Knee replacement

Thank you for taking the time to share your experience and thoughts about TKR. I’m encouraged that this forum has wonderful contributors. Wishing everyone a Happy Thanksgiving!

X-rays are all I had, and then the later mention that there was discussion in the surgery room with the rep of going down a size next time. Do they not measure and anticipate? Damn!

I also agree that problems are not reported, and that I was no well informed (I thought I had prepared) beforehand.
On that note, my other knee woke me up many times last night. Ugh...

How far out are you? A MUA (manipulation under anesthesia) may help get a more functional joint. I had to really press my surgeon into this. I ended putting pictures (evidence) of my therapist measuring me at PT, into the MyChart. He had told me at the 6 week post-op that 90* was a good number! Heck no. Totally non-functional. I'd rather have arthritic pain.
After the MUA I gained from the 90* to 125* (with a strap, I can get to 115 on my own before exercises) and could finally straighten my knee- it was like bent at 7-8* all the time. Now I can get it to 0* easily.

Still a PIA to go down stairs. So many limitations on this new knee. But I am only almost 6m out only... perhaps it will get better?

I never had CT scans on my knees before surgery, both were done successfully a couple of years apart with only lots of X-rays.
I did have CT and MRI scans of my shoulder when the same surgeon did a reverse shoulder replacement. The scans were to determine whether my rotator cuff muscles were usable for a traditional TSR (were not) and a later special scan to calibrate a custom prosthesis.

If there is no muscle or ligament problem with your knee before surgery (like an accident) that needs to be taken into account, then the X-rays should be sufficient for showing bone condition and cartilage loss. CT's and MRI's are expensive and are primarily used to scan soft tissue when that may be an issue, but in a "normal" TKR it is unlikely to provide any more useful information than X-rays .

So many recommendations and suggestions from both patients and professionals over the last 6 1/2 years leaves me to this conclusion: The surgeon does what he is trained to do and hopes for the best with some TKR recipients having better outcomes than others regardless whether they follow pre and post surgery instructions. There are too many factors that come into play outside of the surgeons control. I find reading TKR stories interesting but not very helpful. BoneSmart.com is another website where TRK recipients can tell their stories.
My bad knee didn't go well even though I followed all the recommended instructions and finally had to have revision surgery that is in 11th month recovery. I only did the minimum exercises with my good knee.
I'm writing this following my recommended morning exercises and noticed I'm due soon for my PM exercises. I'm thankful I have one good knee to make it up on the stationary bike.
What do they say about someone doing the same thing over and over expecting different results? A toast to all the guys and gals that had successful outcomes.

I'm in your camp. One knee turned out O.K. but will never will be 100%. I'm in my 6 1/2 year following surgery with my bad knee, including revision surgery. where recovering misery and physical therapy continue. I wish I could turn the clock back. There is no relief in pain and my ROM has decresed considerably to the point that putting on a pair of pants is a challenge. The many lost months of worse than before surgery quality of life can never be regained.

I feel so bad for you. I truly “get it”!!! I just went to another orthopedic dr for an x-ray on my left hip and knee. The hip was bursitis, and he gave me an injection. I told him how my replaced knee was not all that great and that I still have pain and weakness with it. He told me that 65% of patients who have TKR do fine and have no further pain, but that other 35% may not have the total results that they were hoping for. I have had many cortisone shots to this left knee for three years. Now, they are not working, so this orthopedic dr suggested “gel shots” (a series of three…….provided that insurance will cover them!) so I definitely said YES to give those shots a try. Have to wait for insurance approval. I am so sorry for all of the pain that you are experiencing. I wish that I could turn the clock back too, on my knee replacement. Wishing you improvement through PT and OTC medicine. I feel your pain! Take good care. MaryAnn from Boston

I would absolutely get it done to improve your quality of life. Why would you wait as at your age you never know what lies ahead and if you have any aging issues other than your knee you’ll be weaker to recover esp if you’re a point that you can’t wait to get the knee done. I just had mine done in June, back to work as a Crna in the OR at 7 weeks. PT once a week still but about to be released. My motion and all is great. I’ve just had to strengthen my quads and get dry needled for some IT band tightness which is all normal. I’m only 53. My other knee is now hurting and worsening. I will not wait. Assuming it will get worse I’m planning to do it this time next year maybe. Depending on new XRAY and going to my surgeon in next couple of weeks to see where it is compared to last year. My point is if your knee causes significant limitations in your life, if you have to plan your day according to what you can handle and tolerate, DONT WAIT. Get it done.

Also, it’s important to reasearch your surgeon. I work in an ortho OR. I am very knowledgeable on what to look for in a good surgeon.
Look for a surgeon who:
-is not old. Has been in practice about 10-15 years. There is lots of technology coming out and “old school” surgeons may have good reps but they practice old school.
-I suggest someone who primarily does joint replacements only. Knees, hips, shoulders. That’s it.
-I recommend someone who also primarily uses the MAKO robot or any robotic system.
-I would ask what their avg time is for putting implant in and tourniquet time if they use one. It should be less than 45 min.
-ask how many they do a year. It should be at least 400 knees or what ever body part.
-ask about infection rate
-rehab- you should be up and walking with assistance the day of surgery. Especially if you’re going g home the day of surgery.
-you basically want someone who has a niche and does just joint replacents only. That makes them an expert.

Hope all this helps.
I was up the day of surgery and went home day of. Sometimes older folks and folks with other health issues stay. PT started next day. I went back to an on my feet job at 7 weeks. Not same for everyone. Also you want an adductor canal block for post op pain.

Good luck.

Hi ddsack,
I had a second opinion appointment because my recovery from TKR has been so difficult. He surmised from his fairly brief analysis that I had a damaged pcl ligament and weak quad muscles. He wanted me to spend the next four months focusing on strengthening my quad muscles. Which I do primarily in the gym but saturday night in my house just normally taking a step my right knee collapsed on me. I have scheduled an x-ray but when I see my surgeon doctor should I insist on another machine because the x-ray always comes back fine?