The patello-femoral joint :
Is TKR an option rather than TTT? - - Posted by kld (kld), 13 September 2002
OK-here's a kicker of a question.
If i can starve off surgery for as long as possible, it seems like a TKR is an easier surgery to recover from than a TTT. It seems like even if i continue to mal track, and eventually wear down cartilidge to the bone, that a TKR would do the trick--even if i wasnt old enough and later had to have it redone.
Anybody have any thoughts on this?
Posted by opal (opal), 13 September 2002
Kld
TKR isn't a procedure that is recommended (or even considered) for someone under the age of AT LEAST 55-60; older even. TTT can eliminate the pain and wearing down process leading to TKR. Neither procedure is 'a piece of cake', but TKR is a pretty drastic step to take before even considering lesser options. I had TTT 5/23 and am pretty well recovered. I don't personally know about TKR, but I don't think its recovery time or rehab time is any better.
If you do nothing for PFS, it will continue to worsen as I was told by OS. Has your OS 'scoped' your knee to diagnose any of this? Has he/she talked about LR or TTT? Try not to get ahead of yourself before you have some hard info. TTT does [/i]sound[i] scary, but it really is NOT that bad.
Posted by Linds (Linds), 13 September 2002
TKR is an extreme operation. It isn't considered for anyone under 50 years old. They can't redo it if it wears down , because the bones of the leg wear down and are no longer capable of supporting the replacement parts. Can you wait until your 50 in that much pain. I know I couldn't.
If the surgeon want's to operate on you, think seriously about it, but they usually won't offer it unless they feel confident that it can help.
Good luck, take care
Linds 
Posted by Iona_-Uk (Iona_-Uk), 13 September 2002
Hi
It's certainly not easy to recover from any types of surgery and a TKR is a MAJOR operation and take time, patience and true grit to get through, I have seen it with pateints I work with and the pain that they have to undure post-operatively, is not something I think I could bear.
Most TKR's are performed on older patients, around 55-60 yeard of age plus, I have nerver seen a TKR performed on a younger patient and I have been working in hospitals since I was 17.
I think you are wrong to say one type of surger is easier to recover from than another. ANY surgery is going to be hard to recover from and you've got to remeber no two people or operations are the same. Any surgery that is undertaken is going to be hard to recover from, with the greatest will and determination, you will have some problems.
You are 27, you would not be considered for a TKR, I can tell you that, my Dad is in dore need, he is going for carticel at the end of this month but what he really needs is a TKR but at the age of 46, he has been told NO surgeon in the UK would even think of doing it, purely because he has another 30-40 years of use of that joint, having a TKR now would damge the joint further and even if he had it done, it would need to be replaced in 10-15 years by which point the adjoining bones would have been so far weakend, it would be impossible.
I think you seriously need to consider what you are thinking about here, as far as I have gathered, you've not had any surgery yet, so why suddenly decide that you should have TKR, when there maybe absolutely no need. You may not need any surgery for years, that is the way of PFS, it is very hard to treat surgically, even if you ahd a TKR, you could be left with chronic knee pain, adhesions etc.
I think you really need to discuss this with an OS and get their opinion about what surgery if any, you need, but they will explore every other possiblitly before putting you down for surgery, it's not just going in and saying you want surgery, OS's don't work like that, they may put you through the rigours of PT, MRI's, X-rays, Blood tests, eveything.
I know how frustrating it is to be in your boat, I've been there for 7 years, surgery was my last hope, my first 2 failed with spectacular effect. My last hope now is having a TTT on my left knee and I am hopeful.
Please do see an OS for an accurate diagnosis and to implement treatment for you asap.
Iona
Posted by Rina (Rina), 14 September 2002
To echo what has been said here, think about it.
TTT is cut a piece of bone, move it and screw it in a new position. Bone needs to heal and everything else needs to adjust to the new geometry.
TKR - they ream out both the tibia and femur and replace the entire thing with metal parts. Again, bone healing and everything adjusting.
Both are serious operations. Quite frankly if you have serious knee problems, there are no easy answers. On the non-surgical side, for some people serious PT can make a real difference. This should be pursued whether or not you intend to eventually have surgery. If you are lucky, the surgery will be either delayed or no longer necessary. At worst, you will go into it in a much stronger position and recovery will be that much easier. Make sure that you have read all the information available to you and fully understand the TTT's and their variation as well as the implications. And quite frankly this is not somehting you need to decide today. Take the time to get educated, get serious about PT, and even get second opinions if necessary and see where those things lead you. Your knees will still be there, and in the meantime you will be able to make more informed decisions.
Quite frankly - no easy answers. And certainly NO easy surgeries.
Posted by Rina (Rina), 14 September 2002
And read the posting from "Close Personal Friend" about paralysis from TKR.
very frightening.
Updated Thu Apr 29 2010
