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Author Topic: TKR in disabled patient  (Read 2829 times)

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Offline Vickie80

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TKR in disabled patient
« on: August 14, 2017, 01:47:42 AM »
Hi all :) Im new here! Please bear with me as my story is a book!!!

Im from South Australia... I'm 37 and will be going in for my 1st TKR in a months time on my left knee. One of the youngest patients my OS has done this to. He is a highly regarded surgeon, who has trained under some Internationally renown OS. I trust his ability.

I have suffered from/had done: OA, Chondromalacia patellae (grade 4), ACL recons, Lateral releases, Tibial Tuberosity transfers and multiple clean outs (Arthroscopies) and probably more I can't think of right now, all in the past 14 years!

I have lost count of how many surgeries I have had, but it is around the 20+ mark, all up on both knees.

Most recently I had an ACL recon on my right knee, all was good until 9 months later when I needed a revision as the "button" had come loose.
I recovered quite well from that too.

But, because I was favouring my right knee, my left suffered majorly! To the point that I am now confined to a wheelchair/gopher. I can only stand for a short period and even need help getting in/out of the bath and on/off the toilet :( So Im quite disabled.

Because of all the surgeries I have had and have had to use walking aids throughout this time (14 years), my shoulder is now so sore (dislocations and also need surgery on it!), that I cannot use it very well either.

I was told 10 years ago that I needed knee replacements, but "was too young". I have 2 children, who I haven't been able to play with because of my disabilities.
My patella's dislocate, even rolling over in bed!

I used to be a very active person, playing soccer, tennis, swimming and competitive horse riding. So being not able to even stand up for a period of time is, as you can imagine, quite depressing!

I went and saw my OS last week, after having MRI's on my left knee and he said I have 2 problems, 1 is instability/dislocations of the patella and the other is severe pain...

He said that he could do a patella stabilisation surgery, but it would not take my pain away and could possibly make it worse and that I have severe arthritis under my patella (Grade 4, he said if it went higher, then he woud've given me a higher number!)

Then he completely surprised me by saying my best option is a TKR, I burst into tears! It's the news I've been waiting to hear for so many years!!!
So we will be going forward with the surgery.

TKR's on both is not an option my OS would like to do, as my recovery time would be extended due to my atrophic muscles.

My concern is with my PT exercises and walking. My right knee is very unstable and prone to collapsing, as well as my shoulder not being able to take weight with crutches.

How will I go? Are there any other options, exercise wise that I can do? I so badly want this to work! Even if it reduces my pain, I would be happy!
I'm determined, but also scared that I will collapse on my right knee and possibly cause damage to my new knee.

I know that my OS and PT will know best and I will, before anything else, follow their directions, so I am just after some general ideas or hear from some people who may have had similar problems, that might be able to help me :)
I also know the following might sound like I'm looking to the future, but I sort of have to as specialists (PT, hydro pool etc) are around 130kms away, my OS is 300kms away. Gym is only 20kms away!

My plan at this stage would be to concentrate on flexion and extension exercises for the first 3-4 weeks post op.
Then after that time, head to the closest hydro pool once a week, PT once a week, Gym twice a week and when the weather is warmer, I could go to the swimming pool. And obviously continue with my flexion/extension exercises.
I know walking is a big thing, but I just don't know how/if my right knee will cope...
Eventually, I would love to get back on my horse and go for a nice ride, without pain!

My husband (my life saver, my star, my champion!) is my full time carer, he gave up work to look after me :) My children are 17yo and 8yo, so they are both used to helping around the house, cooking meals etc.

My main questions are: Will I still be able to use my gopher when out shopping (long distances) etc? Or would that set back my recovery? Are there any specific exercises that one can do when there un-operated knee is weak plus one shoulder is weak?
Would love to hear your views on my complex situation! :) Any help or advice would be appreciated!

My right knee will hopefully be getting done within the next year, depending on how I recover from this TKR!!!

Offline reflex_nl

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Re: TKR in disabled patient
« Reply #1 on: August 17, 2017, 09:09:47 PM »
Hi Vickie8,

Quite a story and TKR is not my experience area but it's a surgery with a long recovery that will take some effort. However, people tend to have a lot less pain afterwards. Find a good PT who can help you out in the recovery process and get some tools to do exercises at home. Especially stability (e.g. standing on one leg) and quad strengthening exercises are usefull.

Best wishes for the surgery!
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

Offline Brandon123

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Re: TKR in disabled patient
« Reply #2 on: August 18, 2017, 08:50:05 AM »
Neither I know much about TKR, but I stumbled upon this story a few weeks back that might be of interest to you:

https://www.hss.edu/newsroom_not-too-young-knee-replacement.asp

Good luck with your surgery!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment