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.

@joanhope6

Just came back from my surgeon, took CT scan. The results may point us to the problem either. Next Friday 24th January. Thank you for asking.

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Yes pain in same area on left, right, and center front of knee. In fact my movement is slowing down. Despite PT exercises and riding my bike. I do my PT exercises and ride my bike 5 days weekly. I am wondering if I have been doing too much. I do some indoor walking for 10 minutes 3 days a week. I wonder if I am doing too little??? I am praying to regain normalcy.

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@joanhope6

Thank you for the posting. I am sure that every person experience is different after TKR. I am eleven months out. Had physical therapy for 7 months. Still have pain. I am now feeling that I should have never had the surgery. My range of motion is 115, I continue to ride my bicycle, and do all the exercise from my PT. I am now schedule for a second X-ray, doctor tried cortisone shot did not work, and because of continuous pain (7 of 10), I am thinking of getting a second opinion. However, I am getting the feedback that no surgeon will want to touch me in my condition. I will have to continue with the same to fix the problem. Any advice will help.

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If you can manage transportation and have insurance for possibly having to go out of your coverage area (I had to switch insurance policies), I suggest
1) Hospital For Special Surgery in NYC. They are #1 worldwide in Orthopedics. A downside is that HSS does not accept Medicare.
2). The Mayo Clinic in Rochester, Mn., #2 Worldwide in Orthopedics. Mayo accepts Medicare.
I had a second opinion for a condition that sounds a lot like yours. Arthrofibrosis, excessive scarring. HSS recommended that I have the replaced knee replaced with a “Rotating Hinge” knee. With this complex surgery, they remove the knee tendons, as they are a place that excessive scarring often develops with can cause pain and severely limit your range of motion. The hinge then takes the place of your tendons. If Mayo concurs with HSS, I expect to have the surgery in mid 2025. I hope this helps. Best of luck. ☮️

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@joanhope6

Just came back from my surgeon, took CT scan. The results may point us to the problem either. Next Friday 24th January. Thank you for asking.

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Irenesar. As i reflect back on the drawing of fluid from my knee to determine infection, then the cortizone shot 6 weeks later, then for pain block. The pain has been consistent over the months, my surgeon says it was the nerve and prescribed more gabapentin at this point I do believe it's adhesions, based on my pain experience. Thank you for allowing me to reflect and helping me to become aware of it

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@algrieco

If you can manage transportation and have insurance for possibly having to go out of your coverage area (I had to switch insurance policies), I suggest
1) Hospital For Special Surgery in NYC. They are #1 worldwide in Orthopedics. A downside is that HSS does not accept Medicare.
2). The Mayo Clinic in Rochester, Mn., #2 Worldwide in Orthopedics. Mayo accepts Medicare.
I had a second opinion for a condition that sounds a lot like yours. Arthrofibrosis, excessive scarring. HSS recommended that I have the replaced knee replaced with a “Rotating Hinge” knee. With this complex surgery, they remove the knee tendons, as they are a place that excessive scarring often develops with can cause pain and severely limit your range of motion. The hinge then takes the place of your tendons. If Mayo concurs with HSS, I expect to have the surgery in mid 2025. I hope this helps. Best of luck. ☮️

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Algrieco. Sounds like an alternative. And I am now realizing that my symptoms is Arthrofibrosis, excessive scarring. I go back to surgeon on next Friday 24th. Over the past 7 months, he suggest nerves and gabapetin is the midst to no avail. Thank you, This is helpful info.

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@catheem

Here's the thing...I think we all have to decide how much 'pain' is adequate before deciding to go ahead with a surgery that will involve cutting of bone (bone 'cutting/sawing' or any type of injury to a bone is considered one of the most painful experiences...) unless there is something to alleviate that pain...and I'm not talking about pain medication, but more so, getting some type of relief of pain through intravenous methods..which they won't do anymore! In 2020, my husband's TKR involved a 'pain pump' intravenously pumping a type of lidocaine directly in to the knee (like the nerve block given before surgery) that lasted about 2 weeks and helped get him through the worst part of the surgery pain...It slowly gave him a numbing of the area and the pain was so much less than what they are making patients go through now! I totally believe that is why his surgery was such a success because he was able to do all of the exercises/stretches, etc, to heal correctly! The procedure works for most, but the $$ must be the reason they decided to stop doing it...and $$ is always the reason for everything...makes me crazy!

