Minimally invasive knee replacement

[chrisrobt]

I had my MIS TKR Jan 17th and have had very little pain (except for my PT appointments of course).

Christine

[DemiWV]

Hi, Christine,
On July 11 I will have  a TKR with the minimally invasive technique.  Did you have a lot of pain right after the surgery?  What type of anesthesia did you have?   Was the administration of the anesthesia painful?  Was it an epidural?  Can you now go up and down stairs normally?  Can you run or sprint across the room without pain?  Can you kneel?  How long before you could put weight on your knee and walk without crutches or walker?
 Are you havppy you had it done? 

I appreciate your insight.  I might also have to have the other knee replaced.

Demi

[chrisrobt]

Hi, Christine,
On July 11 I will have  a TKR with the minimally invasive technique.  Did you have a lot of pain right after the surgery?  What type of anesthesia did you have?   

I was supposed to have a spinal with sedation, but the spinal only worked on the  non-operative leg, so I was converted to a general anesthesia (but they didn't intubate me, just used a mask/oral airway).  Since the spinal didn't work, I didn't get that magic injection post-op which kills all pain for a day or so.

Was the administration of the anesthesia painful?  Was it an epidural? 

No pain at all; I remember sitting on the edge of the operating table (everyone in the room introduced themselves, but they all looked alike in their scrubs and masks), dangling my legs and felt only a tiny prick.  They asked about my legs and I told them my left leg was numb, then I awoke in the recovery room.


 Can you now go up and down stairs normally? 

I am now 4 1/2 months post-op and can go up and down stairs normally; I was able to go up alternating stairs pretty soon after the surgery, but you need a fair amount of flexion to go down.

Can you run or sprint across the room without pain? 

I'm not much for running across a room, but I did so this last week with no probelm.

Can you kneel? 

My OS told me to use a pad for kneeling while gardening; it feels funny and I don't keep full weight on the knee for long.

 How long before you could put weight on your knee and walk without crutches or walker?

They have you walking with a walker the day after surgery (I went home in two days); I was driving myself to PT at three weeks.  I used the cane for about four weeks, but mainly so I would take normal steps and not limp.

 Are you havppy you had it done? 

Very definitely YES...a friend just e-mailed me today that the last time we were out together in the field (dog training), she noticed subliminally that I was not walking the way I used to and finally realised I was walking normally!!.

I appreciate your insight.  I might also have to have the other knee replaced.

Good luck on your surgery; for some reason, I had almost no pain post-op except for the forced flexion and extension done by PT.  I took my pain pills at night to see if they would help me sleep (not really...I just couldn't get comfortable) and before PT.  At my 10 day appointment to get the staples out, I was asked if I needed a refill of my pain pills (they sent me home with 70 vicodin), but I had loads left so said no.  I can't believe anyone would need that many pills in just 10 days.

Demi

Christine

[DemiWV]

Christine, thanks so much for your thorough reply to TKR mini surgery coming up in July.   I feel much better about it now.  I noticed you had 32 staples, I was told that I would have no stapes, they would use GLUE instead.   Have you ever heard of that?  When you got home did you need any special equipment, i.e., a toilet seat extender, or anything else?

 If you needed to have TKR in both knees, knowing what you know now, would you have had both done at the same time? 

Thanks again.

Demi

[renk]

I also appreciate Christine's thorough reply, as I am having my surgery this Friday, June 9th on both knees.  I am also curious as to what her feelings are as to having TKR on both knees at the same time.  I am having the minimally invasive surgery so hope that's helpful.  Just can't imagine what it will be like having both done at the same but that's what I'm doing.  Would appreciate thoughts from anyone that can offer some encouragement.  Thanks.

[chrisrobt]

Christine, thanks so much for your thorough reply to TKR mini surgery coming up in July.   I feel much better about it now.  I noticed you had 32 staples, I was told that I would have no stapes, they would use GLUE instead.   Have you ever heard of that?  When you got home did you need any special equipment, i.e., a toilet seat extender, or anything else?

 If you needed to have TKR in both knees, knowing what you know now, would you have had both done at the same time? 

Thanks again.

