Truth about Total Knee Replacements

True most comment about their negative experiences rather than positive. At two years I'm still a work in progress as far as thigh pain, soreness etc...did PT 3 times and at home. Not sure if they cut my quad muscle and it took my perineal nerve almost 11 months to come back.

Most of what you say here is true Rick. I'm sure my replaced knees don't feel as good as my originals. For one thing, I can't run anymore and I was a marathoner. As far as pain though, that is as good as I ever remember, meaning I don't have any. I've also had osteoarthritis all my life, so don't remember a time in the last 20 or 30 years when any of my joints felt good as new.

Surgeons who don't offer a follow up schedule - scheduled appointments - should be avoided completely. It's hard to believe there are surgeons who would do this. So if you run into one of the exceptions, find another surgeon. And that applies for any surgery. No such thing as "minor" surgery.

As far as scarring, it's very hard to tell where my incision was made. Whoever closed the incision did a damn good job on me.

As far as recovery, consider what the worst could be, and then work for the best. Every case is different. I hired a trainer to get the muscles around my knee strong before surgery. And then I did all the rehab exercises. I'd say I was fully recovered - no pain (even on stairs), no swelling by 2-3 months. I had both knees replaced four months apart. That's about the best recovery to be hoped for. Realistically, it's gonna take longer for most, and yes, up to a year is possible. And even in my case, I waited a year before really pushing my legs. TKRs are common, but it's still a major, traumatic procedure. That has to be honored. Recovery is very possible, just not very easy so be prepared to work.

And sadly, most people (I think) will have some clicking sound. I've never had that, and again, I'm a gym rat and always have been, so my legs are strong. I think people mostly adjust to the sound. What should NOT be present is pain and swelling. Follow the instructions and the post-op pain and swelling will go away.

Anyway Rick, thanks for your "reality check". It makes me grateful for the results I achieved. And for people considering TKR, you can avoid a lot of the worst outcomes by simply doing the work.

Finally, please research surgeons and get two opinions. Go with the Dr you truly believe is committed to you and will be there as you recover. Expect and demand nothing less.

And I'm sorry Cindy (and others) who have done all the work and are still having a hard time, and to people who simply got a lousy surgeon. That does happen. But patients should know that for a successful recovery to be possible, there is a lot of work to do pre and post surgery.

As far as your quad muscle Cindy, it's very possible the surgeon cut too far, and that can be measured in millimeters. The quad cut is necessary to release the patella.

I had numbness around both knees that resolved in about six months.

All the best to you Cindy. Joe

I’m thinking the stats are higher than that. Who reports their bad outcomes?

Was it a medical professional who recommended the Glucosamine Chondroitin? I have read about studies where it was found to have no effect.

Actually, the quad doesn't need to be cut. It can be 'moved over.' A lot of surgeons do things how they were taught and don't make changes as they improve/change things in the surgery. I was told by both surgeons (hadn't decided on one yet) that yes, cutting of the quad is the surgeon's preference...I wanted to go with the surgeon I knew best (I've seen 2) and he said he cuts the quad..period..the other surgeon said, no, he doesn't cut it..Maybe this is why I cancelled my surgery because there are too many differences in surgery technique, and things change constantly, and both surgeons told me to wait (since my pain isn't bad) because there are even more changes coming up because they learn every day what makes it more successful and saves the patient from pain..I believe this because my double spinal fusion is now done differently than in 2009...and I can tell you that my recovery was unimaginably painful now!

After TKR Anyone has a feeling the implant size is slightly large and feel tight and pain in the lower part of knees. Xray does not show that
Surgeon are ignoring it
Any suggestions welcome

It would be interesting to know who is in change of gathering national statistics and how that is done. In my case, I had a standing one year, and a five year return appointment with my surgeon to check on my right TKR. As I understand, they will contact me again at 10 years -- if I am still around! X-rays are taken as well as an oral interview, so I am assuming that is for their records and statistics to track patient success rates. I know four other people besides myself, who had TKR's all of us had good results, I don't personally know anyone who had a bad result. But from reading here, I know there are those who for varying reasons have problems.

Very good information catheem. This is my first time commenting on Mayo. You mentioned some things I should have been more aware of as concerns surgery.
I have asked, but doctors seem reluctant to share/give information about exercise to: 1) strengthen the muscles supporting the knee prior to surgery or 2) best exercises to supporting the knee even if surgery is not desired.
Is there a section on this site or would it be easy enough for you to share some of the exercises that did the most good for your knee? The internet has SO many things said - someone with experience with them is a better choice for info.
I am 75, been told I was a candidate for both knees to be replaced for about 10 years. I had gone with the orthovisc injections for about 4 years, getting them every year, but missed 3 years during COVID period. Restarted last year and having them closer to 7-8 months, the last being in late March. It helps, but do you think glucosamine/chondroitin is helpful?
Sorry for all the questions...curious first timer here.

Your Dr. can order physical therapy before, to strengthen the quad muscles... It will help tremendously. YouTube has great movies of knee exercises. They would be similar to the ones for after surgery as well.

As for steroid injections- so many reasons not to go this route. Reports show they can further destroy your joints is a biggie. Furthermore you cannot have surgery for at least 3 months after an injection due to the systemic affects.
https://beacon.schneidercorp.com/Application.aspx?AppID=1128&LayerID=28484&PageTypeID=1&PageID=11857&Q=421276638&KeyValue=600000296230
PT, an ice machine through the night, NSAIDS (nonsteroidal anti-inflammatories), Velcro knee braces and elevation have worked better for me prior to my surgery. Highly recommend purchasing an ice machine if you proceed with surgery. Not covered, but comfort that is amazing and worth every penny. We used large yogurt containers to make big pieces of ice to put in machine, so the cold circulates all night long. Decreases need for pain medication for sure. Do place a pillowcase between the pad and skin.
https://www.amazon.com/NEHOO-Continuous-cryotherapy-Universal-Cervical/dp/B08FM8K3PW/ref=asc_df_B08FM8K3PW/?tag=hyprod-20&linkCode=df0&hvadid=693384455945&hvpos=&hvnetw=g&hvrand=16861577769318971619&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9015985&hvtargid=pla-1275929324114&psc=1&mcid=a4a481365c533336924211d62e49304d
"Conclusions and relevance: Among patients with symptomatic knee osteoarthritis, 2 years of intra-articular triamcinolone, compared with intra-articular saline, resulted in significantly greater cartilage volume loss and no significant difference in knee pain. These findings do not support this treatment for patients with symptomatic knee osteoarthritis."
https://pubmed.ncbi.nlm.nih.gov/28510679/