 09:02 AM   #40
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Re: total knee and total hip replacement............

I just had left knee TKR and was curious how long the swelling is going to be here?I had the operation Jan 27th and am now walking without a cane but still at a slow pace. Rehab has been ok with riding a bike etc. able to be done. Being an active person I was just concerned at how long I can expect the swelling to hinder me.
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Old 02-23-2009, 11:21 AM   #41
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

BigBob, hate to say this but it will be different for every knee and situation. As a rule of thumb my doctor and therapist always tell me to be prepared for swelling and warmth in the joint for up to a year. I have a tendency towards swelling so always get my mind around trying to be patient as I usually end up being the patient with the year plus for swelling. But the good news is that over time, the swelling is smaller in intensity and frequency. Just listen to your body and try to avoid the things that generate the swelling and when you get the swelling listen to your body and give your joint a break. Hardest part is being patient, another poster gave some good insight when she said don't expect to be the athlete of your youth but rather rejoice in the fact that you avoid the wheelchair (my version of her words, same message).

PiedPiper, you are so right, positive attitude is so huge in recovery. I used to fight having spinal anesthesia because I had such a negative reaction to it. Once I wrapped my mind around the fact that it was the better anesthesia choice and stopped fighting the doctors, I found that although I still don't like it, I no longer have all the negative side effects. Key to your therapy is a therapist who understands you are an individual and helps you regain your joints to a place that is right for you. The therapists who practice the "one routine is best for all" are the ones that can do you harm. It is important to know what your goal in recovery is and to communicate that to whoever is helping you so that they work toward achieving your goal and not theirs. The hardest part of rehab from a total knee, other than the pain, is being patient for it does take time and in being calm and positive as each day even if it is only a tiny bit of progress is progress and is the fuel to get you to the next step. Good luck, my last surgery was my 9th orthopedic surgery and I hope my last for a very long time.

 
Old 02-24-2009, 06:44 AM   #42
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

Dear I will survive,
I definitely also agree that finding a PT that treats every patient as an indivitual
is crucial in recovery.After my knee replacement my PT thought along with therapy
on knee I should also workout other side because of needing knee and hip replaced
in future.This concept was good but I tolerated this for one day and could'nt walk the next.She had never asked my surgeon and made this decision on her own.
It greatly slowed my knee progress down and has left me in severe pain awaiting
next replacement.I did change therapist after this.

 
Old 04-08-2009, 09:14 AM   #43
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

You are a very brave person, and thank you so much for the detailed info. I need a tkr as well but was told I am too young 49, but now I can't stand the pain it ruins my whole day, sounds odd to look forward to getting older LOL. God Bless you
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Old 04-08-2009, 10:36 PM   #44
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Re: Total Knee Replacement: Recovery - Things I wish I knew!

Hi All
I'm recovering from my TKR of March 9th, 2009. Everything is going good except for the PT. I'm a big man but I've never experienced so much pain from such a small person administering the PT. I know that in the end I will thank my PT for the torture of moving my new knee to such great extents. What I've found is that I can hardly walk for a day or so until the next PT appointment. It's only been a month since surgery and I think PT should be slower and less pain but I can walk on the new knee without pain so it's a definite gain. I've experienced some dizziness after some of my workouts. The swelling is almost all gone now. This is major surgery so I recommend that steady but slow is the key to recovery. i'll be able to ride my Harley in a couple of months at this pace. take care.
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Last edited by Boss Hog; 04-08-2009 at 10:38 PM. Reason: spelling

 
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Old 04-08-2009, 10:44 PM   #45
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Cool Re: total knee and total hip replacement............

hi Big Bob
Sounds like you're doing great. Keep it up. i'm starting the bike tomorrow. Just had my TKR on March 9th of 2009.
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