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Author Topic: bilateral knee replacement  (Read 1526 times)

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Offline jsorr

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bilateral knee replacement
« on: November 29, 2008, 02:56:34 AM »
I have to have both of my knees replaced. My surgeon, who I have a lot of confidence in, has informed me that he will not do them both at the same time. I am very dissappointed as all along I have been expecting to go through this ordeal only once. He says he finds his patients generally do better when only one knee is done at a time. I've spoken to two physical therapists (one is my daughter-in-law) who say that's rubbish and that bilat patients do really well, even old, over weight ones, which I am neither. I'm getting a second opinion from a well-known surgeon (though not to me) who says he will do both knees if I'm in good physical shape. What's you're opinion - what are the real facts? I really don't want to go through this twice. Thanks for your help. This is a real big deal to me.

Offline Caroline109

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Re: bilateral knee replacement
« Reply #1 on: November 29, 2008, 03:52:54 AM »
When I was in PT earlier this month for my own unicompartmental (partial) knee replacement, only one knee, there was a woman there who was having PT for her shoulder. HOWever (I'm getting to the point eventually, lol), she told me she had had bilateral total knee replacments a few years ago and was very glad she did. She told me she went to a rehab facility for 2 weeks following her surgery and when she left it, she left on her own steam, using a cane. She was in her late 60s, I would guess, not overweight. Personally, I would think twice about having it done bilaterally because I found it helpful to have one "good" knee while the other knee is recuperating from the surgery. I'm 54, by the way.
Caroline
Chronic low platelet count
Men. surgery, both knees 2003,2007,2008
R PKR Sept. 17, 2008 - Biomet Oxford Partial
LK-TKR 4/21/2010 Biomet Vanguard Signature Knee
Scar tissue issue next to TKR knee
March 2, 2011: PKR to be revised to a TKR

Offline eaglemom

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Re: bilateral knee replacement
« Reply #2 on: November 29, 2008, 03:57:59 AM »
Be ready to receive a lot of differing opinions here.  What I really want of you is for you to be the final decision maker here, not us on the board.

 While rehabing myself from surgery a woman was rehabing from bilateral replacements.  Hats off to her she was hanging tough.  Interestingly to me the physicians office had no problem doing both at once, but, get this, not one of his pt's (there are 5 full timers) would rehab her.  The os had to bring someone in for this bilateral lady's pt.  I won't go into why the pt's wouldn't rehab her but they refused. 

This has to be a personal decision you and your caregivers make together.  eagle

Offline MD-F

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Re: bilateral knee replacement
« Reply #3 on: November 29, 2008, 10:45:14 PM »
Hi
I hope you are well, just wanted to share my friends experience with you. She had bilateral TKR (total knee replacements) done about 2yrs ago and has never looked back.
 She suffers from severe arthritis and her surgeon felt that she would never get through the P/T for one knee as both knees were really bad. It was a lot of very hard work, and I remember very clearly collecting her from PT (now she picks me up from pt) and seeing her in tears, but she worked through it and is now back to horse riding and yoga.

You need to speak to your OS about why he is against carrying out a bilateral TKR, I know many surgeons will only carryout this surgery in rare cases as there is a lot of post-op pain and discomfort involved and one heck of a lot of hard work and pain involved with the PT, my friend has never looked back but even she admits that she wishes she had been able to have it done one at a time, due to the amount of pain and hard work involved. I don't mean to try and put you off but as with all surgery you need to be aware of all the facts before you go into it, OS are great at saying yes they can do this and that but they are not the one crying at PT twice a week post-op (i work as a theatre nurse and know only to well the 2 sides of surgery)

Good luck, sorry if I have come across blunt but I feel very strongly about patients being aware of all aspects of their surgery, I wasn't and I work for an OS!!

Take care

Offline MoLu

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Re: bilateral knee replacement
« Reply #4 on: November 30, 2008, 03:11:49 AM »
Hi all-

I'm 5 weeks out from a TKR and I cannot begin to imagine two knees at the same time.  The rehab and pain associated with this surgery is so much more than I imagined.  I mean I could not lift my leg for the first week.  Needed help on everything.  Plus had a horrible time getting the pain under control.  How are you at takiing pain meds?  They did not agree with me at all.  And I had only one knee done.  I mean look at it like this - there must be a reason so many doctors won't do the procedure.  It can't all be due to the finances (less money for them).  It's not impossible since you do see a post from time to time that was successful.  But the thought of it makes me shiver!

Martha
Synovial Chondromatosis
9/16/05 Frontal synovectomy and tumor removal
10/26/05 Posterior open knee surgery and synovectomy with tumor removal
3/8/06 Disease is back
4/26/06 Frontal arthoscopic synovectomy and posterior open knee synovectomy
6/23/06 Disease is back
7/24/07 Synvisc
10/23/08 TKR

Offline Gill1960

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Re: bilateral knee replacement
« Reply #5 on: November 30, 2008, 01:07:03 PM »
Hi

I had bi lateral patellofemoral replacements in July.(kneecap and trochler groove) I had arthritis behind both kneecaps and my surgeon and I decided that neither knee was good enough to support the other through rehab. I did some research on the internet, went back to see him and told him why I thought having two done together would be more beneficial, fortunately he agreed, so went ahead and had both done together. I am 48 and overweight but my surgeon did not think this was a major issue.  I did have a couple of complications but these were not down to having both surgeries together. I lead an active life, two kids, 4 dogs, full time work but wouldnt say I was super fit, just normal,

I'm not going to lie and say it was a doddle because it wasnt - it was tough and you have to be dedicated in doing your exercises but I found that if you have your pain under control the results can be achieved.

