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Author Topic: ?'s about TKR or PKR, surgery soon  (Read 1394 times)

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Offline lindym

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?'s about TKR or PKR, surgery soon
« on: July 16, 2009, 04:14:17 PM »
I am having surgery this month on my rt knee, the doctor is not sure if I will need a PKR or a TKR
He will be removing my unispacer, he told me it all depends on what kind of damage this implant has done to me

I do not have full ROM.

When I was doing my pre-op, I found out I will be staying overnight, all my other surgeries it was completely out patient
so I am shocked I have to stay over night, does anyone know why this is? I asked the nurse who was doing my intake why
and she told me I was having MAJOR surgery.

I was also told I will be sent home with a machine, does anyone know what type of machine this is?

All my other surgeries I came home and sat in a chair for 2 weeks!!

I am also thinking I might ask for water therapy instead of traditional therapy in a gym. What do you think?

And I know this may be a stupid question, but what is the difference between a PKR and a TKR? What would determine what
kind I will have?

Also this unispacer has caused me nothing but problems, and from the research I have done about this unispacer it has a failure rate, I did not know this when I had it done a cpl of years ago.

I am kinda scared that this will be another failed attempt to get my full ROM in my knee

What can I expect with this surgery? How long will it take to know this has been a success?

This will be my 4th surgery on the same knee in 6 years

How big of a scar will there be? the current scar I have is about 5 inches long

Thank you very much in advance for replies

« Last Edit: July 16, 2009, 04:18:41 PM by lindym »

Offline cboden51

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Re: ?'s about TKR or PKR, surgery soon
« Reply #1 on: July 16, 2009, 05:22:43 PM »
Each surgery is different and the requirements for the aftercare are different also. Most doctors do both the PKR and TKR with at least an overnight stay , often several because your needs are greater in terms of pain control and beginning rehab.

The machine is a CPM : Continuous Passive Motion that you will start on the hospital most likely. Your leg is placed in the machine and the machine takes your leg through a specified range of motion that is increased as indicated by your doctor. It helps to gain motion more easily. You will have to be in for extended periods during the day but I felt it was quite comfortable and even slept in it with no difficulty. It has velcro straps that you easily do and undo to let yourself in and out as needed.

I don't think you will sit in a chair for 2 weeks! My experience is that you get moving and keep moving so you get back to your life faster!!!!  As far as water therapy there is someone else on this board who is doing it but I think she started after her incision healed?

In a PKR only one component (or at most 2 but most doctors will only do  1) of the knee is replaced, in a TKR all 3 components are replaced. The incision length is different for each with the TKR being longer. I have a PKR and my incision is about 3.5".

It takes about 6 months for you to start feeling really normal and up to a 18 months to be 100% but most people I see on this board get back into the swing of things within the first 6 weeks, some super stars have been back at work and even golfing after 1 month! (this from my own experience and reading on this board).

As you have had surgeries before you know each is different but you can't go on as you are and many people on this board will attest to the freedom they feel after this final step.

I wish you only the best and am happy to share any personal experience I have had.

Connie



Offline jathib

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Re: ?'s about TKR or PKR, surgery soon
« Reply #2 on: July 16, 2009, 07:27:12 PM »
When I was doing my pre-op, I found out I will be staying overnight, all my other surgeries it was completely out patient
so I am shocked I have to stay over night, does anyone know why this is? I asked the nurse who was doing my intake why
and she told me I was having MAJOR surgery.

This IS major surgery. That's why you're staying over night. The main reason is pain control. You will most likely be hooked up to a PCA (Patient Controlled Anesthesia) machine so you can administer your own IV pain meds. This is painful surgery, don't let anyone tell you otherwise. They also need to monitor you for infection and you'll likely be on some meds to prevent blood clots. Either oral meds or a shot that you will have to learn to give yourself.

You'll be out of bed the next day. They don't let you sit in a chair.

Quote
And I know this may be a stupid question, but what is the difference between a PKR and a TKR? What would determine what
kind I will have?
It sounds like you don't really understand this surgery. You should have gone over this with your doctor beforehand so you know exactly what to expect and what the expectations for recovery will be.

In short, you can only have a PKR if one compartment in your knee is bad. You also need your ACL to be intact. If there's a lot more damage you'll get a TKR.


