The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Unicompartmental knee replacement => Topic started by: rkbad on March 08, 2013, 07:05:42 PM

Title: Mako PKR
Post by: rkbad on March 08, 2013, 07:05:42 PM
I have had significant medial OA for over ten years, going through two OSs that recommended TKR. My third did debridlement in 2007, indicating that I had five years to something. He indicated while I had some PF involvement, he would pursue a PKR if it were him.

Did significant research over the last two years and landed on Mako. My biggest concerns going into any replacement was infection control and alignment - alignment specifically with a PKR. Mako addresses the alignment with a carpenters first rule - measure multiple time before cutting. Alignment and resulting compensation are preplanned, verified before cutting, and validated with the trial. Cutting is minimal as it is performed per the plan, using a robotic controlled burring Dremel-type tool, 3cm into both the femur and tibia sides.  Infection control was achieved by find an OS that performs many Makos per week OUTPATIENT!

Had surgery yesterday, March 7,2013. Walking with cane today. Feels better standing than pre-op. Going in, knew I had significant spurring on femoral, tibia, and patella. Had the surprise of a cyst in medial patella region!

Recovery is by no means complete, but early results are excellent! Mako is not available everywhere, and like any procedure, OS selection is critical.  If you are on this board, you are likely doing your research.

Will update on progress, but first days are exceeding expectations!
Title: Re: Mako PKR
Post by: LindaM on March 10, 2013, 02:57:37 AM
Congrats on your terrific first day. Isn't it fantastic when you don't dread every step you have to take!  I hope your recovery goes as smoothly and quickly as mine did-6 weeks and back to full time teaching.  Just make sure you don't overdo the first week or two, you have a lot of healing to do and you don't want a set-back of a week for an afternoon of not taking care of yourself.

Good healing and I hope you post often as you go through your PT and recovery.

Linda :)
Title: Re: Mako PKR
Post by: greatfulgann on March 10, 2013, 06:07:38 PM
I have asked the same question of more than one OS regarding alignment and PKR.  I have yet to get a clear answer.  If alignment is what has lead to the PKR, doesn't it make sense that this should be addressed prior to or during PKR?  Is MAKO the only PKR that fixes alignment at the time of the procedure?  Whats the point of replacing a kneecap if the underlying problem still exists.
Title: Re: Mako PKR
Post by: rkbad on March 11, 2013, 02:55:28 AM
Dear gann....
Alignment is critical - agreed.  Misalignment can result in early wear of the implant or good side.  It is the precision of the alignment that comes with Mako.  CT of knee and pre-determining the overall load and  varus/valgus throughout range of motion capable with Mako and verifying with the trial.  Seeing the overall load and making adjustments increases precision.  In the right hands, can be accomplished with other unis, but consistent precision is more achievable with Mako.

Not sure of kneecap replacement.

Note - recovery is proceeding - no set-back by patient stupidity.....yet!

Title: Re: Mako PKR
Post by: rkbad on March 31, 2013, 11:11:21 PM
Had PKR 3.7.2013.
Surgery started at 12 noon.  Completed at 2:15.  Passed discharge tests at 2:45.  Discharge papers signed at 3pm.  Total outpatient.

Walking with walker on day one, cane on day two.  Day three was the most painful - on pain meds but just all of the adjustments.  Still, no arthritic pain!  Iced most over 18 hours a day over the first week.  Did minor isometric work on the leg just to keep some muscle mass.  Off pain meds after day four.  Flew back home on day six and took pain killers to get through the flight.  Was able to ice and elevate during the flight. Walking was less than 100 yds first week.

Week 2: Continued icing and started walking short distances.  First, just a couple of hundred of yards, up to a block.  Went back to work half days on day 10 and 11.  Full time from there on.  Was able to ice and elevate during the day, which was key.  Expanded on isometrics and increased intensity.  At end week two rode spinner for 3 min (wow!).

Week 3:  Still icing, but less.  Continued to increase walking and decrease icing.  Increased strength exercises.  On Sat and Sunday rode spinner for 7 minutes.  On Sunday, walked 3 miles!

I know I have a long way to go.  Improve flexion, strength, and confidence.  But results are GREAT! 

Title: Re: Mako PKR
Post by: FMRCathelete on April 01, 2013, 07:29:21 PM
Wow!!!! You are doing great!  Keep up the great work & it is soooo good to hear of positive outcomes.  Cheers-A
Title: Re: Mako PKR
Post by: Maary on April 13, 2013, 08:43:46 AM
It sounds like you are doing really well. I'm due same op very soon. Very interested in your progress and any helpful info about rehab.
Title: Re: Mako PKR
Post by: rkbad on April 28, 2013, 04:11:10 PM
Just passed the seven week mark and in Minnesota, spring has arrived.  I was able to go on my first big post surgery bike ride for ~15 miles on Friday.  Wound is well healed and working on building strength and increasing flexibility.  I am going on walks doing exercises for strength, and doing yoga for strength and flexibility.  I am having a blast walking without pain!

My feedback for rehab:
1. Listen to your doctor!
2. Start slow - getting the inflammation down and getting the wound healing.  Light walking early and building, being careful not to have a set back.
3. Listen to your doctor!
4. Ice after activity.
5. Be aware of changes and avoid set-backs.

I needed to travel to Florida from Minnesota as Mako was not available in Minnesota.  I had the medial right knee replaced/resurfaced.

Thanks for checking and I will keep updating.  Looking forward to hearing other Mako stories here.  Check out the Mako site for other stories.

Title: Re: Mako PKR
Post by: greatfulgann on April 29, 2013, 12:29:31 AM
Who is your Florida OS that did the Mako?
Title: Re: Mako PKR
Post by: rkbad on April 29, 2013, 03:05:10 AM
Dr. Buechel in Naples.
Title: Re: Mako PKR
Post by: rkbad on April 29, 2013, 03:06:48 AM
Dr. Buechel in Naples.