Seeking advice from those that "been there just done that" please

[SallyW]

Does anyone know how recovery from a TKR compares to something like a TTT or OATS (OATS, especially since that is a "salvage" op)? I mean - I know that TKR is more complicated, yet after it's over you can still start putting weight on it right away - no protracted periods of NWB. I was NWB for three weeks after my first TTT, then went through 6 months of intense and painful PT, trying to regain my ROM. So I read the TKR recovery advice, about having someone at home to help you bathe and stuff - is that stuff more applicable to those who are a bit elderly? The pictures of the patients always depict someone at least 20 years older than I am!

Are there any TKR people who have had other major ops and can help me compare?

On a side note - is the pain pump worth the bother with a TKR? I had one after OATS; I didn't seem to gain much if any relief from it - if anything, dealing with that "lemon" hanging from my leg when I hopped (and having to pull my pants over it in the bathroom) seemed like too much trouble. Or maybe my doc had the tube placed incorrectly?

[Janet]

Sally:

I haven't had a TTT, but have had a couple of major knee surgeries prior to my TKR. My first surgery was an open repair of a quad tendon rupture. That wasn't easy, either the surgery or the rehab. For my last surgery, I was NWB for a couple of weeks, then not off the crutches until 7 weeks. I was in pain for four months post-op (probably didn't have proper pain control). I was told it would be 6-8 months before we knew if the surgery was a success....and it was every bit that long. My total rehab took well over a year.

How does that compare to a TKR? Yes, I could put weight on the leg from the beginning. But the TKR has been much harder than anything I have gone through before. Just the pain level is higher. Yes, they keep the pain under control, but it is there all the time at the beginning. I used a walker for several weeks, and have used a cane since then (I have to build up more quad strength before I can get rid of the cane). I'm two months post-op from my TKR, and in some ways it has been easier than my last surgery, but it other ways it has been much harder. It's just hard to compare the two.

With the TKR, I was in the hospital three days then came home. My husband stayed home with me the first week, then my daughter was here most of the time the second week. By the second week, I was starting to do things for myself. The first week, it would have been nearly impossible without some help.

Everyone's experience is so different, it's just hard to compare. But the TKR is definitely bigger than anything I went through before. But I wouldn't have been looking at this surgery if my life wasn't so impacted by my pain. I knew it would be hard, and it has been. In my case it is taking a little longer than normal. I never heal quickly, plus I developed scar tissue that required an MUA and put me back a bit. But I can tell it's all going to be worth it!

Janet

[missmyknee]

Sally

I've had a TTT surgery,broken leg surgery ( rod and plate/screws), rebreaking the leg surgery ( removal of rod , replating and screws), TKR and revision and assorted open surgeries all on the same leg, and can tell you the TKR ( and revision) was definitely worse in terms of pain and rehab even though rehab from the TTT took 6mos-yr. Unlike other knee surgeries, you are expected to get up and moving the TKR knee right away. I had my surgery in late afternoon and the next morn I was up and walked 160 ft with crutches. At the end of 2 weeks I was 0-120 on ROM. I remember commenting how different this rehab was from all my others. TKR you are expected to get moving asap and other knee surgeries it's being very careful and gradual. The important thing I learned was the quicker you get moving and establish 0 extension and good flexion , the better. I did the most I could do in the hospital while I had the heaviest pain meds. I had the morphine PCA and percosets. I also made sure I kept my pain meds up like clock work to keep ahead of the pain and always took pain meds 1 hr before PT sessions those first early weeks to get thru rehab and ice,ice, ice. Ice is your best friend. If I was to rate the worst painful surgery I've had , it would be the rod placed down my tibia and my fibula plated when I broke my leg in 4 places....that was more painful than the TKR. I was in the hospital 4 days for the TKR and just overnight for the TTT. I also had complications of blood clot and suspected pulmonary embolis with my TKR. I was 48 when I had my TKR.

Has it all been worth it....yes. TKR rehab takes a great deal of patience and perseverence, esp in the first 6 mos.

Pam

[SallyW]

Thanks, that helps. Faster and more intensive rehab but more painful? Sounds more difficult than a TTT (OATS was more painful than a TTT, but at least I didn't have to work on ROM), but...what I've got going on now (crutches most of every day; "biting the bullet" for a few hours every afternoon so I can do a few things) - that isn't easy either...I don't want to spend years doing this, waiting for more help! It's kind of funny - I've learned how to lean on the cart in the grocery and hardware stores - like a high walker, but without the "senior" look of one. It makes walking easier, but I feel funny leaning on the thing like I'm afraid it'll get away!

Well, I meet my new ortho in about a week. He does computer assisted minimally invasive TKRs, with the rotating platform/mobile bearing knee...It sounds good - but right for me? The weather is warmer now (El Nino?), there's so much I want to do outside this spring and summer!

Sorry to the OP - I didn't mean to hijack your thread!

[mbuda]

i am an orthopedic sales rep for Stryker.  Find out who does a fair amount of total knees a year, at least 100!  Have the Triathalon knee implant put in with a X3 poly insert.  It is the best knee on the market due to the single radius curvature.  If you have any other knee put in Zimmer,J and J Biomet you  will have  midflexion instability due to the J curve design of the knee.

[The KNEEguru]

Thank you for your imput, mbuda. As you are an informed participant here, your opinion is valued, but clearly it is a fine line between an opinion and a sales pitch.

KNEEguru

[wnd45acp]

Well they gave me my surgery date of May 15th since my surgeon only does surgery
2x week at the hospital I want to use that is close to home... didn't make much of a difference the other hospital down in Chicago was also booked to a week prior to the 5/15
date so I'd rather be where I"m most comfortable and close to home.   I got the first of the 2 books suggested in mail Monday and started to read it last night and It is good as
everyone noted that recommend it.   Will do a thorough read through and then make
myself a pre op exercise list to get started on next week since that give me 3 full months to prepare.  Also got the "packet" for the surgery with the pre op, op and post op stuff
and all I can say is I'm so glad I found this site and ordered the two books recommened.
Most of the packet is forms to fill out and send back and to take to my GP for some tests and his signature prior to surgery.. big deal.  They gave me two sheets of dates to go
to pre op "what to expect and know" seminars .. one held at the hospital I"m using
and the other at the practice the surgeon is head of.   I guess its the best way to accomodate it since the doctor/writer of book 1 hit it all right on the nose with this "managed care" system we are forced into here in the USA which makes any sort of real doctor/patient relationship almost extinct.  My GP was on a rant when I was there for my yearly in December.. he said he's had his fill of Corporate Hospital, Managed Care etc and he getting out if he cannot find a smaller city where he can move and practice medicine the way it was meant to be between patient and doctors he's had his fill of all
this BS and all the rules he's forced to play by just to get paid... he was quite angry to say the least.

All in all I think I will get the best truth and advice from the books and what they contain ..
I will do the seminars at both locations about a month prior to surgery and see what they have to say and offer but I'm not counting on any epithany's from either of them.

Soon as I can get caught up here in the office I will go back and read some more of your
diaries and others that have been good enough to take the time to post and hopefully
I will be doing the same a few months from now.

Great group and great advice .. thanks to all of you and I will be back..