Offline lindym

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Re: ?'s about TKR or PKR, surgery soon
« Reply #3 on: July 16, 2009, 10:59:18 PM »
Thank you soo very much for the feedback, I really appreciate it  :)
I had posted the same question at another board and the reply I got was a VERY RUDE one
Basically calling me stupid

I suppose it is my fault for not knowing much about this, when I was first speaking with this doctor, I did just act like I knew what
I was getting myself in for, that is ignorance on my part, I feel sometimes if I ask too many questions I am a bother  ::)

I was wondering about the pain management because in the city where I live, they don't much believe in anything stronger than
Tylenol  and if you have severe pain they MIGHT prescribe Lortab and that is not much prescribed here, so I suppose I will not get anything strong and I will just deal with the pain  :o


I have heard of acl's, but not quit sure what the symptoms of a bad one would be  ???

Ok I just looked it up
the back of my knee hurts very much, I did express this to the doctor he told me it was probably due to swelling??
although he didnt look at the back of my knee, should I tell him this again the day of my surgery or tell him now??


« Last Edit: July 16, 2009, 11:02:39 PM by lindym »

Offline jathib

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Re: ?'s about TKR or PKR, surgery soon
« Reply #4 on: July 17, 2009, 02:36:45 AM »
I suppose it is my fault for not knowing much about this, when I was first speaking with this doctor, I did just act like I knew what
I was getting myself in for, that is ignorance on my part, I feel sometimes if I ask too many questions I am a bother  ::)
It's your doctor's job to answer questions. If he doesn't want to answer then maybe he's the wrong doctor.

Quote
I was wondering about the pain management because in the city where I live, they don't much believe in anything stronger than
Tylenol  and if you have severe pain they MIGHT prescribe Lortab and that is not much prescribed here, so I suppose I will not get anything strong and I will just deal with the pain  :o
I don't know what city you're talking about but hospitals are required to provide adequate pain relief. Tylenol is not going to come close to being enough. You will be given morphine in the hospital and should be given at least Percocet when you leave. They should give you a prescription at your pre-op.


Quote
I have heard of acl's, but not quit sure what the symptoms of a bad one would be  ???

Ok I just looked it up
the back of my knee hurts very much, I did express this to the doctor he told me it was probably due to swelling??
although he didnt look at the back of my knee, should I tell him this again the day of my surgery or tell him now??
Your MRI should have shown whether your ACL was intact or not. Looking at that back of your knee is not going to help your doctor determine whether you have a bad ACL or not. I tore mine in half and didn't have pain in the back of my knee. There is a specific tests doctors do for that.


Offline mind_situation

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Re: ?'s about TKR or PKR, surgery soon
« Reply #5 on: July 17, 2009, 03:34:27 AM »
if you have a total knee replacement you will be in the hospital for 3 to 5 days. after that you will have pt for at least 2 to 6 months. that is if everything goes the way it should. it didn't with my tkr and i spent a total of 20 days in hospital. good luck.

Offline lindym

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Re: ?'s about TKR or PKR, surgery soon
« Reply #6 on: July 17, 2009, 03:34:05 PM »
Thanks so much for the replies
He is a good doc as far as I can tell, he is very freindly and I am sure he would answer my questions,
I guess I feel like a bother if I ask too many ?'s
My 1st visit with him they did an x-ray only
and he was VERY familiar with the unispacer put in my knee but did not do a MRI  ???
so my surgery is a week from today, is there anything I should do or ask now??
I guess i dont know exactly what to say  ???

The hospital told me I would only be staying overnight  ???


That is good to know about the pain meds, I have a low tolerance for pain

Thanks soo much people for all your help, it's much appreciated  ;)

Offline Plumb

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Re: ?'s about TKR or PKR, surgery soon
« Reply #7 on: July 17, 2009, 11:49:27 PM »
Wow overnight is all depending on how healthy you are..  post surgery.  I stayed three nights four days. before going to a sub acute rehab.  You want to cover everything from pain control to nausea control.  Do not hold back on telling them your in pain. It is a very painful surgery. 

Yet you will be up and walking with a walker the next day.  Might not go very far .. but your up..

You can do water therapy when you can bend your knee enough and  your strong enough to get in and out of a pool  maybe three months. after your TKR.

Good luck.


Offline lindym

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Re: ?'s about TKR or PKR, surgery soon
« Reply #8 on: July 18, 2009, 05:09:23 PM »
Thank you for the advice, I am definitely going to keep all of this in mind
I didn't think it would be that painful, I know when I had the unispacer put in, the pain was
TERRIBLE and the rehab was even worse.

So I am looking for more pain this around?


Thank you everyone!! Y'all are the best!!  ;D















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