KNEE ARTHRITIS - Total Knee Replacement :
TKR deciding when - - Posted by Lena (Lena), 22 November 2003
I wrote about this but think I posted in the wrong place.I've read several of your post and it seems to me that most if not all of you are pleased with your tkr.I've was told monday that tkr is my next step.I can't take meds except Tylenol and it isn't strong enough to help much.My Dr. says it is up to me to decide when I've had enough but there is really nothing else he can do.My knee locks,snaps,grinds,has lost some rom,hurts when sleeping if fully extended without support and pretty much feels like a knife is stabbing me when I step up or drive moving my foot from one petal to another.It is getting harded to get up from a setting position.I don't want to keep feeling this way if it can be helped.All motion hurts and getting into a comfortable position is near impossible.I'm a little afraid of this surgery,I think because I saw it done when in school.I know it has restored the quality of life for many people but still have fear.I guess the only question I have really is how bad did you allow your knee to get before deciding on tkr?Also are you happy with the results.One more,how long do you think it would be post-op before I could comfortably walk on the beach?Right now walking in sand is totally out of the question?Thanks!
Lena
Posted by heronak (heronak), 26 November 2003
Lena,
While I haven't yet had a TKR, it's also the only surgical solution left for me. It's a tough decision, and from what I've read and heard you'll know when you can't stand the pain anymore and go for it. For now, I'm holding off because I've had a few months of lessened pain (who knows why?) and I'm only 42.
There's a wonderful forum dedicated to TKR and you can get some great insite into the surgery, recovery, milestones, etc.
http://forums.delphiforums.com/onourfeet/
Best of luck in your decision,
Heron
Posted by Chuck (Chuck), 2 December 2003
Heron & Lena;
It will be a year since I had my TKR on 12/17. It took 6-10 months of hard work, but now I can do things pain free that I haven't been able to do in years.
Don't expect it to come easy. You will have to work hard, but it will be worth it!
It took approximately 9 months before I stopped thinking about my knee.
I am 44 years old and am extremely active. If I didn't have the scar, you never would know I had knee surgery.
For the first three months you will ask yourself, "why did I do this?". Stick with it, it will be worht it!!!!
Chuck
Posted by heronak (heronak), 2 December 2003
Hey Chuck, thanks for your comments. I'm curious about your current level of activity and how it's changed from your pre-TKR days.
I'm also extremely active (hiking, biking, skiing, snowshoeing, weight lifting, cardio workouts), and while I know about what I shouldn't do post-TKR, I'd like to hear about what really active people actually do afterwards! Thanks for your input,
Heron
Posted by Lena (Lena), 3 December 2003
Hello Heron & Chuck,
Thanks for your input.I don't know just what to expect during the first few months after TKR.I understand it takes a while for total recovery.What type of therapy and for how long.What is the ROM during recovery like and weight baring,I'm totally in the dark here.How long are you on pain meds and what type?Are patches ever used for pain management?I can't take oral meds because of stomach problems.After being released from the hospital would otc meds help enough.Did you use a cryo-cuff or cast?You say it's hard work,just what is involved?I'm very happy to read that your quality of life has improved so much.What limitations did you have prior to surgery?Was your pain constant before TKR?If you care to take the time I'd like to know step by step what this has been like for you.Again I'm very happy for you and appreciate what you have shared.Have a great day!
Lena
Posted by Chuck (Chuck), 3 December 2003
Lena;
I wrote a long detailed reply. Unfortunitly it got dumped. I was informed it was too long. So I'll try a short one.
My ROM pre-TKR was 15-105. My ROM now is 0-105. I had alot of stiffness and pain pre-op. I had much trouble sleeping and had difficulty moving.
I was and still am a very active individual.
I played college football, that is how I orginally hurt my knee. I was a Nationally Ranked Bodybuilder. I coach little league baseball ,(17 years) and youth football, (14 years). I have 6 kids, 5 boys and 1 girl.
I had 6 pre-TKR knee surgeries.
The first few months post op are very hard!
