Pre Total Knee Replacement and concerns about 100lbs overweight, is i

Good evening, @etna. Welcome to Connect. Thank you for presenting your medical issue so succinctly. I have had both knees replaced ( TKR) about ten years apart. As I reflect on what I would call "recommendations" and "expectations", these are the things that come to mind. Please realize that there is no way to know just what might be difficult to handle during post-surgery physical therapy treatment. Do you recall or have a copy of what the surgeon was worried about? If not, I would request a list of the recovery issues you face at your current weight. Since your weight is increasing, I wonder what might have to be added to that list.

Has your daily life changed in the last 18 months? Have you explored how weight loss counseling therapy might be able to help you? I have noticed in the press that there are new medications which are being recommended as being helpful for a critical need to lose weight.

Just to get you started thinking ....... here is a list of TKR post-surgery situations that may be a bit of a struggle with an extra 100 lbs of weight.
......getting into and out of the wheelchair that will be waiting for you post-surgery.
......making sure you can move from the wheelchair to your vehicle.
.......assessing the support you will need to transfer from your car to your bedroom and use the bathroom on your way down the hall.
.......elevate your knee on a foam pillow wedge and apply ice.
....... handling the daily exercises selected to strengthen your new knee and diminish the surgery pain.
.......learning to use a walker or rollator to move within your home.
.......getting up the following day and preparing to go for PT.

I could go on, but I think you will comprehend what will be required. As I write this, I assume you can arrange assistance from a home therapist and caretaker for at least three to four weeks.

Please let me know how your surgeon clarifies the post-surgery demands. I think it is critical to understand and accept the requirements and how you plan to meet them.

May you be safe, protected, and free of inner and outer harm.
Chris

Hi there Chris

Thank you so much for your reply. I have shown MRI results to my surgeon, who said that total knee is gone , he mentioned options, keep going as I am , take pain killers , weight reduction, bariatric surgery, TKR. Where I am is , my quality of life has lessened, I have pain but I try to manage , I don’t like how my body is balancing differently on my two legs now , I try to cater for my weight and pain all the time when I walk or stand. The surgeon did mention that the weight makes the surgery more challenging but is possible. He spoke about the surgery part not the post surgery really . He mentioned my weight is double my weight for me, my knee is two thirds fat and one third bone . I find the weight increasing is making it harder , I did weight loss surgery in 2018 but it went wrong . I have tried weight loss medication and it did not agreed with me . I will source a weight loss counselor. I needed to post my original post as I am not totally aware of the afterwards of operation . But I think my journey may have to start in preparation . Thank you Etna

Less than 3 years ago, I was 80# overweight, bone on bone both knees. And had been for several years! My doc recommended 1) our hospital weight management center and 2) an ortho surgeon. Re: ortho, I decided to do walking (ouch!), pool therapy and floor exercises then pursue TKR. However, started weight management counseling IMMEDIATELY (and continue today).

In 2022, I had begun to lose weight w/o surgery and had both knees done 5 weeks apart. Today, at 68, I am blessed to be active, 60# down, continue both protocols for weight loss and exercise.

It made all the difference to me and no doubt saved my life, to have and continue to work with med teams I trust and connect with. It took effort to find the right combination. I know you will research and find the same.

Many blessings on your health journey.

I just wanted to share something that might help a little. I don’t need TKR, but I have been trying to avoid surgery for a torn meniscus for a couple of years. Part of that, included losing 70 pounds. Eventually, it’ll be 100. (I’ve lost most of the weight since September 2023) I can tell it helps me with mobility and less stress on my legs. If I do end up getting the surgery, I feel comfortable I can manage my care better and others will be better able to help me.

I would recommend a consultation with a nutritionist. My rapid weight loss caused me hair loss. If I had known that would happen, I would have avoided rapid loss. Hopefully, it will resolve as I stabilize. It is important to get your nutrition, which you already know about, if you’ve had bariatric surgery before.

Best of luck moving forward. I’ll look forward to seeing how you’re doing.

How in the world did you lose that much weight in such a short period of time? Did you have other side effects. I have had a hip and two knees replaced and am very overweight. My doctors have never made a big issue about it which surprises me, (or I am in denial and don’t hear it.)

Thank you very much

Thank you 😊

I’m no expert, but will share my experience. Of course, everybody is different.

Initially, I developed my own diet that I thought was nutritious, but carb and calorie conscious. I really stick with it, plus I do intermittent fasting. Nothing extreme, just not eating for part of the day. For me skipping lunch worked well, as I go to the gym at lunch. I have 1 cup decaf coffee in the afternoon, with a little whipped cream.

I also increased my activity.
I started walking on the treadmill gradually adding speed and distance (I pay attention to my injured knee and slow down if it hurts) ….did strength building exercises for core and arms. Then added more cardio with stairstepper and elliptical. Gradually, I could feel my body getting stronger and leaner. Went to PT once with my knee. It’s better.

I would encounter plateaus that were frustrating…still do. I met with a nutritionist, who told me my diet was pretty good, but we tweaked it and I saw results. She was the nutritionist at my endocrinologist’s office and she told me that she’s never seen anyone in her career of 34 years, lose that much weight on their own, outside of medical supervision or program. It made me feel really good.

I take supplements like D3 and B12 per my doctor’s orders, due to deficiencies I had BEFORE my weight loss.

I rely on friends and family for a lot of support and encouragement. My therapist helps too. I can’t describe how much better I feel physically and mentally! And, I’m never tired. I always have the energy to do whatever I want. I think I got tired of not living the life I wanted.

Yesterday, a man I’m dating, who is 10 years younger than me, were taking our oxygen levels on a meter…..his was was 97% and mine was 100%!

So, if you want to do it, it is possible. And…..it wasn’t that difficult. I’ve learned to love my healthy diet and do not feel deprived at all! I wish you all tne best. A knee injury can bring you down in many ways. Good luck.

Ask about being referred to physical therapy before surgery. It will depend on your insurance, but I was fortunate that my insurance covers up to 100 PT Sessions per year. The first orthopedic surgeon that I saw had all of his patients do a course of PT pre-surgically. I did not like him and found another surgeon, but I did follow his advice of pre-surgical PT. There was a delay in surgery because I switched surgeons, but I continued to do twice weekly PT for a total of about 3 months and did the exercises on other days at home. I went into surgery fit and strong. I had the TKR that I recovered from very well and was discharged from PT within 3 or 4 weeks feeling better than I had in years. I had the other knee replaced 4 years later and asked for a pre-surgical PT referral. The PA had not been there during my first TKR and was a bit skeptical but humored me with the referral. I did 2 months of PT leading up to that surgery. That replacement went incredibly well and I was allowed to go home the same day after demonstrating that I could walk with a walker around the post op area. The next day I got rid of the walker. I did 2 weeks of PT and was discharged. I went into this process about 20 pounds overweight. I am now at a normal to low BMI and I alternate walking and running every other day. I feel great and yes, I have my orthopedic surgeon's blessing to run/jog.

Thank you this is helpful