Update from me - now Day 25. I am getting around ok but the leg feels a bit stiff and my progress has plateaued in the last week.
Saw the physio yesterday and he thought my progress is good but said swelling is causing the stiffness. My knee is 1.5 cms bigger than the good knee so he has given me tubigrip to wear during day (not at night). He also suggested icing 2/3 times a day, elevate for a few times a day if possible and continue my non weight bearing exercises.
He said to walk as much as comfortable but not to overdo it; realistically he said recovery is a 3 month process and be sensible about what I try to do (no kneeling, squatting, running etc).
He did a light massage of the knee (about 5 mins) and then used TENS type machine for about 15 mins. Definitely felt looser after this but has tightened up today.
Last edited by msgoldenhair; 04-24-2012 at 05:06 AM.
Reason: added massage
The following user gives a hug of support to msgoldenhair: aqua12 (04-24-2012)
Hi msgoldenhair - Thank you for your kind words very much appreciated. I think my problem with a TKR is purely psychological, maybe in part due to my age... I just don't feel ready to part with any of me yet. I don't see OS again for another 4 weeks but have decided to try steroid injections again and ask about synvisc. Think I need to know tried everything first.
In your own above post don't worry about progress plateauing? Having been on arthroscopy path before I found this also happened to me. I believe when AO also present, this happens when start returning to normal activity as when recouperating able to rest and do physio when needed etc. Although I did not get any long term benefits from steroid injections last time, they certainly did help with the swelling and stiffness post surgery.
Being post arthroscopy 2nd time round I have been envious of your progress so far ...you are doing so well. Stay positive ... with your determination ...you will get there! Good luck.
To msgoldenhair and aqua12: As you both probably saw from my previous posts, I had at least one arthroscopy of each knee prior to needing a TKR of each one. My osteoarthritis was so bad in both knees that the scopes turned out to be short term solutions, plus, I could not take the Synvisc due to allergies to one component of the drug. (Plus, my insurance company said they would rather pay for the $50,000 proven track record surgery of knee replacement for each knee as opposed to the unproven long term Synvisc record.)
Obviously, I'm not an Ortho surgeon, but given my patient perspective and all I have learned about osteoarthritis, it sounds like both of you eventually WILL need to have knee replacements done, given your repeated symptoms of OA.
Good luck to both of you. If you have any questions about TKR surgery, don't hesitate to ask me.
Hi Carol Thank you for your post, much appreciated.
My problem with TKR is partially psychological, and I struggling to decide where I should start when it comes to trying to improve my mobility problems. I was told following my first arthroscopy that the only answer was knee replacement as AO already too advanced, so I do appreciate with AO, arthroscopy only ever temporary solution. Following 2nd arthroscopy 2 wks ago happy to report recurring locking seems to have been sorted (hopefully!) but pain no real improvement, or improved function. Due to see OS for follow up in about 3 wks, and been looking for information to decide what I want to do next, to try and get longer term relief.
I also require back surgery for nerve damage, have ongoing foot problem without diagnosis (X Rays - ' well nothing broken' - I knew that!) and bilateral constant knee pain due to AO. It is therefore the interaction of my joint problems I am trying to unravel, and decide where to start. Knee specialist, back specialist and doc re foot seem to only be prepared to see me only as separate walking body parts - which is extremely frustrating to say the least.
I think I hope by delaying TKR that advances will be made meaning TKR can be avoided. Once done, due to my age will require at least one revision, poss two, so decision will leave me on that path for ever.
Although I know the vast majority of joint replacements are successful, it is easy to forget that when it goes wrong it can do horribly. I do not want to scare monger in any way, but I have close personal experience of someone in the mid 50's, who had TKR which resulted in amputation. I also encounter many people through my employment, who regret having replacements, for one reason or other. Such is the success of TKR it is easy I think to forget actually major surgery.
Being more positive if I go ahead with a replacement and successful, then will this help relieve my back problem? Or having the back surgery first would this possibly improve my gait sufficiently relieve my knee pain, so able to avoid TKR revisions. further down the line. This is where I am at - hence finding these discussion boards, looking for answers trying to help with my delima.
Sorry for such a long post, once started think just offloaded! Would love to hear from someone with a similar experience who found a way forward.
I am glad that you appear to be one of the many TKR successes, and wish you continued improved health.
