TKR Scheduled for 03/13/09

[skibum9]

Well after about 6 to 9 months of driving myself crazy, I have finally bit the bullet and decided to have a TKR on my left knee. It's scheduled for March 13. Given all the problems I have had, I figure Friday the 13th can only help the situation.

I have been posting over on the arthrofibrosis board, so for those of you not familiar with my story, the reader's digest version an ORIF for fractured patella in November 2006 followed by severe pain, swelling, and stiffness. I just couldn't get beyond 90 degrees flexion and was starting to loose extension. Original OS did what he could, but just had no clue about AF and what to do about my condition. I sought a second opinion from Dr. Noyes in March 2007 with a diagnosis of AF, patella baja, infrapatellar contracture syndrome, and a few other assorted things. In a nutshell, the scar tissue (cemented the patella in the joint) and shortened patellar tendon were wrecking havoc on the mechanics of my knee and destroying the cartilage. In July 2007, Dr. Noyes used my hamstring tendons to lengthen the patellar tendon and reposition my patella to where it should be. The hardware (30 inches of wire) was removed in January 2008. Motion wise I can get from 0 to 125 degrees (good leg goes to 150) and the patella is pretty mobile in the joint, but the constant 24/7 pain and limited daily activities finally just became too much. This will be surgery #8 in less than 2.5 years.

Any words of wisdom in what to expect in the days, weeks, or months afterward would be appreciated.

Sharon

[digginit]

WOW!!!  I will take the time to really lay out my experience for you, though it may take a few days.  I'm running on no sleep since Thursday night, and I'm hitting the hay as soon as my son finishes his plate of nachos.

My experience has been good overall.  I've worked hard and pushed the limits so far, and it seems to be paying off.  There is some real loss, though, associated with having a TKA.  It's less than what goes along with a bad arthritic joint, but once you have the TKA, your delusions of it getting better (and being able to do those things again) are over.

I'd make the same decision again.  But I can't say I don't wish it hadn't come to this.  I'm glad I was realistic enough, though, to see it needed to be done.  It's good to get on with things and to actually be doing better than before surgery.

~dig

[groundsman]

Hi Sharon,

I had my LTKR back just before christmas, and now at the post op six weeks, my knee is doing really good, I went it to hospital expecting the worse (pain) but hoping for the best, which was the case, I had a good positive aproach and a lot of confidence in my OS.
It is however hard work and you must keep the exercises regin going even when your knee feels like it is a lead weight.

all the best for your op.

Nigel Kent England

[Janet]

Sharon:

You probably know from reading my posts here and on the AF board that I had a hard time with my TKR. It was 2 years in November, and I continue to have daily discomfort (I can't call it pain...but I'm not totally pain-free). Because of all my previous surgeries, the patella baja and IFPC, all the scarring issues and soft tissue damage, it's no wonder I had a hard time! But my OS kept assuring me I'd have a good outcome in the end, and he was right. I never, ever, ever regret that I had the surgery. Do I wish I was pain-free? Yes. Do I wish I could be more active? Yes. But I have my life back! I can do my activities of daily living without a problem. None of the discomfort I have now is bone-related, it's all soft-tissue pain. I could get to about 125 before my TKR, and now have about 110. That's enough, although it's at the limit for going downstairs, so that is sometimes a problem if the stairs are steep.

You've had big surgeries before, so you will be somewhat prepared. My experience wasn't typical, so I won't go into my first weeks at home, but here are some general suggestions. I made sure to have someone stay home from work with me for the first week; set up a bed on the first floor so I didn't have to do stairs; set up a shower chair and handheld showerhead (although I couldn't shower for three weeks, I used these for months!). Put pillows on the chairs you want to sit in...not so far to the seat! Definitely get a seat for your toilet to raise it up. Take your pain meds...don't try to be "tough"! Be prepared to elevate your leg high...my OS said as close to 90 degree as I could get. I built a pillow tower on the couch that stayed there for weeks. And have lots of ice ready...those bags of peas were great because I could put them in a tote and carry them back and forth from the freezer myself.

Good luck. I'm sure you'll be happy you did it...in time!

Janet

[skibum9]

Thanks Nigel and Janet for your words of encouragement.

I know the rehab will be hard work, but I have a good PT crew to get me through the process. I acknowledged along time ago that my retirement dreams near a ski slope are over. However the constant pain and limitations on daily activities just has to stop. This cannot go on another 30 years or so. I just want to stop thinking about every step I take. I just want a life back. It may not be the one that I was planning on before the accident a couple of years ago. I can and am willing to change the plans. Just don't know what I want to do when I grow up. I had such a good plan. It's hard to figure out a new one when my final capabilities are not defined yet.

