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What disqualifies someone from having TKR surgery? AFib?
I've been under a tremendous amount of stress for the past six months due to significant pain in my knee and lower back, dealing with a hospital falsifying my medical records, and overall despair about what seems to be my fate to not be able to have a much needed total knee replacement surgery. Every way I turn, I seem to be blocked from ever getting this surgery Without it, I am doomed to a shortened life filled with pain, decreasing mobility, and increased cardiac problems due to not being able to exercise and keep my heart and body healthy. After my knee gave out last September, it looked like I was going to have a knee replacement surgery in January. I had just changed to new cardiologist at a hospital I had gone to about 30 years ago. Little did I know that during the time I had not been going to that hospital for any reason, there had been a mixup of my records with another person of the same name. She had Type 2 diabetes. So my new cardiologist thought it was me and refused to approve my surgery. Because he was intimidated by my complicated medical history (I had endocarditis in 2019), he started adding ridiculous things to my records, cherry-picking things from my care provider's records from the time of my illness and resurrecting them, then confirming them as being current condition that are being actively treated. These are lies. The only thing I can figure is that he's trying to discredit me to distract from his lack of knowledge. I've worked hard and uncovered a lot. My proof that these are lies is solid. But now, there's a new problem. Months of stress and not being able to sleep well due to the pain have taken a toll. My current cardiologist just told me that my pacemaker monitor revealed that I had 5 hours of AFib. We haven't talked about it, but I suspect that this means that once again, I'm going to be told that it's too risky for surgery. If my suspicions are correct, what this really means is that I have a chance of dying if I have the surgery, and a certainty of dying early because I cannot. Has anyone had a TKR after having an AFib incident?
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I was diagnosed last September as needing a total knee replacement. The surgery was scheduled and all looked good, but eventually had to be cancelled due to unrelated circumstances. Ever since then, I'm been having trouble getting another surgery scheduled. Can anyone tell me what cardiologists and surgeons see as being disqualifying for TKR? And if nobody will do the surgery, what will happen? Just wait until the whole thing breaks and I'm left totally immobile?
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1 Reaction1. Too much weight- the rehab process is brutal. A new knee will not work if patient can’t adhere to the physical therapy program.
2. Inability to prepare for surgery- exercises, quit smoking, lifestyle choices…
3. Cardiac issues
4. A1C high- indicates uncontrolled Diabetes
5. Smoking/ impairs healing process big time
All of these factors will contribute to poor outcomes. A surgeon has more patients than they have time. They can choose. It is elective on both sides.
If cardiologists are involved, perhaps it's a concern over the anesthesia. However with a TKR, you can opt to have a spinal block instead of general anesthesia, which shouldn't affect your heart at all. Just a thought. Good luck. I do know there are BMI restrictions (even though the science evidence is fat folks don't have any higher risk for negative outcomes than non-fat folks), but some surgeons will work around that. If you have a teaching hospital accessible to you, you might try there as they are often more willing to take on "difficult" cases.
I have Hereditary Spherocytosis (HS), a rare blood disorder. There have been no studies about its effect on TKA outcomes, but many studies have linked HS to increased inflammation. According to my physical therapists, my degree of inflammation in the first four months post-op was higher than average and I was quite ill during the first six weeks post-op (vasovagal episode and lab values out of range). My early post-op illness and excessive inflammation may have contributed to my inadequate range of motion. (At six months post-op, my active ROM is -3 to 102.) Although my hematologist medically cleared me for TKA, research is needed to determine is HS is associated with poor outcomes and should be a contraindication for this surgery.
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1 ReactionHi Jan,
You deserve to know why you aren't being cleared by a surgeon for TKR. Have you asked for an explanation?
All the best. Joe
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