Demi

I had no special equipment at home; my husband took some time off work to help the first few days, did all the shopping, laundry and cooking for about 3 weeks.  I was able to bend my knee enough by the time I got home (I think about 105-106 degrees) that I was able to put on socks/shoes and my underwear by myself.  I was allowed to shower once the wound stopped draining which was maybe 4-5 days post-op.  I have heard of others having the glue but otherwise can't comment, although it was a bit uncomfortable having the staples taken out.

I developed hypersensitivity in the toes and part of my foot on the TKR side 3 days post-op so was told to remove the Ted hose at that time; I was on Lovenox injections for two weeks post-op and then daily aspirin for two weeks beyond that.  This is much easier than the warfarin/coumadin given over six weeks for most TKRs.  I have OA in only the one knee so didn't have to think about getting two done at once; it may be like giving birth to twins...you get your entire delivery process done all at once, but those first 3-4 weeks are really difficult.  I'd guess if both were done by the MIS procedure it would be a much easier recovery.

I still have the nerve problem in my foot and toes (diagnosed as RSD) and I wish that were gone, but otherwise am very glad I had the surgery.  I am still a bit stiff first thing in the morning bout generally forget about my knee.

Good luck to both of you on your surgeries.

Christine

[DemiWV]

Renk, Hi,

Good luck on your MIS TKR surgery tomorrow!  My prayers go with you!   Please let us know how it went and how you feel.  Did the epidural hurt and did it totally knock you out or where you awake?   Did/do you have a lot of post op pain?   Did you rent a continual motion machine that moves and bends your leg for you?  If so, when and by whom was that arranged?

I have my MIS TKR on July 11 and I can't wait. 

Again, good luck and speedy recovery! 

Demi

[renk]

Demi
Thanks for the good wishes.  I will let you know how I made out.  They tell me I'll be in the hospital for about 3 days and be transferred to a rehab facility for approximately 5-7 days.  I'm hoping it's more like 5 days. Needless to say, I'm a little apprehensive tonight as to what will happen tomorrow.  I chose the MIS because the recovery is suppose to be easier and faster and I was happy that I'm a candidate for it. I'm having both knees done at the same time.  So when I get home and can get back on the computer, I'll let you know how I made out.  They tell me I should do good because I'm a little younger than the average patient (I'm 54) and judging from my x-rays, they think I tolerate pain well.  We'll see. I have been looking forward to this for the past 3 months and at this point, I just want to get it over with. Thanks again and I'll answer your questions when I get home.
Renee

[DemiWV]

Thanks,  Renee.   I'm 54, too.   Take care! 
Demi

[chrisrobt]

Demi
Thanks for the good wishes.  I will let you know how I made out.  They tell me I'll be in the hospital for about 3 days and be transferred to a rehab facility for approximately 5-7 days.  I'm hoping it's more like 5 days. Needless to say, I'm a little apprehensive tonight as to what will happen tomorrow.  I chose the MIS because the recovery is suppose to be easier and faster and I was happy that I'm a candidate for it. I'm having both knees done at the same time.  So when I get home and can get back on the computer, I'll let you know how I made out.  They tell me I should do good because I'm a little younger than the average patient (I'm 54) and judging from my x-rays, they think I tolerate pain well.  We'll see. I have been looking forward to this for the past 3 months and at this point, I just want to get it over with. Thanks again and I'll answer your questions when I get home.
Renee

Renee, good luck with your surgery; hopefully you will have minimal pain post-op...still the first two weeks are a bit tough.  I found it uncomfortble to sit for any period of time especially at my computer.  I was up and moving around alot (and I had alot of trouble finding a comfortable postion in which to sleep for weeks).

I used the CPM machine in the hospital only...

