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Author Topic: Bilateral patellofemoral replacement questions  (Read 4340 times)

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Offline hredmond2

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Bilateral patellofemoral replacement questions
« on: March 11, 2015, 07:13:49 PM »
I am 39 years old (as of yesterday  :'() and will be having bilateral patellofemoral replacement surgery in a few weeks. I have currently had a total of 8 surgeries, 4 on each knee, since 2009, including Fulkerson osteotomies on each knee and cartilage resurfacing on each knees. Obviously this is the next step. I was wondering if anyone has had the bilateral replacements and could give me any insight about healing, recovery, hospital time, back to work, back to driving, etc. I am a teacher and hoping to go back to work in 1-2 weeks max from my surgery date and back to the gym shortly after, but I fear I may be unrealistic. Insights from anyone?

Offline Mr.F

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Re: Bilateral patellofemoral replacement questions
« Reply #1 on: March 12, 2015, 01:46:15 AM »
I just read your post and started to laugh (and so did my son).  I have had 8 operations on each knee (clean out with lateral and distal realignment on each knee,Fulkersons on each knee, and bilateral PFR and revisions on both knees).  I am a teacher and I had the PFR when I was 35.  I returned to work 3 weeks after surgery. 

Let me start off by saying everyone experiences something different when they have replacements.  With this being said I would say there is no chance to get back to work in 2 weeks.  I was in a wheelchair for several weeks and could not drive.  I was forced back to work in 3 weeks.  If not I would have taken more time to recover.

As for driving what type of car do you have (automatic or stick)?  I had a stick shift and my wife had to drive me to work for at least 2 months.  I do not know what the recovery time would be for an automatic car.  Talk to your OS and then use your judgement.

As for physical activity use common sense.  Do not do anything drastic and try to rush into anything.  The outside of your body will look like it is heald.  What is going on inside is a different story.  Your quad muscles will need time to heal.  You might be able to feel the implant inside your body and you need to get use to this.  There are other obstacles you will face during this time.

If you are into running, biking, swimming, etc you might want to see if you have a local Achilles International group you can join.  They are fantastic.  They work with disabled athletes (I am a member of my state and I work with recruiting athletes and guides).

After your surgery the physical therapist will come in and work with you.  The PT will get you out of bed and walking.  You will have a walked.  Yes like the walkers you see at the mall with the tennis balls on them.  You will most likely be asked to sit in a chair.  Once you are mobile the PT will take you to a room to start physical therapy.  This is when the fun begins.  Follow the exercises.  Make sure if the PT tells you to exercises 4 times a day you do it.

As for pain management you can take the meds they give you.  If you want to bypass the side effects and go another route look into getting 2 passive motion machines.  One for each leg (see if your insurance will cover this).  This will not help build muscle.  It will help with pain management and sleeping (and this is another problem).  What you do with this machine is strap your legs in, set the angle you desire, and start the machine.  It moves your legs back and forth.  (This helped with stopping pain and muscle cramps in the middle of the night).  As you are increasing your range of motion you increase the angle on the passive motion machine.

Another item you will want for pain management are 2 IceMan Coolers (this looks like an iglu cooler but it has a tube attached to an area where you place a pad on the knee).  You fill them with ice and water.  You plug it in and the cooler send cold water through the tube to the pad.  (You will need to place a clean pillow case or cloth over the knee before you use this.). You will place the pad on the pillow case and strap it to your leg.  The cold water will ice down the knee and you will feel less pain.

When you get home from the hospital you need to have a large area, say the living room floor, near a bathroom (you do not want to be climbing up and down stairs).  Set the passive motion machines on the floor near where you are going to sleep (yes this is easier than getting in and out of a bed and you can place everything you need close to you).  Make sure the machines are plugged in so you do not need to find a plug when you are in pain.  Start off with small settings on the machine.  5 degrees.  If you can handle this great.  Do not push to increase the angle too quickly.  This machine does not build up muscle.  I found that when I had both legs moving (at first I had only one machine, the company providing my items thought there was an error) I could fall asleep for 5-8 hours at a time.

As for your cannot get your knee wet until the wound heals so you need to figure out how you are going to clean yourself.  This is somewhat embarrassing so I am going to skip how I did this.  Let us say you have to find away that works for you.  (During my revisions I shaved my head so I would not have to wash my hair).  Your toilet use is another struggle.  If your toilet is low you might want to get a toilet seat.    After surgery getting on and off of the toilet is an adventure (not to mention getting to and from the toilet).  You will need assistance and eventually you will find what works for you.

As for your daily needs (food, clothing, washing dishes, laundry, etc) you will need a lot of assistance.  I do not know if you are married, dating, or have family that can help but get as many people as possible to assist you.  With everything you are going to have to go through it is extremely difficult for one person to handle. 

When you leave the hospital and get situated at home one thing you will need to set up is your physical therapy.  My suggestion is find a physical therapist now.  If you can have at home physical therapy even better.  You want to give yourself time to get cleaned up and put on clothing before going to physical therapy.  This will take some time.  You will need to get use to putting on as little clothing as possible.  Why?  In the beginning it takes forever to put on underwear, shorts, and socks (forget about shoes).  And think about the walk and time it will take  from inside your house to the front door, the front door to the car, and how are you going to lift your legs to get into the car? If you have to drive over bumps, railroad tracks, potholes, etc the driver needs to drive very slow over these areas if not you will be in some pain.  (And once you get to the place for physical therapy how are you going to get out of the car, how long will it take you to walk from the car to the physical therapy building, and once you are inside from the door to the office?

After physical therapy you will be in pain.  I will not sugarcoat it.  Wow the pain.  Some people take pain meds prior to physical therapy.  Some people take pain meds after.  If you take pain meds and can not feel the pain you can mess up your knee(s) and not realize it.  If I took pain meds it was when I got home from physical therapy.  No way of injuring myself because I could not function (pain meds kicked in).

There is so much more that I can talk about but I do not want to write a book.  If you want to check out what I have been through look me up on the message board and read my posts (I have 3 or 4 different entries).  The first post you will see should be either below or above yours.  Check out the others and you can read about my adventures.  You can always send me an email if you have any questions.  Good luck and stay positive.

Take care,
Mr. F