How do you know, and find, the right technique for knee replacement?

Posted by trimomlewis @trimomlewis, 6 days ago

I see several comments from folks about the type of knee replacement. How does one find out which one is the right one for you? What are the different types? I see one doctor doing “minimally invasive TKR” and not sure what that it? I’m going to need a TKR one day and trying to figure out when, how and where.

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@trimomlewis What a good idea to think ahead!
New techniques for joint replacements are being developed all the time, and older techniques are being improved. How far down the road are you looking?

Here is a comparison of traditional, minimally invasive and partial methods as well as less invasive treatments:
https://www.arthritis-health.com/surgery/knee-surgery/types-knee-surgery-arthritis-treatment
Jiffy Knee replacement is one minimally invasive technique.

Another technique is the robotic-assisted surgery, of which Mako by Stryker is one technique. These surgeries require specialized equipment and extra training for the entire surgical team, so may have limited availability.
https://www.mayoclinic.org/departments-centers/robotic-orthopedic-surgery/overview/ovc-20472153
This is not a complete list - just what I found using a quick search.

Here are the most important things to remember - joint surgery technology & techniques are a constantly changing field, but the patient and surgeon are partners in the endeavor. Maximum success is achieved by finding a skillful surgeon YOU can work with, preparing for surgery by being as strong as possible beforehand, and committing to the HARD work of physical therapy to recover fully - sometimes for as long as a year depending upon your body. In other words, 10 hours of this journey belong to your surgeon, but 1000 hours belong to you.

Have you been trying PT, injections or other strategies to keep your own knee going?

REPLY
@sueinmn

@trimomlewis What a good idea to think ahead!
New techniques for joint replacements are being developed all the time, and older techniques are being improved. How far down the road are you looking?

Here is a comparison of traditional, minimally invasive and partial methods as well as less invasive treatments:
https://www.arthritis-health.com/surgery/knee-surgery/types-knee-surgery-arthritis-treatment
Jiffy Knee replacement is one minimally invasive technique.

Another technique is the robotic-assisted surgery, of which Mako by Stryker is one technique. These surgeries require specialized equipment and extra training for the entire surgical team, so may have limited availability.
https://www.mayoclinic.org/departments-centers/robotic-orthopedic-surgery/overview/ovc-20472153
This is not a complete list - just what I found using a quick search.

Here are the most important things to remember - joint surgery technology & techniques are a constantly changing field, but the patient and surgeon are partners in the endeavor. Maximum success is achieved by finding a skillful surgeon YOU can work with, preparing for surgery by being as strong as possible beforehand, and committing to the HARD work of physical therapy to recover fully - sometimes for as long as a year depending upon your body. In other words, 10 hours of this journey belong to your surgeon, but 1000 hours belong to you.

Have you been trying PT, injections or other strategies to keep your own knee going?

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In Australia..in my research...only PRP injections / Stem Cell therapy are the only latest treatments. Overseas, I believe many other treatments like Replacement cartiledge insertions, MISHA knee, chicken comb injections ++ are being used for over 5 years but not approved here in Oz. This is my research.

REPLY
@sueinmn

@trimomlewis What a good idea to think ahead!
New techniques for joint replacements are being developed all the time, and older techniques are being improved. How far down the road are you looking?

Here is a comparison of traditional, minimally invasive and partial methods as well as less invasive treatments:
https://www.arthritis-health.com/surgery/knee-surgery/types-knee-surgery-arthritis-treatment
Jiffy Knee replacement is one minimally invasive technique.

Another technique is the robotic-assisted surgery, of which Mako by Stryker is one technique. These surgeries require specialized equipment and extra training for the entire surgical team, so may have limited availability.
https://www.mayoclinic.org/departments-centers/robotic-orthopedic-surgery/overview/ovc-20472153
This is not a complete list - just what I found using a quick search.

Here are the most important things to remember - joint surgery technology & techniques are a constantly changing field, but the patient and surgeon are partners in the endeavor. Maximum success is achieved by finding a skillful surgeon YOU can work with, preparing for surgery by being as strong as possible beforehand, and committing to the HARD work of physical therapy to recover fully - sometimes for as long as a year depending upon your body. In other words, 10 hours of this journey belong to your surgeon, but 1000 hours belong to you.

Have you been trying PT, injections or other strategies to keep your own knee going?