Kind of funny the other day. We just moved offices at work and I noticed my neighbor was taking the long way to get to the stairs. I made a comment to this effect, that if he went the other way it would be 10 steps shorter. Sure enough he stopped in yesterday to tell me that it was 5 steps shorter to go my way. Thus the 10 steps total. It's sad that I know that.

Every time we go to Cinci, Mom picks on me because I load the truck up with all my "knee stuff" and only half a duffel bag of clothes. I don't even need to pull out the checklist this time. It's all still in the downstairs closet from last time all pack and ready to go.

Gotta go. Thanks again for the support.

Sharon

[pblevy]

Just an FYI. My wife has had two TKR's on the same knee! That is the bad news. The good news is she still skis. She has to  limit herself to the smooth green and blues but is able to go out there and have a great time. So with hard work your skiing days may not be over.

[digginit]

Hey Sharon!  Thought I'd pop in again on you.  I'm a little over 4 months out from my right TKA.  My recovery has been hard work, but really, really good. 

Like you said, ya' gotta accept some limitations.  But you're probably realizing that you're already limited in a lot of areas that aren't gonna improve on their own.  For me it was kinda hard to let it sink in that these things really weren't gonna get better.  It was after my last arthroscopy when I learned how much cartilage was actually gone (and how much worse it had gotten over a 9-month period) that reality struck.

Now that I'm several months post-op with my bionic knee, I can already do more than I could before surgery.  That's awesome, in my book.  Sometimes when it dawns on me that I really won't be able to skydive again, it kinda bums me out a little, because now I feel good enough to do the things I used to.  But then if I run across the street, the metal jamming against that spacer reminds me that landing a parachute would be no fun...as it is with anything I'm limited from.

Bottom line, my total knee is a very good thing for me.  I can function without pain and do almost anything I want to...and there's still a good year of healing to go.  I'm pleased.  (And recovery wasn't all that bad either).



~dig

[bavage]

I won't bore you with how I came upon the truisms below. Just accept that most of the posters here would agree with them.

1. TKR's are primarily performed to alleviate pain.
2. Your abilities after surgery should be equal to your abilities B/4 the operation.
3. Scar tissue is unpredictable. Pray it overlooks you.
4. A small percentage of TKR's come through the process with flying colors.
5. The large percentage who don't come out in great shape are still happy we had the procedure.
6. It is best to keep a positive attitude. No whining!!

Good fortune to you.

[lenorem9]

Hi Sharon,  Just found your thread and wanted to make a comment here so I can follow your progress.  2 weeks to shiny new parts is great.  Can't wait to hear how well you do.

Thanks again for your PM's and comments on the AF side.

[froggy]

Hi,

Your story  is dreadful  really hope you will come through this....

I had a knee replacement in November 04 ans it has been a success story.   The frist few months were difficult but it has been good.  I have been skiing ( gently) every year and did a few treks ...my replacement knee is greatand gave me a new life.  I do not regret the operation.
My advice makr sure you have a good doctor thats all.

Keep us posted on how you are doing and good luck

Froggy

[skibum9]

Thanks for all the good wishes. 11 days and counting.

I have an excellent doctor and PT staff, so I know that I will be in good hands.

Sharon

[Janet]

Sharon:

It's almost here!! By the weekend, you'll have shiny new parts and be on the "other side." Good luck!

Janet

[lenorem9]

Good luck Sharon!

[Just_Vi]

Good luck Sharon! 

I had BOTH knees replaced on January 27 (as in, 6 weeks ago) and they are doing better all the time.  I went from the hospital to a rehab center on day #3, stayed for 10 days and that helped a lot.  Those people PUSHED me but also helped me to adapt my behaviors so that I could cope.  If your insurance allows it, you might consider this option if you have a good facility available to you.

In general, the first 7-10 days for me were really really tough.  But I experienced fairly strong progress every single day, beginning with day 1, and that helped me stay focused and positive.

Insist on great drugs and make your doctor and nurses work with you to manage your pain as well as possible.  Pain management makes all the difference.  If you have a choice, have your incisions glued instead of stapled--you can shower right away and it limits the possibility for infection.  I was able to manage by using tools--a gizmo that was a handle with a loop at the end so that I could move my weak leg on and off the bed; an arm extender with a handle on one end and a retractable claw on the other, for grabbing things that were out of reach.  If you are offered assistance devices like these, take them.

When people offer help, take them up on it.  A casserole for your freezer, assistance with dog walking or cleaning the house, it all helps.  As you get well the company will be worth it.

You will do great.  And having knees that don't slip and hurt all the time is awesome.

Vi

[skibum9]

Thanks again to everyone for their support and helpful hints. It's greatly appreciated.

Tomorrow we leave to Cinci. Thursday is filled with pre op appointments and Friday is the big day. Where did the time go since I made this decision?

Sharon