Looking back if I had had just one done, I really dont think I could have gone through recovering from one op then going straight into another and start all over again, I got it all over in one go. People kept saying that I was mad having both done together but then they didnt have the pain of the arthritis to contend with so I felt they couldnt really pass judgement.

Coincidently, while in physio I got talking to a lady who had bilatereral TKR done a week before me , she was 50 and slightly overweight but her results were amazing, she told me how she coped and I took a leaf out of her book and I too have good results.

At the end of the day I believe it is your choice and I would recommend you get any info on having two done and present it to him, if he still not willing then find another surgeon who will.

Good luck and I hope you get the decision you want

Gill x
2005 - arthroscopy & Lateral Release left knee
2006 - Arthroscopy & Lateral Release Right Knee
2008 July 8 - Bilateral Patellofemoral  replacement
2008 July 10 - Massive P.E.
nov 11- patellofemoral revision surgery left knee
Jan 09 - awaiting MPFL reconstruction left knee

Offline eaglemom

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Re: bilateral knee replacement
« Reply #6 on: November 30, 2008, 04:57:09 PM »
Maybe I should give a little explanation as to why the pt's in the office wouldn't do this woman's bilateral pt.  All 5 of the pt use slightly differnet method's with people, which make sense.  But what none of them could accept was the os doing the procedure and then its in the hands of pt to totally rehab both knees.  None of the pt's were comfortable with that.  The os naturally didn't think it was a big deal - of course not.  He's not just had both knee operated on and he's not trying to pt a person who has had both knee's done at once.

You'll find every option here, and opinion.  Also what you'll find is total support of your decision.  eagle

Offline TIBBAR

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Re: bilateral knee replacement
« Reply #7 on: December 01, 2008, 07:32:18 PM »
Hi Jsorr
Ok this is me raising my hand and saying I had bilat 11-06. Sorry you are in this position but like everyone said this is your quality of life and your decision alone to make.
My knees ( both) were so bad on the xrays that the caps were sitting on the side of my knee. There was no way I could have had the surg. and have one to support the other in rehab. Not to mention the time off work and the copayments of 2 surgs. I was off work for 4 mos. but I was one of the unlucky ones to get arthofibrosis and had to have a MUA which set me back several weeks. I probably could have been driving much sooner but I had no bend in my knee to get in and out of the car. If you have a SUV or van it will be a lot easier.
I was in the hospital 3 days then on the rehab ward for 13 days. Some go to a separate rehab center but I was lucky enough to be able to stay in the same hospital. They have an excllent PT dept.
I feel that going to a rehab place for at least 2 weeks is essential for a good outcome. For many reasons that I won't go into here.
As for condition and weight. My OS isn't in the habit of doing bilats. I am somewhat overweight and was in good condition till the 18 mo. before the op. I was riding my mountain bike but when my knees got so bad I could not even pedal so quit. He never even brought the weight or condition up to me. Although they both play a part in how good or bad the outcome.
I was one of the lucky ones in that my os was a good pain manager. If I had pain he gave me meds. I quit taking any narcs. about 3 weeks after the MUA.  It is very important to keep ahead of the pain. You can't rehab when in pain.
It took about 18 mos. to feel really good, but for me that could be due to another orthopedic problem which I will be having surg. for in the coming year. Would I do bilat again? YOU BET!!!
That is just me. It is not for everyone please think long and hard about how you want to have it done. It is your body and your life and your decision alone.
If you want to chat further please feel free to say that here and I will PM you with my email address as you have to have 20 posts to send me a PM. I will be happy to add or answer any questions you have. There are not very many bilats out there. Good Luck with what ever you do and please keep us informed.            TIBBAR
PS. OH BTW I live alone not easy but even with both legs compromised I managed.
« Last Edit: December 01, 2008, 07:34:17 PM by TIBBAR »

Offline eaglemom

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Re: bilateral knee replacement
« Reply #8 on: December 01, 2008, 09:14:56 PM »
I just had a phone call from a sore knee friend.  She has several arthritis in both knees, toes and hands.  Both knees need to be replaced.  She went to a new os for her and he said both need to be replaced but I won't do that at the same time.  However, (don't you just love that?) my partner will.  When she asked what he meant it was:  this os would perform one knee and then move her to another operating room and the partner would do the second knee.  When she asked why he wouldn't do both he said he just felt fine doing one but not both so this would solve her issue of wanting both done at the same time.  I guess that's another way of looking at it.  She is doing this - matter of fact at weeks end!  Planning of 5 days in hospital then home.  When I told her I thought that was alittle aggressive for recovery she thought I was being to overprotective of her.  To each his own.  I'll keep you all posted on her progress.  I've just never heard of it being done this way, maybe thats how its always done.  I just don't know. eagle

Offline TIBBAR

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Re: bilateral knee replacement
« Reply #9 on: December 01, 2008, 09:55:38 PM »
Eagle
At 5 days po you can't lift your leg by yourself. Just think not being able to either leg let alone do anything for yourself. Someone has to literally move both your legs just to move.  There is a reason for 99% of the ppl going to rehab for a few weeks. Even a spouse can't get you to the bathroom safley. Plus a thousand other issues. Been there done that and I can't even imagine that happening. Please keep us informed I will be very curious to see how she gets on. Makes me shiver to think about coming home from a bilat at 5 days.  Thanks for the post. TIBBAR

Offline TIBBAR

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Re: bilateral knee replacement
« Reply #10 on: December 01, 2008, 10:02:00 PM »
Ok I know this is a little long but this is a good example of what happens with a bilat. I did not find this site till 5 mo after my op so I did not do a diary but Judy did and it anyone is interested her it is.  TIBBAR

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=38781.0















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