First of all, a piece of advice - YOU NEED TO FORGET ABOUT THE FEW BAD OUTCOME TKR'S YOU'VE HEARD ABOUT!!! A lot of factors could have contributed to those patients' bad experiences, including the possibility that they were non-compliant about post surgery therapy! I know this from personal experience. My aunt had both her knees replaced last May (a month after my right TKR), and, well, being the "orthopedic patient expert that she was" (that's sarcasm big time!), she did ABSOLUTELY NOTHING she was supposed post surgery and almost a year later, is suffering because of it! Her right knee is still swollen all the time, and she is very aware that she has prosthetic knees! (You're not supposed to be able to tell the difference around the six month mark post surgery! - if you do EVERYTHING the surgeon asks of you post surgery, around the 6th or 7th month, sometimes even sooner, because each patient heals at different rates, you will basically "forget" that you have a prosthetic knee.) As a matter of fact, two weeks ago, probably out of jealousy, this same aunt, "Mrs. Know it all", said to me on the phone that "you know your left TKR will not heal as well as your right"! - Good thing it wasn't a video phone connection, because I was giving her the finger aimed at the phone receiver for saying such a mean spirited thing! The next day, I had to go to my surgeon regarding a minor concern about my scar, and I told his physician assistant who was the one who saw me, about my aunt. She confirmed for me that, had my aunt been my surgeon's patient for at least one knee, and he found out she was non-compliant post surgery, he would have dismissed her as a patient and told her to go to someone else for the other one and not waste his time!
So get that out of your head. If you do everything that's asked of you and you have the top joint replacement surgeon where you live doing your procedure, you have NOTHING TO WORRY ABOUT! I PROMISE YOU, your results will be what you expect and your mobility will come back almost 100% over the course of your rehab.
As for your back issues, I think you need to find a group Orthopedic specialty practice near you, where there are specialists who focus on one aspect of orthopedic treatment - spine, back, knees, shoulders, hands, etc. That's the kind of practice I go to. This way, they can consult with each other on the best course of treatment for you and the order in which to do your surgeries - back or knees first. (Though, if you have the knees done first, that just MIGHT alleviate some of the balance and back pain issues because your knees will then be "even" with the ground, so to speak.) It just so happens, I did develop a muscle spasm in my back in January as a result of an EMG test that my Ortho surgeon had ordered. (I had balance/gait problems that were directly related to my bad knees.) He sent me to a pain management doctor (anesthesiologist) who gave me 4 cortisone shots at the site of the back spasm. TWELVE HOURS LATER, I was fine, and the following week, when I returned to my surgeon, he was able to give me the go-ahead for the knee replacement surgery. (He just didn't want me to be in pain post surgery from both the knee replacement AND the back problem.)
As for waiting for a "cure" for osteoarthritis that would negate the need for the TKR? I wouldn't hold my breath on that! Researchers are not even sure what exactly causes OA in some patients and not others OR what causes the condition in the first place.
I would not want you to get to the point where you can't walk at all, so my recommendation is to find that group Orthopedic Specialty practice I suggested above, and do what they recommend re surgery on your back and knees, in the order that they suggest.
YOU HAVE TO THINK POSITIVELY about the TKR surgery! Just get yourself super motivated into believing that you are going to get your mobility back 100% if you work hard at rehab, and believe me, you will find that you CAN DO THIS! If you are scared about the knee surgery, I would seek out psychological counseling to help you both pre and post surgery.
One other piece of advice - make sure the joint replacement surgeon who is to do your TKR's has at least 10 to 15 years experience AND does at least 200 TKRs per year! You DON'T want someone who only does a handful per year, because THAT bodes for the possibility of complications if the surgeon doesn't know what he's doing! And don't be shy about ASKING the surgeon how many years experience he has and how many of the TKR's he does per year. If his answer doesn't match up with my recommendation here, go for a second or third opinion, if necessary!
Hope all this info helps and let me know what you decide. But I say - GO FOR IT!!!
By the way, back in January, I offered my surgeon my volunteer services in the Ortho Unit of the hospital where he did my knee surgeries, so that I could help his future knee replacement patients get through their post surgery hospital stay with a good, motivated attitude. He loved the idea, and as soon as I am done with MY own rehab, I will be doing just that. It's my way of saying thank you to him for all he's done for me the past two years! Verbal and written thank yous just DO NOT SUFFICE ANYMORE with this special surgeon of mine! It's my way of "paying it forward", if you will.