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My surgeon uses robotic surgery and cryoanalgesia done at the time of surgery. This numbs the leg for about three months and there is supposed to be no pain the day of surgery. It didn't work quite right on me but kicked in a bit late, leaving me in pain in the recovery room and unable to move my leg at all when physical therapy came to get me up. By the next day, however, I was up and about and pain free for the most part. It's a strange feeling. My whole leg felt heavy and tingly, and that gradually subsided over several months. At 7-months out, just my knee feels tingly, and my surgeon said that will probably never go away. I had in-home PT for six weeks, followed by out-patient PT until I was a 6-months out. I'm continuing to improve as healing happens without doing anything special.

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@joanhope6

Yes pain in same area on left, right, and center front of knee. In fact my movement is slowing down. Despite PT exercises and riding my bike. I do my PT exercises and ride my bike 5 days weekly. I am wondering if I have been doing too much. I do some indoor walking for 10 minutes 3 days a week. I wonder if I am doing too little??? I am praying to regain normalcy.

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I had my surgery 12 days ago. Outpatient and robotic. I couldn’t take hydrachodone so I’m on Tramadol. It doesn’t help that much. My pt person is a beast. Had me lifting with a weight today. I go 3 times per week. My bend is 115 and my straighten is 0. I try to make myself do more exercises at home but it is really painful. Just hearing about someone else’s experience is comforting!

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@july1955

My surgeon uses robotic surgery and cryoanalgesia done at the time of surgery. This numbs the leg for about three months and there is supposed to be no pain the day of surgery. It didn't work quite right on me but kicked in a bit late, leaving me in pain in the recovery room and unable to move my leg at all when physical therapy came to get me up. By the next day, however, I was up and about and pain free for the most part. It's a strange feeling. My whole leg felt heavy and tingly, and that gradually subsided over several months. At 7-months out, just my knee feels tingly, and my surgeon said that will probably never go away. I had in-home PT for six weeks, followed by out-patient PT until I was a 6-months out. I'm continuing to improve as healing happens without doing anything special.

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They did a block on me. I have total feeling in my leg.

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I have total feeling too. My knee isn't numb, it just has an unusual tingly sensation inside. It has changed even since I saw my surgeon 10 days ago, so I expect it to end up feeling pretty normal. My neighbor had TKR done in 2020, and he says, "I can still tell it isn't real," even though it works perfectly. He couldn't describe it any better than that. I am feeling more optimistic almost every day. I took my first step up a stair with my new knee going first today! I look forward to walking up a flight of stairs "normally". What I find interesting is that a lot of people have trouble accepting the new knee, feeling very aware of the presence of the hardware. Everyone seems to have a different experience. A lot of the articles I read were interviews with people only 3-6 months out, so I am curious how people overall feel 2-3 years out.

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I understand that there are unknowns such as the individual's propensity to build up scar tissues based on their body's immune response, but .... is it also possible that the surgeon's expertise and interaction with his patient could help to mitigate some of the negative outcomes? My surgeon who operates out of the "supposedly #1 orthopedic hospital in the US... (World?) did not afford me the time of day when I reached out to him before the 6 weeks appointment that was scheduled.
He refused to do imaging such as ultrasound, Ct scan, MRI that would identify the presence and an amount of scar tissue that seemed to be building up 2 to three weeks after the procedure. Why would a medical professional wait 6 weeks before checking in on a major incision? Why would he refuse to respond to the patient's request for additional imaging? Research says that procedures such as arthroscopy is best done within 6 weeks of the operation.
He then proceeded to perform an arthroscopy without any imaging to predetermine the areas that needed the attention.
We need to stop blaming ourselves and scar tissue buildup as the reason why some of us are experiencing such pain and discomfort after tkr. There are procedures that can be done to help us to heal better. Of course, that is where your surgeon (and insurance) comes into play. Many of them are not telling you the options that are available for helping (mine didn't) and I had to do my own research and actually force the issue. My healing is still not complete, but I believe that I am better off having done the post operation procedures. After all, these are modern times, and I believe that technology is advanced enough to help those of us who are experiencing tkr post operation issues.
I hope that we will continue to stay positive and advocate for ourselves and that additional research will result in improved outcomes for us in the near future.

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@jdth

I had my surgery 12 days ago. Outpatient and robotic. I couldn’t take hydrachodone so I’m on Tramadol. It doesn’t help that much. My pt person is a beast. Had me lifting with a weight today. I go 3 times per week. My bend is 115 and my straighten is 0. I try to make myself do more exercises at home but it is really painful. Just hearing about someone else’s experience is comforting!

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Sounds like you are doing great! Get an ice machine as that really helped with comfort. More than pain medications.

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