Life after TKR

[PTCTom]

Howdy all,

I was hoping someone would share their story of their 'activity life' after a TKR and full rehab.

Have you tried to return to any sport?  Does the knee feel 'normal'?  Do you trust the knee in flextion?  Do you follow your doctor's recommendation as far as limitations go (no impact sports, running, etc.)?  Anyone play basketball on it?  Football?

Any responses would be appreciated.

Tom

[EOD1]

It will be two yrs this July since my bilateral TKR, I was 57 at the time.  Last weekend I refereed in a soccer tournament and did a total of 14 games.

Do I follow mt Dr.s recommendations? No!  Well he told me not to run or do any impact sports because it would wear out the knees.

Well, maybe it will but I refuse to live my life worrying about a day that my never come. Who knows what tomorrow might bring, I want to live my life to the fullest.  If I need a revision,at some date, I'll deal with it at the time!

[Plumb]

At  57  --- even if you had a revision in the next 10 -15 years.   You would still outlast your second knee most likely.  30 to  47 -- you may want to rethink the ruff and tuff piviot sports.    I mean  could you.. get to that point where you would think .. hey I can run jump and play..    Sure..  but one bad move .. and something happens.   would the OS being able to get you back to the spot you had be in ?    Most likely no.. revisions appear to reduce your mobiltiy and from what I have seen on folks who had multiple revisions they get extra special issues as well.. like RSD.. 


So while getting out to play a game is a great goal.    I wouldnt want you to have your life suck with pain management appointments  post revsion.. 

Something to think about before going rambo.. 

Btw it would be a year or so before you feel normal enough to even want to think of  baseball volleyball  and what not.

[Redwing]

At  57  --- even if you had a revision in the next 10 -15 years.   You would still outlast your second knee most likely.  30 to  47 -- you may want to rethink the ruff and tuff piviot sports.    I mean  could you.. get to that point where you would think .. hey I can run jump and play..    Sure..  but one bad move .. and something happens.   would the OS being able to get you back to the spot you had be in ?    Most likely no.. revisions appear to reduce your mobiltiy and from what I have seen on folks who had multiple revisions they get extra special issues as well.. like RSD.. 


So while getting out to play a game is a great goal.    I wouldnt want you to have your life suck with pain management appointments  post revsion.. 

Something to think about before going rambo.. 

Btw it would be a year or so before you feel normal enough to even want to think of  baseball volleyball  and what not.

I dunno what RSD is but..........wise words indeed from Plumb!  I'm only 4 months post TKR but my running days are over............but I'm really OK with that! 

[EOD1]

To each his own.  Everyone can do what they want.

I'm not out to prove anything.  I enjoy being active and continuing to do what make me happy. 

The original question asked if anyone returned to any sports.  I did and I just shared my experience.

I wasn't looking for approval or disapproval, just sharing my experience after TKRs.

[teachmath912]

I don't technically play any sports regularly- but I have returned to a lot of activity.  I coach two Varsity sports (Basketball and Soccer) at the same high school where I teach freshman math.  I will go out and be on the court and field with the girls and will demonstrate things for them if needed. 
My goal after this summer's surgery is to get out as soon as I did with my left tkr- 8 weeks after surgery I was out on the soccer field coaching two 2-hour sessions a day for the first week of pre-season.  I wasn't running, but I was walking from one end of the field to the other at that time.
I will admit that I don't run- but I never did.  I can lightly jog (though I don't enjoy it!) and play a short game of basketball. 
I played three softball games last week, two volleyball games, and a kickball game at field day last week.  I let the kiddos do a lot of the fielding, but I still was an active participant in each game.  And that is with my left tkr being almost a year old and my right needing a replacement (and getting one in 18 days from now!)  My right knee was the only one that hurt at the end of the day- my replacement knee was okay.
Hope this helps some!
~ Kit

P.S.  I am 36 years old so I worry a little about my replacement wearing out too soon, but I'd rather enjoy life right now as I have had arthritis and bone-on-bone pain since I was about 2 years old.  The pain barely slowed me down then and I am not going to let it do it to me now!

[Janet]

I had my TKR almost four years ago at age 49, and am happy doing my day-to-day activities without pain. Of course, everyone's situation is different. My TKR was my fifth surgery in seven years following a traumatic injury. I never fully recovered from that injury, so I had been so extremely limited for such a long time, I just wanted my normal life back. I could not run even if wanted to. People who go into the TKR with a background of surgery and trauma are in a different place than those who have the TKR because of wear and tear with age.