Pre TKR surgery I had a pelvic nerve block, came out of surgery with a morphine drip. That was removed after 24 hours. I took oxycotine and percocet (sp?) for 2 weeks, then percocet and tylenol w/codine for 2 weeks. The OS precribed Vioxx, but my stomach couldn't take it.
I had a manipulation done at 6 weeks post op.
I had 5 months of PT.
I am pain free. I can run, with my teams. I bike. The OS said I can ski if I like. The only thing he has told me not to do is play basketball. As the pounding will shorten the life of the TKR.
Please ask any questions you would like. I'll try my best to answer.
Chuck
Posted by Chuck (Chuck), 4 December 2003
Lena;
Regarding recovery from TKR, I didn't explain what I meant by hard work.
The main function of PT is to get your ROM back, or as much as possible. This is accomplished by stretching and breaking down scar tissue.
I would arrive at PT, They would wrap my knee in moist heat wraps for 10 minutes. I would then do various warm up activties, these varied as my mobility and strength increased. I then did some strengthing activites, these also varies as time went on.
Next came the best part!!!!
Stretching. First the PT sat me on a flat table, raised my heal and applied constant pressure directly on the top of my knee to "flatten out" my leg. Pressure was applied for 30 -45 seconds. This was done 20 times.
Then I slid to the end of the table with my legs hanging over the end and the PT would slowly force my leg to bend. Pressure was applied for 30-45 seconds. Again 20 times.
These stretching activities really hurt!!!!!!!!
After stretching I was iced down for 10 minutes.
Then I left.
As time went on the stretching became less painfull. When I was able to get ROM of 0 or flat, the first stretching ended.
Getting "flat is the most important as that will determine if your gait is normal.
Don't mean to scare you.
Chuck
Posted by Val_M (Val_M), 27 February 2004
Hi Everyone
I'm in my 40's now with the very real possibility of having a TKR fairly soon. THe OS doesn't want to do the TKR for as long as possible as it only lasts 10 years or so. The revision sounds quite complicated and would likely happen in my 50's. If this lasts for 10 years, what do I do in my 60's?
I know this is all in the future and rather depressing but I was just wondering what anyone else has been told. Do TKR's last longer than 10 years depending on the type? How many times can a TKR be "revised"?
Posted by bernieboy31 (bernieboy31), 27 February 2004
People,
FWIW - There is only one person who knows when the time is right and that's yourself. 
Having had OA for a number of years it has progressively got worse and worse - pain, lack of mobility, unable to stand at the bar in my local etc.etc. has driven me to go for it - Booked in on 13th April.
IMHO it comes to the point where your quality of life gets so low that the risk vs benefit arguements for TKR become pointless. Hence I am going for it!!
OK, I know that there are hard times ahead but I am looking forward to going for a walk with my wife in the countryside and generally wandering around neither of which I can currently do without serious grief.
Hope that helps
Cheers
Bernie
Posted by Stevejw (Stevejw), 31 March 2004
Hello Val
I had a TKR at the the tender age of 37. The decision to proceed with the operation was tough due to the issues that you raise regarding revision. I am a very active individual and therefore the demands on my replacement are significantly higher than thse of an individual 20 years my senior. This was factored into decsion makeing process and I am aware that the new joint may only lasy 8-10 years. My surgeon belives that whilst revsions are complicated and more demanding (on everyone) it is a bot journey then losing the more active years due to pain and mobility issues. I try not to look beyond the next revsion - I hope that technology will have advanced and others will have the soultions for me by then - I hope that helps.
Steve
Posted by Beauzer (Beauzer), 1 April 2004
Hi,
How did you really know when enough was enough? What was your final deciding factor for going ahead with the TKR?
I'm only 29, but my knee is buggered. My OS thinks that TKR is likely within the next 5 years. I'm already at the point now where I have pain with daily activities (like standing and walking). I have an unloader which helps some. I've already tried Synvisc and glucosamine without any relief. I take Celebrex and Tylenol every day. The past week has been especially bad with a lot of pain even at rest and not being able to sleep.
I feel like I need to give the consevative stuff some more time, since my last chondroplasty was in January. I also need to lose some weight and hope that this will help some. But where do you draw the line?
Danielle
Updated Tue Dec 2 2008