Banner - Hide this banner





Author Topic: Need Help Deciding between PKR and TKR ...Please Help  (Read 6142 times)

0 Members and 1 Guest are viewing this topic.

Offline renegaderob18

  • MINIgeek (20-50 posts)
  • **
  • Posts: 20
  • Liked: 0
Need Help Deciding between PKR and TKR ...Please Help
« on: January 04, 2013, 10:29:26 PM »
I have had pain in my right inside knee for a little over a year know...have tried the injections, rest, ice, therapy and 2 surgeries for chondromalacia, but everything makes it worse. I am to the point where my knee is ocking up on occasions, I can't drive more the 15min max, and have to use one or both cruthces at times to get around. I saw two OS docs and was told after they saw my MRI that at age 35 I need replacement done. The one doc said he reccomends TKR and the other one said there is a chance PKR might work, but can't promise for how long, but to consider the TKR. I was being told by the first doc that said TKR only I should have that due to having arthritus in both shoulders as well it will most likely eat my whole knee up within a few years. The other doc did agree, but said we can't say either way if that will happen so he said PKR is a possibility. What do you all think. I am leaning toward the TKR even though I am 35, because of the arthritus in both shoulders. I also don't want to have PKR and the other side get arthritus in a year or 2 or so and then need TKR. I am tired of trying things and being in pain. I also have maltracking in the knee and we tried lateral release and all of that, but it didn't help. I also have slight swelling and water on the knee that keeps coming back as well that we can't get rid of. Would a PKR help the maltracking better or would a TKR and which would help with the swelling/water on the knee to stay gone? Please any help would be greatful.

Offline LindaM

  • Forum Faithful
  • ****
  • Posts: 488
  • Liked: 8
Re: Need Help Deciding between PKR and TKR ...Please Help
« Reply #1 on: January 05, 2013, 02:29:09 AM »
Hi Rob,

I am the happy owner of two partial knees and they are terrific.  I was a candidate for PKRs despite arthritis in most of my joints for over 20 years (I had one thumb surgery before Christmas and am in a cast right now).  Just because you have other arthritic joints does not mean everything will fall apart in a hurry.  In my case, my bad arches led to uneven wear and the medial part of my knees gave out way ahead of the outside.  If you are carefully chosen, your PKRs can last 15 years or more.  In the past, doctors were not always as selective, so the average lifespan was much shorter not to mention the designs have improved.  With each of mine, the OS was sure ahead of time that a PKR was all I needed, but he still reserved the right to do a TKR if he saw anything that changed his mind when he started working.  I expect that the OS who said you might be a candidate was also concerned about what he would find when he got in there, especially if he didn't do the previous surgeries.  I am not a surgeon-  I think that would be a question to put to the experts.  Either get that answered by your doctors or check and see if you can find some published comparison studies on line.

Good luck in your decision making.

Linda :)
>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline Caroline109

  • SuperKNEEgeek
  • *****
  • Posts: 2433
  • Liked: 1
Re: Need Help Deciding between PKR and TKR ...Please Help
« Reply #2 on: February 05, 2013, 05:29:40 PM »
My PKR started giving me trouble a year and a half after getting it. I started having arthritic pain where there had been no pain or arthritic damage when I got the PKR. I ended up getting it revised to a total at about 2.5 years old-would've had it sooner but the other knee had to be replaced and then I had some issues with it. If I knew then (at the time of the PKR) that I would need to get it revised, I never would've gone with the partial at the start. The partial was wonderful until it wasn't.  I know at least 1 other person from this page who had to get their PKRs revised.
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 SallyW

  • Forum Faithful
  • ****
  • Posts: 212
  • Liked: 2
  • User's Text
Re: Need Help Deciding between PKR and TKR ...Please Help
« Reply #3 on: February 05, 2013, 07:07:34 PM »
I've been told that one of the criteria for PKR is *no* arthritis in either of the other compartments of the knee. That is the big thing; there are some other criteria as well, but most people that have enough arthritis for a PKR are going to have damage in the rest of the knee. When you go for a PKR, even people that are told they qualify, they have you sign permission for a TKR. So many times they start the operation and then find out that you have other damage and have to have the complete replacement.

I was originally told that I might be able to have a PKR, but my main doc says that I have moderate to severe damage in the medial compartment, so there is no point in even considering a PKR. So this fall - when I have time (after we finish building our ADA accessible new house), I'm headed for a TKR. Life is going to be rather challenging until then, although I'm hoping that my current round of injections will help.
Right knee: LR/TTT 1995 Left knee: LR/TTT 2000, Microfracture & partial meniscus removal 2004, Synvisc 2004, Unloader 2004, OATS 6/20/2005, Synvisc 2006, Debridement 2006

Offline Caroline109

  • SuperKNEEgeek
  • *****
  • Posts: 2433
  • Liked: 1
Re: Need Help Deciding between PKR and TKR ...Please Help
« Reply #4 on: February 05, 2013, 07:50:27 PM »
There wasn't a speck of arthritis in my knee except in the medial compartment, which is why my doctor felt I was an excellent candidate for a PKR. I was in my mid 50s, not overweight, and he felt that it would be less invasive for me than a total knee, so that is what I had. I also had had a recent scope and MRI (having torn my medial meniscus for a second time about 10 months before) of the same knee so it had been seen to be clear of arthritis everywhere but medially. So I had it. Unfortunately, 1.5 years later, arthritis showed up in the lateral and PF compartments. That was the end of the PKR.
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