Christine

[renk]

Hi Demi and Christine - This past Friday was two weeks since my surgery and I told you I would letyou know how I made out.  First to Christine, you are absolutely right that the first two weeks are tough.  I had bilateral minimally invasive total knee replacement.  I know now why some doctors don't recommend doing both knees at the same time.  It is very tough but at this point I'm glad I did it because I wouldn't want to do it again.  Demi, I remember you asked Christine about the spinal and I can tell you that I don't remember anything about mine.  All I remember is them transferring me to the operating table, putting a cap over my hair and telling me to move up a little.  That is the last thing I remember but I did have a epidural (spinal). They kept the epidural hooked up for about 3 days and I was also on a morphine pump, and I controlled both. I was also on oxycontin and percocet, which I didn't tolerate well at all. When I went to rehab, I was switched to tylenol with codein every 4-6 hours and Ultram, once in AM and once in the PM. I also have Lidoderm patches for pain on my knees for 12 hours during the day. That is all I take for pain at this point.(well, I guess that's enough!)  I am also on coumadin for 6 weeks. I also had the CPM machine in the hospital and rehab only.  My surgery was on Friday, June 9th and I was transferred to the rehab facility on Tuesday, the 13th. I stayed there for a week until the 20th.  I walk with a walker and have my physical therapy at home now for 3 days a week. They tell me I should switch to a cane by the end of this week.  My main complaint is that I cannot find a comfortable position to sleep in and it was very hard to find a comfortble position to even sit in but that is getting better.  As far as the minimally invasive surgery goes, it did make a difference in rehab because I noticed people who had their surgery the same time as mine had more trouble bending their knees than I did.  My range of motion is now at 105 and at the time I left rehab it was at 90 so I'm advancing pretty quickly.  If you have any specific questions, just let me know and I'll try to get on the computer to answer you as soon as I can.  Everything I do is still a little tiring but that is also passing.  Hopefully, now that I'm passed two weeks, things will be easier like they tell me.  If I don't hear from you again, good luck with your surgery. And Christine if you can offer any encouragement, I would appreciate it.  I just would like to sleep comfortably again. Take care.

[DemiWV]

Renee, UGH,  In the middle of typing up a reply to you, my note disappeared!  I'll try again.

Renee. Great to hear from you and that after the two weeks, you are doing better!  Yeah!

1.  Renee, a week before your TKR, did you have to get off all your pain and anti-inflammatory meds?  What was that like?   I am fearing that day because I have been on pain meds accompanied by 2 Tylenol Arthritis, and went I miss taking them by a few hours, I hurt and ache almost everywhere.  That's going to be very bad news for me.

2.  Did you have to use any blood products?  Did you donate blood for yourself?

3.  Did the initial pain meds assure that you slept well at least at night?

4.  Did you have anyone at home to help you?  Did you go to a rehab place because you did both knees at one time or because there was no one at home to help you?

5.  Did you/do you kneed any special equipment other?   Did you need crutches or did you go straight to the walker?   Did you need a toilet seat extender or anything else?   A friend told me to make sure I get a toilet seat extender.  Did you need that or anything else?

6.  Did they use staples/stitches or glue?

Renee, I have a lot of questions here, please don't feel you have to answer them all at one sitting or two or whenever.  The info you sent us in your first post after surgery was great.  Please keep us informed on your progress, that will be encouraging for us all.

Thanks again, Rene, and good luck!

Demi

[chrisrobt]

Renee, UGH,  In the middle of typing up a reply to you, my note disappeared!  I'll try again.

Renee. Great to hear from you and that after the two weeks, you are doing better!  Yeah!

1.  Renee, a week before your TKR, did you have to get off all your pain and anti-inflammatory meds?  What was that like?   I am fearing that day because I have been on pain meds accompanied by 2 Tylenol Arthritis, and went I miss taking them by a few hours, I hurt and ache almost everywhere.  That's going to be very bad news for me.

2.  Did you have to use any blood products?  Did you donate blood for yourself?

3.  Did the initial pain meds assure that you slept well at least at night?

4.  Did you have anyone at home to help you?  Did you go to a rehab place because you did both knees at one time or because there was no one at home to help you?

5.  Did you/do you kneed any special equipment other?   Did you need crutches or did you go straight to the walker?   Did you need a toilet seat extender or anything else?   A friend told me to make sure I get a toilet seat extender.  Did you need that or anything else?