Jump to this post

Gosh thanks! Yes I’ve been getting Hyaluronic injections and they are working. With insurance, I can do them every six months. At the end of six months, I’m ready!

REPLY

6 months out here from my traditional total knee replacement by a highly touted surgeon and medical center for orthopedics.

What to check for on all methods:
1) Will there be close follow-up with the team?
2) Will the surgeon want to see you for a physical exam after, ore than just at 6 weeks?
3) What kind of communication will occur with your physical therapist team and the surgeon?

These are vital concerns that I didn't know so much about beforehand and realize are very important in your recovery. Do not make assumptions.

Ask:
4) Will my knee have full flexion (bending) up to at least 115*?
5) Will it lay flat 0*? Should it lay flat right after surgery (mine didn't, it hurt to).

My surgeon at the 6 week check up stated he was happy if folks get a 90* bend! My knee couldn't lay flat and was stuck at about 10*! This certainly was not a functioning knee. If I had known this info going in, I would have run away. I didn't even know to ask how mobile will my new knee be. I assumed it would function better than my arthritic knee at least.

I had major issues with ROM (range of motion), pretty much from the start after my replacement, though I followed all recommended PT and home therapy. My physical therapy team were concerned about my lack of progress and they pushed me hard (painfully so). After a second opinion, I had to go back in at 11 weeks for an MUA (manipulation under anesthesia), which resets the clock and starts basically all over again for daily physical therapy.

Now I haven't heard anything back to see how I am doing, or to come in for a real check up... Can't do my second knee like this next time. If I get the courage...

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I had such a quick recovery w/no problems in the almost 3 years since. I don’t even know what kind of knee replacement I have. But I think the key is surgical skill and that is difficult to access. For that reason I chose a doctor who used robotic surgery. I believe it leads to a perfect result regardless of surgical skills. Or at least that was my result.

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Iam facing the real possibility of revision surgery. My current 2nd opinion surgeon wanted to wait until two years since my Tkr which will be in Feb. My question is: is robotic surgery at all offered for revision surgery. Also what are good questions to ask this surgeon before I make this difficult decision. My greatest difficulty beside my bend is my knee collapsing causing me to fall to the ground . . . .answers?

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What are the options for knee replacement surgery?

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@clydub

What are the options for knee replacement surgery?

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Please read the previous posts in this thread and follow the links for an explanation of options.
Are you a candidate for knee replacement? Have you spoken with an orthopedic surgeon yet? Not every option is available to each patient because every case is different

REPLY
@cathymw

6 months out here from my traditional total knee replacement by a highly touted surgeon and medical center for orthopedics.

What to check for on all methods:
1) Will there be close follow-up with the team?
2) Will the surgeon want to see you for a physical exam after, ore than just at 6 weeks?
3) What kind of communication will occur with your physical therapist team and the surgeon?

These are vital concerns that I didn't know so much about beforehand and realize are very important in your recovery. Do not make assumptions.

Ask:
4) Will my knee have full flexion (bending) up to at least 115*?
5) Will it lay flat 0*? Should it lay flat right after surgery (mine didn't, it hurt to).

My surgeon at the 6 week check up stated he was happy if folks get a 90* bend! My knee couldn't lay flat and was stuck at about 10*! This certainly was not a functioning knee. If I had known this info going in, I would have run away. I didn't even know to ask how mobile will my new knee be. I assumed it would function better than my arthritic knee at least.

I had major issues with ROM (range of motion), pretty much from the start after my replacement, though I followed all recommended PT and home therapy. My physical therapy team were concerned about my lack of progress and they pushed me hard (painfully so). After a second opinion, I had to go back in at 11 weeks for an MUA (manipulation under anesthesia), which resets the clock and starts basically all over again for daily physical therapy.

Now I haven't heard anything back to see how I am doing, or to come in for a real check up... Can't do my second knee like this next time. If I get the courage...

Jump to this post

Thanks. And good luck!

REPLY
@sueinmn

Please read the previous posts in this thread and follow the links for an explanation of options.
Are you a candidate for knee replacement? Have you spoken with an orthopedic surgeon yet? Not every option is available to each patient because every case is different

Jump to this post

Have spoken to Ortho surgeon. Had lubrication shots. On my second shot.
Medial meniscus is gone. Is partial knee replacement an option or should I have a complete replacement when it gets worse?

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