Truth about Total Knee Replacements

Posted by rickraleigh @rickraleigh, Jul 31, 2021

Your new knee will never feel as good as your original old one

For most people it takes a full year to get most of the benefits of the surgery

Many people experience a clicking sound when walking for years or forever after the surgery

You should do physical therapy for a year after the surgery to get the best range of motion results even though your therapist will discharge you after several months.

There are no studies which will tell you what activities you can do after TKR. Is doubles tennis OK? Golf? What you read online varies. There are no clear answers.

Many surgeons are finished with you after the surgery. If you have issues with the surgery's aftermath, they may not be that helpful.

The scar is big, and no amount of ointment (vitamin E, etc.) will substantially reduce it.

Good news: If you had bad knee problems before the surgery your knee will feel a lot better after the surgery.

Interested in more discussions like this? Go to the Joint Replacements Support Group.

catheem | @catheem | Oct 15 9:52am

In reply to @algrieco "Was it a medical professional who recommended the Glucosamine Chondroitin? I have read about studies where..." + (show)

Actually, my husband had 2 knees needing TKR...he decided to have one done and then have the other one done shortly, but in the meantime, starting taking the Glucosamine/Chondroitin...the 'bad' knee stopped hurting...SO...I decided to do it, as well. I have a pain management doctor, and I told him I was taking it (it's over the counter) and his response was, 'I have many knee patients who have taken it with a lot of success.' So that's why I started it!

michellemu1992 | @michellemu1992 | Oct 22 4:30pm

In reply to @sprinrosa64 "More truth, no doctor mention 20percent of TKR have mid to major problems after. No doctor..." + (show)

Well I was a lucky one. But after 40 years of 1 knee replacement and a revision. I’m looking at more surgery and it’s not good either a knee replacement which the doctor will take out the artificial knee and let the bones heal for four months or longer or I can have it fused or amputated so there are my options for having a knee for 40 years of good luck now I have to figure out what to do.

irenesara | @irenesara | Oct 23 9:27am

Wow michellemu. Please elaborate. When did your symptoms of a problem begin and how was it determined that there was such a problem that they have to take the drastic measure you describe. 40 years is long past the life of a knee replacement they say they will last. Did it just wear out or fall apart?

ouch89 | @ouch89 | Oct 23 10:29am

In reply to @michellemu1992 "Well I was a lucky one. But after 40 years of 1 knee replacement and a..." + (show)

I appreciate the difficulty in your decision making especially with hyped up stats from TKR institutions. Not one of my Ortho's, including a revision, have ever discussed risk. How often have we read "good as new," only to discover "not so." My life experience and communications with other TKR recipients agrees with Jeffrey Peng MD, go to YouTube, that 1 in 4 people are not satisfied with their TKR. The good news is that knowledge in knee replacement and procedures have greatly advanced. Your challenge will be finding the right combination, best wishes.

ouch89 | @ouch89 | Oct 23 10:52am

I agree with all your good honest assessment, except for the last "good news" statement. Before my first TKR surgery I suffered following a day at the mall with my family. A good night's sleep with taking anti-inflammatory's took care of it. Today, one year post a revision, I wouldn't dare visit a mall or anything with long standing or walking.

hsminc | @hsminc | Oct 23 3:17pm

In reply to @heyjoe415 "Most of what you say here is true Rick. I'm sure my replaced knees don't feel..." + (show)

@heyjoe415

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.

Jump to this post

I feel terrible about all these bad experiences. I am almost ten years out after bilateral total knee replacements in 2015. They do feel like my original knees - no pain, no clicking, etc.. I don't run because I am not interested in wearing out the protheses and having revision TKRs but I certainly feel that I could get back to running miles - my running many miles and jumping rope (2000 times a day) was probably the excessive behavior that brought me into the orthopedic surgeon's office.
I did a lot of research and found a great surgeon. He and his anesthesiologists worked with patients to find out the biggest problem areas. Then they modified their techniques and technologies to correct those problems. That may have been part of the reason my experiences were good.
I also had a hip done by this same surgeon. I was walking with out pain, without a walker, without any pills at all, within three days.
I had a shoulder done at the same facility. Same experience. I never did PT with any of these replacements.
Being in good shape before the surgery, no matter how much terrible pain it takes to go through those exercises I think paid off. Also, as others have indicated, taking care to selecting a surgeon that does research, teaching, and clinical work can pay off.

anadarko | @anadarko | Oct 24 7:05am

In reply to @hsminc "I feel terrible about all these bad experiences. I am almost ten years out after bilateral..." + (show)

Can you share the name of your surgeon?

hsminc | @hsminc | Oct 24 7:17am

Mark Pagnano knee and hip (Mayo in Rochester).
Sanchez Sotello (shoulder) Mayo Rochester.

mackad2024 | @mackad2024 | Oct 24 10:11am

In reply to @catheem "Actually, my husband had 2 knees needing TKR...he decided to have one done and then have..." + (show)

Do you think that would also help hips that are bone on bone?