Last edited by ldy12; 04-25-2012 at 02:53 PM.
Reason: Additional comments, punctuation corrections
Sorry somehow had totally missed your reply. Thank you for taking the time to offer your opinion, it is encouraging and reassuring to know that so many people have good results from a TKR's. I do know the inevitable is approaching and much sooner than I would like my knees are going to say sorry no more. I do still think it is major surgery though, not to be taken lightly. Like any major surgery, its usually not reversible and when it does go wrong, it can do with horrible consequences. Unfortunately my friend actually did everything by the book - always does diligently - so unlucky as infection just took over.
Personally I still feel for me, I need to delay for as long as possible, with good pain management, which reading these boards I realise I am very fortunate to receive, in the longer term this may be more beneficial for me.
I'm really sorry that you're so uncomfortable about having this necessary surgery ASAP. Just because a VERY SMALL PERCENTAGE of TKR patients suffer complications (even if they DO everything post surgery that's asked of them), you really need to get those cases out of your head! I'm not trying to be mean here. I'm really trying to help you.
I believe I told you about my aunt who had both her knees done in the same hospitalization last May. All of a sudden, she thought she knew MORE THAN HER SURGEONS AND DID ABSOLUTELY NOTHING she was asked to do post surgery! Because of that, a year later, she's suffering the consequences of her "know it all attitude"! (She still has inflammation and is still aware of having prosthetic knees. HOWEVER, THIS WAS HER OWN FAULT!!!! I tried to warn her before she went in, since my right TKR was a month before her surgery, that she needed to do EVERYTHING her surgeon and physical therapist asked of her in order for her to get an excellent outcome. She CHOSE to ignore both them AND me!!) Then, a few weekends ago, which I chalk up to both jealousy and anger at herself, she made the comment to me that my left TKR which I had six weeks ago "would not heal as well as the right one."! I let it roll off my shoulders because, as I say, I think it came from her being jealous that I actually had TWO INCREDIBLY SUCCESSFUL TKR SURGERIES within a year of each other and that I have been motivated to keep those prosthetics in good shape by continuing to go to PT on my own, regardless of whether my insurance was still paying for therapy! My surgeon (whom I see for a checkup tomorrow, Thurs.) is absolutely ecstatic at my outcome on both knees and that I had the courage and motivation to be a FULL participant in my own care to get these great outcomes. And, contrary to my aunt's comment of a few weekends ago, my new TKR is actually healing MUCH FASTER than the first one did last year!!!!
I have been referring, (and have been asked for an orthopedic referral by several friends) people who are in need of TKR surgery to my Orthopedic surgeon. He is about to do both knees next week on a friend of my hairdresser's who she had asked for his name for this person last fall! Another friend has finally convinced her mom, based on the rapid success of my recent left TKR surgery, to make an appointment to see my surgeon and most likely will have him do both her TKR surgeries!
My point, I guess is, that word of mouth always helps convince people to go ahead with the surgery. When they hear of the success story of someone like me, they are very quick to ask for a referral to my surgeon, because they know that I would only give the referral because I TOTALLY TRUST my surgeon to do right by them, as he did me.
I hope you can find a surgeon who is highly recommended and has the extensive experience that mine does. If you do, MAKE SURE you ask if you can talk to a couple of his patients who have had successful TKR surgery with him/her. Any surgeon worth their salt WILL NOT BE OFFENDED BY THIS REQUEST. If they don't want to violate patient confidentiality, ask him/her to ask those patients who would be willing to talk to you, first, and that way it would be THEIR choice to give you their names and talk about their great experience with TKR surgery. The other possibility is to ask that particular surgeon (if he/she won't let you talk to his/her patients), is to ask if THEY can recommend someone else THEY would trust with your care. It may finally just ease your mind about going ahead with it now.
I would hate for you to wait till your cartilage snaps completely and the TKR surgery becomes an emergency situation. DON'T LET IT GET TO THAT POINT! Again, TRUST ME, if you do it before it becomes totally unbearable or crippling to the point of you ending up in a wheel chair, which I know you don't want to happen, you WON'T BE SORRY AFTER YOU DO HAVE THE SURGERY NOW!!!!
Just make sure that you get a surgeon who has been performing TKR surgery for at least TEN YEARS and does AT LEAST 200 of them PER YEAR!!!