Janet

[painter33]

I had bi-lateral TKR 10 years ago at age 49, went through extensive and demanding physical therapy with a sadistic therapist (she was the best one I ever worked with and she inspired me to work as if I were going back to contact sports), and have been pain free since.  I had played semi-professional basketball, meaning ex-NBA and Div I players, until a year before my surgeries, but I knew I could never get back to that level of activity, mostly because my prosthesis model places certain limitations on rotational movements (my PCL was sacrificed due to the requirements of the hardware.  I was "reduced" to playing golf exclusively for getting my competitive infusion, and the knees only had a positive effect on that - I walked 18 holes 12 weeks post-surgically and have been walking courses ever since.  Getting in and out of carts places more strain on my knees than does walking on soft turf (not to mention that golf is meant to be played on foot - unless, like Casey Martin, there are extenuating circumstances).  My handicap dropped from 15 to 7 after surgery because before surgery I had to compensate for my bad knees.  Basketball? I still shoot by myself in a gym 5 mornings a week, but I definitely do not want to jeopardize the integrity of the replacements by playing in a game.  My game was predicated on my leaping ability and speed, as I wasn't the most dependable shooter, so playing that way just isn't possible, I know.  Thinking that revision surgery is a breeze might be a little cavalier when one considers the increases in hospital acquired infections (HAI), the reality that more bone is removed, and all of the other possible uncertainties that accompany any surgery.  I fully appreciate the "do it now while I can" philosophy, but now is also when with the right regimen of sensible exercise (v. high-impact sports) the prosthesis can last far beyond its predicted life.  I want to be in a position that when the hardware starts acting up, it's only the polypropylene "meniscus" buttons that have to be removed and new ones snapped in.  Believe me, as a truly certified gym rat, my basketball addiction was second to none, but my desire to live for as long as possible without the intense chronic pain I endured is much stronger.  Good luck to other TKRs no matter what you do or don't do;  enjoy life without pain.

[captainruss]

Janet,

I believe you are the one who answered some of my questions.  I cannot find replies to my posts.  Someone provided me great sites on my tkr with arthrofibrosis.  Someone told me about doctors....I have contacted Dr. Wojtys and have my OS sending him my info.

I need to get those pain studies, info on AF.  If you can help me or help me again, I would appreciate it.

Russ

[oohyeah4]

I had my TKR at age 47 and a revision last year at age 48 ...it has been a night mare for me...and I do no sports ..no jumping ect....I guess Im one of the few, with the "unknown"...

[captainruss]

Welcome to the nightmare.  I am the same age.  I have had multiple TKR's in the past 16 months.  I finally convinced an OS that my knee was not infected and no matter how many times they take it out and put it back in, it is not going to be right. 

I honestly have spent days looking to see if there was just one person who has recovered.  Missmyknee has improved, but I would not call her cured by any means and she has been fighting this for 11 years.

Russ

[MRW]

Hi Russ,

I am sorry to hear that you are having so many problems with your TKR’s.
You say that you have had “Multiple TKR’s in the past 16 months” WOW!!! Normally it is very rare for a surgeon to do a revision before the 2 years period, simply because they want to give the bone and soft tissue time to heal. Is there another issue going on here? For example metal allergies?
Why did they revise your first implant?
What types of prosthesis are they fitting, cemented or uncemented?
Robert and myself have (Had in Roberts case) the Zimmer NexGen ‘uncemented’ and we both have experienced problems, Roberts implant was shown, on a bone scan to be lose, so he has just recently undergone a revision which will hopefully, be the end of his pain and problems.
I have had ongoing pain (Worse than pre-TKR) since the implant was fitted nearly 3 years ago (When I was 55 yrs old). I have had every test available to try to find out what is causing the pain to no avail. My surgeon has strongly advised me NOT to have a revision because there is NOTHING obvious that is causing the pain, therefore I would still have the pain after the revision.
In Roberts case he was lucky (In a weird sort of way, and I am sure that he won’t mind me saying this ) because the bone scan showed a DEFINITE reason for his ongoing pain therefore it CAN be cured by revision.
I have just had a very painful Arthroscopy/chondroplasty which revealed NADA, so I now have to decide whether to take the surgeons advice, which makes sense because research has shown that revisions under my circumstances do not work, also how can you fix what ain’t broke? Or insist on a revision.
The only ‘spanner in the works’ is that the surgeon has admitted that the pain ‘could’ be caused by the looseness that he built into the knee to give me max ROM.
I don’t know if any of this will help you, but I do hope that you find an answer somewhere.
Good luck.