6.  Did they use staples/stitches or glue?

Renee, I have a lot of questions here, please don't feel you have to answer them all at one sitting or two or whenever.  The info you sent us in your first post after surgery was great.  Please keep us informed on your progress, that will be encouraging for us all.

Thanks again, Rene, and good luck!

Demi

Demi, let me see if i can answer any of your questions; I'm 5 months out and doing quite well.

I was not on a lot of pain meds prior to surgery so can't answer your first question (I stopped my anti-inflammatory a few days before surgery and did get stiff and sore but not unbearable).

I dontated two uniis of blood the three weeks before surgery and they were given back to me during the two days post-op (I didn't need them as there was very little blood loss, but it does make sense to give them back as long as they were available)

My two nights in the hospital were difficult; I didn't have much pain, but didn't sleep and had some funny "waking dreams" due to the percodan they gave me after I came off the morphine pump.

My husband took some time off work (actually he went in for a few hours in the afternoons, but fixed all the meals and di all the shopping for about a month.  His time off work was about a week.

I used a walker immediately after the surgery (borrowed from my 87 y/o father) and "graduated to a cane within two weeks after surgery.  I was expected to have a 90 degrees bend in my knee the day after surgery and had about 95-98.

I had staples which were removed about 8-9 days post-op; it was a bit uncomfortable, but not unbearable.

Rene, I thought the first two weeks were the hardest, but then I had only one knee done; once I started outpatient PT and driving again, I felt much better.  It was also nice to ditch the walker (I continued to use it at night for a couple weeks) and use a cane by two weeks.  I was offered a refill of my pain meds when the staples were removed, but I had hardly used half of them.  I continued having trouble getting comfortable to sleep for several weeks after the surgery.  I have always slept on my right side (operated R knee) and still cannot do so at 5 months...

Christine
.

[renk]

Demi
To answer your questions....
I was taking 600mg of Advil everyday and had to stop 2 weeks prior to my surgery and I have to say it was quite hard.  I didn't expect to feel so bad because I thought my body got used to it but it did make a difference not taking them. I was told I could take Tylenol, which usually does nothing for me, but I took it anyway and it did help a little.

I donated 2 units of blood before my surgery (one at 3 weeks before and the other at 2 weeks) I was given both units back after the surgery.

I was able to sleep for the 4 nights I was in the hospital, I think probably because of the strong meds I was on. But I had some weird reactions, like waking in a sweat and having weird dreams. When I transferred to the rehab facility, I went on the other meds that I mentioned in my earlier post and they were more tolerable but didn't help me sleep as much.  I was given ice which also helped the pain in my knees. I was sent to a rehab facility because that is what is recommended whether you help at home or not. I guess if my insurance didn't pay for it, it would have been a different story.

I do have help at home and I'm glad that I do. I think it would have been easier having only one knee done but it's what I have to deal with now. My husband took off from work the first two days and my mother lives nearby and comes over every day. I really don't do anything but take care of myself. My husband does all the shopping and my mother is doing the household chores. I get around on a walker but am suppose to start the cane this week. I also have a toilet seat extender which helps a lot, especially during the night when I'm not feeling as strong as during the day.  The rehab facility recommended and arranged for me to get the toilet seat extender and my insurance paid for it.

I had staples (I think about 30 in each knee) and they were removed two weeks after the surgery date. I now have steri strips where the incicision is and was told to just let them fall off naturally. I was not allowed to get the incision wet until the staples came out.

I am doing better than I was, I'm just impatient and want it to go faster.  Christine, you sound like you're doing great since you didn't have to take much of your pain medication. I honestly think if I had one knee done, it would be a lot easier. If my right knee wasn't done, I could at least sleep on that side and stand on that leg when doing things.  My therapy went great today.  I reached 110 degrees on both knees but my therapist did a lot of stretching, which was a little painful on the right side, but worth it if I'm where I'm suppose to be.  She told me I'll probably have therapy at home for about 3 weeks and then be able to go as an outpatient somewhere. 

I'll keep you informed of anything.  Christine, if I have any questions, I hope you don't mind if I ask. Demi, if you have any questions for me, I don't mind answering. Take care.
Renee

[DemiWV]

Thanks, again, Renee!

Demi