Since I'm not allowed to post my personal email address on this site, can you maybe tell me where in the county/state you live. If you don't live here in Westchester County, NY, I might be able to at least ask my surgeon for a Orthopedic surgeon recommendation near you. (My Ortho surgeon has been on the national Top Doctors list FOR TWELVE YEARS RUNNING and is very well connected via various Orthopedic surgery organizations and nationally well known/widely published on the subject of joint replacements). He probably could give me a couple of names for you whom HE would trust to take excellent care of you. Please let me know if you are interested in this possibility of recommendation.
Good luck and hope you find a way to change your thinking to do what's best for your health.
Last edited by ldy12; 05-02-2012 at 09:04 PM.
Reason: punctuation, spelling , additional advice
Almost two months since my arthroscopy so time to update my progress.
Overall really good in that the pre op pain is pretty much gone apart from the odd twinge inner medial area) so definitely the op has helped.
On the downside there is discomfort at times with swelling and pains in the muscles of my leg; some days I walk almost normally and others I have bit of a limp...the physio says it is all about strengthening and retraining my leg as I had been using my good leg for 10 months...this sounds plausible so I am trying a number of exercises to strengthen the leg muscles. He also says its a 3-6 months recovery so still plenty if time to improve.
Interestingly I note the wear on my shoes is definitely favouring the good leg so I am consciously trying to put weight into each step with the bad leg although it feels odd.
Thanks Carol for your strong support of good outcomes and advice for TKR...when my knee starts to go again I will be more comfortable with the prospect...but i can understand aqua12s apprehensiveness!
So glad to hear that you are making progress with your therapy and that your pain is gradually subsiding with therapy. Your therapist is right - it CAN take about 3 to 6 months to recover from either an arthroscopy or TKR, though each patient heals at different rates. It also depends on how good a job the surgeon did with either type of procedure.
And it's not uncommon that you still are favoring the good knee. I was actually doing just that with my right TKR from last year while going through PT for my left TKR two months ago! The reason is usually because the surgical knee is still too sore from being worked on and your tendency is to avoid that pain when you really should be building up the surrounding muscles like your therapist told you to. It makes the soreness dissipate that much faster the more you work at building up the muscles in the surgical knee. So keep going and pretty soon, you will be walking "normally" all the time! The one thing you might consider asking either your therapist or surgeon that may help with support is to get arch support inserts for your sneakers that you use for therapy. It will give you more symmetry between both knees and you'll find that you won't be favoring the good knee quite as much, so that you CAN get the surgical knee back to "normal" sooner. (I've had flat feet all my life and and just asked my surgeon two weeks ago about this. He sent me to an athletic shoe store and they fitted me with arch support inserts. I'm walking much more normally with both my TKRs now since I started using the arch supports!)
Good luck and keep me posted!
Last edited by ldy12; 05-28-2012 at 07:23 PM.
Reason: spelling correction
Hi Carol, Thanks for the advice and I will certainly look into arch supports as that makes sense to me...hopefully it might make the difference in getting to me to the next level of improvement. Will keep you posted. msg
Good to hear from you and I hope you do go get those arch support inserts. I think you will be pleasantly surprised at how much they will help your recovery!
Definitely keep me posted!!
Now I have to go and read all the articles about my NY METS FIRST NO-HITTER IN THEIR FIFTY YEAR HISTORY FRIDAY NIGHT by Johan Santana!!!!! I've been a Mets fan my whole life so this one was really special!!!! It was an AMAZING GAME ALL AROUND!
Last edited by ldy12; 06-01-2012 at 09:58 PM.
Reason: grammar correction
Just an update as I am now 5 months post op; while I am happy I had op and believe it was the right option for me my knee still suffers from transient pain and feeling of tightness/swelling that occurs randomly throughout my lower leg and for no obvious reason.
However the pain pre/post op is like 10/10 (being high pain) to 3/10. Good although I had hoped for a period of no pain which was perhaps unrealistic. Probably the osteoarthritis is progressing although I also wonder if it is bone bruising and just taking a long time to heal as bruises on me take forever to heal.
I did see a podiatrist who said my gait was fine and did not recommend orthotics. I continue to see the physio who changes my exercises and is now focusing on the vastus medialis muscle and the gluts. Sometimes I am motivated to do them but not always so I need to be a bit more committed. The hard part is you reach an ok stage so the motivation lessens particularly because I am not an exercise person.