Cheers, Martin

[captainruss]

Martin,

My first TKR was in March 2009.  I was fully functional, but bone on bone after 29 years of working.  I had 5 knee surgeries when I was 17 after shattering my knee cap in football.  OS stated that six weeks and I would be pain free for 10 years.  First TKR was painful, swollen, red almost immediately.  First had a MUA with no luck....60 degrees of ROM max.  All cultures for infection were negative.  Indium 3 phase bone scans...etc. all negative.  Only indicator was increased CED Rate and C Reactive Protein was high.  This is indicator of inflammation, not infection.  First OS scheduled me for second TKR in July, wanted to remove cemented joint, clean it out, and replace to rid the infection.  When on the table, cultures again came back negative.  First OS carves out pounds of scar tissue, closes me up, and states he can do no more for me.  No PT, no mention of AF. 

I go to specialist in Orlando.  He did 6000 knees including Orlando Magic and Shaq's knees.  He does multiple cultures....no proof of infection.  He tells me he wants to remove TKR, put in antibiotic spacer, six weeks of antibiotics and then replace joint before Jan 1st 2010.  I agree.  He takes on TKR on October 19, 2009.  Two weeks later, not one of multiple samples grew cultures.  No infection.  He leaves me on vancomycin through a pic line for 13 wks.  My knee is horrendous looking...dark purple, my entire leg is swollen and my left leg swells also.  No blood flow and my scars look like a drunk cut me open.  I hobble around on spacer which is just siting in the notches of my leg bones for six months.  OS and infectious disease docs again tell me leg is infected.  They say it is cured and put joint back in.  I go 60 days and cannot weight bear at all.  Again he takes out TKR and puts in non moveable spacer.  Again vancomycin and major pain on this spacer.  April 2010 my back doctor leaves the Spine Clinic he was at.  He is my 3rd OS.  He did not do my initial knee because the spine center would not let him do revisions.

I have two total TKR's in which OS #3 takes out spacers, cleans out leg and replaces spacers.  September 2010 He finally puts in a Stryker cemented TKR.  Huge scar tissue, but much better color, pretty scar, much better blood flow.  October 2010 total TKR to change spacers and lengthen my main tendon (don't remember name) to increase ROM.  It is at this point that my wife finds Knee Guru and we learn about AF.

December 2010 total TKR to again change spacers and remove scar tissue.  Leg seems better, ROM 70-75.  Pain increasing by Christmas...XRAYS and MRI's before Christmas.  I now have Heterotropic Ossification (bone growing in soft scar tissue).  I cannot bend my leg or weight bearing because of stepping on bone putting pressure on scar tissue.  February 1st, my OS tells me nothing more he can do.  Only way to remove HO is to cut it out and then treat with radiation to keep bone growing.

I have had multiple upper and lower spinal fusions and four rotator cuff surgeries on each shoulder.  Now, bone is growing in my back and shoulders.  Doc says he does not know what to do...getting second and third opinions if I can afford the travel.  I have been out of work for 2 years....three teenagers home schooled.  My 16 year old son on his 4th semester of college.  My daughters going in August.  should have gone last August, but I burned through the 401k and retirement.  Sold my gun collection except for the guns I will need to rob banks some day! 

I have 3 options according to my favorite OS.  Live with it, fuse it solid so it reduces the pain but tears my hip and back apart walking stiff leg, or amputate the leg above the knee and go with a prosthetic.  I have found a company that specializes in motorized knee/ankle prosthetics. 

I am getting info.  I feel if I cut it off with a dull soup spoon, they have to replace it and I can start healing. 

Treatment of AF in the first week or two is vital.  If you lose that window I don't know if anyone will be cured without a breakthrough in medical research.  I have not worked for 2 years.  i am totally miserable.

Russ

[wanna]

Hi Russ

Sorry to hear your story. I thought I'd had it rough over the last 7 years, but mine has been easy compared to yours.

Don't think I can give any advice as your problems are outside my experience.

I was pretty close to the choices that you talk about - and may be again if I can't get any more movement from my next attempt to sort. The one thing I would do, is ensure that you take your time making any decision and don't be rushed into it.
I have always avoided talk of amputation as this is an area that would frighten me to death. I am told by others that it is worth following, but I am not convinced.
I would be balancing how far I could walk and how much pain I have now, compared to a fusion. I'm sure amputation would frighten me too much.

Good luck

Andy

[MRW]

Bloody hell Russ, you really have had some bad luck.
I am really sorry but it will be impossible for me to offer you any advice as I cannot even imagine being in the amount of pain that you are in. The only thing that I can suggest is that if you type ‘Fusion or Amputation’ or any other reference word into the search box you will be able to get some information and feedback from other people that have experienced, or are experiencing your dilemma you can then contact them via a personal message which will go to their message board and will bypass this forum. Contact as many people as you can so that you will be better informed to make your next decision.
Good luck.

Cheers, Martin